Hello everybody, and welcome back to the blog!!!

As our internship comes to an end, I have been trying to take in every moment here: the people, the culture, and everything we have been learning. This week, Dr. Lee visited the country, and we traveled with her to San Pedro de Macorís to visit the bateyes. These are small communities where many residents work in the sugarcane fields.

During previous visits, I had only seen these towns from a car window, but this time we were able to walk through one. It was the first time I really saw what life is like there. Many of the homes did not have flooring, the roofs were improvised, and there was no air conditioning.

Still, the sense of community stood out to me. Even though it is a small area, everyone greeted each other in a friendly way. The church was full of energy, with people singing and dancing in Haitian Creole. It was my first time hearing the language. At the same time, learning about their situation was difficult. Because of the immigration issues in the Dominican Republic, many Haitians are afraid to go to hospitals. Some fear being deported, while others worry about unfair treatment. As a result, people sometimes die from conditions that could have been prevented. Maternal mortality is especially high in these communities because women with high-risk pregnancies often avoid care out of fear that they and their babies could be deported.

We were guided through the area by Mrs. Malena, a local woman who leads programs to help other women learn new skills and also provides emotional support. She explained the need for a mobile clinic because the towns are far from each other, and the regional hospitals are even farther. She shared that when she was a child, it took her two hours to walk to school, even though it was still within the batey region. As we traveled between communities, we saw families walking long distances in the heat with groceries. Cars were rare, and motorcycles were the main form of transportation.

She also showed us places where bodies had been found. That moment really stayed with me and reminded me how serious the situation is.

The next day, we went to Santiago de los Caballeros, the second largest city in the country. We visited Circuimed and met again with people we had previously spoken with at Altagracia. Circuimed distributes and refurbishes medical equipment. They showed us their mock operating rooms and several incubators that needed repair. During our conversation with the owner, we learned that most problems with incubators come from the heating source or temperature sensors. Many of these parts are replaceable, but medical staff are not always aware. Sometimes they reuse disposable sensors or do not realize replacements are available. Because of this, many incubators go unused when a simple fix could solve the issue.

We also visited hospitals in the area, including one [name to be added], where all the incubators were functioning. They were even using ceramic wrap instead of tape to seal older incubators. Tape leaves residue that increases the risk of contamination, so this was a much better solution.

After Dr. Lee left, we met with David Kimmey, a Rice360 fellow who worked on the Celsi Warmer and Monitor. He explained that the device was originally designed for hospitals in Africa, but we noticed a lot of overlap between that context and what we have seen in the Dominican Republic. We also spoke with Jackie Foss, a tech translator from Rice360, who told us that the Celsi Warmer was recently approved by the FDA. We connected her with Dra. Floren to explore whether the device could be used in local NICUs to address issues with temperature regulation.

I also worked on prototypes for a training model for the LEEP procedure. From our hospital visits, we found that LEEP is frequently used to treat cervical intraepithelial neoplasia (CIN), a condition that can lead to cervical cancer. Some hospitals perform the procedure up to five times a day. A common problem is access to small and affordable electrosurgical generators. Our goal is to create a training model that doctors can use for hands-on practice while keeping costs low.

In addition, I have been writing down need statements based on what we have observed. I plan to share these with UNAPEC, since they are working on launching a biomedical engineering major. These statements could help guide their future projects and classes in a direction that addresses medical topics, which I think would be wonderful for the country.

This experience has been very informative. I am so thankful to have had the chance to learn from the people here and to better understand some of the issues they face.

– Valerie

Some bonus pics!!