The students arrived Nov. 19 for two weeks of on-site training in critical care. This visit was especially significant, as the nurses who participated will be the first UASD graduates in critical care nursing.

"Because they are the UASD's first nursing class to complete a critical care specialty, there were no role models for these students to follow in Santo Domingo," says Dr. Mary Mundinger, dean of the School of Nursing. "It was very important that they come to our facilities to observe."

Adds Dr. Sarah Cook, vice dean, "The students were most interested in the acuity of the care. They were dealing with patients with episodic illnesses or exacerbations of chronic illnesses, and they wanted to observe how we make the move from a community-care focus to a hospital-care focus."

The students came to the United States just one week after the crash of Flight 587, which had been bound for Santo Domingo. When the Columbia community conducted a memorial march just a day after their arrival, all 16 students participated.

"Their presence was a powerful representation," Dr. Cook says. "They were there to mourn, but also to celebrate both their Dominican heritage and their association with Columbia University."

The nursing partnership between Columbia University and the UASD began with the desire to provide a continuity of care for the Dominican residents of northern Manhattan.

"The Dominican community is largely itinerant," Dr. Mundinger says. "Many people may spend part of the year here in the United States and part in the Dominican Republic. What we wanted to do was set up a linkage so that these patients would have a seamless experience between the primary care they were receiving through the practices we set up here and the primary care they were receiving there."

The School of Nursing located a clinic run in part by UASD faculty and students in the Santo Domingo suburb of Haina. The venue was ideal for attempting to replicate the primary care facilities available to Dominicans in Washington Heights.

"With the Haina clinic, we can provide true continuity of care," Dr. Mundinger says. "Care begun in New York can be continued without difficulty in the Dominican Republic."

The association with UASD and the Haina clinic also paved the way for a successful exchange program, led by Dr. Richard Garfield, the Bendixen Professor of International Nursing.

"Dr. Garfield is one of the world's foremost scholars in human rights and conflict resolution," Dr. Mundinger says. "He knows how to protect and advance the health of vulnerable populations."

The exchange is reciprocal; a few years ago, several Columbia students spent a summer in Haina performing a community-based needs assessment, designed to determine what was needed to make the program work.

"With the help of funding from Baxter Pharmaceuticals, which has a large presence in the area and a strong desire to give back to the community, we have been able to make improvements to the clinic in Haina," Dr. Mundinger says. "Professor Garfield put together a proposal and was able to secure the money needed to modernize the quality of health care available at the clinic."

Overall, the impact of the partnership over the past five years has been a positive one. Patients welcome the Columbia professionals who make home visits and notify the practitioners when they move.

"A significant trust has been built. And it's only the beginning," Dr. Mundinger says. "There are many opportunities to use this program to further education and health improvement. We'd like to consider this a permanent partnership between Health Sciences and the country that has given us so many of its citizens."

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