Equipping Dominican HIV providers with the tools for best patient care

Guest post by Dr. Ramona Bhatia, Clinical Research Associate, Center for Global Health, and Instructor of Medicine, Feinberg School of Medicine

Arrival of the Project CURE shipping container at Clínica de Familia La Romana

Physicians such as myself practicing in high-income countries are privileged to utilize the latest medical technologies for patient care. In the majority of healthcare settings globally, however, even the most basic medical supplies, such as gloves, gowns, and gurneys, are limited, and more sophisticated technologies are exceedingly rare.

In my role as a global health clinical researcher in the Center for Global Health at the Feinberg School of Medicine, I had the pleasure of traveling to the Clínica de Familia La Romana in October 2013. Located in the La Romana province in the southeastern part of the Dominican Republic, Clínica de Familia is the second largest HIV clinic in the country. It provides subsidized care to approximately 1,600 patients, including a large proportion of vulnerable Haitian migrants living in neighboring bateyes (sugarcane labor camps). My initial task was to develop and implement a Spanish-language training course on the latest HIV care updates for Clínica providers, but from my conversations with Clínica leadership and site visits I quickly realized that more than a care update was needed. A lack of medical equipment, such as an EKG for heart tracings, was preventing Clínica staff from providing the best care possible to their patients.

The container: Fully stocked with needed medical supplies

To address the supply shortage, the Center for Global Health, with support from Northwestern Memorial Hospital, formed a partnership with the not-for-profit group Project C.U.R.E. Project C.U.R.E. is the largest supplier of donated medical supplies to developing countries around the world. One of my responsibilities was to assist with the on-site Project C.U.R.E. needs assessments in the Clínica de Familia and neighboring hospitals, including one in Guyamate, a bateye and Northwestern University Access to Health site. Conducting detailed assessments was important to ensure that donated supplies would be needed and could feasibly be used. We interviewed providers for first-hand accounts of the supplies that were most needed and discussed logistics with Clínica leadership, including availability of regular maintenance for large equipment, proper storage facilities, and personnel to safely and effectively utilize certain technologies.

Three months later, in January 2014, a large shipment of supplies was loaded onto a shipping container in Denver and set sail from Houston for the Dominican Republic. After travel and customs processing, the shipping container carrying tens of thousands of dollars worth of medical supplies arrived at the Clínica de Familia in July 2014. The community came together for the large undertaking of unloading the supplies at Clínica de Familia.

Today, just a few weeks after the arrival of the shipment, providers are already utilizing some of equipment: The EKG machine is being used for heart rhythm examinations and the colposcopy equipment is set up to begin women’s health exams, all due to the targeted matching of supplies with the Clínica’s needs.

We plan to return to La Romana next year with the first group of Feinberg medical students to engage in HIV and primary care medical rotations at the Clínica de Familia. I’m hoping to see these supplies contributing to a sustained improvement in health care for HIV patients in the La Romana community.

Unloading the container: A community effort

Clínica de Familia La Romana staff checking supplies

Setting up the colposcopy machinery for women’s health examinations

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