I have eaten half my body weight in food. Bread, butter, sour cream, cheese, cheese, cheese, more cheese, and pounds of bacon fat. The food here is so great and comforting that after eating all of that (yes that can be all in one meal) I just nap for hours and get up and do the same thing. So this week my “eating out less” and “moving my body more” plan will begin and I can feel less bloated and less fatigued.
Polenta with cheese, sour cream, and pork fat/bacon
Traditional Romanian platter: cheese, graves (pickles), pork fat, and sausage
Papanash – Romanian dessert made with cheese, fried, and topped with jam and sour cream
I consider Romania my third home-away-from-home. I have only been in two places for long periods of time: Chicago and Iowa. Each place offers warmth, familiarity, and a friendly face. I feel that way about Romania. I thought I would forget places, food, and where everything was, but I didn’t. I still get stares and look of shock when I walk around, but that does not bother me. Living in Iowa, which lacks some ethnic diversity, I am use to being the only in many settings, so being in Romania is no different. I don’t get homesick here, I don’t long for anything because I feel like I have everything I need. Hey, never know! Might end up moving here! Becoming a pharmacist only requires a language and pharmacy exam (sorry mom!).
Our first week of rotations was shadowing pharmacists at the large pharmacy chain Farmacia Ducfarm. Our preceptor, Diana, was trained as a community pharmacist and has vast knowledge about the healthcare system and pharmacy practice in Romania. She works extremely hard to ensure that patients are getting care and that things are done correctly and according to her pharmacy and healthcare law. Unlike independent pharmacies in Romania, she believes that some of the pharmacy laws and policies in the country are not good or do not protect patients. For example, patients do not necessarily need a prescription to receive antibiotics. Some pharmacists have rules that they will not give patients an antimicrobial unless they have a prescription and others do not. Pharmacies are abundant in the city of Cluj, so pharmacists do whatever they can to make money and increase foot traffic in their stores.
Diana walked us around to other Ducfarm stores so we can compare how each one is structured and functions. Since there are 11 pharmacy schools in Romania, and not many jobs for clinical pharmacists, most pharmacists go into retail pharmacy. Because of the high number of pharmacies across the country, many community pharmacies are primarily staffed by pharmacists. We went to a pharmacy that had 14 pharmacists, which is insane! Can you imaging paying 14 pharmacists in a Walgreen in the United States?? You may think it is great that patients have options to pharmacies and there are not gaps in healthcare, but that is not true. If one pharmacy does not provide the patient with what they want, they will just hop next door and ask someone else. Pharmacists do not know what they are taking and do not have access to a medical record or pharmacy record to keep track, despite the fact that they have universal healthcare. Romania is facing the same problems in continuity of care as the US and other countries where an EHR/EMR is not accessible.
Most pharmacies sell cosmetic products. Because of theft, Ducfarm has locked up the cosmetics in all of the locations.
Diana helping a patient
OTC medications along the wall
Lots of baby stuff: food, pacifiers, bottles, diapers, etc.
Herbal or homeopathic therapy is sometimes preferred by patients, especially older patients. There are hundred of teas that fight everything from insomnia to upset stomach.
Eye and nasal medications and more baby stuff
She’s the BEST!
Most of the pharmacies do not have a lot of space, but have tons of medications. Diana says they have so much of everything because if they do not, then patients will go somewhere else. Overall, I was surprise to learn how similar America and Romania are in terms of pharmacy practice, academic curriculum, and basic beliefs of healthcare. I think that pharmacy is a profession that is struggling everywhere and trying to make strides for the profession and for the patient. However, sometimes it is not the top priority of legislators or stakeholders. Working on my smoking cessation project here, I have learned that there is not much data about pharmacy practice, demographics, etc. I find that to be fascinating seeing that there are so many pharmacies in Romania. However, I noticed that, with the pharmacists that I met, that they want change and are eager to make it happen in the country.
And lastly, more Iowa students came this week! They are awesome and I am so excited for them to have this experience. The MHIRT internship changed my life, and I hope it can do the same for them!
From left: Marisa, Michael A, Madalina, Raluca, Nathen, Michael P, & Claire