Among young people, what seems like a game has repercussions for them and future generations that procreate, because poverty also increases, due to the expenses that it implies having children with health complications. Of 7,976 early births, some are fortuitous. However, the specialists in the area are concerned about the harmful substances consumed by adolescents and young people,  as for the lack of checks during pregnancy and malnutrition.

The statistics of the National Health Service (SNS) indicate that of 114,580 births registered in the country last year, 59,207 were of mothers under 24 years, and of these, 23,258 were teenagers, including 859 under 15 years. “The use of substances during pregnancy promotes prematurity, low birth weight, and that the embryo is not developed properly when the woman abuses so much drug, hookah or vape,” said Leandra Cordero Oñate, pediatric pneumologist and nutriologist. The babies suffer many complications when born prematurely or with low weight. In 2022, 9.04% of births presented low weight and 0.3% malformation. Dr. Cordero Oñate sees in consultation an increase in interstitial pathology, pneumonic processes, and secondary fibrosis and attributes it to the abuse of that type of product at an early age. “All these findings are seen in young people, who understand that using Hookah or vape is not smoking, it is quite the opposite,” he said.

Law 16-19 prohibits the use of Hookah in public and private places in the country, but electronic cigarette has no restrictions and is widely used among adolescents. Studies conducted at the Maternal Child Hospital of Los Minas determined that 73% of teenage mothers consumed alcohol during pregnancy and 21% of their babies required attention due to the condition of fetal alcohol spectrum disorder. Among other factors of prematurity and risks of children’s deaths are hypertension (preeclampsia), obesity, diabetes, having a sedentary life, depression, and low schooling. Maternal-infantile hospitals in the Dominican Republic are endowed with units specialized in attention to premature and low-weight babies, with the required drugs and specialized doctors.

Santo Domingo, DR
In the “Great Forum,” a total of 18 speakers and panelists reflected on the approach to the pandemic, with the mistakes and successes experienced by the country, moderated by Eddy Perez Then, director of the Research Center and presidential advisor for COVID-19.

Chanel Rosa, former director of the National Health Service (SNS), in explaining the context in which the virus struck, pointed out that “the worst thing that happened to us was that the pandemic occurred in the middle of an electoral process, because we all become more petty, more denigrating… and this is transversal to the political class of the Dominican Republic, unfortunately, these are things that happen”.

Rosa emphasized that the good things done in both governments and continuity should be recognized. “It was not easy to manage a pandemic for two governments, however, the fact that a new government took office did not prevent us from continuing with public policies and I feel very proud,” he said.

Among the measures taken, he pointed out the declaration of the State of Emergency and social protection, such as the FASE program, as well as the creation of a national commission for the management of Coronavirus; while among the lessons learned, he listed the strengthening of the Provincial Health Directorates, the Collective Health Programs and the training of health professionals.

Mario Lama, current director of the SNS, said, “we learned that the management of this pandemic was dynamic… we were learning along the way, from the patients themselves and from the panorama we had… we did not take from what was happening in other countries.”

He added as a significant achievement that 18 hospitals were available for the treatment of COVID-19 and, as a lesson, that they had to innovate, creating, for example, daily reports to inform the population about how the hospital occupancy was.

Eladio Pérez, Vice-Minister of Collective Health, indicated that “we all became epidemiologists at that time” when dealing with new medical terms and highlighted the work carried out by the General Public Health Laboratory.

Mr. Perez explained that among the strategies for epidemiological management, the operational structure of the National Laboratory was strengthened and took advantage of his presentation to announce the Forcontact Project, an electronic platform that will allow contact tracing for COVID-19, which will later be used for other diseases.

Santo Domingo, DR
The director of the San Lorenzo de Los Mina Maternity and Children’s Hospital, Leonardo Aquino, indicated yesterday that between 90 and 100 children are admitted daily to the center, of which 45% are for “respiratory phenomena.”

While the other pediatric ailments are febrile syndromes (high fevers), acute diarrheal diseases, and other pathologies.

Aquino also stated that the cases of respiratory diseases “have always predominated,” mainly in hospitals, because they are located in areas close to neighborhoods and sectors where there is little awareness of “proper health care.”

He also indicated that fewer patients were admitted with respiratory ailments last year because, in previous years, the vestiges of Covid-19 and its variants were still felt.

She also revealed that the health system is taking “adequate” measures to prevent these diseases through the influenza vaccine, one of the leading “producing agents” of these phenomena. In that order, the person in charge of Pediatric Emergency, Marlene Perez, indicated that most respiratory problems are asthma or acute respiratory infections.

Half of the people consulted in the Pediatric Emergency Department of this hospital, located on San Vicente de Paul Street, Santo Domingo East, pointed out that the patients came for flu-like processes and fever, among whom two had severe congestion.

“She woke up with no strength in her body, with no spirit. She has had the flu and fever for several days,” said a mother with her little girl in the emergency room.

“Since last night she has been coughing a lot with a little cough and congestion. She is already on her third nebulization,” explained another mother named Julissa, who had her six-month-old baby with her.

Like them, other parents accompanied by their children occupied the spaces in the emergency room of this health center, seeking attention for their ailments.

At the Reid Cabral

During the tour made by journalists of this media, at least 15 patients waiting for attention at the Robert Reid Cabral Children’s Hospital were consulted. Two presented flu-like processes and congestion, while two others presented fever.

The others came for routine consultations, vomiting, stomach problems, sore throats, and other ailments that afflicted their children.

In Event Hall A of the Pontificia Universidad Católica Madre y Maestras (Pucmm), the venue of the event, its rector, Presbítero Secilio Espinal, highlighted prior to the invocation the role played by higher education institutions, schools, and colleges in a moment of “uncertainty”, as the one experienced in the Covid-19 pandemic. “Higher Education institutions saw the need to design policies and procedures, as well as organize the different environments for the development of academic, administrative, research, and extension activities with the highest possible quality, preserving physical and emotional health of those involved,” Espinal said.

Secilio Espinal added that a great innovation in the educational field was the implementation of the Flipped Classroom teaching-learning Methodology, aimed at guaranteeing a competency-based approach and meaningful learning, ensuring that the student uses time outside the classroom to learn theory and concepts independently, and time within class sessions to apply, analyze, evaluate, and create knowledge. He also called for a minute of silence for all those who have died from the virus. Immediately afterward, the director of the newspaper Listín Diario, Miguel Franjul, gave some introductory words for reflection in which he reaffirmed the commitment assumed by the authorities and citizens of the nation at that moment of crisis, taking the case of the same medium.

“The Listín Diario sighted what could come here and since February 5 it has focused on this threat. In this forum, it is necessary for the population to know how we accepted it, how we reacted, to what extent we were resilient… which gave rise to the idea of holding this forum last December,” said Franjul. Franjul took advantage of the moment of his address to thank the Minister of Public Health, Dr. Daniel Rivera, for making an appointment and collaborating so that many health specialists and experts could come to explain his ideas; in addition, to the scientists, academics, and authorities who decided to participate. He also paid tribute to the doctors and nurses for their hard work.

Then Dr. Daniel Rivera, in his opening remarks, stated that the Dominican Republic has been a benchmark for management in all areas of the COVID-19 pandemic for other countries, a feat that has even been recognized internationally. At least five exhibitors and 11 panelists will present the experiences and actions adopted by the country in the face of the pandemic. The first speakers will be Dr. Mario Lama and Chanel Rosa, director, and deputy director of the National Health Service (SNS), respectively, under the moderation of Eddy Pérez Then, director of the Research Center and presidential adviser for COVID-19.

The information was offered by the director of Risks and Disasters of the Ministry of Public Health, Gina Estrella. Estrella indicated that there are no new reports of patients infected with this bacterial disease, with the total number of cases detected since the beginning of the outbreak in October 2022 remaining at 91.

The director of Immunopreventable by Vaccines, Luchy Vargas, said that a total of 36,784 people have already been vaccinated against cholera in the country.

Santo Domingo, DR.
The Dominican Republic continues with low records of coronavirus cases, a disease that has caused 4,384 deaths and 660,814 affected in three years.

The General Directorate of Epidemiology of the Ministry of Public Health notified 14 new cases of covid-19 after processing 935 samples, of which 249 were PCR and 686 were antigenic.

Bulletin #1079 indicates that the daily positivity stands at 2.29 % and that there are now only 53 active cases.

Regarding hospitalizations, no persons are in Covid beds or Intensive Care Units.

Lessons from Covid

On March 1, 2020, the first case of Covid-19 was diagnosed in the country, and for three years, it has been fighting against the disease.

To know the experience, Listín Diario will gather four speakers and 12 panelists who have played essential roles in the fight against Covid-19 to expose the experiences and actions adopted by the country in front of the pandemic during the National Forum Covid-19, which will take place next Friday, March 10.

The activity, organized by Listín Diario together with the Pontificia Universidad Católica Madre y Maestra (PUCMM) and the Ministry of Public Health, is aimed at presenting the experiences of the work carried out in the management of the Covid-19 pandemic to see the lessons learned and the strengths left to the health system, three years after the diagnosis of the first imported case in the Dominican Republic.

The forum, which will have three large panels, will include the participation of the Minister of Public Health, Daniel Rivera, who will speak on the Management of the Public, Private, and Citizen Alliance, and Mr. Chanel Rosa Chupany, who headed the SNS, among others.

It should be noted that the latest variant of covid’s severity has lessened substantially, with mild symptoms and no hospitalizations. Also, the natural immunity produced by an infection prevents further contraction or spread of the virus.

To avoid situations like the one that occurred a decade ago when hundreds of thousands of Dominicans contracted chikungunya, the doctor understands that it is necessary to protect oneself from the bite of the Aedes aegypti.
The also director of the Robert Reid Cabral hospital warned that chikungunya could cause lesions in different body organs, such as the heart and kidneys. By way of example, he cited meningoencephalitis, myocarditis, and pericarditis, among others.

Greater danger

Children and adolescents could be at greater risk should chikungunya spread in the country as it did in 2014.
The Dominican Republic has been under epidemiological alert since the World Health Organization spoke of the presence of the disease in The Americas.

Mosquito control Authorities advise eliminating standing water where mosquitoes could lay their eggs.

Once a week, empty, scrub, turn over, cover, or throw away any items that accumulate water, such as tires, buckets, flower pots, toys, swimming pools, birdbaths, flower pot dishes, and garbage containers.
Mosquitoes lay their eggs near water.

Protecting yourself from mosquitoes

The U.S. Centers for Disease Control and Prevention (CDC) recommends controlling mosquitoes inside and outside your home. These include using window and door screens; using air conditioning if one is available; sleeping under mosquito netting if rooms don’t have air conditioning or screens on doors and windows, or if you sleep outside.

“Once a week, empty, scrub, turn over, cover or throw away any items that collect water such as tires, buckets, flower pots, toys, swimming pools, birdbaths, planter dishes and garbage containers. Check inside and outside your home. Mosquitoes lay their eggs near water.”

For children and infants, CDC recommends protecting infants and children from mosquito bites and dressing in clothing that covers the arms and legs. “When using insect repellent on children: Always follow directions when applying insect repellent to children.

Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under three years of age.”

It also urges not to apply insect repellent to children’s hands and eyes or cut or irritated skin.

Although the behavior of these diseases cannot be viewed on the Epidemiology Directorate website, because it is outdated, one death from leptospirosis and six reports have already been observed in just one week, the first in 2023. Although the numbers are not available to make comparisons of the behavior of dengue, as of the first week of this year, 70 cases of dengue had been reported, a viral disease that requires epidemiological surveillance and that greatly affects children under 15 years of age.

For the same period last year, 68 cases had been reported. No deaths had been reported as of this date. Hospitals such as Robert Reid Cabral and Hugo Mendoza report a low amount of patients. However, the disease is a latent threat and community collaboration is required to prevent it.

Pérez explained that the alert is issued in a preventive mode, since, in countries of the Southern Cone, such as Brazil and Paraguay, there has been an exponential increase in affected patients.

In this context, the director of Epidemiology, Ronald Skewes, indicated that by the year 2021, in the region of the Americas, 137,000 cases of chikungunya were recorded; 271 thousand cases in 2022, and 30,707 cases during the first four weeks of 2023, marking a pattern of accelerated growth. “That it arrives in the country is a matter of time,” highlighted the doctor.

Swekes indicated that the term “chikungunya” means “The bent man”, alluding to the severe pain that this disease produces throughout the body, making it difficult to walk upright and whose conditions can persist for long months. Other symptoms are fever, rash, and general malaise.

In less than 15 years, the country has gone from less than 25% of its people being overweight to more than 70%, according to the latest survey carried out by the Health authorities in 2021, and that, without the rigor of a scientific study, serves as an indicator of the need to act against a problem that is worsening and causes diabetes and hypertension. 

“31% of schoolchildren are overweight. In less than 15 years, the country has gone from less than 25% of people overweight to more than 70%.” With the causes documented in more than one report and much more consequences, even the economic cost of being overweight has been analyzed, the country has to apply measures so that the balance begins to decline.

But the recommended actions have not yet materialized and the Dominican Republic experiencing the failure of the goals set, despite the millionaire burden that being overweight implies for the State. Controlling overweight will require national policies that go beyond training and information. One first step could be to tax sugary drinks in the country.