Global Health beyond Family Medicine Karen WeiRu Lin

Global Health beyond Family Medicine Karen Wei-Ru Lin, MD, MS, FAAFP Assistant Dean, Global Health Rutgers Robert Wood Johnson Medical School New Brunswick, New Jersey Rutgers, The State University of New Jersey

Optional Presentation Title Goal and Objectives • Goal – To explore the sustainability implications of short-term international projects vs. partnerships in DR • Objectives: – – • Identify disease oriented medical missions Discuss chronic diseases management Demonstrate education through school Sustainability through local partnership

Optional Presentation Title Infectious Diseases in Dominican Republic • Hepatitis A – Fecal –oral , person-to-person • Hepatitis B – Exposed to blood and body fluids through medical treatment • Malaria – mosquitos • Rabies – Outdoor, contact dogs, bats, mammals, • Typhoid – Small cities, villages, rural areas

Optional Presentation Title Infectious Diseases without vaccines in DR • Dengue: – virus spreads through mosquito, Urban and residential areas, Vector borne, mosquitos, ticks, flies • Chikungunya: a virus spreads through mosquito bites: fever and joint pain; HA, muscle pain, joint swelling, rash • Cholera: a bacteria causes diarrhea and dehydration, contaminated food or water

Optional Presentation Title WHO Chronic diseases • • • Asthma Cancer Depression Diabetes Epilepsy HIV/AIDS Hypertension Tobacco cessation Tuberculosis

Optional Presentation Title Chronic Diseases in DR • • • 9. 4 million, 5. 7% are aged 65 and older Life expectancy is 71 yo for men, 75 yo for women GDP is $ 9200 per capita, 42% below property line 2011 people were interviewed at own homes HTN, 73%, similar to Americans Anemia 35%, 3 times more common than Americans DM 17. 5%, lower than Americans Depression 13. 8% Dementia 11. 7% Metabolic syndrome: women>> men, 39% lower than Americans

Optional Presentation Title Strategies for Chronic Disease Management • Prevention – Monitoring trends in prevalence, may help to assess the effectiveness and equity of primary and secondary prevention strategies – Identify and targeting the causes and address the health disadvantages • Health inequalities – Poor health of older women – Screening tests by government

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Optional Presentation Title La Romana Province

Optional Presentation Title A Story started with Hurricane • 1998 Hurricane George and Hurricane Mitch swept Caribbean Sea, Honduras, Haiti, Dominican Republic were affected. • La Romana Province – Villa Hermosa (town), thousand of people lived around a garbage dump hill, it was not even a landfill. Houses were built with materials from the dump, collect food from garbage trucks • Free medical clinics – Dentist, physicians, nurses, pharmacists – Medications, vitamins

Optional Presentation Title La Romana Province • La Romana City – capital, 3 rd largest city in DR, 207, 784 population, – Central Romana Corporation, Gulf+Western: sugar, cigar factory – Tourism- beaches, resorts and hotels • Casa de Campo, one of the world's largest resorts and golf destination • The Teeth of the Dog, Diente del Perro, world renowned golf course • Altos de Chavón, a 16 centry mediterranean village amphitheater • Villa Hermosa – Area: 61 square miles (158 sq. km) – population (108, 563) – Density: 1300/sq. mile

Optional Presentation Title Villa Hermosa

Optional Presentation Title How did it start • • 1998: charity and medical clinics 1999, long term assistance is education – built school 2000, recruitment of elementary and middle school 2005, 40 graduates of middle school, 200+ per year, total >1082 graduates • 2010, evening adult school -> 560 graduates • 85 weekend adult high school • the 57 th Session of the Commission on the Status of Women, held by the United Nations in New York on March, 2013. The theme "Elimination and prevention of all forms of violence against women and girls”.

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Optional Presentation Title Graduation cards from youth volunteers in NJ

Optional Presentation Title A volunteer and her son

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Optional Presentation Title Cooperation with local Mr. Santana, former governor of La Romana education department

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Optional Presentation Title Education beyond classrooms respect appreciation

Optional Presentation Title For community • Free clinic: medicine, vitamins, toothpaste and brushes, blankets, clothes • School: backpack, uniform, supplies, books, bus fare to high school in the city • Home visits: rice, corn flour, powdered milk, pasta, daily necessities.

Optional Presentation Title Volunteers • Volunteer health workers from far away – – Communicable and non-communicable illnesses medical and dental professionals, pharmacists, acupuncturists Students medical aid distribution • Local volunteers – – visit patients with chronic illness or disabilities patients with terminal cancer, patient with injured form MVA or accidents mental illness.

Optional Presentation Title Volunteers from NJ, NY, Penn

Optional Presentation Title Free medical clinics

Optional Presentation Title Local volunteers train the trainers ensure efficient care in the resource limited area.

Optional Presentation Title Home visits • • • Serve the community surrounding the Tzu Chi School Patient with bone cancer after amputation Patient who lost one leg after MVA Patient with Paralysis after fall People who Live alone Patient who injured foot with osteomyelitis

Optional Presentation Title Alternative home visits Household goods Bags and books

Optional Presentation Title Impact of Local Volunteer

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Optional Presentation Title Beyond medications and vitamins • • Health education, dental hygiene Infectious disease prevention Mental health: depression, anxiety, domestic violence Family planning

Optional Presentation Title The Power of Education • The school has become the center of the community – – Annual free medical missions Health educations Regular home visits Community activities. • • Education – Improves people’s lives efficiently – Brings health and happiness to the children and their families; – High impact low cost interventions to address the most significant challenges the world faces •

Optional Presentation Title • Only when we witness suffering first-hand will we appreciate our blessings. 
 • Jing Si Aphorism by Dharma Master Cheng Yen