Roger Williams University January 2015 Dominican Republic

PH 430: Perspectives in Public Health: Dominican Republic (3 credits)

Winter Intersession, January 2-20, 2015

Dr. Kerri Warren (kwarren@rwu.edu) Associate Professor of Biology

In coordination with The Foundation for International Medical Relief of Children

Restauracion, Dominican Republic www.fimrc.org

DESCRIPTION This faculty-led short-term study abroad course introduces students to public health in the Dominican Republic in the context of Restauracion’s history, people and specific social determinants. The course will explore the infrastructure and delivery of health care and health issues specific to the Dominican Republic, as well as the historical structures of inequity, poverty and marginalization. The community of Restauracion is situated in the second poorest province in the Dominican Republic, just 12 KM from the border with Haiti, with a complex past and present relationship with their Haitian neighbors. There are five clinics in the vicinity that rely on the public health system, but funding is insufficient. Large micro-communities of undocumented citizens of Haitian decent lack any access to health care or preventative education. The foundation for International Medical Relief of Children (FIMRC) operates a clinic and public health support system in Restauracion with a dedication to addressing the needs of the community. FIMRC will provide the infrastructure to our service in Restauracion, and will provide the critical link between our classroom learning and engagement with real world public health.

Learning Objectives: Students will be able to- -Connect historical events to structures affecting health in the Dominican Republic -Participate in Service, and communicate experience in writing -Work together in an interdisciplinary team -Engage with cultural differences, both within the country and between themselves -Demonstrate an understanding of the lived experience in DR -Illustrate the interdisciplinary nature of global public health -Identify social and biological factors related to health and disease in the DR -Describe the organization of the DR’s health systems and its evolution -Apply the public health approach (problem, cause, intervention, implementation) to a new public health problem -Explain how Public health efforts can utilize health information/communication to improve population health -Systematize information collected during service in a written analysis. -Integrate the multi-directional links between health, social and economic factors in the Dominican Republic GRADED MATERIAL Workshop I Assignment ( Travel Ethics and Responsibilities) Workshop II Assignment ( Practical Health Training) Portfolio: Daily Artifact + Journal Entry Photo Essay Critical Reflection, Guided Written analysis of PH Issues Encountered/ Social Determinants Assignment Formal PH proposal (Apply the Public Health Approach to a DR Challenge) Presentation to the Latin American Studies Faculty and Students Evaluation Handout and Study Abroad Survey

SCHEDULE CLASSROOM: 9:00am-12:00pm ( 1/2/15- 1/9/15 ) F,M,T,W,Th,F Additional Session 1/8/15 3:00-5:00pm Jan 2,5 Basics of Public Health in the DR, Student Responsibilities and Ethics Essentials of the Case Study Jan 6 Determinants of Health- Demographics, Society, History, Poverty Jan 7 Public Health Approach and Policy in the Dominican Republic Practical health Training part 1 Jan 8 Current Health Concerns of Restauracion- Biological principles Communicable, Non-communicable, Conditions Risk Factors Malnutrition, Poor Housing, Sanitation Practical Health Training part 2 Supply packing in afternoon Jan 9 Youth Initiatives in Restauracion- Gender Equity, Reproductive Health, Empowerment Leadership Development, Teaching Techniques WEEK IN Restauracion, Dominican Republic (Tentative Itinerary, Winter 2015) Saturday, Jan 10th

Travel Day (Boston to Santiago), FIMRC staff begins the orientation at the ‘hub’, a guest house for Peace Corps Volunteers in Santiago. The volunteers will learn about food safety, regional cuisine, options for clinic work, community work and cultural visits throughout the week. FIMRC Van travel through the mountains to Restauracion and Guest House Assignments.

Sunday Jan 11

8am-4pm Cultural and historical tour of Restauracion, including meetings with the Hospital Staff and Local Government

Lecture on local initiatives with speakers from other NGOs focused on Environmental Health, conservation, forestry and sanitation

7pm Clinic Orientation

Monday Jan 12 9am-12pm Service Learning and tour of the clinic, donation sorting,

community needs assessment, Spanish language skill assessment and group assignments

1pm-4pm Preventative Health activity with elementary school children, community ‘rounds’ with physician

5pm-8pm Dinner and Instruction Tuesday Jan 13

9am-12pm Service and shadowing (Physician in Clinic, Public health Ministry official in community)

1pm-3pm Preventative health discussion with young adults, young parents

3pm-6pm Visit and Tour of Sustainable Model Farm- Behavior, Ecology and Medicinal Agriculture

8pm-9pm Instruction Wednesday Jan 14

9am-12pm Community house calls, data collection or health screening 1pm-3pm Plan health education lessons 3pm-6pm Community visit with health care workers- Cholera prevention 8pm-9pm Instruction

Thursday Jan 15 9am-12pm School Visit- Grade school project. Help coordinate and

collect data on height, weight and general sight ability. 1pm-3pm Deliver seminar/activity on water hygiene and healthy

nutrition practices 3pm-6pm Youth Initiatives- Interaction with leadership groups- Super Man and Wonder Woman 7pm- Dinner and discussion Friday Jan 16 9am-12pm High school lessons- parasite prevention, sexual health 1pm-5pm Clinic Improvement Construction project 6pm - Dinner and Summary Discussion Saturday Jan 17 5am Departure, Travel Day- Reflections and Connections Post Trip Activities Two Meetings will be scheduled for Critical Reflection and Evaluation Portfolio with Formal Public Health Project Proposal Due in February

Learning Outcomes

Assessment Activity [evidence student has achieved outcome]

Learning Activity [what student does to

achieve outcome] Historical learning of the Dominican Republic

class discussion review student journal

class lecture special guest lecturers

Experience and writing

review notes of case study development review student journal

visiting members shadow doctors and PH workers,cultural activities case study prep

Engage in cultural differences, both within the country and between themselves

reflect in writing assignments on issues of gender, ethnicity, class, socio-economic

interaction with community members, home stay families

Demonstrate an understanding of the lived experience in DR

students will incorporate this experience in their travelogue, photoessays and presentation to Latin Amer Studies Group

students will volunteer within the clinic, a school and community project to have an opportunity to talk and share with members

Illustrate the interdisciplinary nature of global public health

Concept map the US/DR contributions of PH disciplines/professions to improving health in DR

Concept map workshop Lecture Video Seminar on Global Public Health

Apply the public health approach (problem, cause, intervention, implementation) to a new public health problem

Presentations of student-identified topics: risk factors, key biological concepts required to address the issue in DR

Case studies practice Volunteer experience and discussions with FIMRC clinic staff and health educators

Explain how Public health efforts can utilize health information/communication to improve population health

Students will host a photo essay exhibit on campus with narratives & will present to the Latin Amer Studies fac and students

Preventative Health presentation experiences with Restauracion community members and discussions with FIMRC health educators

Demonstrate the multi-directional links between health, social and economic factors

Students will present a seminar connecting the experience, reflections and learning & will host a photo essay exhibit on campus with narratives

Volunteer experience with Restauracion community members and discussions with FIMRC clinic staff and health educators

CONTACT HOUR EXPLANATION Pre-Trip Classroom 6 days of 9:00am-12:00 pm, One day of additional 2hr session Total: 20 hrs On site Contact Hrs (related to Course Objectives): Travel days 2 at 3 hrs each, 5 working days at 6 hours minimum Total: 36 hrs Post Trip (Two Sessions) Two meetings on campus upon return at 2 hrs each Total: 4hrs 3 credit Program Contact Hours: 60 REQUIRED READING Paul Farmer (2004), Pathologies of Power: Health, Human Rights, and the New War on the Poor Alan Cambeira (1996), Quisqueya La Bella: The Dominican Republic in Historical and Cultural Perspective (Perspectives on Latin America and the Caribbean) Julia Alvarez (reprint 2010), In the Time of the Butterflies Michele Wucker (2000), Why the Cocks Fight: Dominicans, Haitians, and the Struggle for Hispaniola Margo J. Krasnoff (2013), Building Partnerships in the Americas: A Guide for Global Health Workers SELECTED READINGS- Articles listed on Bridges TRAVEL AND ACCOMMODATIONS: Air Transport: not included in price – Land Transport: FIMRC hired vans (included) Accommodation: Home Stays (Included) Meals: Provided, local cook PRICE: $ 2664 per person Includes tuition, accommodation, all local transportation, cultural activities, most meals. A $500 deposit is required to hold your seat, payable to Roger Williams University. PRICE DOES NOT INCLUDE AIRFARE