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Basic health education key in Dominican Republic

EL ABANICOS, Dominican Republic -- The tropical environment here is great for tourists but brings a number of health issues to the local population that foreigners may take for granted or be entirely oblivious of. 

A high prevalence of issues caused by sunlight, insects and the high sugar content of foods combined with a general lack of education and understanding of these issues results in U.S. Air Force medics on a Medical Readiness Training Exercise here treating a large number of patients for afflictions that are otherwise preventable. 

"The long term benefit of education far exceeds that of any medication we can give to them," said 1st. Lt. John A. Vann, a physician assistant from the 42nd Medical Group at Maxwell Air Force Base, Ala., "medications may help their problems for a couple of weeks, but education and insight will last a lifetime." 

Many people only describe general symptoms without any real understanding of what is causing the affliction. In many cases by educating patients on minor changes they can make in their lives, long-term issues can be minimized thereby reducing dependence on medications required to reduce symptoms. 

Overexposure to the intense sun here and minimal use of sun-protection causes harmful effects to both the skin and eyes at a much higher rate than in the United States. 

"It is a matter of them growing up in a culture that is constantly exposed to the sun, they do not understand that any inflammation of their skin's pigmentation can result in a dark blemish," said Lt. Col. Steven E. Ritter, a dermatologist from the 81st Medical Operations Squadron at Keeler Air Force Base, Miss. "For a lot of our patients this is the first time they have heard that the sun can damage their skin." 

The medics here, too, get sunburned through the clouds and from reflected sunlight inside of the rooms of school buildings converted into temporary clinics. For others on the joint U.S. Air Force, Army and Marine team, multiple applications of high SPF sunscreen are no match to even short intervals in direct sunlight. 

Likewise, many of the Dominicans are surprised at the suggestion to wear sunglasses; resultantly, eye problems are a common occurrence. Many patients arrive with pterygiums, a condition where the white part of the eye begins to grow over the cornea and eventually over the pupil, and cataracts, which cause the pupils to appear cloudy. 

"These conditions are somewhat preventable if they would wear sunglasses with UV protection," said Col. Mark. J. Welter, an optometrist from the United Stated Air Force Academy, Colo. "Some people begin to wear sunglasses as they get older, but the wear of UV protection should really begin in childhood." 

Other patients mistakenly describe lower-back muscle pain caused by poor posture and leaning over throughout their workday as kidney pain, quarter-inch diameter scars cover their bodies from incessant scratching of bug bites and numerous teeth are extracted as poor dental hygiene eventually rots them to their core. One patient even attributed his internal ailments to witchcraft and asked for eyeglasses so he could continue to read his bible and make the witchcraft go away. 

Through it all, the medics here continue to work at a feverish pace to treat patients not only for the problem of the day, but also to send them away with knowledge useful in preventing its recurrence and the onset of other preventable ailments as well. 

The team of 45 medics and support personnel treated approximately 4,000 patients during the first four days of medical operations here in the northern region of the Dominican Republic as part of the U.S. SOUTHCOM sponsored Beyond the Horizon 2009 - Caribbean.

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