Today is the halfway point for our work in the DR.  As usual, this was a day off: a beach day for the students, and a chance to visit the beautiful Zona Colonial for those of us not going to the beach.

The work is overall going well.  We have seen more patients than we had planned, and have had 2 community meetings…though the meetings were more health outreach events than true community events: not our intent, but apparently what the community most needed.

Our main difficulties are logistical: we need more medicines, and the costs of transportation and lodging have been higher than expected.  However, we are on target to finish up successfully at the end of this week.

Tonight is our last night with Dr. Augustine Lewis: he leaves for home (and family) tomorrow.  Drs. Jen Martini (who joined us tonight) and Scott Black (who comes in tonight) will be sharing the supervising roles with me starting tomorrow. 

We have two more days in the community (with one or two more community meetings), and we will try and complete some housecalls as a team.  Then, on Thursday and Friday we will move to work with the Fundacion Sol Naciente, our long-term in-country partner.

The community seems smaller than I recall: the more distant parts of Esfuerzo seem less busy and seem to have more empty homes, and the dredged kanyada drainage ditch has not really solved any problems.  Our focus on chronic disease management seems to be going well, and we have found a few patients with diabetes who had not been previously diagnosed.

Overall, a good job thus far…but always more work to be done.