Health Horizons International News - June 2012 Farewell to Rachel, Welcome to Perla After a year in the Dominican Republic, our Programs & Operation

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Health Horizons International News - June 2012

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Farewell to Rachel, Welcome to Perla

After a year in the Dominican Republic, our Programs & Operations Manager, Rachel Peterson, completed her term with HHI and returned to the US in June. We wish her the best of luck as she begins a doctoral program in Population & Health at the University of Colorado at Boulder, and thank her for her amazing efforts and contributions to HHI this year.

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Rachel's experience, talent, skill, and dedication resulted in important developments and improvements for HHI. Among many accomplishments, she spearheaded the first formal evaluation of our Chronic Care Program and Community Health Workers Program; coordinated and improved the logistics and operations of our medical service trips; streamlined our financial management procedures; and set high standards of planning and evaluation for program growth. She has left a lasting impact on HHI and our partner communities, and will truly be missed by our staff, volunteers, community health workers, and partners.

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As we say goodbye to Rachel, we are also delighted to welcome Perla Martinez Chance as our Logistics Coordinator. In this new staff position, Perla will be responsible for managing HHI's office and operations in the Dominican Republic, in addition to providing logistical support for our clinical and public health programs. Perla brings several years of experience in office management, accounting, and volunteer support for international service groups, and is currently completing her final year of law school. Her professional experience, knowledge and skills, and local expertise will bring important administrative capacity to Horizontes de Salud, and we are excited to welcome her to our team!

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Launching COPE

To improve the long-term health of our patients and partner communities, at the core of HHI’s mission lies the belief that our efforts must focus on strengthening the local health system. Since our inception, we have trained 19 community health workers in our four partner communities, whom we support year-round in providing individualized patient care and health education in their own communities. As we engage with the existing health system, and discuss the possibilities of expanding our Chronic Care Program, we have also begun building the foundation of partnership with the Puerto Plata Provincial Ministry of Health (MSP) and the Hospital La Maternidad Dolores de La Cruz (“Maternidad”), the public clinic that is the primary point of service for health care in the Montellano area.

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In an important step forward, this summer we are pleased to host a Boston University doctoral student, Myriam Scally, MPH&TM (right). Myriam is working with HHI, MSP, and Maternidad, with the primary aim of increasing the quality of health services provided at Maternidad. Her project is based on a model called COPE (Client-Oriented, Provider-Efficient). The COPE model was developed by Engender Health in 1988, and to date it has been used to improve health services in over 45 countries worldwide. The program is based on empowering healthcare providers to identify the problems they face every day, collaboratively develop solutions to these problems, and implement an action plan to create lasting improvements in quality of care.

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The initial COPE process is implemented over the course of several weeks, during which patient interviews, patient flow analyses, medical record reviews, and staff self-evaluations occur. At the end of implementation, a plan of action will be constructed, and findings and recommendations will be reported to MSP, Maternidad, and HHI. Myriam will be training and working alongside a co-facilitator from Maternidad, Fernando Medina (left), who will then lead an internal COPE committee, with the participation of HHI and MSP, in using the action plan to guide and evaluate progress during the months and years ahead. The action plan will also allow the Ministry of Health to determine if this pilot can be applied to other hospitals in the province.

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In late June, after several weeks of assessing the current state of Maternidad and engaging the commitment of key stakeholders, Myriam led the first COPE meeting. It was attended by all Maternidad personnel, including Director Luis Hiraldo, in addition to the Director of Public Health Programs for the Puerto Plata Provinical Ministry of Health, Dr. Vicente de Peña. After introducing the program, Myriam and Fernando divided all personnel into ten teams, each of whom will complete an evaluation of important quality indicators, including client access to services; personnel access to training and development; continuity of care; client rights to dignity and comfort; safety and infection control; materials, supplies, and infrastructure; and more. According to Dr. de Peña, “This project is an opportunity. It is a chance to use a proven tool to identify areas of improvement, and ensure the investment of Maternidad personnel in creating solutions.” (translated from Spanish).

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We look forward to being involved in this process alongside Maternidad, and thank Myriam for her facilitation and leadership in spearheading the project. For more about Myriam’s experience as a researcher and project manager in the Dominican Republic and other countries, please visit https://bu.digication.com/myriam_scally/Special_Projects.

(At left: back row: Maternidad Director Luis Hiraldo, Myriam Scally, Fernando Medina, and Dr. Vicente de Peña of the Ministry of Public Health; front row: HHI Public Health Director Tracy Kaye, Clinical Programs Director Janelle Bitikofer, Logistics Coordinator Perla Martinez Chance)

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Medical Service Trip Volunteer Opportunity

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Are you passionate about global health and direct patient care? We have two open positions for a pharmacist and an allied health professional to join our upcoming medical service trip, scheduled for September 1st - 8th, 2012. Visit our website for more information about this unique and exciting volunteer opportunity. If you or someone you know is interested, please contact us at info@hhidr.org. We look forward to hearing from you!

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HHI In The News

Quinnipiac University Physician Assistant student Kate O’Connor was featured in the June newsletter of Physician Assistants for Global Health. In a genuine and vivid reflection on her clinical rotation experience with HHI, Kate’s article describes HHI’s mission and programs from an on-the-ground perspective -- check out the link on our website here.

Our Executive Director, Laura, was also featured as a guest author on Everyday Ambassador, a blog dedicated to responsible global citizenship and service, run by World Bank public health consultant, activist, and author Kate Otto. Laura was also interviewed for a spotlight feature on social justice author and teacher Tara Sullivan’s blog.

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Community Health Workers Spotlight

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Nestled in the mountains nearly an hour’s motorcycle ride from the nearest paved road, Arroyo de Leche is, in many ways, an idyllic town. The winding river that gives Arroyo de Leche its name provides residents with water for cooking and cleaning, a place to bathe, and, where it drops down over sandstone walls to form large swimming holes shaded by tall leafy trees, the perfect place to send kids to burn off some extra energy. Arroyo de Leche is quiet and serene. But seclusion comes with many challenges, including the difficulty of accessing medical care. It is here that HHI community health workers Mercedes Sánchez Garcia and Santa Corina Sánchez make an important impact.

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Mercedes and Corina's partnership as cooperadoras de salud exemplifies HHI’s work to increase the accessibility of primary care services in marginalized communities. Mercedes and Corina collaborate closely to put their skills in first-aid and chronic illness management into practice. Mercedes was HHI’s first Community Health Worker in Arroyo de Leche. With her warmth and generosity, it is easy to see why she was recommended by her peers to take on this role. Before joining HHI, she had worked with other nonprofits to distribute vitamins to those most vulnerable to malnutrition, and she has long administered injections, commonly prescribed by Dominican doctors for a variety of maladies. Mercedes completed HHI’s Community Health Workers Training program in June 2010, and after about a year and a half, she was joined by her neighbor Corina, an active mother of five who has embraced her new role with energy and enthusiasm. These women are active practitioners of community-based patient care, who perform monthly home visits to patients enrolled in HHI’s Chronic Care Program, and serve as trusted resources for health education and first-aid to their whole community.

Two of Corina's patients are a pair of elderly sisters, who are both enrolled in HHI's Chronic Care Program for high blood pressure. They are both blind, and spend most of their days sitting inside or enjoying the breeze on their porch. Corina's outgoing personality and sense of humor infuse their day with brightness, and her visits are always a welcome chance to discuss their health, ask questions, and learn about the medications and behavioral factors that affect their hypertension. Her approach to these two women, treating them with respect, dignity, and personalized attention, reflects the values of primary care that our cooperadores program is built on.

HHI is very grateful for the hard work and dedication of Mercedes and Corina, as well as our other sixteen community health workers. For more information about HHI’s Community Health Workers Program, visit our website here.

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On The Horizon

In July, our Dominican Republic office will be moving to a new location on Calle Silencio, Montellano, Puerto Plata. We will also be continuing to prepare for the arrival of HHI's new Executive Director, Paul Guggenheim, at the end of the month. Thank you for your continued support during this exciting time of transition!

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Health Horizons International is committed to improving community health and expanding access to primary health care in partnership with communities affected by poverty in the Dominican Republic.

Thank you for your support and belief in our cause.

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