the next season...

Okay we are still full of turkey from yesterday but onward we go at the Guesthouse in San Juan.   It's been awesome having our fall teams in town and now we are preparing for the Winter Season/team arrivals.

I've heard from many of you asking which supplies you should bring and I'm excited to hear from and see every one of you.   We have teams back to back to back from December 31st to the first week in April this year so.....the list will change FREQUENTLY based on what the team before YOURS brings, uses and replenishes.  :)    After eyeballing the pharmacy here, I'm going to ask for some things that we may already HAVE but which I know we will use great amounts of...and the same for the OR supplies.    Some of these things will ALWAYS be on the list.    We are aware that not everyone can bring every medication- these are suggestions.

Medications
Ibuprofen (each barrio team should bring at least 6000-10,000 pills of 200 mg strength)
Adult Vitamins (at least 8000 to 10,000 multivits)
Child Vitamins (at least 10,000 chewables.   Gummies are okay but chewables are better)
Child vitamins drops (at least 50-100 with iron if possible)
Antifungals creams (50-200)
Hydrocortizone creams
Vaseline (5-10 per team)
BP meds (beta blockers, ACE, calcium channel blockers- we always have a need for these.  Many of the patients in the barrios are taking enalapril, amlodopine, lisinopril, or nifidipine)
Children's tylenol/ibuprofen suspension/drops (at least 50-100 per team)
Children's cough medicine suspension
Singulair/Clarinex/Claritin- You will see a lot of asthma/allergies in the barrios
Inhalers-  We do not have ANY in stock.  We do, however, have a lot of albuterol for nebulizers.
Toothbrushes/toothpaste- These are excellent to hand out in the barrios.
Diflucan- There are always complaints of yeast infections  in the barrios.  You can bring diflucan or vaginal creams but the diflucan is a lot easier.  
Hygeine products- It is a good idea to hand out soaps/lotions/small shampoos in the barrios as well.  You will then want to bring at least 300-400 to hand out.
Shampoo for "hongos"- There is often a large amount of tinea capitis noted in the barrios.   We can treat with antifungal creams but bringing medicated shampoos would also be a good idea.
Permethrin cream for scabies:  bring at least 10-30.
Small plastic baggies for meds:  Barrio teams should plan on prebagging most medications BEFORE going out to the barrios (this is often how you will spend your Sunday afternoon or evening).   Your vitamins, ibuprofen, tylenol, etc should DEFINITELY be prebagged.     You will need at least 2000-5000 small baggies to put your medications in.   It's also a good idea to bring brown paper bags to put the medications, toothbrushes/toothpaste, and hygeine products in for the patients in the barrios.    You should prebag a month's supply of most of the medications (30 vitamins, tylenol, ibuprofen, BP meds, etc).  Antibiotics are bagged differently based on type and prescription.
Antibiotics- This is obviously dependent on which antibiotics the doctors like to prescribe.  However, we recommend Amoxicillin, Doxy, Cipro, Flagyl, Augmentin, Keflex, Azithro...to start.  :)
Glucometers-  this is a very tricky request- because I probably have at least 100 glucometers in the med room.  However- most of them DO NOT HAVE test strips orrrr they have test strips that will last one month..orrrrr the test strips are expired......orrrr there is no way to do quality control on them.   My recommendation would be that you bring a glucometer with plenty of test strips to use while you are here    or bring one with at least a years worth of test strips.   We do NOT need lancets or alcohol wipes or insulin syringes.  We do not have insulin here, nor will we give out insulin in the barrio clinics.
BP cuffs/stethoscopes:  for triaging patient in the barrios.
Small measuring cups for water/cough syrup, etc.  Dixie cups for handing out water with the albendazole.

OR supplies:
* This is based on assessment at this moment.  We have a month before the first surgical team arrives but there are Dominican doctors operating in the clinic during this month and using some of these supplies. Therefore- this supply list CAN and will fluctuate/change.
Instruments:  There are many many basic instruments here.  However, any specialty instruments should come with your group.
Blades:  We have some 10s,11s, 15s but please plan to bring what you would like to use.
Foley catheters:  There is an abundance of straight caths but NO Foley catheters in stock.
JP drains- we have a few (very old) drains but no bulbs.  
Gloves: sterile AND clean
OR packs/drapes
Sterile Bovies
Sterile suction tubing
Sterile spinal needles if you plan to use them.
IV tubing of your preference (but not insytes- we have a lot of IV insytes at this moment)
STERILE Laps/sponges/ratex/ towels:  We will always have a need for these.
Wrapping material for your instruments/packs
Anesthesia- it's a good idea to bring your own laryngoscopes/bulbs.
Pain meds:  Most of the post-op patients will go home with tylenol or ibuprofen.  If you would like your patients to have anything else at discharge- you'll probably want to bring it.  :)  We can order Fentanyl (IV) and Morphine (but only in 0.2 mg IV dosage form) here a few days before your arrival if you would like.
Circuits:  We have an abundance of anesthesia circuits at this time.  I will update this if we start to run low.
ET tubes:  There is a variety of ET tubes available, however- we do not have many small sizes/ children sizes.
O2 tubing/masks/oral airways:  There is an abundance of tubing/masks/oral airways at this time.  I will continue to update if we start to run low.
Anesthesia meds:  We have sevo/iso/propy/succs in stock.   HOWEVER, there is surgery in the clinic in December so I cannot guarantee quantities at this time.   You may want to bring what you would like to use...or call me at 829-982-1136 to check in closer to your arrival time.  We can order ketamine but Ephedrine is in VERY SHORT SUPPLY here and very very difficult to obtain.   Please bring it if you can.  

Well- here is a start. As I stated previously, because we have patients in our clinic at this time, the lists above can fluctuate greatly.   Please let me know if you have any questions or feel free to email me at phillynic@gmail.com.   I am sooooooo looking forward to working with all of you and can't wait til you get here!

Nicole Eby
829-982-1136

Greeting From New Community Church

This week New Community Church from Elizabeth City, NC is staying at the guesthouse.  You can follow our journey here!   http://www.newcommunitychurchmissions.blogspot.com/

More Barrio Clinic Days

Days 2-4 for the Barrio Clinic Team included visits to Elias Pinas near the Haitian border as well as 2 clinics northeast of San Juan de la Maguana.

This team required the skills of a translator who could speak Creole so anyone with Spanish skills did limited talking.  We were in a city-like setting with running water at the church.  During lunch the team took a bit of a walk around to see the markets and at the end of the day traveled the short distance to the Haitian border for a look through the gate to "no man's land" that exists at the river between the 2 nations.

On Wednesday the team got a little lost and enjoyed the experience of the bus getting stuck.  Instead of getting to the planned location, the team decided to set up at an available school.  Just before getting there our fearless leader, Juan Ernesto, began recruiting patients by yelling out the bus door letting the residents know that a team of American doctors and dentists was there to serve them - it was like having our own pied piper. Our lunchtime walk took us to the river that served as the crossing point between neighborhoods as well as the local bathing spot.

The final day of barrio clinic on Thursday was held in a very remote school down a valley accessible only by gravel road.  We finished a little early and headed to a nearby waterfall to eat our late lunch and enjoy the cool waters of the area.  Upon returning to San Juan de la Maguana we made a quick stop at the local market and then walked into town to visit the main cathedral including a climb to the very top for a 360 degree view of the city.

Three of our team members opted to sponsor children attending a school built by Solid Rock.  On Thursday night those children came to meet their sponsors.  It was great fun to watch them see the children meet their new friends and "cheerleaders:"

Our Friday morning departure greeted us with a little bit of excitement as a nice sized tarantula had made its way into one of the rooms to say good-bye.  We're all just hoping none of his friends found their way into our luggage for the return trip to the US!!!

We really enjoyed our visit and guesthouse stay.  Dan, Kari, and Nicole make for a wonderful team and we thank them for their tremendous care of all of us.  God speed to them all and may God bless them for their service to all.

Peace out from the First Presbyterian Nashville mission team - Doc Holliday and the best team ever!!!

Clinic-Day 1 & 2

 So since you guys got a taste of the Barrio...check out our exciting first two days in the Clinic!

Pre-op is the place to be...

We found out this little girl was not only a fire cracker before surgery....but afterwards as well!

Pre-op looks like fun...but if they only knew what was to come!

Mickey is a universal language!

Anesthesiologist of the year because his scrubs match the sheets

We found out NOT to mess with Stuart!

The result of monkey perfume :)

Stay tuned for more....

Barrio Clinic - Nov 7

A portion of the team headed to a barrio about 40 minutes from San Juan.  Two dentists, an internist, a nurse and several Dominicans joined the team.  Approximately 140 patients ranging in age from 11 months to 80+ years were seen for primary care needs while the dentists pulled upwards of 40 -50 teeth.

The best part of the barrio clinic was setting up outside under a tree.  The shade and breeze were soothing and we were able to enjoy being a part of all the noise, laughter, and commotion of the community.  The barrio is home to about 200 families so based on patient counts it seems we saw nearly one member of every family living there!  Solid Rock Missions sends medical teams to a barrio only once or twice a year so this was an important visit for the community.

The barrio clinic was a delightful day that even included a visit from a neighboring pig as s/he cooled down in the small drainage creek that ran through our treatment area.  We gave out around 30 pairs of reading glasses - see below for a happy patient still unwilling to remove the sticker listing the correction strength.

A lunch time walk around the community included a view of the local police outpost and trip to the river that serves as the water supply for drinking, bathing, and laundry washing for the community.  No doubt this is the reason we treated so many adults and children for parasites and malnutrition.

The clinic/surgical team started off strong w/ 8 surgeries for the Matt Speyer - all kids w/ tonsils being removed.  Stuart Smith had ortho consults all day preparing for surgeries on Tuesday and Wednesday.  More may appear as word spreads about the team's presence.  We are the last medical team for 2011 and the next team won't arrive until next January.

After dinner tonight most of our team headed off to play in/watch a local baseball game.  We think we won, but no one really cares as the team is a combo of adults and kids and just hanging out is the real goal despite the intense passion of Dominicans for baseball.  Stuart Smith and Jon Alderman were brave enough to join in while the rest of the gang were loyal fans.

We're all tired from our first day of service and know that God is present as we serve in His name.  We pray that we have clothed ourselves with compassion, kindness, humility and patience to enable us to live out the calling for the week.

Benediciones a todos nuestras familias y amigos.  Hasta manana.

Day 1 - November 6, 2011

Wow...words cannot begin to describe the experience here.  I am amazed at how God is already working after only 24 hours here...we were able to worship this morning under a mango tree with the people of San Juan and the presence of God was so real.  We played and spent time with the children after the service - they loved having their pictures made and then looking at them - just like my own kids.  I have great anticipation for what God is going to do this week - I am so humbled and blessed to share in this experience.  blessings, Stacy Walton

First timers!

Hi all, this is Holly and Alison. We are student registered nurse anesthetists from Wake Forest, here in the DR for our first mission trip experience. So far, the countryside is absolutely beautiful, and the locals are so welcoming! We are so excited to have met many great new friends. This morning, we even attended a church service under a mango tree in a nearby village. It was truly rewarding to see! We start in the OR tomorrow, and WOW, we are taking it back to the basics. It will be the best learning experience for us both. Looking forward to the week ahead making so many more memories!

FPC Nashville Team Has Arrived

After 12 hours of airport and bus transport, we have arrived all 26 donations bags in tow plus 13 roller boards and backpacks overflowing the trailer and back rows of the bus.

The team has dined, rec'd their orientation and the crew is waiting to load up the LSU - AL football game.  More tomorrow after church and unpacking.

Peace Out, the best team ever per Doc Holliday