Santo Domingo.- Clínica Abreu, at the forefront of cutting-edge medical services, is celebrating a noteworthy accomplishment marked by the successful completion of its first-ever robotic surgeries in gynecology. This milestone serves as a testament to the clinic’s commitment to innovation and excellence in healthcare. Heading the team in the realm of robotic surgery is Dr. José D. Eugenio-Colón, a distinguished Dominican gynecologist renowned for his expertise in minimally invasive procedures..

With an annual experience of over 300-350 minimally invasive surgeries, covering diaphragmatic and cardiothoracic procedures, intestinal resections for endometriosis, fibroids, hysteroscopies, and cystoscopies, Dr. Eugenio-Colón has conducted approximately 1600 endometriosis procedures throughout his career. This wealth of experience significantly enhances the services provided by Clínica Abreu.

Utilizing the advanced Da Vinci robotic system, Dr. Eugenio-Colón and his team have achieved surgical precision and control. Robotic gynecological surgery offers numerous advantages, including smaller incisions, reduced infection risk, shorter recovery times, and a substantial decrease in postoperative pain. This technology is particularly valuable in treating complex conditions such as endometriosis, allowing for precise removal of affected tissue while minimizing damage to surrounding organs.

Moreover, robotic surgery has proven instrumental in preserving fertility and minimizing complications in intricate gynecological procedures. By enabling more precise incisions and minimizing tissue damage, the chances of a complete recovery and maintaining healthy reproductive function are heightened.

The incorporation of robotic surgery at Clínica Abreu not only solidifies its status as a healthcare leader and a premier medical tourism destination in the Caribbean but also broadens its service portfolio with cutting-edge technology. This reaffirms the clinic’s commitment to medical excellence.

This withdrawal was made through the General Directorate of Medicines, Food and Health Products (DIGEMAPS), although the type and severity of the damage caused by its consumption were not specified.

Below is the complete note:
#SafetyAlert – Voluntary recall of infant formula product NUTRAMIGEN PREMIUM WITH LGG.

Our Ministry through the General Directorate of Medicines, Food and Health Products (DIGEMAPS), reports the voluntary recall issued by Mead Johnson Nutrition (MJN) of lot ZL3FGL, of the infant formula product Nutramigen Premium with LGG due to possible health risks.

Cases of Covid-19 and other respiratory infections increased considerably, which keeps the population worried. For specialists, the most important thing is to maintain epidemiological surveillance and to activate educational programs to educate the population and empower them in health.

In 2023, the country had several outbreaks of cholera, and the year that began recently, in the Vietnam sector of Los Mina, in Santo Domingo East, the inhabitants of the area reported cases of acute diarrhea suspected of cholera. The health authorities are investigating the possibility of cholera cases in the Vietnam sector of Los Mina.

If the cases are confirmed, an epidemiologic fence will be established, informed the Minister of Health, Dr. Daniel Rivera.

Other problems
According to the first reports of the year 2024, the viruses that cause respiratory infections are very active. Among them is the respiratory syncytial.

Likewise, there is a reactivation of health problems, such as asthma and allergies, due to environmental issues and global warming, says Dr. Clemente Terrero, pediatrician and infectious disease specialist.

Regarding the cases of whooping cough in the adult population, the health authorities remained silent. The Ministry of Public Health called on the population to redouble hygiene measures to avoid increasing diseases, especially viral ones. And to go to the nearest vaccination posts to reinforce their defenses.

The intervention, which improves the quality of life of this locality’s more than 10 thousand inhabitants, responds to the government’s interest in strengthening the infrastructure of the country’s health centers.

Delivering to this community the refurbishment of the Municipal Hospital of Partido satisfies us because we know that it is a work of great value for its progress and development, Peña emphasized.

The vice president specified that the government continues to improve health infrastructures and their working conditions so that each hospital precinct can continue to offer health services in the best conditions to the entire population.

《The reason that moves us to continue doing this work is that we are aware that health and life are the most important things), she added.

Meanwhile, the head of the SNS indicated that with the delivery of this hospital, the revolution of the Dominican healthcare system continues, which is palpable with the increase in the production of services with which it closed in 2023 and the two healthcare facilities delivered in Pedernales this week.

“Luis Abinader’s government is focused on making healthcare more efficient and taking care to communities that are difficult to access,” he said.

Dr. Mario Lama explained that the Municipal Hospital of Partido now has ten inpatient beds, four consulting rooms, one pre-surgical and one post-surgical, an operating room, a delivery room, and three neonatal cribs.

In addition, the X-ray, Sonography, Laboratory, Dental module, Nursing station, Sterilization, Administration, Laundry, Kitchen, Dining Room, Storage, and morgue areas were readapted. The Emergency Room has been expanded to include a Triage, observation cubicles, and restrooms.

The ceremony was attended by the directors of the Regional Health Service of Western Cibao, Ramón Rodríguez; Kenia Santana of the Municipal Hospital of Partido; and the SNS, Alexander Ramírez of Infrastructure Equipment and Deyanira Galán of Nursing Care.

Also, scandals linked to the death of 34 newborns at the San Lorenzo de Los Mina Maternity Hospital, the abduction and subsequent recovery of a newborn baby girl, and the discovery of newborn corpses scattered in a cemetery in Santo Domingo East captured the public’s attention. They caused the country’s maternity centers to be under scrutiny.

At least six epidemiological alerts were issued this year, including one in May and another in November linked to the risk of diseases arising from flooding as a consequence of atmospheric phenomena; two for an increased incidence of respiratory viruses, including one at the end of December for the presence of the new JN-1 variant of COVID-19; others for advanced cases of measles and chikungunya in the region, although the country did not register any of both cases.

Non-communicable diseases

Non-communicable diseases, such as cardiovascular diseases, diabetes, obesity, traffic events, and mental health conditions, continued to increase in the country amidst voices of concern from specialists.

As part of the actions aimed at strengthening prevention and health promotion and encouraging healthy living and thus impacting these indicators, the Minister of Health intensified his strategy of the “Ruta de la Salud: cambia tu estilo de vida” (Health Route: change your lifestyle), which takes medical and educational care to the different provinces of the country.

This year, 2023, 31 of these activities were completed, and 1,400,000,50 people benefited throughout the country, according to information provided by the Minister of Health, Dr. Daniel Rivera, who heads the activities.

The youngest

The Contact Center “Cuidad tu Salud Mental” of the Ministry of Public Health shows the impact of mental health problems in the country and its attention requirements.

Its latest report indicates that of the 6,377 calls received, 67% are from people between 21 and 40 years old who express sadness, anxiety, anguish, insomnia, and anger, among other ailments, including minors, who constitute 10% of those who demand these services.

Of the calls received at the center, which opened last March 16, to date, 60% correspond to sadness, 50% to anxiety, 49% to anguish, 39% to insomnia, 19% to anger, 17% to lack of appetite, 17% constant worry, 16% suicidal ideation and 14% imitation and feelings of guilt.

Medical conflicts

The conflicts between the Dominican Medical Association (CMD), the authorities of the National Social Security System, and the Health Risk Administrators (ARS) remained latent for a good part of the year.

This led the medical profession to exhaust a calendar of marches, work stoppages, and paralyzations of services to several ARSs, demanding changes in the social security system, including increased health coverage for the population and the rates and fees received for services rendered.

The National Social Security Council (CNSS) recently issued a new resolution increasing coverage and fees.

Last December 8, the CMD changed its board of directors, with Dr. Waldo Ariel Suero assuming the presidency of the guild for the sixth time, replacing Dr. Senén Caba.

Cholera and Covid

The year began with an outbreak of cholera, which spread mainly to different sectors of Greater Santo Domingo. In contrast, in the last quarter, another outbreak was registered in Barahona communities. This year, the country introduced its vaccination with the acquisition of 85 thousand vaccines, which have been applied in high-risk populations through a protocol developed for this purpose.

The COVID-19 virus, although still circulating in the country, maintained a low incidence, except for a slight peak in the number of cases registered this year. At the end of December, the circulation of the new highly contagious JN.1 variant was detected in the country, which prompted the Ministry of Public Health to issue a new epidemiological alert for respiratory viruses.

After over two years of issuing daily information bulletins, the health authorities issued the report once a week last March.

Dengue epidemic

The most significant stress to the hospital system was generated by the dengue epidemic, which continued for several months, especially in Greater Santo Domingo, where the high demand for medical attention exceeded the capacity of the leading pediatric hospitals, forcing the National Health Service (SNS) to set up a network of beds in different health centers.

As of mid-December, corresponding to the 50th epidemiological week, the total number of accumulated suspected cases detected by the system is 24,735, with 23 confirmed deaths, for a case fatality rate of 0.1 percent.

Under surveillance

Reports from the Epidemiology Directorate of the Ministry of Public Health indicate that during the first 11 months of 2023, 116 cases of cholera, 19,467 cases of dengue, 215 cases of malaria, 564 cases of leptospirosis; 23 cases of diphtheria; 29 cases of tetanus in non-neonatal ages; 10 cases of pertussis and six cases of meningococcal disease were reported to the system.

In addition to 150 maternal deaths and 2,700 infant deaths. The National Health Service reports an 11% reduction in neonatal mortality this year compared to 2022, following the implementation of the Neonatal Mortality Reduction Acceleration Plan.

New coverage approved

At the end of the year, the National Social Security Council (CNSS) announced the approval of new coverage, including that of outpatient medicines, which increased from 8,000 to 12,000 pesos per year for members of the Family Health Insurance (SFS) of the Contributive Regime.

Resolution No. 581-03 took this decision, including coverage for 70 new procedures, biopsies, and new approaches to reduce surgical complications and hospital stays.

In addition to an increase in the monthly per capita of the Family Health Insurance (SFS) of the Contributory Regime (RC) of RD$128.08 charged to the People’s Health Care Account, from RD$1,555.14 to RD$1,683.22 and a 50% reduction in the co-payment of the SFS of the Contributory Regime for hospitalization services, cesarean sections, surgeries, renal transplants and other high-cost illnesses.

There was a 40% increase in medical fees for procedures, a 50% increase in inpatient consultations, and a 7% increase in diagnostic tests and examination costs. There was also a 15% increase in the use of rooms, equipment, and rooms in clinics and hospitals.

Santo Domingo—Some 99 municipalities in the country reported a decrease in dengue cases this week compared to those reported the previous week, with the surveillance system capturing 983 new cases of the disease, which has maintained a high demand for medical attention in recent months.

Reduction of cases

According to reports from the Epidemiology Department of the Ministry of Public Health, during epidemiological week number 48, 983 new dengue cases were reported, showing a reduction in the last four weeks of registration, when the average number of weekly cases exceeded 1,000 reported.

This year, the country is experiencing a dengue epidemic, generating a demand for attention in the emergency and hospitalization areas of clinics and hospitals, especially in Greater Santo Domingo. Epidemic conditions of dengue are also registered in different counties of the region.

In a document, he expressed that the operations and interventions have impacted 5,670 people, with the application of vaccines, 4,457, kit with liquid and paste chlorine to purify water, placement of oral rehydration serum, and prevention. He said that the laboratory results of the Bahoruco and La Palmita rivers showed positive results for fecal coliforms, E. coli, and pseudomonas but negative for vibrio cholera. “However, we recommend not to consume these waters given the contamination.”

He assures that the health authorities “approach this situation with the utmost seriousness. Our medical teams are on the ground, attending to each case with the objective of providing the appropriate treatment to preserve the lives of patients.”

Dr. Nelson Rodriguez Monegro
Refused to admit
Since Saturday 4, the Ministry of Health has been notified by the Provincial Directorate about the appearance of this outbreak but has insisted that it was amebao or shigelas. The population blamed Inapa for the problem due to carelessness with the collapsed aqueduct.

The doctor had already said.
What is happening is an outbreak of cholera, given that the amoeba and echerichacolis do not have those characteristics, said Nelson Rodriguez Monegro, former director of the National Health Service (SNS), before the report.

“It is worrying and calls attention to the attitude of the authorities, which is apparently their norm, in the face of an epidemic outbreak. At the time, the same thing happened with dengue,” he said.

He recalled that they began by denying the increase in the number of epidemic cases, then that “everything was under control, that the cases are decreasing, and the opposite is true. He warned that these diseases have different characteristics than cholera. He explained that the parasitosis has a fever, gas, abdominal pain, willful desire to evacuate, pain in the hypogastrium, semi-solid evacuations with mucus, and may be accompanied by blood.

People with cholera present vomiting without nausea, abundant watery evacuations similar to rice water, and there is no abdominal pain. They may have muscle cramps due to loss of electrolytes.

“They are different pictures, and the diagnosis is made with laboratory tests. Without a doubt, it is cholera.”

José Iván Encarnación, President of the Dominican Foundation for Integral Development, highlighted the measure taken by the Presidential Commission to support neighborhood development since a fortnight ago, a girl died of the disease in that area.

He thanked the President of the Republic, Luis Abinader, for instructing the director of the Commission for Neighbourhood Development, Rolfi Rojas, to intervene in the neighborhoods of Villa Duarte in alliance with civil society organizations.

“We are carrying out an unprecedented operation in terms of fumigation, cleaning of streets, avenues, alleys and gullies to eliminate the reservoirs where the larvae multiply and then become the mosquito that produces dengue fever,” he said.

He informed that, in addition to dengue, the operation prevents other diseases such as malaria, leptospirosis, chikungunya, and other illnesses that attack marginalized sectors.

In addition to the operation against dengue and other diseases, the Commission for Neighbourhood Development will impact dozens of houses in poor condition in Simonico with the replacement of roof floors paving of alleys, as well as the intervention of the gullies.

Joel La Ho of the Simonico neighborhood council highlighted the workday because it would prevent other children from dying of dengue fever, in addition to the announcement by Rolfi Rojas to start next week in the continuation of the workday with the repair of houses in poor condition.

Some health centers have been forced to suspend elective surgeries due to a lack of beds, the director of a prestigious clinic in Santo Domingo told Hoy. The reality is no different in cities like Santiago and La Vega. People go from place to place looking for a bed in the private sector, and they use primary relationships with doctors, politicians, and journalists to get a bed. In practice, there are none.

One pediatrician has up to 16 patients, another has 10, and this figure is repeated when they are consulted privately.

The private centers that have up to 35% of their beds occupied by patients with dengue are Gynaecology and Obstetrics, Otorhinolaryngology, Abreu Clinic, Plaza de la Salud, Abel González, and the UCE Medical Centre. The Independencia, Alcántara y González, and Rodríguez Santo clinics also have high occupancy rates. In Santiago, Unión Médica, Corominas and the Hospital Metropolitano de Santiago (Homs).

Public centres
The public hospitals with the highest number of patients under 18 admitted with the viral disease transmitted by the bite of the Aedes aegypti are the Robert Reid Cabral and the Hugo Mendoza. Also known as the yellow fever mosquito, Aedes aegypti is a mosquito that can spread dengue fever, chikungunya, Zika fever, Mayaro, and yellow fever viruses, and other disease agents. The mosquito can be recognized by black and white markings on its legs and a marking in the form of a lyre on the upper surface of its thorax.

State hospitals
Data released by Robert Reid Cabral indicates that by mid-afternoon on Friday, 63 children with symptoms of dengue fever were admitted. The hospital reported that it has 13 new patients. Three patients are in intensive care. The emergency room is full of patients with fever and other symptoms.

The Hugo Mendoza Hospital has 60 admissions and one in intensive care. The Hospital General de la Plaza de la Salud has 23 minors admitted; six were waiting for beds in the emergency room.

Other viruses
It is not only dengue impacting the Dominican health system but also respiratory infections.

In that order, the authorities call the population to go to vaccination centers to be immunized against the influenza virus.

Personnel from different institutions participated in the fumigation work, elimination of mosquito breeding sites, and orientation to the citizens to stop the epidemic outbreak of dengue affecting the country in the second stage of interventions at a national level, which will continue this Sunday, informed the Ministry of Public Health.

In addition, the operations included the distribution of water tank lids, chlorine, and educational material to sensitize the population on the importance of keeping their environment clean and preventing the formation of water accumulations that serve as breeding grounds for the mosquito that transmits the disease.

The authorities focused on the sectors that have registered the highest incidence of dengue fever in different provinces of the country, including Santo Domingo, where members of the Military Commission of the Ministry of Public Works (Comipol) disinsected the facilities of the Cristo Redentor National Cemetery, applying larvicide in some 320 tombs and where they eliminated 37 mosquito breeding sites.

According to the latest figures provided by the health authorities, so far this year, 13 deaths have been confirmed due to dengue, and there are almost 14,100 suspected cases of the disease in the country.