January 16, 2015

Room in the private hospital
Photo Credit: Kirstie Geier 

Sign of services in private hospital
Photo Credit: Kirstie Geier 

Kirstie: As our trip was coming to an end, we had another day to reflect on our experiences and feelings regarding our time here. Our biggest topic of discussion was concerning the vast differences between the public healthcare facilities and the private healthcare facilities. On Thursday we had the pleasure of visiting a private healthcare facility and we were truly amazed by the appearance of this hospital compared to a public hospital. This hospital was not over-crowded, had private rooms and appeared neat and orderly. We also were informed that this hospital provided a better quality of care to patients, but was much more expensive. One of the rooms was $400 a night, which is a large sum of money, especially for the Dominican population who greatly struggles with poverty. The private hospitals have many specialties such as dermatology, bariatric surgery, oncology, and much more. The private hospital experience is much better and the quality of care is much higher than that received in a public facility. Unfortunately, many of the Dominican people struggle to obtain access to private healthcare facilities due to their lack of monetary means. This results in many people in the country utilizing the public healthcare facilities and ultimately receiving a lower quality of care, potentially producing an overall negative health outcome for the country in its entirety.

Plants used for traditional medicine
Photo Credit: Crystal Croom

Crystal: Today’s final lecture the topic was about traditional medicine, and how it affects doctors. Maria started with teaching us different types of remedies that are still being used. Traditional medicines included shaman, herbal cures, healer, and prayers for the mind, body and heart. In opposition to traditional medicine there is modern medicine, which is practiced by doctors. Almost all of traditional medicine is based on the different ways you can use plants. The knowledge is passed down from generation to generation, but is also shared through trusted friends. One plant can be used to cure more than one problem. The uses vary as well, from teas to baths, rubs, and lucky charms. Traditional reasons for using these medicines were for GI problems, aphrodisiacs, flu and fever, and to cause abortions. With the change in times and disease they have other uses, such as for blood pressure, diabetes, kidney stones, and psychiatric illness. For anyone using traditional medicine, you have to believe the medicine will work and therefore producing a better outcome for yourself. In some cases traditional medicine just can’t help some and they have to see a doctor any way. Doctors do not really like the use of these practices because it can get confusing as to finding out how to solve their problem. Most people do not know the dosage of the traditional medicine that they are taking let alone what is actually in it. So if they are visiting a doctor and share that they have tried other remedies first, the doctor may have to do a full check to see what is actually wrong with a patient. 49% of patients use traditional medicine before they visit the doctor. When it comes down to it, it is about what kind of medicine the patient truly believes in.

The students and several nurses and doctors from the level three hospital
Photo Credit: Xavier

Rose: In today’s seminar we also focused on the culmination of our experiences thus far and with what we have seen, examining the roles communication, ethics and morals, and family have in this country’s healthcare system, in their culture as a whole, and what roles these topics play. We discussed these topics as a group using our experiences from yesterday’s visit to the hospital and found that a lot of our classmates were very shocked about the way the hospital operates. We noticed that communication was a big issue, from being able to communicate effectively between doctors/nurses and patients or even how patient charts were documented all on paper, which leaves much room for error and miscommunication. We also gave examples from our trip so far as to how ethical and moral values relate to health and illness. We have heard over and over how abortion is illegal so that is one moral that affects the health of women. We also explored how cultural values affect health and this is when we moved into the discussion about the role of the family in Dominican culture in general and more specifically the family’s role in health and illness. In the hospital, a lot of our classmates witnessed family members helping with the patients to empty urinary catheter bags or put a patient on a bedpan for example, all practices that American families would not even be allowed to do for the patient in a U.S. hospital. I think this part of the discussion was most interesting because after analyzing the role of the family I think a lot of us realized how helpful it actually is to have family present to help provide care for the sick patient. At first, I was sure this shocked most of my classmates and probably would have shocked me as well, but once we were able to really discuss and weigh the pros and cons we realized how a society like the Dominican Republic would thrive on this kind of support.