Office of the Vice Provost for International Relations
Columbia and the World

After squatting on a friend’s couch for a week in the Medical Center Towers, I packed my summer clothes into a big black suitcase and flagged down a gypsy cab to Morningside where I met up with a first year medical student and split a yellow cab to JFK airport.  Six or seven hours later, wait time included, I was in Santo Domingo with four first year medical students who spoke Spanish better than I did.  Thanks to a personal gwa-gwa driver, we arrived two and a half hours later to our final destination: Casa Columbia in La Romana, Dominican Republic. A major tourist town with some of the Caribbean’s most beautiful beaches, La Romana is also a center of poverty and is the region with the second highest HIV/AIDS prevalence in the DR at 2% .  I would spend the next ten weeks with Columbia University’s International Family AIDS Program working with an extraordinary team of international doctors and social workers committed to reducing this sobering statistic. 

My activities were varied and required both physical and emotional stamina.  Some days were spent entirely on foot at the IFAP clinic shadowing super doctors like pediatrician and infectious disease specialist Dr. Consuelo Beck-Sague. In just one day, I might do rotations at the local public and private hospitals, visit a brothel house to interview sex workers, or accompany a social worker on a house visit to deliver ARV meds to a rural patient living in the batey where the poorest Dominicans and Haitians work the sugar cane fields. Most days I needed an interpreter to understand the doctor-patient interactions and patient clinical histories.  However, much of my understanding of the health disparities I saw in the DR-- inside and outside the clinic – required merely visual observations as well as a familiarity with Mailman faculty Jo Phelan and Bruce Link’s fundamental social causes of disease theory.   

But my research was not about fundamental causes of disease but rather pediatric adherence to HAART. Given the danger of drug resistant mutation, it is essential that HIV-infected children take their ARV medications as prescribed. In addition to socio-economic barriers to adherence, for kids, it is sometimes all a matter of taste.  Thus, the research topic I explored with my partner was related to taste and pediatric adherence to liquid antiretroviral drugs in the Dominican Republic. 

Before coming to the Mailman School of Public Health at Columbia University where I am concentrating in social science research in the Sociomedical Sciences Department, I spent two and a half years in Niger, West Africa where I helped to manage a USAID-funded food security and nutrition project. Before working in Niger, I assisted in managing several development programs in Francophone West Africa including projects in HIV/AIDS prevention, good governance, and sanitation as a Program Manager for Africare, a D.C.-based private voluntary organization. This past summer in the Dominican Republic was my first time working in the Caribbean. IFAP is administered by former head of pediatrics at Harlem Hospital and bachata lover, Dr. Stephen Nicholas.

USAID. The synergy Project- Dominican Republic Brief: September 2004. Santo Domingo: USAID/Dominican republic