Hello again!
It’s kind of wild to realize we’ve already been in the Dominican Republic for a month now. Time really does fly when you’re fully immersed in meaningful work and constantly learning in a new place.
This week was one of my favorites so far! It was packed with experiences that challenged me, moved me, and reaffirmed my interest in gynecology and maternal-child health.
Early in the week, we had an in-depth discussion about the Kangaroo Mother Care (KMC) project we’re contributing to. George Suazo visited to present the scope of the work: developing a low-cost alternative to the gooseneck lamps currently used in NICUs to warm premature babies, and designing sensors that could be placed on infants in kangaroo care to monitor vital signs. These sensors would help generate clinical data to support the efficacy of skin-to-skin care.
We had already visited the Kangaroo Clinic at Los Mina the previous week, where we observed about 10 consultations under the guidance of Dr. Guillermina Nadal. Seeing KMC in action really helped us understand the value of the method. Most of the babies were stable and benefited greatly from the warmth and regulation skin-to-skin contact provides. Since I’m NREMT certified, Dr. Nadal even let me take vitals, including bpm and lung auscultations, which was incredibly rewarding. Some babies were underweight, some had genetic or neurological conditions like Edward’s syndrome, and each had their own unique challenges. I was very astonished by how small some of these babies were, as she told me they were all the same age, but their development was an issue.
The visit to the NICU also brought up some critical insights. Many incubators lacked proper heating regulation and instead relied on gooseneck lamps, which sometimes led to burns due to fragile neonatal skin. On top of that, humidity regulation was missing, and only the most critical babies were hooked up to vital-sign monitors. These conditions really shaped how I interpreted George’s presentation and highlighted the urgent need for both thermal regulation and accessible vitals monitoring, especially for premature babies in both stable and critical conditions.

A major takeaway from this week was realizing that we could possibly be designing for two very different neonatal audiences:
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Stable premature babies—these infants benefit most from kangaroo care and shouldn’t be placed on warming beds unless necessary.
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Critical premature babies—these require intervention in NICUs, whether for jaundice treatment, ventilation, or monitoring. They can’t stay in skin-to-skin contact for long stretches and thus need a reliable thermal crib setup, ideally with vital monitoring sensors as well.
However, since we don’t have much time left, we want to figure out which is more of a priority.
On Thursday, we discussed our project plan with Dr. Emin Rivera. While we came up with a few great ideas, we also agreed that we needed to talk to more clinicians and nurses to really sharpen our needs statement. The upcoming trip to Barahona with Dr. Floren will help us do just that, and we are excited to practice some need-finding skills and ask all the right questions to pediatricians (the most difficult part!).
The highlight of the week for me was shadowing OBGYNs in the obstetric ward at Los Minas on Tuesday and Saturday.

I had the honor of working with Dr. Rosa, a second-year resident, who explained each prenatal patient’s condition during rounds. I met patients in early labor, those requiring C-sections, and others with high-risk conditions like preeclampsia.
Preeclampsia is a complication of pregnancy involving high blood pressure and signs of organ damage. One patient I observed had a catheter inserted, which helped monitor her urine; a darker color could indicate HELLP syndrome, a dangerous progression of preeclampsia. Due to systemic inequities, many patients at Los Minas arrive without having received any prenatal care, making these complications more common and severe. For these cases, babies are delivered pre-term in order to save more lives.
I witnessed three births: one vaginal and two C-sections. Watching the medical team manage each step of the delivery, from using Doppler ultrasounds to track fetal heart rates to performing an amniotomy with a syringe instead of a specialized amnihook (due to resource limitations), was incredibly eye-opening. I even learned how the placenta is removed and how physicians carefully stitch vaginal tears after childbirth. Dr. Solano Turbi, the chief resident, took the time to walk me through the C-section procedures, including each layer of incision and the cauterizing tools used. Truly unforgettable.

Something that I noticed at this ward was the fact that they walked patients who were about to give birth to the OR. These patients almost tripped and fell multiple times. I asked one of the residents about this, and he told me how he disliked how they do it here. He believes that walking these patients over results in the frequency of vaginal tears here. I’ve been trying to brainstorm an alternative to walking patients over to the OR; however, the hallways are pretty narrow and bringing over the whole bed would be inconvenient. This is definitely a problem I want to explore in different hospitals.
Other than that, I couldn’t believe they had 50 births scheduled that day; it was a hectic but amazing environment to learn in. I fully plan to return to this hospital to continue learning and maybe even get feedback on our prototype.
As the week wrapped up, we focused on refining our approach to the KMC project. We now clearly understand that:
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Babies stable enough for kangaroo care should stay with the mother and do not need a thermal crib.
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Babies who require NICU interventions must have a reliable thermal environment and do need vitals sensors to guide care.
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Both groups would benefit from affordable, non-invasive sensors to monitor vital signs.
We’re heading to Barahona soon, where Dr. Floren will also be distributing Dream Warmers—a portable, non-electric warming solution developed by Boston Children’s Hospital. I’m really excited to see how these are received and to learn more from the pediatricians and nurses working in those facilities.

Now moving on to some quick excursion updates! Went to Soana Island last Sunday! SO surreal! Fun fact: Pirates of the Caribbean: The Curse of the Black Pearl was filmed there. I also tried quenepas for the first time—they brought back memories of similar fruits I’ve had in Thailand. Definitely a nostalgic (and delicious) moment!

Thanks for tuning in again this week!
Writing these entries reminds me how lucky I am to be here. I came in loving gynecology, and each week I get to experience it firsthand, I leave more sure that I’ve found something I’m truly passionate about.
Until next time,
-Valerie
(P.S. here are some long-awaited photos of the first time I tested my model at Los Minas!)


