Pomme's Paradise

On Monday, we got an opportunity to go up to meet Pomme see and talk to him about his way of life The hike up there was a little more challenging after hiking Boiling Lake the previous day but we all made it and it was well worth it! Pomme's Paradise was beautiful and very peaceful. It is tough to put into words. It is incredible to me that someone this day and age can truly "live off the land" the way Pomme and his family do.
Pomme is an inspiration. On the hike up to Pomme's home, I kept thinking to myself why would anyone live like this and lucky for us Pomme answered that very question. When we got to Pomme's house, we got the opportunity to hear his story on why he lives the way he does, secluded miles away from town and other people without any modern technology.  Pomme's explained he  didn't like what he saw when he was an musician in the virgin island, selfish people not taking care of other people, people driven by money, and the list goes on.  Pomme then moved back to his native Dominica and headed to the mountains with a machete and axe.Years later, Pomme's has an incredible self-sustaining farm where he has everything he needs "clothing, food, and shelter" and he could not be happier.  I could have stayed there and listened to him talk for hours but what really stuck with me is when he referenced the apricot seed. He said that humans are born with everything they need right from birth just like the apricot seed. People germinate just like the seed would but when people get caught up is this crazy world tainted by greed and selfishness they fight what they were born with and  they fight who they really are as a person. I am definitely are person who can get caught up in the hustle and bustle of things and "lose myself" and Pomme's really hammered home that I need to make time for myself so that does not happen. I cannot "fight" what I was born with and I have to let that flourish.


Time and flown by here in Dominica. I cannot believe we only have a few days left!
Griffan

LaPlaine Clinic, Cinnamon Trees, & The Veggie Man (04/30/2013)

Today, our group got the opportunity to visit the LaPlaine Clinic, which was quite a bit larger than Petite Savanne and Riviere Cyrique clinics we were at last week. We begun the clinic by talking with various patients about why they came in to the clinic today. Though many just came in to see Dr. Jeremy for their monthly checkups, others had aches or pains that they were seeking medical attention for. One patient in particular described arthritic pain she was experiencing for over three years! A look at her patient notebook showed me that she was not taking any medication for it. Though there is a myriad of pain medications for arthritis available in the United States, the options here in Dominica are limited to basic NSAIDs or paracetamol (Tylenol/acetaminophen).

We then spent some time with Kent, the pharmacist. Since Kent works for the public sector, he is the pharmacist for five different districts, including LaPlaine. I was astonished to see how he runs his traveling pharmacy; packing and unpacking all of the medications and record keeping logs for each day. Though there is a computer with internet in the pharmacy, electronic outages short out the computer quite often, so prescription logs are all penned by hand into a large manual. Additionally, supplies are limited, and many tablets go into plastic bags instead of vials. Kent explained to us how there aren't many pharmacists in Dominica, so he is always on call. He described different scenarios in which it was a holiday or it was the middle of the night and he was called in to work and he did just that. My biggest question for Kent was how he deals with stress when he's never off the clock. Unfortunately, he didn't really have an answer for me. I think our biggest role to help alleviate some of Kent's burdens is to donate supplies from the United States. Kent mentioned in particular that they do not have access to basic antibiotic creams and antifungal ointments that we can easily get over-the-counter in the United States, so this is where I'll target my donation efforts for the future!

We spent the rest of the morning observing appointments with Dr. Jeremy. Instead of a full workup, I noticed she used a lot of close-ended questions for the sake of time. This is drastically different from our culture. In the states, you have to be able to ask the right questions to get the right answers, and many people are shamed to bring their medical ailments up in conversation, even with their own doctors. In Dominica, it seems that patients are more involved in their own health, and if something is concerning them, they are not afraid to bring it to the doctor's attention.

I'll let Aimee talk about the rest of our busy day "making" cinnamon and meeting "The Veggie Man"!

- Christina

In the afternoon, Kirvin picked us up from the LaPlaine Clinic to bring us to his place for cinnamon making. Due to the rain, Kirvin invited us inside his house to prepare the cinnamon trees. Hassan and Kirvin cut down three cinnamon trees for us to harvest. The tree contains an inner bark layer of cinnamon, so we had to carefully scrap away the top bark first without going to deep to remove the cinnamon layer. Then we had to remove the cinnamon bark layer from the rest of the tree to then be dried. Removing a layer of bark as one piece was harder than Kirvin made it look! Kirvin has many plants outside his home, one being a breadnut tree. He pulled a fruit from the tree and we counted that one fruit contained 79 nuts! We brought the breadnuts and cinnamon back with us to Jungle Bay to use for another time.

After our hard work at making cinnamon, we got to visit with someone else down the road that also works very hard. His name is Tony, but many people in Dominica refer to him as the “The Veggie Man”. He owns an organic farm that grows vegetables such as lettuce, carrots, cucumbers, tomatoes and bell peppers. He sells his vegetables to many local businesses, like Subway and even to Jungle Bay! He has very extensive lines of water to his three different greenhouses. He also has many gardens that are raised above the ground to keep away insects and animals. We learned that Tony can grow lettuce in just 15 days, which is much faster than other farms. Last year, he had bell peppers the size of grapefruits and plans to have the same success this year. Tony’s hard manual labor brings the fresh meals to our plates every day at Jungle Bay. We thought of him fondly at our family dinner, admiring our salads and discussing how his hard work affects so many people in Dominica. 

-Aimee

 

House of Hope

Thursday 4/25/13

On Thursday of last week myself, Tressa, Jessica, and Aimee went to the House of Hope. It truly was a a humbling experience and I am so grateful I got the chance to be apart of it. When we first got to the house of hope, I struggled a little bit emotionally because I had very strong emotions of sadness when we first got there and were being showed around then  remembered Dr. A telling us before we went that "remember, this is much better than the alternative" which helped me stay on track. 

During  our time at there, we got a chance to play with the residents (all girls), which I loved because you could tell all of the girls really enjoyed having visitors which they do not get often. We also helped the staff with lunches which I thought was great because we got to give them a little bit of a break as well and I am sure they needed it. 

Out of all the things at the house of hope the one of the thing, that really stood out to me during our time there was the staff's faith. One of the staff member who got involved with the house of hope through her church even said that she was working through Jesus which I thought was incredible. I also have a strong faith and the staff members at the house of hope are exactly what it is all about for me, helping others and doing it with a giving heart. Matthew 40:25 now is painted on one of the walls there "Whatever you do to the least of of my brothers, that you do unto me."

Petite Savanne Primary School (4/22/13)

On Monday, our group went to a primary school (grades K thru 6) in the town of Petite Savanne. I noticed instantly that the children at Petite Savanne were very respectful of their teachers by addressing them by “sir” or “miss”.  We introduced ourselves and talked about pharmacy and where we came from.  Many of the children wanted to work in healthcare when they grew up, and even some wanted to be pharmacists! We taught them the importance of asking a trusted adult when they wanted medication or candy because both can look very similar. They loved the medication vs. candy game that we played with them. We also brought stickers, jump ropes and chalk for the children to play with during their lunchtime. The children loved eating lunch and playing with us. I don’t remember being so keen to strangers when I was younger, but they invited me right over to sit next to them in their 2^nd grade desk (I was surprised I even fit!). Possibly it’s just the culture these children are raised in. With eager minds and playful smiles, they wanted us to join in their games of tag and skip. The classrooms were much different than the ones in New York. No doors and open windows for the cool breeze to flow in and the smell of nature in the air. There was a mutual bonding and sadness as we departed, but thankful we could brighten the hearts and minds of the children of Petite Savanne.

Aimee Whiteman

Our First Clinic Day (4/23/13)

On Tuesday morning, we had our first rural clinic experiences. Half of the group went to the La Plaine Clinic, while the other half including (Dr. Abrons, Aubrey, Christina, Eric, and I) went to the Petite Savanne Clinic. The health clinics are very different from what one might expect in the US. They are run almost entirely by nurses. Patients come in by appointments or as needed for their health checkups. Only 1-2 times per month is a doctor available. When we arrived at the clinic, there were about 20 people sitting in what looked like a waiting room. After introducing ourselves we dispersed to sit and chat with the different people. I had thought, as I think the others had as well, that these people were waiting to be called into their appointment by the nurse. However, upon talking to them, we realized that they had come to see us. They had been told that a group of pharmacy students would be available to provide diabetes education on that day, so that's just what we did. We tested everyone's blood sugar and answered any questions they had. Everyone was so friendly and open. Some had many questions and concerns to discuss with us; others just wanted to share their stories. I think we can all say that we learned as much from the patients as they learned from us.

After the patients left, our group stayed to talk with the nurses for a bit. The nurses were a mother-daughter duo whose knowledge and expertise amazed all of us. They told us all about their roles in the clinic as well as health care in the country. Because there is rarely a doctor on site, they are often in the position to depend on their clinical judgment to treat the patient on the spot, especially in emergencies. They live close by to the clinic, so if a patient has a problem after hours, they often call or stop by the nurse's home. They frequently do home visits and household checks on all of their patients. The younger nurse described her active involvement in community health. 

I think the most surprising thing to me was how involved the nurses were in caring for their patients. They cared about these people as a whole instead of just their lab values and vital signs. They seemed to know every patient by name as well as have an idea of their medical history. I think any health care provider could learn from these women that patients are just people who want to be treated as such. This is definitely something that I will carry forward to my clinic days on the island as well as in my career.

I will let Christina talk about our afternoon, which included Sam's story, a cooking class, and Paix Bouche!

Jackie

After a group lunch, Sam told us the story of how Jungle Bay came to be. Though no one person can articulate the story like Sam (or have a voice as soothing as Sam's for that matter), I will try to paraphrase as best I can. Sam is a Dominican native, but spent much of his life in the U.S. Virgin Islands and the United States. He took up real estate and was quite successful at it. He was contacted by the Dominican Minister of Health and a Merrill Lynch representative suggesting he purchase land in his home country. He returned to Dominica, and after seeing some land that was highly overpriced, Sam was able to snag a different property tat a great price! Originally, the land was set to be a campground, but Sam saw the potential to be something more. After years of planning and construction, Jungle Bay was born!! The part that really spoke to me was when Sam talked about hiring the Jungle Bay staff. He talked about his philosophy of treating your staff well and letting them really find their niche in their jobs and they will be good to you! This is reflected even in the Jungle Bay staff's name tags. No one has a job title on their name tags, which I think gives a team sense to all the staff and doesn't make any one person seem more important than another.

Afterwards, we enjoyed a cooking class taught by the lovely head chef, JoAnne. I was eager to watch this, because everything we eat at Jungle Bay is so delicious! We learned how to make pumpkin ginger soup and coconut crusted fried plantains. Of course my favorite part was sampling each of the dishes, but it was nice to see that each dish was made using fresh local ingredients without any preservatives. It really made me rethink the processed food that I've grown so reliant on in the states. I'm hoping to steal some recipes so I can make more dishes when I leave her!

In the evening, our whole group decided to do the dreaded Paix Bouche hike. Paix Bouche roughly translates to "shut up", because you won't be able to talk because the climb is so steep! So naturally I was looking forward to it [sarcasm], but the power of peer pressure swayed me to do it. The hike itself is about a mile and a half uphill, and as the name suggests, I was not talking to anyone, but spent the majority of the hike trying to catch my breath! I used the time alone to really reflect on what Paix Bouche is about: mind over matter. The key to completing Paix Bouche is continually making small landmark goals; just get to this boulder, that pothole, or that tree. This is a great philosophy to take to other places in life. Sure, a project or boards may seem overwhelming, but making small tangible goals makes the "impossible" possible. I was definitely slow, I took a lot of breaks, and it wasn't pretty, but I made it! And that's all that matters :)

- Christina 

Moses, Plants, and the Sugarcane Press

On Wednesday the group and I went to go see one of the local herbal medicine men, Moses. Moses’ land is at the trail head of the Victoria Falls Trail. He has a little restaurant for the hikers to eat and drink at if they need something cool after the hike. Two of his sons, Moses Jr. and Israel, live on the same land and Moses Jr. is building a house there as well.

Aubrey already spoke some about Moses and his family being a part of the Rastafarian movement. She describes it in great detail below, but to sum it up the movement consists of people living off the earth and using the surrounding plants and resources to live. Moses also talked about the importance of the moon cycle for doing certain activities and how the cycle of the moon (month you were born) affects your personality. He said that the stars (Gemini signs) help shape each of us.

Moses said that he learned much of what he knows about herbal therapies from his parents and grandparents. It also seems that he is trying to pass his knowledge down to his children. He showed us a book that he wrote and had published, that looked like a very informative and interesting read. We talked some throughout our time with Moses about how to use the different parts of the plants in teas. It was amazing to hear him describe how many leaves or how many handfuls were needed to be put with water to make each herbal infusion. It seemed like for most of the herbal infusions he told us about, they required a handful or so of the leaves and then around a pint of boiling water. I am very interested in trying some of these infusions for myself to see how well they work, hopefully giving me another option to tell my patients back in the States.

The best part of the day for me was walking around in his gardens and making the sugarcane juice. Moses took us first on a tour of his gardens, some of which were down closer to the White River. As I said before, he was very informative on the many different plants that he had growing and about what each of the different plants were used for. I was also very happy to see one of the plants, Comfrey, I will describe why later.

After the tour of his gardens, he took us back to the restaurant and taught us how to squeeze sugarcane to get the juice out. He had a wooden machine that had two rollers with metal rods on the ends to help turn them. These rollers were turned and the sugarcane was inserted and squeezed as it was pulled through. We had a kettle underneath the rollers to collect the juice. It was amazing to see how much juice each of the sugarcane stalks contained. After about a half hour of switching the roles of turning the rollers, pushing the sugarcane through, and then pulling the sugarcane, we were able to enjoy our work. As Aubrey commented, the juice was very sweet and one could only drink a little bit.

As I mentioned a little earlier, I was very excited to see the plant called Comfrey. On Monday, each of the students were given two plants to identify, take a picture with, and then interview someone about the different uses and if they have ever used it. I was able to find my other plant, Noni, fairly easily, but had yet to find or even determine what my second plant was. I found out this morning that my second plant was not in the Plants of Southeast Dominica book that we have and that was called Comfrey. So seeing the plant in person in Moses’ gardens allowed me to see what it actually looks like. All I need to do now is spend some more time looking around Jungle Bay and find another plant to take my picture with.

I am looking forward to the rest of the time here and hopefully we have wonderful weather.

Eric 

A Conclusion to Dominica, For Now!

What keeps me coming back to Dominica are the people.  The people all around Dominica, including Jungle Bay, are the most friendly and caring people I have ever met in my travels.  On my arrival I was immediately met with hugs from so many people at Jungle Bay and warmest congratulations of my recent wedding.  Everyone around Dominica displayed such a positive attitude during my entire stay, and I truly appreciated all of it.   When traveling around Dominica, for example at the Delices Health Fair I was reminded of how caring and compassionate even newly met Dominican citizens can be.  I interacted with so many gracious people and taught/learned so much.  I cant even begin to recount the ways that someone around Dominica helped in an important way, and it made me feel so blessed to be around such selfless people with such a sense of community and compassion.  On my departure I left with a heavy heart with the warmest of wishes from all, and it felt amazing.

The experiences that our group shared within the last week allowed us all to grow as people and pharmacists will always be remembered.  Such experiences included attending La Plaine clinic and where we met some of the most pleasant Bush Medicine experts, visiting Moses and feeling/smelling so many Bush Medicines, and the House of Hope where we spent quality time with the residents and caregivers. 

Overall it is the people with their culture and sense of community that keep me coming back to Dominica to help in any capacity that I am able to, and to learn more about the most important perspectives of life.

When I am away I miss the sense of community the most.  I plan to use the positive influences around me in Dominica to portray that sense of community to those around me in my life and work.  I am committed to being an uplifting influence on my return to the U.S. and will do so as an extension of the culture of those in Dominica and Jungle Bay, eventually to make a widespread effect in favor of compassion and community towards our fellow people.

Theresa Nobles

**I also posted A Renewed Perspective of the House of Hope on Thursday April 25^th, 2013.

An Herbal Scavenger Hunt with Justin

On Monday, we spent the afternoon on an "herbal scavenger hunt." Before we left Jungle Bay in the morning, each student was assigned 2 plants to find, research, and photograph, and compile the information and send it to Dr. Abrons by the end of the rotation. We were also asked to interview someone in Dominica about our plants and upload the videos and photos to the group's Shutterfly.com site.

Because our scavenger hunt began immediately after returning to Jungle Bay from the Petit Savanne Primary School, we were all wearing nicer clothes, but most of us had moderately appropriate walking shoes and were told that it would be a paved, easy walk. Naturally, I was wearing sandals, and they were not the appropriate footwear. This unfortunate choice made me less excited about the scavenger hunt, but it was really an amazing experience.

We hiked from Jungle Bay along some local roads, and Justin stopped occasionally to point out certain plants or explain a medicinal use. I had no idea that so many plants had such a variety of uses! Nearly everything growing in Dominica has some kind of practical, medicinal, or spiritual use, and it makes me realize how little Americans value our natural resources in comparison to the people of Dominica and those who might use more traditional remedies for their ailments. It also amazed me that Justin could identify such an encyclopedia of plants simply by sight. I am so thankful to have him as a resource! 

As we walked, Justin found a freshly fallen coconut and dehusked and cracked it open in front of us. We got to enjoy fresh coconut milk and coconut "meat" (the fleshy, white inside that is so delicious) on our walk, and as the sun shined on us, a breeze ruffled my skirt, and I ate the tasty fruit, I was elated. Justin and the preceptors (Dr. Abrons, Erica, and Theresa) kept pointing features and dropping hints on the locations of our plants, but it was definitely a team effort to find them! Some of us returned empty-handed, but once a couple of us found our plants, we all began looking for each others', as well. Some of them too more effort than others to find, though. Jackie's plant was very far away, and Justin had to climb over other plants and rocks to reach it and pluck off a leaf for her, while one of Eric's was over our heads a few times before we noticed it. By the end, we were all hunting for the leftover plants of a few people, and kept finding things that looked similar but were not the plant of interest. The funniest moment was when Griffan, who was convinced that her plant was lemongrass, walked the path and stopped to smell every grassy plant on the way. Once we did find her lemongrass, though, it was extremely clear how it got its name: it definitely smelled like lemon!

On our way back to Jungle Bay, we also got to stop at a small area covered in spongy, spiky grass (or maybe it's a type of moss) that overlooks the beach, which was where Dr. Abrons and her husband were married. It was so beautiful! This picturesque locale was also where Justin used to live, and I cannot imagine being so close to hear the surf against the rocks every day. It would be very relaxing, though never totally silent. It was a lovely detour and helped the group get to know Dr. Abrons a little bit better, since we could see this very special place with her.

We returned exhausted, but I had a wonderful time beginning to explore the natural resources of Dominica, and look forward to learning more about the herbal remedies and other uses for plants here. Hopefully, we can take some of this information home to the USA in order to help some of our patients at home!

Jessica Shalita