The mission of the Medical Partnerships team is to foster collaboration with health centers in Dominica in order to identify and begin to remedy current needs in the healthcare system. To better understand and identify problems with Dominican healthcare, the team has performed extensive research by analyzing assessments and studies conducted by previous groups.Their research has indicated a shortage of trained personnel and resources, and that specialized care is not available anywhere on the island. The healthcare system offers both primary and secondary levels of care. Primary care health centers include fifty-two health clinics that are spread throughout the island and two district hospitals in Marigot and Portsmouth. These primary care facilities provide basic services such as treating common illnesses and non-emergency injuries. This is provided to citizens free of charge and acts as a mediator to limit over-crowding of Princess Margaret Hospital (PMH), the only place that provides secondary care (specialized needs like orthopedics, maternal care, and psychiatry) on the island, located in the capital of Roseau. PMH holds 225 beds and is has only six ambulances that serve a 70,000+ population. Tertiary care services, such as cancer screening and specialized surgeries, are not provided in Dominica and patients are forced to seek care off the island at extremely high personal and government expense.
Dominica also has two medical schools, All Saints Medical University and Ross University School of Medicine; however, students from these medical schools perform clinical rotations in the US and Canada and typically do not return to the Dominican healthcare system afterwards. Thus, the medical schools do little to alleviate the shortage of trained nurses and doctors in Dominica.
The leading cause of death in Dominica is chronic, non-communicable diseases (CNCDs). Additionally, the Caribbean region has the highest incidence of HIV/AIDS in the Americas and the second-highest regional prevalence in the world behind Sub-Saharan Africa. The major problems in the current healthcare system include poor equipment maintenance, low retainment of trained medical personnel, and insufficient record keeping. In many cases, equipment breaks and the necessary personnel and supplies to repair the equipment are not available. Another major issue is poor record keeping practices that make patient documentation difficult to track between clinics and lower the efficiency of healthcare administration.
In addition to research, the team also met with Dr. Delphine Dean, an Associate Professor in the department of Bioengineering at Clemson. She is the head of another Creative Inquiry group that develops medical technology for use in developing countries, specifically Tanzania. She provided the medical group with invaluable advice on how to interact with clinicians in Dominica and the necessity of medical equipment repair to improve primary and secondary care.
In the future, the group will be seeking partnerships with clinics on the island to identify the most feasible areas for improvement with current aid groups and determine an appropriate plan of action to address them. Finally, the Medical Partnerships team plans to complete a written assessment of the healthcare system in Dominica as a guide to future efforts to improve healthcare on the island. We look forward to forming partnerships with local clinicians in Dominica and improving the quality of patient care throughout the island.