LaPlaine Clinic 01/29/13

On Tuesday, we had the opportunity to visit LaPlaine clinic for the second time.  I met a young mother who was using bush medicine in combination with Western medicines to control her morning sickness. One of the bush medicines she was trying was a bay leaf infusion she drank as needed and she felt it was very helpful.  She also used mint candies and dry crackers to help settle her stomach. I felt it was a great opportunity to learn more about the bay leaf and its uses. Additionally, I appreciated how open she was about her use of herbal medications, as this is not an attitude often seen in the States.
My second encounter was with a young girl who had been bitten by a centipede and this had subsequently led to an infection. I counseled her on the use of her antibiotic and she quickly verified the directions and possible side effects. When asked what questions she had, she timidly told me that she was in pain and wanted to know what would work more quickly than the antibiotic to provide relief. I explained the antibiotic would take a few days to show signs of improvement, but some options would be paracetamol (Tylenol) or ibuprofen. I reviewed her medical file and noted that the doctor had not prescribed any pain medications. Understandably the girl was upset.  I wanted to help her and I recalled that I had ibuprofen in my bag. I spoke with the preceptor, quickly explaining the situation and asked permission to share my medication with the patient. He agreed and I was able to give her a few tablets and some instruction on further pain relief.  This was a previously unknown situation for me as I could not recall a time when a patient did not have access to a medication as 'common' as ibuprofen.  My simple encounter with this girl really drove home how limited medical resources are on the island. 
My realization brought about a conversation about medical donations with Kent, the local pharmacist.  Through him, we learned that medications can be sent to the island via the government as donations. However, if this is done the officials may redistribute items they feel will be more beneficial if they were located at the hospital or another district. This means that even though a package was labeled specifically for the pharmacy at LaPlaine, some of the items might not make it to Kent or his patients! I was disappointed when I learned of this attitude towards donations, however, I can also understand this point of view -- if there is a particularly rare medication a patient needs it may be better to have the supply centrally located so everyone will know where the medication will be.
The experience at LaPlaine clinic has opened my eyes to the issues facing many people in the world today.  Before my visit to Dominica, I do not think I ever would have considered a medication as ubiquitous (to me) as ibuprofen would be in short supply elsewhere in the world. This also made me realize that there are going to be many other necessary medications that are limited in Dominica. I will never take for granted all the resources available to us in North America and upon our return I hope the group continues to give back to those in need, both in Dominica and in our own local communities.

Courtney Thomas

Tuesday's Le Petit Savanne clinic day

Today was tuesday and that means clinic day. One group went to the La Plaine clinic while my group went to Le Petit Savanne's clinic. The last time we went to this clinic it was closed but today the district doctor and pharmacist were there so there was a huge turnout. I think we counted about 35 patients waiting there at one time. One of our preceptors said it was the largest turnout she's seen in 3 years. Upon arrival, the nurse made an announcement of our presence and that the patients could ask us anything. She was extremely hospitable and the patients were incredibly warm and more than happy to share with us; welcoming the extra help.  My first impression was that the clinic was very small; about the size of someone's kitchen and dining area in north America. The patients came in the morning and the nurse and doctor started triaging people based on the severity of their illness. I asked one of the patients how long they usually have to wait for and she said if she wants to go to the clinic, she plans on staying the whole day ... and yet none of them got impatient or complained.  After talking to the patients, it seemed like the most prevalent disease states were diabetes and hypertension. Although the medications are free, the supply is extremely sparse which limits not only which medication is prescribed, but also the amount. The pharmacy was the size of a small walk in closet but no one seemed to complain about that either. The pharmacist gave the patients their medication and kept track of the remaining inventory after every patient manually in a huge book. If a medication was not available, the patient could go to the city which is an hour drive away and purchase it at a pharmacy there which really hinders compliance. At the end of the day, the pharmacist would pack up what little medication she had and take it with her. It was shocking to see such little inventory. One of the patients I talked to was asking for GERD therapy and although we donated some PPIs, we didn't have anymore and so I had to recommend H2RAs or over the counter and non pharmacological therapies. Thus, although the island is very lavish and the people have plenty of food and water, medicine is what seems to be lacking as their health issues increase from the influence of North American culture. Hopefully we can teach them and help them in any way we can that is sustainable once we leave, but in the meantime, I've realized how important it is to keep sending even the simplest medical supplies such as bandages for which they are almost too happy to receive. 

~ Sincerelly Maria 

Monday, January 28, 2013

On Monday afternoon, we went to harvest cinnamon with a Jungle Bay staff member. I was glad that there was not as much walking involved in this activity because I was tired after the Boiling Lake hike yesterday, and it's been the activity I have been looking forward to the most on this trip. 

I tried every step to the process except the first, which was the chopping of the tree with a machete. I was too exhausted for the amount of effort that it would have taken me to try. There were a few of us who did not even know that cinnamon came from a tree. 

The next step was like shaving the outer skin of the tree with a knife. It was similar to the sugar cane we did last week, but I thought it was much harder. If you shaved until you saw a white color, you went too deep. 

After that, the staff member cut 6 inch pieces around the tree branch so we could get the knife under the top layer of the tree. It looked a lot easier than it was. Most of us couldn't get the piece off in one in order for it to curl like cinnamon sticks, but I had fun harvesting it!

We all got to take a piece of the cinnamon with us to dry ourselves. It usually takes a couple days to sit out to dry. I can't wait until mine is done so I can make some cinnamon iced tea like Jungle Bay serves because it is to die for!

Ashley Gulvik

          Today the group visited Pomme’s place.  Pomme is a 62 year old man who has spent the last 35 years of his life living entirely off the land of Dominica.  The hike we made to get to his home took well over an hour.  This path is the only way to and from Pomme’s home, meaning he has to make this journey on foot in order to get anywhere.  Pomme lived among the rest of civilization up until 35 years ago, when he started living his current lifestyle due to his religious beliefs.  Pomme told us how he felt living in the developing world.  He explained how to him it seems the more technology we develop and the more doctors we train, the more the world struggles and the more sicknesses spread throughout the population.  He feels the world needs to return to Eden, referencing the Bible and the Garden of Eden.  That is why he decided 35 years ago to “return to Eden.” 

          Approaching Pomme’s place after our long hike, I was struck by the beauty of his land.  The house he made on his own sits in a large, open valley, surrounded by mountains and streams.  Pomme’s garden stretches in all directions, full of colorful plants, herbs, and trees.  Pomme took us around his garden, showing us the various plants and telling us their uses.  Most were plants I had never even heard of outside of Dominica!  After our tour, Pomme’s wife served us a delicious Vegan meal prepared using some of the vegetables and herbs from the garden.  Even the bowls our stew was served in were made using calabash from the garden. 

          Pomme’s place was an amazing retreat for all of us.  His lifestyle is very different from our own, and gave us an entirely new perspective on life.  I understand and respect his views on the modern world and his reasons for living this way.  I also can’t help but ponder the concept of giving back to the community and to those around us.  Pomme’s lifestyle is one we could debate endlessly, but getting this perspective was an experience I know none of us will forget!

Kelsey

Weekend Activities (1/26 - 1/27/13)

Just like any other rotation we have the weekends 'off'. Jungle bay offers several activities for each day of the weekend. This particular Saturday we all decided to go snorkeling at Champagne Beach. This is usually scheduled during the week but since we are busing with rotation related activities during the week Jungle Bay worked with us and set up a trip to accommodate our interest in this particular activity. We were all very grateful and would have been disappointed if we didn't get to enjoy snorkeling in such a beautiful location. The weather was absolutely gorgeous! The sun was shining and it was the perfect temperature. Even the water was warm enough! It was definitely amazing to see the bubbles coming from the volcanic sea floor, which is how the beach received its name. It was like swimming in a glass of champagne at one point! The beach itself is not your typical beach and is very rocky. It is not the place to lie out on your towel. The water was crystal clear and a beautiful blue- prefect for seeing the coral reef and the variety of colorful fish. There were fish with rainbow colors, bright yellows, various shades of blues (which were my favorite) and numerous more combinations. Carlos, our awesome guide from Jungle Bay, found a hot spot for us to check out. The water coming from this area on shore was toasty warm- even boiling at the beginning and way too hot to touch! Unfortunately we did not see any sea turtles but it wasn't a big deal. The snorkeling trip was an awesome experience and we all thoroughly enjoyed our time at Champagne Beach!

Since the condition of my ankles didn't permit me to join in on the Boiling Lake hike on Sunday, I was able to go whale watching in Roseau with Jill and a few other Jungle Bay guests. We were very lucky to have this alternative option to explore Dominica more! The weather was mostly cloudy and periodically raining. From the boat we could see it raining in various locations in Dominica. I was glad we avoiding most of this being away from the land but I felt bad for the Boiling Lake hikers! The boat left around 2pm with about 13 people so it wasn't too crowded. We headed out to sea keeping close enough to the coast for about 30 minutes when the crew decided to use their sonar instruments to see if they could hear any whales nearby. Unfortunate we didn't pick up any sounds beneath the water so we headed north for about 30 more minutes and tried again. Still nothing! Dive Dominica had about an 85% success rate but considering I am impatient I was starting to get my hopes up. We continued north for another 30 minutes and listened again. This time they could hear whales 1-3 miles toward the north, northwest and northeast. We continued north more to head in their directed and listened again. It seems like we were in the right area so we were told to keep looking since it they could be underwater for 30-45 minutes before surfacing for air. The captain gave this information to another sightseeing boat and told them to watch since they might be heading their way. After about 5 minutes the other boat informed us they spotted the whales and we headed on our way to see them closer! Luckily the whales were still 'socializing and catching their breath' when we arrived. There were two sperm whales ahead of us... Moby Dick whales as the captain said. This was my first whale watching experience and I was super excited to see whales so close. It was awesome! They were apparently females since the male whales will leave the warmer waters while the female whales don't. They were about 30-40 feet in length, about half as long as the boat. They casually swam for a few minutes before diving down for more food. After several minutes we were able to find more whales and catch up to see them. The boat was about 50 feet from the whales so it was a great view. We saw about 4-5 whales total since and were able to follow some since they did shallow dives where they resurfaced several minutes later before taking the deep dive for 30 or more minutes. One whale even swam right beside the boat giving us a great show. We were able to see the whale under the water while on the side of the boat and were right there for the deep dive that followed. All of this happening maybe 30 feet away! It was an amazing sight to be able to see the whales so close and personal. They were so beautiful and I definitely could not capture it on camera. After that whale it was about 4:30 and we started heading in, arriving to shore around 5:10pm. It was rumored that the trip last weekend saw 20 whales but I was just so glad we had to chance to see one that the 4-5 we watched was awesome, especially since I didn't think I would see anything halfway through the trip. I'm very grateful I had this opportunity. Such a wonderful day with the whales!

Sarah S :)

Boiling Lake (1/27/13)

It's Sunday and we as a group have been lucky enough to be a part of the Jungle Bay family for a week now.  As it is the weekend, we get to experience some of the natural beauty this island has to offer and today we are all eagerly anticipating the hike to the boiling lake which is the second largest boiling lake in the world and one of Dominica's greatest treasures.  With all our lunches packed and with enough water we began our trek with the hour long drive to the base of the boiling lake.  To me the excitement actually began with the drive itself as the scenery associated with the drive allowed me to further understand why Dominica is known as the nature island of the Caribbean.  Along with the multiple attractions on this island, the untouched landscape and beauty is reason enough to attract tourists from everywhere.

Upon arrival to the base, those of us who wanted walking sticks were given them and while writing this blog upon completion of the hike I can honestly say that I was really really glad that I decided to take that stick for reasons which will be explained later in this blog if you keep reading :).  The hike began at a reasonable pace with fairly flat ground in the beginning, then began the never ending stairs up the mountain.  It was at this point where I required plenty of breaks to keep up, but individuals wanting to do this hike must remember to always go at their own pace as after all it's not a race instead a hike of self-accomplishment.  Once on top of the mountain, we were greeted with pineapple from our friendly guide, Brother.  It was probably the best pineapple I have ever had in my life, maybe because of sheer exhaustion or perhaps because the pineapple was really that good, honestly it was probably a bit of both.  Throughout the hike thus far, there were many areas to just stop and enjoy the endless beauty of the landscape surrounding us, and I highly suggest that people do stop to just look around.  We then headed down through the many many stairs to the valley of desolation which again was a site to remember and also the area where we all received our very own sulfur facials from the surrounding land, courtesy of Brother.  At this point we were almost there, but yet so far away, well at least it felt like it, but we had to keep going as we didn't make it this far for nothing.  It was just a little while longer till we saw the famous boiling lake of Dominica.  Half an hour later and we were finally there with the spectacular view of the lake that was literally boiling and now had a place to enjoy our lunch before beginning the trek back.  It was during the trek back that I hurt my right knee due to the multiple downhill stairs we needed to get through to get back and it was then where the walking stick became my third leg.  Although last in the group to end the trek back, I did feel a sense of accomplishment that I managed to complete this extreme hike and was rewarded at the end with a cliff jump over a gorge which was probably the most exhilarating and rewarding part of the whole hike.            

Overall this hike became more of a test of endurance, strength and will power more than anything else but definitely an experience I will cherish and take with me.  To anybody willing to take on this challenge, a hike I definitely recommend, the only advice I can give is to keep pushing yourself and never give up, as the self accomplishment you feel upon reaching the boiling lake is satisfaction enough on top of the incredible, breathtaking views of the valley of desolation and the lake itself, not to mention the hot spring and the gorge in the end with the cliff jump for all you daredevils willing to try (although I highly recommend it for everyone to at least try it, after all you only live once).  Upon completion of this hike, I am even more driven to get myself into the fittest shape possible and take on even more challenging hikes.

Pearl Martis    

Friday Afternoon's Drug Free Rally

After a busy day at the health fair, we stopped in Petit Savanne where the local school was hosting a drug-free rally. Several students, teachers and parents walked from the elementary school to the health center promoting a drug-free community. They carried catchy signs saying 'Do pot your brain will rot' and 'Leave the joints to the bones!' The teachers led the crowd in chants during the entire walk. When we arrived at our destination, several people spoke to the children on the consequences of drug use and how to avoid going down that road. Even Dr. Abrons was asked to speak out for the cause!

The rally was a great chance to connect with the people of Petit Savanne on a closer level. The experience reminded me that we all face similar problems, even if we are oceans apart. The rally was similar to the D.A.R.E. program so many of us went through in school. I am glad to see the children here have the same support!

I am so glad we were invited to this event. It really helped us submerge ourselves in the local culture an connect with the community around us.  It gave us a better understanding of one of the social challenges that Dominica faces and how they are working together to overcome it.

A big thanks goes out to the people of Dominica for being so welcoming during our stay here!

Bridget Sterling