Dominican Republic Zachary Alholm

Constanza, Dominican Republic

Constanza, Dominican Republic Population: 59,052 Distance from Santo Domingo: 140 km Major business: agriculture (oceanic climate) and tourism

International Health Initiative Founded in 2015 Board members include individuals from: University of Kansas Medical Center Brown University Harvard University Tufts University ”Empower global communities to develop self-sustaining public health solutions”

Trip Objectives Community assessment HIV Assessment Referral clinic in Barrio Los Flores Create GPS map of Barrio Los Flores Coordinate Dental Clinic

Community Assessment Data collected in Barrio Los Flores, a small neighborhood in Constanza. Our team visits this neighborhood 2x/year Goal: obtain consistent data through observation/understanding of a small, particular community 105 household surveys collected Houses were randomized before data collection We only interviewed the “Donna”/eldest woman of the house. Surveys collected by local Peace Corps volunteers Data was collected with electronic tablets

Community Assessment Survey questions: Basic Demographics including age, # of people in household, educational level Past Medical History Access to health care Sexual history, use/understanding of contraception, past pregnancies Zika virus HIV and access to testing/medications Key point: We DID NOT ask if patients had been diagnosed, but were much more concerned with their understanding of the disease and their access to testing

HIV Assessment HIV Survey Questions: Have you ever heard of HIV? Have you ever had an HIV test? Do you know others with HIV? If we had an HIV test, would you be willing to be tested today?

HIV Assessment Main observations: Access to HIV testing is difficult In most cases, patients will wait over 24 hours at a hospital for a blood HIV test Rapid HIV testing is not well-understood and recognized as a standard of care While 97% have heard of HIV, 32% of people have never been tested 83% of the community members were willing to get an HIV test (though we were not testing on this trip)

Referral Clinic We did not treat patients or hand out medication, but instead screened patients and referred to local clinics or the hospital. Goal: Empower the local physicians Staffed by 2 US physicians and several Peace Corp staff We saw 80 patients, with over 50% of them having abnormal test values 15 of them had never been diagnosed with hypertension While the referral clinic was not the main objective of our trip, it functioned to reinforce to the community and local physicians that our main goal was to empower the local healthcare system

GPS Map Collected GPS coordinates during our community assessment surveys (electronic tablets) There is no current map of Barrio Los Flores

GPS Map The goal of this map: Help the local Peace Corp volunteers with their community projects by giving them access to a map Create a process for other communities to create their own map (through the Peace Corp volunteers) Allow for easier and coordinated data collection on future trips

GPS Map During the surveys we took a picture of each individual house. This allowed for future coordination between the individual house and it’s GPS location

GPS Map More examples of the houses we assessed during the week.

Dental Clinic Mobile dental clinic put on by La Vega Dental School (located 3-4 hours from Constanza) 2-day clinic in local elementary school Over 200 kids were seen for dental cleanings and basic procedures Funded by International Health Initiative