Clínica de Familia La Romana

Country: Dominican Republic
City/Town: La Romana
Type of Site: Clinical/Research/Community Service Learning
Organization/Institution: Clínica de Familia La Romana
Year of Study: All
Dates: Open
Website: http://clinicadefamilia.org.do
Application Procedures: International Students

Requirements:

Conversational Spanish, minimum

Program Description:

The Clínica de Familia La Romana provides medical attention and psychosocial support to adults and children with HIV, sex workers, adolescents, and other highly vulnerable populations in the eastern part of the Dominican Republic.

It provides comprehensive primary and HIV-specialized outpatient medical care, community- and home-based services, psychosocial support services, and an annual summer camp for HIV-positive children.

Clinical services include:

• general medicine
• gynecology
• pharmacy
• laboratory
• ultrasound
• nursing services

The clinic currently provides antiretroviral treatment to the second-largest number of children and adults with HIV in the Dominican Republic. Moreover, the clinic oversees special programs for the reduction of vertical transmission of HIV and prenatal and reproductive health care for adolescents through the Maternal-Infant Health Annex (MAMI), in collaboration with the largest public hospital in the province.

Clínica de Familia La Romana aims to improve the quality of life of the poorest and most vulnerable populations in the eastern part of the country with a holistic, family-centered approach that includes specialized medical care, social services, community outreach, prevention and education programs.

Clínica de Familia La Romana provides education and training rotations, internships, and practicums for:

• medical
• public health
• social work
• nursing students
• residents
• fellows

For medical students and practitioners, the global health experience includes a clinical component, allowing students to shadow providers providing care to people with HIV and sex workers in Clínica de Familia La Romana and adolescents at the Maternal-Infant Health Annex.

The goal is that the students have a valuable experience and come to understand the challenges that clients face within a developing country while learning about the treatment of HIV and reproductive health care.

Visits, and in some cases, clinical rotations, are also organized with Hospital Francisco Gonzalvo (large public provincial hospital with whom Clínica de Familia works closely), Centro Médico Central Romana (a private hospital owned by the sugarcane company), and Hospital Buen Samaritano (accompanying their outreach teams to rural bateyes), among others.

The Clínica de Familia global health experience allows students to observe and learn from clinic providers in the areas of HIV care, pediatrics and obstetrics and gynecology, observe Cesarean sections at Hospital Francisco Gonzalvo, visit homes of clinic clients with outreach workers, observe educational sessions and prenatal care at MAMI, accompany an outreach worker to “negocios” (where sex workers work), and observe client sessions with the clinic psychologist, adherence counselor, and HIV pre and post-test counselors.

Depending on students’ previous experience, knowledge, and level of Spanish proficiency, they may be able to assist clinical staff in taking clients’ vital signs and conducting the medical histories and physical exams (if patient flow/time allows and the provider is in agreement).

The medical doctors on staff include five generalists (four of whom specialize in HIV care), two pediatricians, one internal medicine doctor, and one obstetrician/gynecologist. Altogether, Clínica de Familia La Romana employs 56 staff. 

In addition to clinical rotations and observation, students conduct projects of public health importance, which may include surveys, research, data extraction and analysis, assistance with client education programs, or participating in continuing medical education for staff.

Current and past projects have included a statistical analysis of HIV virologic suppression, an epidemiological study of clients co-infected with HIV and tuberculosis, facilitation of a quality improvement process with staff, collection of client satisfaction surveys, and creation of waiting room client education modules, among others.

Students are able to give and receive weekly feedback from their staff supervisor (assigned to them based on the topic of the project), the volunteer coordinator, and the clinic’s assistant director. Students have also participated in ongoing Clínica de Familia La Romana research investigations, several of which have been published. The Volunteer Coordinator for International Volunteers is also available to arrange Spanish classes for those that are interested at a cost of $15/hour.

Additional Information: See website and contact the CMHE Assistant Director of Global Health.

Estimated Budget for 1 Month:

Item	Cost (USD)
Airfare	800
Accommodation B&B (per month) $30/night	600
Dinner (per month)	237
Transportation (airport pickup and drop off) $80/trip	160
Visa/Exit Fee	30
Miscellaneous	500
Total	$2,327