Northwestern University Feinberg School of Medicine

Program in Public Health

Northwestern global health researcher helps Dominican Republic advance HIV care

Dr. Ramona Bhatia speaks with Clinica de Familia La Romana director Dr. Leonel Lerebours Nadal about the HIV care curriculum. (Photo courtesy of Brendan Walsh)

As of 2012, roughly 45,000 people in the Dominican Republic are said to be infected with HIV, according to the UNAIDS Global Report.

In the same report, the Dominican Republic is listed to have “few” health facilities that provide HIV services integrated with other health services, leaving many in rural areas unable to have access to treatment centers and information about their conditions.

Dr. Ramona Bhatia, an infectious diseases physician and clinical research associate at Northwestern’s Feinberg School of Medicine Center for Global Health, returned from her third trip to the Caribbean island in early March. Each trip she makes, Bhatia spends a few days at the Clínica de Familia in La Romana, a small region on the southeast corner of the island.

Guaymate, a rural town just outside of La Romana, is one of Northwestern’s Access to Health Project sites. The project was created by the Northwestern Law School and the Center for Global Health to combine health and human rights studies. The Clínica works closely with Guaymate as part of their community outreach.

“The Clínica reached out to us because they wanted to continue to integrate HIV [care] into their primary care,” Bhatia said. “They wanted to make sure the HIV care they were giving to their patients was as up-to-date as possible.”

Supported by the Global Health Initiative through faculty physicians at the Chicago Lake Shore Medical
Associates, Bhatia’s project with the clinic is to assess its needs as a healthcare center in order to improve patient care. From her first couple visits to La Romana, she spoke with the healthcare providers to pinpoint these specific needs. Aside from new equipment, what the clinic really lacked was guideline-driven HIV-care education for its primary care providers due to the lack of HIV-specialists, she said.

Along with her team, Bhatia created a curriculum that was specifically tailored to the providers at the Clínica. The curriculum, taught in Spanish, is a pilot program that provides healthcare personnel with comprehensive HIV care training, basic science fundamentals, and how to provide the best HIV treatment practices per patient. The next step, she said, is to speak with public officials in the region to scale up

Derrick Lewis, clinic volunteer coordinator, completing his evaluation of the HIV course. (Photo courtesy of Brendan Walsh)

the program to teach other trainers and expand the curriculum to other similar areas.

“I would say their educational needs are definitely substantial based on what they told me,” Bhatia said. “There’s always room for knowledge improvement.”

Especially in a technological age when the Internet can be quickly accessed for frequently updated information, she said, outreach and education is strongly emphasized in places like La Romana, where Internet may not be readily available.

As for equipment, Bhatia said the clinic is set to receive a defibrillator and a centrifuge – things she said we take for granted here in America.

Those, along with other needed medical equipment and supplies were shipped out in January and once they have been cleared by customs, they will be delivered to the clinic later this summer, she said.

To Bhatia, this project is about integrating HIV primary care into resource limited settings and attempting to alleviate health disparities for vulnerable HIV patients, she said. She is looking to schedule her return to La Romana this summer.

“I think they truly do have their patients’ best interest at heart,” Bhatia said. “They’re really good people; they have good intentions. That is really one thing that distinguishes this clinic and community from perhaps other sites.”