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Thursday, 16 October 2014 00:00

ETSU public health interns gain perspective by studying abroad Featured

Written by Melissa Franklin
Milca Nuñez and Chris Bush collected supplies for the Project HOPE clinic in Monte Plata before their journey. Milca Nuñez and Chris Bush collected supplies for the Project HOPE clinic in Monte Plata before their journey. Melissa Franklin

Passion and dedication is what two students needed to journey 1,400 miles from home, determined to improve health conditions in another country. 

Milca Nuñez and Chris Bush traveled to the Dominican Republic in early September to begin their field experience for the College of Public Health at East Tennessee State University.

As of 2013, the Dominican Republic had a population of 10 million, with 40 percent living below the poverty line, according to The World Bank. Receiving medical care is a challenge most Dominicans face; there are an estimated two physicians per 1,000 persons.

The Dominican Republic also has a higher number of adolescent pregnancies than any other country in Latin America, and according to the Centers For Disease Control and Prevention, the infant mortality rate is 23 per 1,000 births.

This is Bush's second trip to the Dominican Republic. The first time Bush visited the country was on a family vacation, but during an excursion to a small town his eyes were opened to the country's poverty. This is the first time Nuñez has worked in a developing country.

The students are working toward their bachelor's degrees in public health, and need 400 hours of field experience before they graduate. They are the first students from the College of Public Health to work in the Dominican Republic, and the first to work with Project HOPE.

DSC00114 deleted 8c3d73665f4d4bc7774d6739820400d4Project HOPE is an international healthcare organization that started in 1958 to deliver health education, medicines, supplies and volunteers to areas of need. There are two clinics in the Dominican Republic, one at the capital of Santo Domingo and another in the rural town of Monte Plata.

Both Nuñez and Bush speak Spanish, which is a requirement to work for Project HOPE in the Dominican Republic. The application process consisted of essay questions centered on their background, education and career goals. They were required to either have a degree or be a student.

"We applied for the program and it was like throwing a rock to the sky to see what would happen," Nuñez said. "We got accepted and then everything started unraveling."

Nuñez and Bush spent the first seven weeks of their field experience in Santo Domingo and the rest in Monte Plata.

"The stories that these kids have, you can't even imagine."

                             – Chris Bush 

Mikki Johnson-Maczka, an instructor for the field experience program, visited the Dominican Republic during the summer to make sure everything would be up to the college's standards. First, Maczka checked to see if the clinics were close to a hospital for medical emergencies. Also, Maczka questioned the crime rate in the area and how they could safely navigate the city.

According to Maczka, the main objective is for students to get a real-world experience of what it is like to work in the healthcare field and for them to apply what they have learned in previous courses. The field experience must include projects for the students to work on during their stay.

"We definitely wanted to make sure they had a project in mind, because we didn't want to send them over there and not have anything to do," said Maczka.

During their seven-week stay in Santo Domingo the interns worked with Alerta Joven, a project centered on the youth in the Dominican Republic.

Alerta Joven is a new initiative for at-risk youth, and was brought to the Dominican Republic through the U.S. Agency for International Development and the consulting agency Entrena.

According to Alerta Joven, 30 percent of the country's population is youth. At-risk youth include 10-24-year-olds who do not finish school, commit crimes or do not have proper identification documents, which are required to attend school. Most of the youth do not have access to education and if they do have access, 36 percent do not complete their basic education requirements.

"I told them not to suffer in silence, talk to someone who they look up to and know they are not alone."

                                                        – Milca Nuñez

"The whole concept of Alerta Joven is to get these kids off the street and give them an alternative," said Bush. "Let them know that they do have a future and it's in their hands."

Nuñez and Bush said that some problems the youth face are eye-opening.

"The stories that these kids have, you can't even imagine," said Bush.

During a session with the youth, the interns discovered that one of the children was being bullied in school because her mother drowned in the Caribbean Sea.

Nuñez explained that they were working with that student on effective communication, because mental health is a vital part of living a healthy lifestyle.

"I told them not to suffer in silence," said Nuñez. "Talk to someone who they look up to and know they are not alone."

According to Nuñez and Bush, these types of problems are not unusual for the youth of the Dominican Republic.

An Alerta Joven counselor, Jeffery, shared his story with the interns. Jeffery grew up in poverty, without parents, and had to turn to the streets for survival. Jeffery walked 10 miles or more to shine and clean shoes in Santo Domingo. Eventually, a local church rescued him and provided him with an education. Jeffery is now working toward his mechanical engineering degree. He hopes that his story will inspire the youth to work toward something better and to overcome poverty.editedvolpic

The interns will also be working on a project centered on expectant mothers and the scope of care they receive. According to the World Health Organization developing countries like the Dominican Republic have higher numbers of adolescent pregnancies because access to education and resources are limited. Maternal deaths are higher among adolescents 16 years and younger.

The clinic already has a five-star system where the expectant mothers receive a star for every essential service their receive, such as nutrition counseling and check-ups. This will encourage the mothers to go to the doctors frequently. They will be creating a certificate for those mothers who do receive all five stars.

The interns were exposed to many low socio-economic Dominicans during an open medical clinic at a nearby school. According to Nuñez and Bush, the school was filled with people who needed medical care but could not afford it.

"It's really sad to see, but that's the reality of it," said Nuñez.

Maczka talked with Nuñez and Bush through Skype to keep up with their progress. Maczka said the trip will broaden their understanding of international health and how they can compare and contrast it to the health system in the U.S.

"I hope it enlightens them to just how we truly are one," said Maczka. "But I hope they get a lot of hands-on experience and a deeper understanding of what it does mean to live in these developing nations and communities."

Above left: Interns work with Alerta Joven youth.  Bottom right: The Alerta Joven team and interns (Photos: Contributed).

En español: Pasantes de salud pública de ETSU ganan experiencia estudiando en el extranjero


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