View walking down the hill from the school on Altos de Paraíso down into the community of Esfuerzo

This afternoon, I received word that the last 2 members of our team (who stayed behind for one more day’s travel) arrived safely back stateside.  This means that everyone is back from the trip and we can start thinking about what worked and what needs to change for the next time.

The overall impression is one of a trip well done: averaging about 80 patients a day, while also working to teach medical students clinical skills and clinical reasoning and providing necessary care to the community.  All told, the team provided care for about 640 patients during our time in the community and in our partner organization’s clinic.  The team became increasingly efficient during the time in the DR, and I believe our students will benefit from the experience.

The major challenges on this trip were related to logistical issues: sufficient supplies of medications, reliable transportation, the government’s help/interference with the work we were doing.  Some of these will recur year to year, but we are seeking to find better ways to plan for the medications and ensure that we are able to provide appropriate services to the community.

This has also led us to consider what other services we should be providing.  For the first time this year, we checked blood sugars on patients with high blood pressures and we made a number of new diagnoses of diabetes or prediabetes.  This will hopefully allow patients to receive better care heading forward, but has re-opened the discussion of whether we should be providing other services (cholesterol checks?  urinalyses? GYN exams) in the context of a resource-poor community and a lack of formal medical facilities.

Still: despite the questions and challenges, I am grateful to have had such a strong and hardworking team.

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo

HOMBRE 2012: Scenes from Esfuerzo