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.

Santo Domingo, DR.
The National Health Service (SNS) clarified yesterday that the Padre Billini Teaching Hospital, handed over in the middle of last year by President Luis Abinader, is functioning at full capacity, with its areas and services available to citizens who come to the health center in search of health care.

As announced in a press release last week, the Intensive Care Unit, Operating Theatres, and Admission areas, which completed 100 percent of the iconic hospital’s services, were enabled the previous week.

It is recalled that the modern dental area of Padre Billini was put into service in January. It has two dental units, two periapical X-rays, a sterilizer, and a panoramic X-ray.

The portfolio of services of the health center, available to the public, includes Emergency, Outpatient, Laboratory, Imaging, Haemodialysis Unit, Blood Bank, Pharmacy, Tuberculosis Unit, Nutrition, Pathology, Endoscopy, High-Cost Programme (Rheumatology and Haematology) and Liver Programme. From its inauguration in August 2022 to January 2023, the Padre Billini Hospital has offered 101,174 services, such as emergencies, imaging, and laboratories.

Villa Hermosa

The SNS reported that the Villa Hermosa Hospital in La Romana has the necessary staff and equipment to offer services.

As announced during the inauguration, work is based on a schedule for opening services that begins on 13 March with outpatient consultations (six clinics), laboratory, imaging (ultrasound and X-rays), and dentistry.

On 3 April, the emergency room will come into service; on 17 April, the in-patient ward and the intensive care unit, while on 1 May, the operating theatres will be ready for use, leaving the commissioning process at 100%, just two months after its handover.

During the handover, which took place on the 24th of this month, the SNS announced that the health center has now entered the qualification stage by the Ministry of Public Hea. In this protocol phase, each process is supervised to qualify it and affiliate it to the various Health Risk Administrators (ARS) and thus guarantee the hospital’s and its structure’s sustainability.

The SNS is working on training staff in the proper handling of the advanced equipment available at the facility, and this induction began once the equipment was installed.

The National Health Service reported that as soon as other health centers intervened under the Ministry of Housing and Building (MIVED) management delivered, the commissioning process will begin, which is continuously published during inaugurations.

In recent years there has been an improvement in the application of diagnostic techniques and the use of precision medicine to enhace the efficiency of treatments and patient care and the best strategy in the fight against cancer is multi-disciplinary management: prevention controls, early detection, and equal access.

The topic was exposed by patients and oncology specialists during the discussion “Comprehensive Vision and Cancer Challenges in the Dominican Republic”, held at the Santo Domingo Technological Institute (INTEC). The president of Fundación Un Amigo Como Tú, Juan Manuel Pérez, shared his experience as a survivor of non-Hodgkin Lymphoma. He said that these limitations are compounded by the emotional impact of receiving the diagnosis and the lack of information about the causes of the disease.

He added that cancer patients face late diagnoses and insufficient coverage for drugs and services. In turn, Dr. Mariel Pacheco del Castillo, pathologist and master’s degree in Molecular Oncology, said that today the objective of cancer treatment must be to restore a state of complete physical, mental, and social well-being in patients and not only eradicate the tumor burden.

S.M.L., who supports himself by selling bottles of water and soft drinks in the vicinity of Parque Enriquillo, assured that since last Friday the 17th he has suffered constant diarrhea, although he has not undergone laboratory tests to identify its origin. His neighbors, a family of three made up of a grandfather, his daughter, and his adolescent grandson were on their way to the Félix María Goico Hospital at the time for the same reason: acute diarrhea for several days.

In Villa Francisca, they receive two types of water in the pipeline, one fresh and the other brackish. “Today fresh water came to the tap,” said the lady. Upon noticing the presence of reporters in the area, Ana, another community member, commented that some people do not have bathrooms in their homes, and they throw fecal matter and garbage out into the open, contaminating the environment. The fetid smell corroborated the affirmations of the young mother, who asserted that she could not open the windows to ventilate her home.

A few meters away was Cirilo, a vendor of yaniqueques and boiled eggs, who assured that he had adopted very hygienic-sanitary measures, although “sales are not very good.” “Very clean hands,” he said as he showed them as a sign that they were clean. “Look at the showcase, not a fly gets in there,” he added.

Rivera indicated that only through the Directorate of Access to High-Cost Medications, some RD$9 billion have been made available annually to benefit around 15,000 patients with chronic diseases, which in two years adds up to more than 18 billion in that area. While an amount of RD $5,126,266,797 have been invested in infrastructure (construction, reconstruction, and equipment of 179 health centers).

Likewise, he highlighted the investment of more than RD$3 billion in the budget increase of the Essential Medicines and Central Logistics Support program (Promese/Cal), which went from RD$1,568 million in 2022 to RD$3 billion in 2023.

Deep leaks in the walls, areas infested with humidity, and meeting rooms without tables or chairs. Bathrooms with pipes about to collapse, among other problems that the building presents.

It is thought that a building of more than 50 years of construction drags the absence of maintenance as governments usually do. If that is true, so is the lack of funds that would be affecting the Directorate of Medical Emergencies, where, despite the fact that retired General Juan Manuel Méndez was appointed in June 2022, the administration does not start because the funds destined for the management are not arriving, nor has the general’s work team been approved: administration, human resources the spinal cord of the control and the employees who were appointed to it have still not been paid in seven months.

The teams of doctors and paramedics that provide emergency medical care services, which are reported through 9-1-1, are even worse off.