Outcomes of an Immersion Experience in the Dominican Republic
Etienne, Marie O.
Messmer, Patricia R.
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Session presented on Sunday, July 26, 2015: Introduction: The Haitian American Nurses Association (HANA) joined forces with the Haitian Professional Coalition (HAPC) and the Bejamin Leon School of Nursing Miami Dade College (MDC) since 2005 to care for the migrant workers in the Dominican Republic. HANA organized and conducted medical missions in various 'Bateyes' (sugarcane plantations) in the Dominican Republic to provide healthcare and supplies to the migrant workers living in impoverished conditions. On March 16-23, 2013, 15 RNSN participated in the immersion project, similar to Gonzalez's (2013) immersive experience. Students collected over 375 book bags filled with school supplies while HANA received donations of medications and clothing. HANA,HAPC and MDC partnered with Universidad Central del Este (UCE) medical school to work collaboratively in the Bateyes. RNSN received service-learning hours for the immersion experience (Chen et al, 2012; Stallwood @ Groh, 2013). Problem: These migrant workers have a life of poverty and hardship. They are prone to gastro-intestinal (GERD), hypertension and cardiac problems along with vitamin deficiencies and respiratory illnesses. Methodology Descriptive, exploratory study Results: At all the Bateys, women and children stood in lines to undergo a physical assessment exam and receive medication and treatment for their conditions. Fewer men were seen since they were working in the sugarcane fields. Of 1098 patients seen during the one-week mission, 503 charts (50%) were analyzed. Demographics- The largest age group was the 12-21 for 26% and the smallest age group was 77-87+ for 3%.; newboRN years and 66-76% accounted for 5%; 6-11 for 14%; 22-32 and 33-43 for 17%; 44-54 for 11%; 55-65 for 9%. There were more females (65%) than males (35%) due to their working in the sugar cane fields. There more physicians/medical students (72%) treating the patients compared to the ARN (29%) treating the workers and families. The most common diagnosis was GI, especially GERD, epigastric and abdominal pain with poor appetite (44%) with Neuro (27%) headache and seizures; GU (21%) bladder infections and yeast infections and STIs; Muscosketeton (20%) back, knee and shoulder pain; ENT (17%) eye, now and throat problems; Derm (15%) tinea corpis and skin disorders; Resp (13%) asthma and respiratory infections; Cardiac (11%) cardiac problems and hypertension, Hema (5%) blood disorders. Many had multiple diagnosis; several were diagnosed with cholera and PTSD resulting from the 2012 Haiti Earthquake. Discussion: The conditions at the 2nd batey were deplorable with 10-12 workers (both men and women) living in a very small unit. The women prepared their only meal in the unit where they reside while the men workers were in the fields. The workers slept on iron bunk beds with no mattresses. There was neither electricity nor water. There was no education provided to the children of these sugar cane workers. Conditions have deteriorated in some bateyes to the point that one of the patients wanted to give her baby to one of the RNSN students. The mother was having a difficult time caring for the baby and could no longer support all her children. One could only imagine the poor mother's anguish over wanting to give up her child. In all the Bateyes, RNSN students and and UCE medical students provided education to the children on hygiene, safety, growing-up healthy, and teeth brushing, hygiene, disease prevention and health promotion. They taught the adults how to use a condom stressing prevention of HIV/AIDS and STIs. There were many sad cases. In one instance a child with cerebral palsy was not attending school since there were no available wheelchairs. The child laid on the floor moRNg and night and even got wet during rain storms due to the substandard housing and leaking roofs. One of the challenges faced by ARN/nursing students, physicians/medical students was how much medication to prescribe or give since many medications required follow-up and there was no guarantee of follow-up care or any monitoring. There was only one clinic at the medical school that these families could attend for follow-up care. Conclusion The one-week immersion project provided RNSN students with opportunities they would not often see in clinical agencies in the United States. Lives were saved, hearts were touched, tears were shed; lives have changed forever by the overwhelming experience. Once could never imagine living in such conditions, yet, we feel fortunate and blessed to be able to help others in need as we count our blessings. It is difficult to imagine the horrendous conditions that these poverty stricken families endure and try to live their daily lives.