Working in school buildings and one-room churches, a team of nursing faculty and students from the University of North Georgia (UNG) faced challenging conditions to provide healthcare services to impoverished sugarcane workers and their families in the Dominican Republic in May.
The group works with Rivers of the World, a Dawsonville-based international ministry group, to provide medical services throughout the region surrounding La Romana, the country's third-largest city. The annual trip, which is supported by UNG's Center for Global Engagement, reflects the university's mission to provide students with service-learning and international opportunities that prepare them to become leaders in a global society.
The Dominican Republic has only 1.88 physicians and 1.7 hospital beds per 1,000 people, which is about half as many as in the United States, according to the CIA World Factbook. Andrea Fowler, a student in UNG's graduate-level family nurse practitioner program (FNP) said patients were very grateful for the aid, and people were often lined up waiting to be treated four hours before the team arrived.
FNP students Becky Simmons, Andrea Fowler, Margaret Presswood, and
"I wanted to experience healthcare delivery in a poor, underserved culture, and we definitely saw that here," Fowler said. "Our clinics were set up in one-room churches or school buildings, and most often dealt with problems arising from diabetes, high blood pressure, headaches and miscellaneous pain, much of which was caused by malnutrition."
With faculty guiding them, the 10 students worked together to triage and treat patients. In five days, the team saw nearly 500 patients, not including more than 100 children per day in need of de-worming.
"The undergrad students took the patient's vital signs and worked in the pharmacy, filling the prescriptions written by the FNP students," said Lauren Mitchell, who is pursuing a Bachelor of Science in Nursing through UNG's RN to BSN bridge program. "We also helped with wound care; some of the injuries were violence-related, such as from knife fights, and others were just from a lack of healthcare."
Mitchell said that one of the patients, a man with diabetes, had very advanced ulcers on his legs that had become gangrenous.
"Treating him and others like him helped us learn more about the patient care aspect, and how to respect a patient's feelings," Mitchell said. "We did all we could for him, but later we learned it was a near-certainty that he would die, which was difficult to deal with."
Dr. Elaine Taylor, associate head of the Department of Nursing and trip organizer, said the hospital's chief nurse insisted on having her staff meet with the UNG group to learn about several other things related to staffing, such as nurse-to-patient ratios, shift length, and end of shift transition. She said she is already considering ways that she and next year's team can prepare and what resources they can bring next time to help the hospital staff.
"What I enjoy most about these trips is seeing how the group develops, grows, and comes together as a team during the week," Taylor said. "Every village that we set up clinic in is different, so there is not a set organizational 'formula.' By the second day the students are problem-solving and making things go much smoother, and by the third day the clinic runs like a well-oiled machine."