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New Medical School Rotation Takes Prof Home

September 28, 2004

Heather Heilman
Phone: (504) 865-5714

hheilman@tulane.edu

Cesar Fermin loves the beauty and heritage of his home. He grieves over its flaws and hopes for its future. He talks about it with a passion that is not unlike that which many native New Orleanians have for their hometown.

ferminBut Fermin isn't from New Orleans. He grew up in poverty in the Dominican Republic during the oppressive regime of Gen. Rafael Trujillo. He was the oldest of 10 children living in a tiny one-room house. Now he's a professor of pathology at Tulane.

He got a lot of help along the way--from his immediate and extended family, from the Sisters of Our Lady of Perpetual Help and from mentors in the Dominican Republic and the United States. That's why he feels a responsibility to give back.

"I try to find ways to bring good things to the Dominican Republic," he said.

In 1996, he helped initiate relationships between Tulane and two medical institutions there--the medical school of the Universidad Tecnologica de Santiago and a cancer institute, the Instituto Oncologico Regional del Cibao.

Since then, Tulane has donated equipment and supplies to the two institutions and has sponsored a molecular biology research program. Now, thanks to Fermin's initiative, Tulane's medical students have the chance to be part of those relationships. The Dominican Republic is one of the sites where fourth-year medical students can elect to do a rotation.

The rotation is sponsored by the Department of Internal Medicine, but students will have the opportunity to work in a variety of different settings during the eight-week rotation, including a week at a pediatric hospital, two weeks in a general hospital, two weeks at the cancer institute, and one week focusing on tropical diseases. They'll have the chance to gain a different perspective on practicing medicine, according to Fermin.

"They'll see how developing countries without big budgets deal with the rising cost of healthcare, and do it very well," he said. "They'll see tropical diseases that they won't see in the United States. And they'll work with a large contingent of terminal cancer patients who are receiving palliative care."

The oncology institute offers cancer diagnosis, treatment and palliative care for the poor. It sees 15,000 patients a year on a budget of only about $60,000. No patient is denied treatment. But because of the lack of resources, their approach to cancer care is much different than what students see in the United States.

The Dominican Republic is in an interesting stage of development. It now has one of the most stable democratic governments in the region, in sharp contrast to neighboring Haiti. It has modern airports and shopping malls and, according to Fermin, "better highways than Louisiana." But there is still a sharp divide between rich and poor. There is little in the way of a middle class.

Haiti and the Dominican Republic share the island of Hispaniola, where Christopher Columbus first landed in the New World. While Haiti has been environmentally devastated, the Dominican Republic retains much of the natural beauty that Columbus first encountered. And much of the colonial architecture is still intact.

Because of such attractions, the Dominican Republic is quickly becoming popular as a tourist destination. But Fermin wants to make sure that Tulane students get a deeper look at the country. The rotation will include excursions throughout the country, to historical landmarks, rural clinics and the Haitian border. He hopes to offer them the opportunity to stay in a private home during their visit.

Tulane medical students can also choose fourth-year rotations in Jamaica, the U.S. Virgin Islands, Belize, Costa Rica, Guatemala, Guyana, India, South Africa, Ecuador, Nigeria or Israel.

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