Memoir of a medical mission pharmacist

Transitions New Practitioner Spotlight By By Mohamed Jalloh, PharmD

As I stood in the security line at JFK Airport in New York City, my heart was racing and I felt hotter and sweatier with every second. I could tolerate the heat because the majority of it was radiating from my body. I was so excited that I was going to participate in a medical mission trip in the Dominican Republic this past summer.

This was my first medical mission. I spent months in Spain learning the richness of the Spanish language, but I mostly used it to order food or talk to people at the local market. This time I was going to use my Spanish for a different purpose—to serve patients who do not have consistent medical resources for themselves.

Handling barriers as a team
When I arrived in the Dominican Republic last summer, I met the other student pharmacists and professionals who were going to be a part of this exciting journey. We were all a part of the Creighton University International Latin America Center, which is devoted to serving patients in the Latin America countries in various clinic settings. There were several clinics located throughout the Dominican Republic and a “team” of health care providers and students were assigned to volunteer at each of them. The team included physicians, nurses, dentists, and pharmacists who would oversee/supervise their respective students. This team-based model allowed us pharmacists to feel truly valued on the health care team.

Pharmacists and student pharmacists were tasked with establishing a pharmacy in a remote location. During our pharmacy set up, we had to bring the pharmacy “up to code.” We had to convert a rural classroom to a working pharmacy within the next 24 hours of arriving at the clinic. Here we did not list medications by alphabetical order like in traditional community pharmacies. Instead, we separated the medications by “use.” This made it very easy to make therapeutic recommendations based upon the physician or nurse practitioner’s evaluations.

Although this felt empowering (making recommendations for medication management) there was one catch—our pharmacy supply was limited to random medication donations. Therefore, we had a random assortment of medications and limited medical tools to manage the pharmacy. For example, we had a vast amount of cloxacillin, cefoxitin, and cimetidine—medications that always raise a young pharmacy resident’s eyebrow. While many claim that pharmacists are not very creative or have that “Type A” personality, let’s say that we completely eliminated that stereotype during our medical mission trip and used medications that were therapeutically appropriate but not commonly used.

Finally, we were tasked with dispensing and counseling patients about their medications in Spanish. We had translators to work with us, but many times we had to rely on our own Rosetta Stone Spanish skills to communicate with the locals. Some words were easy to translate or speak about (e.g. diabetes). Other Spanish words were false cognates (e.g. embarrazado) and may have made some patients chuckle when all of us struggled.

Although all of these tasks seemed overwhelming in a very limited location, we worked with the all of the other health care teams to compensate and help each other when the rush of patients became unbearable.

It takes a family
During our time in the Dominican Republic, we were bombarded with patients throughout the various villages. Moreover, of course, the pharmacy was the place to be. When patients came, they also brought their family members, especially kids or grandkids.

The kids definitely brought energy into the pharmacy. Many times, after counseling a mother about the importance of taking prenatal vitamins, I would play “caballo” or “horse” with the kids. This is where I not only served as the pharmacist but as the “caballo” that drove the excitement of the kids.

Also, when I would make a recommendation to the patient, one of their family members would be there to act as my “enforcer” and make sure that their loved one adhered to our recommendations. The patient would never get defensive. Instead, they would feel so loved and welcomed that all of us cared for him/her to make sure that he/she was healthy. In some cases, I would counsel a patient in conjunction with other health care providers and we would provide a synergistic type of counseling session—complementing and/or improving each other’s recommendations, especially the Spanish recommendation translations. Here, two teams would work with each other and not compete for superiority.

This was the common theme that I learned while volunteering at the clinic—it takes a family to make someone healthy. Whether it is a family of healthcare providers or family of aunts or uncles, families allow patients to address their healthcare problems with full support.

The gift of friendship
As I left my new family of health care providers and patients and returned to the United States, I realized that I received so many intangible gifts from this trip. I originally thought that I was going to solely serve and not receive anything in return. However, I kept receiving the gifts of friendship and support from each family member and health care provider I met. My life has forever changed after this medical mission and I created bonds that will withstand the distance between us.

For in-depth excerpts from my trip, please follow my Instagram or Twitter accounts at @drmohamedrx. If you are a licensed pharmacist and want to consider volunteering, feel free to contact the Creighton University Institute for Latin American Concern at (402) 280-3179.