Unfortunately, this post is coming a bit late, as I managed to catch a quick flu in between all our travels. But not to worry, there are plenty of photos that will help me catch you all up to speed.
After our trip to Punta Cana, we returned back to our home base for most of this trip, Los Mina Hospital, where we met up with the chief resident, Dr. Jaisson Abel Colon Bautista.
Dr. Colon showed us around the OB-GYN emergency room, the labor waiting room, and the delivery and operating rooms. We were very lucky, and also got to watch a C-section and a vaginal delivery. Lastly, Dr. Colon brought us back to the simulation room for residents, where we caught the end of a training session. Dr. Colon also took the time teach us some clinical skills, like how to measure cervical dilation, with some of the materials in the simulation room.
Towards the end of the week, we spent some time polishing up the Pumani bCPAP utilization survey, and sent it out to representatives at hospitals we had visited across the different regions of the country.
On the weekend, we visited the local zoo in Santo Domingo, where we saw everything from water buffalos, to ostriches, to toucans!
Lastly, we took a quick boat trip to Saona Island, off the eastern coast of the main island. Some locals on the boat were happy to teach us some of the basics of Merengue and Bachata, so we were finally able to check that off the list! After spending some time soaking in the sunshine on the white sand and in the clear waters, we headed back to get ready for the next week ahead.
It’s been a few weeks since my last post, but I know Zoe and Ansh have done a fabulous job keeping you up to date and sharing photos from our adventures here in the DR. As I’m writing this post, we’re just finishing up our first month here, and the time has absolutely flown by!
That said, I’m glad to share what we have been up to this past week and some updates on our projects. We started off the week visiting the Hospital Maternidad la Altagracia with Dr. Emin Rivera from UNAPEC. At the hospital, we met with Dr. Kathy Rodriguez, who shared some of the current issues the hospital is facing with the NICU warming beds and heating lamps. Many of the heating lamps were malfunctioning, and only the temperature monitors were in use. As a result, many of the babies were being supplied heat from gooseneck lamps Instead of the overhead lights built into the heating lamps.
NICU at Hospital La AltagraciaWarming Bed Setup at Hospital La Altagracia
Dr. Floren and George had previously told us about these gooseneck lamps and how they are dangerous to the babies , as they can easily cause burns. DOFMI, in conjunction with the manufacturer Johnson, have taken on a project to design new overhead heating lamps with temperature sensors built in. Dr. Kathy Rodriguez also showed us the initial prototype that DOFMI had donated to the hospital, and walked us through the improvements that would need to be made before the lamp could be put to use.
Heating lamp design by DOFMI
Thermometer on DOFMI heating lamp
The lamp height would need to be adjusted, and a better temperature monitor installed. Additionally, the bed portion of the design would need walls that could collapse fully for doctors to have easy access to the baby in case of emergency and a greater degree of finishing on some of the nuts and bolts. Dr. Floren is hoping the students at UNAPEC, with the guidance of Dr. Rivera can help design a better temperature sensor for the warming beds.
The next day, we sat in on Dr. Rivera’s class, where the students are working on designing microcontrollers for monitoring different criteria in incubators, such as temperature and humidity. We were very lucky to talk to a few students presenting their proposed projects and plans for the course.
While at UNAPEC we also stopped by the entrepreneurship fair, put on by some of our friends we met at Cemprende last week!
Later in the week, we met with Dr. Rodolfo Soto Ravelo, the chief of pediatric surgery at Los Mina Hospital. After shadowing him on his morning rounds, we sat down to discuss gastroschisis, and current treatment options for babies with gastroschisis at Los Mina. For the past ten years, the doctors at Los Mina have been treating gastroscisis with the ABS Silo bag, designed by pediatric surgeons in Colombia, Brazil and Argentina. The bag is made of polyethylene and an endotracheal tube sutured in a circular shape.
Looking to future weeks, we are hoping to modify our design to perhaps be made of a plastic closer in texture to the polyethylene bag, as Dr. Soto Ravelo warned that the twisting the IV bag could potentially cause damage to the intestines.
While work has been keeping us busy, we had some time this weekend to adventure east to Punta Cana, where we went for a morning swim in Hoyo Claro, before joining a buggy tour with stops at a local coffee and chocolate shop, Playa Macao, a beach with beautifully clear waters, and a cave. Ansh only crashed the buggy two or three times.
Hoyo Claro
Ansh driving the buggy in Punta Cana
Playa Macao
On Sunday, we stayed local, and went to the Zona Colonial with some of the students from UNAPEC to grab dinner. Unfortunately, we weren’t able to find a place where they could teach us merengue, but we’re not giving up yet!
Now that you’ve gotten to know a bit more about me, I’m very excited to tell you about our first week in Santo Domingo.
Shortly after departing from our homes on Saturday, Ansh, Zoe and I met up at the Miami airport. A quick two-and-a-half-hour flight later, we were touching down in Santo Domingo, and waiting for our luggage at baggage claim. Outside of the airport, we met up with Freddy, who drove us back to our apartment, with a quick stop at Barra Payan, a classic DR sandwich shop along the way.
In our attempts to settle into the apartment and get ourselves situated, we’ve visited a few different supermarkets to buy some necessities and some massive avocados!
Throughout the week, we’ve had a few meetings with our on-site mentors,
George, Teresa, and Dr. Floren. In these meetings, we’ve been discussing some of the leading causes of neonatal mortality in the Dominican Republic, such as jaundice and intrapartum asphyxiation as well as the limiting factors preventing care of these conditions.
We’ve also spent a lot of this week conducting independent research to prepare for our clinical site visits next week. To prepare for our site visit to the eastern Dominican Republic next Thursday, we’ve read about the history of the bateyes, towns with large Haitian immigrant populations subject poor living conditions. These populations are often far from a hospital where they can receive maternal care. Dr. Floren asked us to look into case studies about maternity waiting homes as a possible solution. These maternity waiting homes have been implemented worldwide as a stepping stone between community care and hospital care, to ensure proper maternal care for women at high risk due to anemia, hypertension and infections during their last weeks of pregnancy.
On Thursday, we were able to go on our first clinical visit to San Lorenzo de los Minas Maternal and Child Hospital. While there, we visited the NICU, the PICU, where we were able to see our first Pumani bCPAP machines.
In addition, we saw their kangaroo mother program, the triage area, and their resident training room for live birth and infant resuscitation. We also had the opportunity to talk with physicians about Minas Data, a website they are compiling to facilitate communication between physicians through case studies and editorials.
While the week was full of work, we’ve also had some time to get out and explore as well! One evening, we were able to head into the Zona Colonial, or the “old city”, a Columbus settlement and the first point of influence for Spanish rule over the Americas. On Saturday, we explored Los Tres Ojos National Park, four freshwater lagoons situated in underground caves, before heading up to Boca Chica Beach for dinner and a quick swim.
It’s been a great first week, and I look forward to sharing more with you all soon!
Hi everyone! My name is Anathea Carrigan, and I’m a rising junior at Sid Richardson College majoring in Chemistry and minoring in Medical Humanities. I’m so excited that you all will be following along my journey in the Dominican Republic over these next two months.
But first, a little bit about myself and how I ended up here. My interest in the medical field and my desire to learn more about the most pressing issues in global health today prompted me to enroll in the introduction to global health class this past fall. In this class, I was not only challenged to reconsider my preconceived notions about global health and international collaboration but encouraged to take an active role in prototyping low-cost colostomy bags. I was eager to think critically about a prominent medical condition and apply some creativity while trying to come up with low-cost, accessible solutions. My positive experiences in this class left me wanting to do more and inspired me to apply for the Rice360 Summer Internship. And here I am!
This summer, Ansh, Zoe and I will be working with the Dominican Foundation for Mothers and Infants. With the guidance of our on-site mentors, George Suazo, Teresa Narváez, and Dr. Angelica Floren, we will be exploring the available resources and current standards of care in hospitals across the country. More specifically, we will be observing the functionality and utilization of Rice360’s Pumani bCPAP machines, current methods of intrapartum fetal heartbeat monitoring, and methods for warming premature neonates in the NICU. I am hoping that through our observations and research we will be able to identify some critical needs in the Dominican Republic and develop some new project ideas to bring back to Houston with us.
While in Santo Domingo, we are also looking to receive some feedback from local experts on two prototypes that have been developed by student teams at Rice. We plan on presenting our first prototype, ScarStretch, an automated device for massaging pediatric burn scars, to physicians in a hospital burn unit. Our second prototype, No Mo’ Silo, is a low-cost alternative to silo bags, used to treat gastroschisis, a condition where an infant’s small intestine is exposed due to improper formation of the abdominal wall.
Although we’ll be pretty busy making clinical visits and working on improving our prototypes, I also want to be sure to fully embrace the Dominican culture while I’m here. Ansh, Zoe and I have already started to explore different restaurants around Santo Domingo, stumble our way through some conversations in Spanish, and search for somewhere to learn merengue!
I cannot wait for all the new experiences I will have over the next two months, and I look forward to sharing them with you all.
