GHOT 2013 Trip Descriptions

Ken Leonard

University of Florida College of Pharmacy

Global Health Outreach Trips Trip Descriptions

2013

The Global Health Outreach Trips of the College of Pharmacy

seek to accomplish 3 missions: To provide pharmaceutical care to communities in resource-limited settings

To bring value to an interdisciplinary team through our expertise in drug formulary, medication

supply logistics and storage, provide medication recommendations to prescribers based on

patient-centered care, and to council patients to get the best medication utilization outcome.

To allow students the opportunity to gain a rich experience in cultural diversity that will shape

their pharmacy practice and careers

How we accomplish this mission: Student-led/Faculty Supervised Health Outreach Trips to resource-limited/culturally unique

settings.

You can think of it as students bring the “service-learning” component and preceptors provide

the “teachable moments”.

Mobilize a great number of pharmacy students while bringing maximal value to the

interdisciplinary team and considering the burden of volunteers on our in-country host

Trip Descriptions for GHOTs 2013

Haiti Lake Azuei: Lake Azuei, Port Au Prince

DR Salud: San Francisco de Macoris, Dominican Republic

DR Help: Jarabacoa, Domincan Republic

Project Audiology: State of Campeche, Mexico

Ayuda Nicaragua: Matagalpa, Nicaragua

Project HEAL: Ecuador, Andes, Amazon

Project Haiti: Fonds Parisien, Haiti

Project Thailand: Chiang Rai & Bangkok, Thailand

Team Honduras: El Porvenir, Honduras

Project Yucatan: Merida, Yucatan Peninsula, Mexico

Haiti Lake Azuei: Lake Azuei, Port Au Prince Estimated Out-of-Pocket Expenses: approximately $800

Estimated Reimbursement: Unknown (new trip)

Fundraisers planned for 2013: Unknown (new trip)

# of Pharmacy students: 6 to 8

# of Medical Students: 3 to 5

# of Doctors

# Pharmacists Two

# Physicians + PA, Residents Two

Trip Description:

Our in-country partner is Caribbean Harvest Foundation which has been for 7 years involved in a

fish-farming operation to help build self-sustainability in the families of the villages. We will hold

medical clinics to serve the seven very remote villages surrounding Lake Azuei, the largest lake

in Haiti with a surface area of 170 square meters and a depth of 25 meters. Since there has

been almost no medical care given to these people, this first visit will concentrate on patient

assessment, primary care, and immunizations along with the establishment of medical records

for use in subsequent visits. Some of the villages are so remote that there are no roads and they

can be reached only by boat. The native language is Creole, although French speakers can do

quite well. Translators will be provided.

Accommodations:

Guest House on the east side of Port Au Prince…facility is secure with A/C and food prepared on

site. Transportation is by vans to the lake region (approximately 45 minutes away).

Recreation:

To be decided (new trip)

Anticipated Leave & Return dates:

Depart March 2, Return March 9

Travel Medicine Considerations:

Routine (MMR, DPT, Polio),

Hepatitis A & B – Verify with Travel Medicine Clinic

Typhoid, Rabies – Verify with Travel Medicine Clinic

DR Salud: San Francisco de Macoris, Dominican Republic Estimated out-of-pocket expense: $430 Estimated reimbursement: $100

Fundraisers planned for 2013: T-shirt, UF tumbler

# of Pharmacy Students: 3

# of Medical/interdisciplinary students: ?

# of Doctors

6 physicians

1 pharmacist

Trip description:

This is a busy interdisciplinary trip in which we see over 300 patients a day

There really isn't a typical clinic day since you are at a completely different clinic site each day. Days run from about 7-8am til anywhere from 3-5pm.

Overall, most of the patients that we saw were children, young women, or older men and women. Most of the younger/middle-aged men work during the day, so we saw some but not many within that age group.

Accomodations

Last year they stayed in a hotel w/ a pool, restaurant, tennis courts, basketball courts, bar and a casino next door. Two people assigned to each room and each person has their own bed. The rooms have air conditioning and hot water. Authentic Dominican food provided by hotel for breakfast and dinner.

No computer lab or public access computer, but there was Wifi available at the hotel. The Wifi, however, was extremely weak signal and very slow. If you were able to connect at all, the connection didn't last.

Spend the week at the same hotel and travel each day to a different clinic site

Recreation

4th year bilingual DR medical students; allows students who do not know Spanish to go on the trip; They show you around town and the last night in the city, they throw a party.

2 nights, all-inclusive Resort stay at the end of the trip!


Leave first Saturday of Spring Break & return the following Saturday

Travel medicine Considerations

Carry DEET insect repellant

DR Help: Jarabacoa, Domincan Republic Estimated Out-of-Pocket Expenses: $500

Estimated Reimbursement: $100

Fundraisers planned for 2013: Green Plantains Dinner, Letter Drive,

social fundraisers

# of Pharmacy students: 4 (3 Spanish-speakers)

# of Medical Students: 25

# of Doctors

1 Pharmacist

9 Physicians (OB/GYN, Peds, Adult Med)

1 Dentist

Trip Description:

DR Help partners with a local doctor who identifies sites around the city of Jarabacoa to set up clinics. The travel time to the site ranges from 15 minutes to about one hour. From Sunday through Thursday, the DR Help team splits into an “urban” group and a “rural” group (both sites are rural). The population at these sites is largely of a low socioeconomic class. On one of the days there is a night clinic in addition to the morning clinic and on Thursday, a half-day of clinic, the group packs up to leave the monastery for a resort. Each day the team loaded the truck and left the monastery around 7:30 AM and arrived at the site to set up. The sites ranged from a person’s home to a school to a church. Upon arrival, pharmacy students find an appropriate (typically shaded, blocked-off) location to set up the medications while waiting for the first patient to arrive. The medical students conducted patient histories and physical exams and then presented to the attending for assessment, plan, and medications. They wrote this on a form which was brought to the pharmacy, which dispensed the medications with appropriate counseling.

Accommodations:

While in the Dominican Republic, we stayed at El Centro Pinar Quemado monastery in Jarabacoa. Each room

had two beds, ceiling fans, outlets, a shower that was mostly cold and occasionally hot, a flushing toilet, and

a sink. Wifi was available in the central area. Breakfast and dinner were provided at the monastery and

lunch was brought out from the monastery to the clinic sites. Most places in the DR accept US dollars.

Recreation:

In Jarabacoa, the group went out to dinner one night, went dancing at a discoteca, and the last two days

were spent at an all-inclusive resort near the capital. There were activities available at the resort, including,

scuba diving, horseback riding, and kayaking. After clinic students would walk to nearby roadside shops and

purchase refreshments. After returning to the monastery, some students organized Frisbee and soccer

games; some went for runs through the area outside the monastery or explored the surrounding area. On a

couple of afternoons, groups went out to the local market to purchase food and souvenirs and experience

the local cuisine.


The total travel time from Gainesville to Jarabacoa is about 15 hours. Therefore, in 2012 we left at 4 AM the

Saturday morning before Spring Break and we arrived back in Gainesville around 1 AM Sunday morning at

the end of spring break.


Students are expected to be up-to-date on HepA, HepB, and Tetanus. Malaria prophylaxis was considered at

the individual student’s discretion but most people chose not to take it.

DR Help: Jarabacoa, Domincan Republic


Estimated Out-of-Pocket Expense: $400 Estimated Reimbursement: $150 Fundraisers planned for 2013: Bar fundraisers, Car wash,

Breakfast, Salsa dancing, Candy Grams # of Pharmacy students: 9 # of Audiology students: 15 # of Doctors 2 Pharm.D’s 1 Physician – anesthesiology 3 Audiologists Trip Description: Last year we saw a total of about 1800 patients. The clinic we worked at was a state-of-the-art children’s

hearing and speech rehabilitation center. There were doctors and nurses available on-site if there were any doubts or questions. We had our own room for the pharmacy with shelves/tables for the drugs as well as a computer with internet for reference. Also, on certain days there will be opportunities to go to surrounding communities of Campeche where you will provide services to patients unable to make it to the main clinic. Since every patient must go through the pharmacy before they leave, we had a lot of opportunities to counsel patients and treat any minor infections. Last year we implemented a diabetes program where we screened for high glucose levels and helped patients set up appropriate follow-up with local physicians. We also screened patients for hypertension and provided counseling for lifestyle modifications.

Accommodations: Hotel, 2 people per room. Hot showers, WIFI, A/C Recreation: From whenever we get to Mexico until Sunday night is recreational time. This year we visited Mayan ruins

and the president of Ayproda threw us a party at her mansion in Merida, Mexico. Every day after clinic you are free to site-see around the city, eat dinner, etc.

Anticipated Leave: Saturday- Saturday Travel Medicine Considerations: Recommended HepA and typhoid. ****Next year, we may be changing locations within the state of Campeche. We may head into the jungle for a

few days in which case a dengue fever vaccination will be recommended.


Ayuda Nicaragua: Matagalpa, Nicaragua Estimated Out-of-Pocket Expenses: $1400


Fundraisers planned for 2013: T-shirt Sales, Professional

Name Tag Sales, Cover Donation at a Club/Bar,

Sweatshirt Sales, Pharmacotherapy Dress Down

Days, Alumni BBQ Sales

# of Pharmacy students: 13


# of Doctors

4 Pharm.D – CVS and VA

4 M.D. – Emergency Medicine

Trip Description:

Every day was spent at a different clinic site in the rural mountain villages. We would leave each morning

around 7 am and get to the village around 7:30 am – 9:00 am depending on where the village was located.

Each clinic day was divided into stations, triage, doctor, central pharmacy and counseling pharmacy. Each

station had 3-4 pharmacy students, the stations were rotated daily so that students would have a chance to

work at each station. Students at triage would determine the patients age, current medications and

complaints as well as blood pressure, temperature and weight. Students at the doctor station would assist

the doctors in examining of the patient and evaluating their chief complaints. Students at counseling

pharmacy would assist the Pharmacist with the medication therapy plan as well as counseling the patient on

how to take their medications. Students at the central pharmacy work as technicians filling the prescriptions

and assisting the Pharmacist. The majority of the patients seen were women and children. Clinic days usually

lasted until 5 pm and were located in schools and churches.

Accommodations:

We stayed at Hotel San Tomas, which is located on top of a mountain that looks over the city of Matagalpa.

The hotel is considered a resort. Each bedroom has enough beds for every individual, showers with hot

water, clean towels every day, and televisions. Breakfast and dinner are served every day at the hotel; there

is also a bar with soda, milkshakes and ice cream that can be purchased. The lobby area has Wi-Fi access.

The hotel is located in a safe neighborhood and morning exercise is possible around the area or in the

basketball court.

Recreation:

The first Sunday we went to a local church and were able to participate in their events for the day, play with

the children afterwards and visit the Nutritional Center located next to the church. We also spent some time

in the city, visiting a local pharmacy, pottery shop, grocery store. The last Saturday we went to Volcan

Masaya, zip-lining, and went shopping at the large local market.


In 2012 we left on the first Saturday of spring break and came back the following Sunday. We left early

Saturday morning from the Orlando Airport and arrived in the afternoon on Sunday.


This past year it was a dry season in Nicaragua during the time we were going to be there so no vaccinations

or malaria preventions were required. Students got Hepatitis A vaccines and malaria prophylaxis

medications if they wanted to.

Ayuda Nicaragua: Matagalpa, Nicaragua

Project HEAL: Ecuador, Andes, Amazon Out-of-pocket Expense: $400 + vaccines (yellow fever) Amount Reimbursed: Depends on fundraising Fundraisers planned for 2013: Selling Ecuadorian goods,

5-K race, letter drive, bake sales # of students: 3 Pharmacy (2 fluent Spanish Speakers), # of Medical Students: 15 Medical, 2 Nursing # of Doctors: 5 US attendings and 3-4 Ecuadorian attendings 1 dentist 1 pharmacist Names and Specialties: Dr. Fernandez – Pharmacy (US) Dr. Wood - Pediatrics (US) Dr. Griffis – Pediatrics (US) Dr. Westenbarger – ER (US) Dr. Leo – ER (US) Dr. Shah – Internal Medicine (US) Dr. Szutz – Dentistry (US) Dr. Masache- OB/GYN (Ecuador) Dr. Tamayo- Pediatrics (Ecuador) Dr. Heredia – Primary care (Ecuador) Trip Description: There are around 5 clinic days, the communities served are rural. Travel to clinic on several days so start out

early (7 AM) and finish around 5 pm (occasionally later). There are different cities visited every year, in 2012 visited Santo Domingo, Pacto Gualea, Cotacachi, and Nono. Students usually pair up with at least 1 other student so that at least 1 can speak Spanish. Pharmacy has its own room to set up medications for dispensing, and every patient receiving medication is counseled on use, side-effects, etc.

Accommodations: Mostly stay in hostels may sometimes stay in houses from the local's in the village at the clinic sites. Recreation: There is usually 1 day set aside for ecotourism, with activities depending on the cities visited (River, Equator,

Volcano, etc.). There is also some downtime in Quito which is very limited! Students must be aware that this trip has the least recreation, there is a lot of traveling after clinic days and we see more that 1000 patients that week

Anticipated Leave & Return Dates: Friday before Spring Break & Sunday last day of spring break Travel medicine Considerations: Students should be up- to-date on vaccinations (HepB and Tetanus) and will need to receive the Yellow-

Fever vaccine. In addition, students may be recommended to receive Malaria prophylaxis and receive additional vaccines (Typhoid, HepA).

Project HEAL: Ecuador, Andes, Amazon

Project Haiti: Fonds Parisien, Haiti Estimated Out-of-Pocket Expenses: $375


Fundraisers planned for 2013: 5K Race, Annual Gala with Club Creole, massage fundraiser, benefits at social spots, sweetwater coffee, and others.

# of Pharmacy students: 3 ( 1 fluent in French, 2 fluent in Creole) # of Medical Students: 20

# of Doctors: 5

1 Pharmacist: Dr. Puentes

4 Physicians

Trip Description:

The first day of the trip, Saturday, we spend getting settled in, learning about the area, and pre-packaging medications. From Sunday through Thursday, we set up clinics in different rural villages from 8am-4pm. The Haitian Mission Christian (HCM) group, whom we stayed with, has a medical site on the compound with surgery rooms, patient rooms, and its own pharmacy which we were permitted to use when we stayed on the site. The medical students triage and prescribe, while the pharmacy students dispense and counsel. We were provided about 6 translators, but having students who spoke the native language was much more beneficial. On occasion, we split the group where some remain on the compound while others go treat patients in villages, orphanages, schools, etc. Friday is our off day, and what we do is up to the group but usually it involves some sort of resort. The following Saturday we head home.

Accommodations:

While in Fonds Parisien, we stayed at the Haitian Christian Mission compound – there were several

bedrooms (they gave us four but there were plenty more) with bedding enough for the whole group. Each

room had its own bathroom and shower with running water (not heated). Each room also had a portable

A/C unit and a fan for comfort. The compound was clean. All meals were provided to us by the compound’s

personal cooks. Breakfast consisted of oatmeal, pancakes, eggs, etc., lunch was mostly peanut butter and

jelly (when we were away from the compound), and dinner included foods such as rice and beans, salad,

chicken, and soups to name a few. Also, we were supplied plenty of bottled water to drink in addition to

sodas and other cold beverages.

There was wifi internet access but it was slow due to the high traffic of people trying to use it at once.

This was the first year we stayed in Haiti and worked with HCM. During previous trips, the accommodations

would vary depending on who the team was able to stay with.

Recreation:

After the clinic day, there were opportunities to hike mountains, visit nearby lakes, visit national monuments

and other touristic like things.

On the last full day of our stay in Haiti, our team went to the Kaliko Beach Resort. There they have a

beautiful pool, their own bar, a beautiful beach, a volleyball net, and an amazing dinner and breakfast buffet

among other things.


Leave: First Saturday of spring break

Return: Following Saturday


Up-to-date on HepA, HepB, and Tetanus. Medications for diarrhea and/ or constipation are recommended.

Everyone is required to have a malaria prophylaxis (doxycycline, quinolone, or malarone).

Project Haiti: Fonds Parisien, Haiti

Project Thailand: Chiang Rai & Bangkok, Thailand Estimated Out-of-Pocket Expenses: $1500


Fundraisers planned for 2013: 5K Race, Golf Tournament,

Vendor Fair, and Letter Drive



# of Doctors

1 Pharm.D – Pediatrics

4 Physicians – 2 E.R., 1 Pediatrics, and 1 Primary Care

Trip Description:

Project Thailand works with the Children’s Rescue Mission in Chiang Rai, a training center for Ahka children. Clinics are set up daily to provide assessment and primary care to the hundreds of children that live at the rescue mission. Clinic days are set up around the children’s school schedule – the little ones are seen typically in the mornings and the older students are seen after school. There is also a day that we go into a village for a full-day and see the children there. Pharmacy students will help set up and organize the pharmacy area in the rescue mission, administering vaccinations, and dispensing medications for the children during the 3-4 clinic days. We also have a team of OMSF students that set up a dental clinic each day to perform extractions.

Accommodations:

While in Chiang Rai, we stay at the Children’s Rescue Mission in a dormitory – a large room with bunk beds

that sleeps most of the pharmacy and medical team, with toilets and showers with hot water. Breakfast,

lunch, and dinner are prepared by the Rescue Mission.

While in Bangkok, we stay at a nice hotel with showers, hot water, A/C. These rooms are shared 2-3 per

room.

Recreation:

In Chiang Rai, our host will arrange for us a day spent taking elephant rides and going to an “all-you-can-eat

buffet”. This is a very special day because we bring a group of about 30 Ahka children with us. Other than

that, we stay at the center the entire week – unless you need to run an errand into town for supplies. At the

end of the road there’s a small shop that you can buy sodas, candy, ice creams.

In Bangkok, there is no set schedule and you are free to explore the city as you wish. Usually groups of

students will go to markets, the shopping malls, get Thai massages, go suit shopping, and sight-seeing at the

Temples. There are taxis, boats, and sky-trains to take you around the city. At night – there are several nice

clubs and sky bars that we go to.


The total travel time from Gainesville to Bangkok is about 36 hours. Therefore, in 2012 we left early Friday

morning before Spring Break and we returned early Monday morning after Spring Break.


Most students receive malaria prophylaxis and bring antibiotics in case of traveler’s diarrhea. You are

expected to be up-to-date on HepA, HepB, and Tetanus.

Project Thailand: Chiang Rai & Bangkok, Thailand

Team Honduras: El Porvenir, Honduras Estimated Out-of-Pocket Expenses: $1200

Estimated Reimbursement: Not available in 2012

Fundraisers planned for 2013: UF COP baseball caps



# of Doctors

2 Pharmacists

1 Physician

Trip Description:

Team Honduras was first initiated in 2012 and works with Missionary Ventures to set up clinics in 5 different

villages. Clinics are set up to provide assessment and primary care to the local people of the village.

Pharmacy students are expected to help set up the different stations, which include: reception, triage,

doctor, wound care, pharmacy, and counseling. Each station has its’ own responsibilities and each student

will be able to rotate through the stations throughout the week. Approximately 900 patients were seen in 5

days.

Accommodations:

While in El Porvenir, we stayed at the Missionary Ventures 2-story house with our hosts, Scott and Susan

Ledford. The student rooms are dorm style with bunk beds. There are 2 girl’s rooms that fit about 8 girls

each and 1 boy’s room that fits 10 boys. Bathrooms are communal with toilets and two showers per room

with cold water. There is one warm shower available on the first story. The hosts provide breakfast, lunch,

and dinner which is included in the trip price. Lunch on clinic days consisted of sandwiches with chips and

cookies. Dinner included an authentic home-cooked meal with dessert the majority of the evenings. There is

no A/C but fans and screened windows sufficed. There is free Wi-Fi in the chapel of the house but no

computers.

Recreation:

The missionary house has a game room with a ping pong table and board games.

Our free day was Saturday after our last clinic day. We took a hike up a mountain, Pico Bonito, to a waterfall.

We also had the choice of going zip lining, however, majority voted for the hike to the waterfall. After the

hike, we went to the nearby city of La Ceiba to eat authentic Honduran food and do some souvenir

shopping.

We are not allowed to leave the missionary house after dark. If we came back from clinic early enough

(before 5) we were allowed to go the beach across the street. We had free time 3 out of the 7 days.


We flew out of Orlando to Miami. The plane ride from Miami to San Pedro Sula airport is 2 hours. From the

San Pedro Sula airport to El Porvenir, there is 3-hour bus ride. We left early Saturday morning before Spring

Break and we returned Sunday afternoon before school resumed.


Most students receive malaria prophylaxis. You are expected to be up-to-date on HepA , HepB, and DTaP

(diphtheria, tetanus, and pertussis).

Team Honduras: El Porvenir, Honduras

Project Yucatan: Merida, Mexico (Yucatan Peninsula) Estimated Out-of-Pocket Expenses: ~$550 (for flight and hotel)

~$200 (for expenses during the week: food/drink, souvenirs, admission to cultural activities)

Estimated Reimbursement: $550 in 2012

Fundraisers planned for 2013: Medical- Tall Paul's, 101 Downtown,

Sharab, Valentine's Day Social, UF COM gear ; Pharmacy- Cuba

Libre, Ice skating, Dress Down Days, Salsa Lessons

# of Pharmacy students: 5 (3 fluent Spanish speakers)

# of Medical Students: (15- 2 1st year, 7 2nd year, 3 3rd year, 3 4th year)

# of Doctors: 3 minimum from US and other MDs from Mexico

Names and Specialties

Dr. Array- internal medicine

Dr. Dominguez- family medicine

Dr. Arrango- pediatrician/infectious disease

Dr. Montoya - Pharmacist

Trip Description:

Project Yucatan primarily works with the underserved Mayan population in Mexico. We travel 1-2 hours each day to serve four different rural villages (Monday-Thursday). We partner with the Universidad Autónoma de Yucatán (UADY) to set up the clinics. We treat anywhere from 100-400 patients each day and mostly treat acute infections and conditions. On a typical day of clinic we leave the hotel at 7am and work in the clinic from ~9am-4pm depending on travel distance and the patient load. The pharmacy team sets up the pharmacy while the medical team sets up the triage area. Each patient is triaged by the medical students, then sent to see an attending physician if it is necessary. Once they are done being seen, they are sent to the pharmacy to have their prescriptions filled. Because we mostly treat acute infections and conditions, this is a good opportunity to review antibiotic treatment and dosing. Many times we have UADY students in the pharmacy helping to fill prescriptions and to counsel patients. The women of the towns make a meal for lunch each day, which we eat after we are done with clinic.

Accommodations:

Hotel del Gobernador in downtown Merida: nice hotel w/ AC, hot running water, pool, restaurant, electricity, free wifi; museums, free cultural events, colonial buildings nearby.

We have a bus that picks us up from the airport and stays with us throughout the week. The same bus drives us to and from clinic each day, and to and from any event we attend so we don’t have to worry about taxis or driving.

Recreation: On the first Saturday and Sunday we have various cultural activities planned, such as visits to the Mayan

ruins, underground caves, and swimming in cenotes. Each night after clinic the UADY students take us out

on the town to restaurants, karaoke bars, bowling etc., and on some evenings you will have time to see the

city beforehand. On the last Friday we have an opportunity for more cultural events, and that night the

UADY students plan a farewell party for us.


We fly out of the Orlando airport the first Saturday of spring break and land in Cancun. We then take a bus

to Merida. We arrive back in Orlando the last Saturday of spring break.


Most students bring antibiotics in case of traveler’s diarrhea. You are expected to be up-to-date on all

routine vaccinations. The CDC recommends Hepatitis A and typhoid vaccinations.

Project Yucatan: Merida, Mexico (Yucatan Peninsula)

Documents

GHOT 2013 Trip Descriptions