Center For Advanced Practice Nursing Inaugurated In Dominican Republic

NEW YORK, NY, June 23, 2000 - The first health center staffed exclusively by advanced practice nurses officially opened in the Dominican Republic city of Haina, 20 minutes from the capital Santo Domingo. The center is run by the National Autonomous University of Santo Domingo (UASD) Program in Nursing, which is now preparing master's level specialists in maternal-child health. The center uses the same "faculty practice" model -- nursing school faculty in clinical practice in a nursing center -- that was pioneered by the Columbia University School of Nursing in the predominantly Dominican community of northern Manhattan. Developed in collaboration with the PAHO/WHO Collaborating Center for International Nursing Development in Advanced Practice at Columbia, the center is funded with the financial support of the Baxter/Allegiance Foundation. "Baxter saw the needs in this community but was not confident that local institutions could respond to those needs until the Columbia University - National Autonomous University partnership was created," according to Richard Garfield, the Henrik H. Bendixen Clinical Professor of International Nursing and director of the WHO Collaborating Center. The clinic was inaugurated June 1 with a gala celebration, the participation of local authorities, and hundreds of community members. Presentations were given by the mayor of Haina, the clinic director, the head of the university, and the director of its medical and nursing schools, and the directors of the local plant and international foundation established by Baxter Health Care Corporation. Following these speeches, the youth groups established by the nursing center presented dramas and dances they had prepared for the event. Also present at the opening were nursing students from Columbia University. Ten students are at the center to provide primary care services for a period of two months as part of a residency requirement normally carried out in the United States. This integration of the Dominican and American faculties is a higher level of academic coordination than any previous efforts. "Both universities gain from these student and faculty exchanges. And with our patients going back and forth between New York and the Dominican Republic, the primary health care that we provide has to be bi-national as well," said Adalgisa Linares, director of the UASD Program in Nursing. Further collaboration will include teaching visits by directors of the clinical specialty programs of the Columbia University School of Nursing and joint research on environmental contamination and domestic violence in the Dominican Republic and in New York City. A visiting professorship for Latin American nursing faculty and a fall conference on Dominican health issues are being planned. The center began providing consultations in August of 1999. In the last three months, the number of visits has grown three-fold in most areas, including a total of 680 patients in April. The center now has its own transport and computing facilities and has built a playground on the clinic site. This playground, the first in the town of Haina, is so popular among people of all ages that more facilities are now being constructed. The center's director is a member of the national university faculty. A second senior faculty member is now joining the staff to develop a program of community-oriented research. This effort will assist the ministry of health's new focus on primary care and is consistent with the direction of the president-elect, who won on a platform of distributing the benefits of economic growth with health and social services at the community level. The nursing center works with a medical clinic operating under the same roof. Nursing visits have generated a rising level of funds, which have been used to renovate the medical clinic and save it from closing. The nurses and doctors are now collaborating to identify major priorities for Haina. These include further community health organization and health promotion, further construction of latrines and establishment of oral rehydration centers, and the provision of high-quality medical services to the 15 rural settlements in the Haina municipality. Further clinic developments envisioned include provision of an electric generator and equipment to attend births. The center is already in the process of being designated by UNICEF as one of the few "baby-friendly" centers in the Dominican Republic. The presence of students and faculty from Columbia University will assist in further developing the mission and capacity of the nursing center to provide services to poor urban and underserved rural residents.