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Published: November 3rd 2008
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Bayaguana Sports Complex
This is where the clinic was held in Monte Plata Province. The Dominican Republic was both interesting and challenging Weather got in the way a couple of times, making it impossible for the helicopters to pick us up from the clinic sites. So we had to ‘Remain Over Night (RON)’. I had this opportunity not once but twice! We stayed in a barracks that is in the Sports Complex where we held the clinic. The local fire truck brought water and filled a cistern at the barracks so there was water. The caveat was that the environmental health people checked the water with their instant color change kit and it was positive for E. coli and other coliforms (from fecal contamination). So I opted to delay a shower until I got back to the ship. We did have plenty of bottled water for drinking and brushing teeth (and I suppose, had I been desperate, I could have created a sponge bath with it). I did have baby wipes with me, a very handy item when traveling overseas. The barracks had metal bunk beds with mattresses, and our first overnight they provided us with plastic garbage bags to wrap around the mattresses. Unfortunately, the second time we didn’t have any, but no one
Inside the Sports Complex
Looking down on the 'clinic' area - far right - patients waiting for optometry and dental, upper right - medical area, center - optometry, upper left - dental area with portable chairs, far left - pharmacy reported any bed bug bites. One of my Project HOPE colleagues lay down on her bed to read in the evening and when she got up her white sheet had a number of tiny black bugs. The entomologist thought they were probably some kind of beetle. I opted to bring a sheet that had a pattern, so if there were little critters sharing it with me, I was blissfully unaware of them. We were also lacking bed nets in a country having an outbreak of dengue fever. This is a viral disease transmitted by mosquitoes (Aedes egyptii) that hang out around human developments and breed in standing water such as in flower pots, etc. There is no treatment for it, and in some cases it is a hemorrhagic form that can lead to death. We had to be careful to apply DEET. Toward the end of the two weeks, they did obtain bed nets for the site, but by that time the weather cooperated and there were no more overnights at that site. Isn't that always the way of things?
Holding clinic at the Sports Complex was interesting. It is a huge complex with a very nice track and
People lined up waiting to be seen
The first in line arrived at 3:00 or 4:00 am and waited for hours soccer field with stadium seating, and a very large building with a large basketball court and open space. Despite the fact there was seating for hundreds, the patients had to stand in line outside waiting to be registered. We had hundreds of people hoping to get optometry services, dental care or medical care. Because of the large numbers, we limited each patient to one service per day, but many returned on subsequent days hoping to receive the other services. Unfortunately, our capacity was far short of the demand for optometry and dental. The optometrist could see 70 or 80 patients a day, the dentist only about 10 and the hygienist about the same (because people had never had their teeth cleaned, each cleaning was a big job). The second time I went I devised a scheme to keep people from cooking out in the sun for 8 hours or more only to find they couldn’t get the service they came for. I numbered the encounter forms, and with a guard, went down the line and handed them out. Those who didn't get a form could then elect either to go home and come back another day, or to stay for
medical services (medical managed to see everyone who came each day). At one point the people started to rush me and the guard had to physically force them back. But ultimately, it resulted in far fewer people having to wait such a long time.
People we saw in the Dominican Republic were generally well-nourished but many suffered from conditions resulting from lack of access to health care. Many young people with dental caries, many older folks with uncontrolled hypertension, even those who were receiving medications (those who could afford to buy them). Many people are of African descent and thus hypertension is a major issue for them and is more difficult to control than in Caucasians or Asians. I diagnosed at least 3 apparent cancers in people who just couldn’t afford to go to the doctor.
One interesting incident at the Sports Complex: at the end of the first day the pharmacist came by, inviting everyone to come look at the tarantula that had been his companion in the sink all day long (see photo - that is my hand next to it). It apparently just sat there all day, moving once from one sink to the other.
My bed in the barracks
Plastic garbage bags on the mattress, with a bedroll on top, and my backpack for a pillow A number of the guys were determined to kill it, but one of the other doctors and I caught it in a box and I carried it outside and set it free in some shrubs. I have since learned that they can jump 8 feet straight up in the air, but this one was not motivated to do much of anything (poor thing was probably starving).
One nice opportunity here was that Project HOPE has a land-based operation in the Dominican Republic. They currently operate two clinics in conjunction with the Order of Malta - one in the provincial capital of Monte Plata, a city by the same name, and another larger clinic in Santo Domingo, in the section called Buenos Aires de Herrera. Although we didn’t get to visit the latter, there was a health fair one day at the Monte Plata clinic. I went with 5 other volunteers from the ship and we saw patients, did education and did some health screening for about 100 people that showed up to see us. It was a treat to work in their lovely facility, and I even got to order a lab test - woo-hoo! The pharmacy was about
The pharmacist's eight-legged friend
For size comparison, my hand next to the tarantula that spent the day in the sink in the pharmacy area as limited as ours with the ship, but we could write a prescription that people could fill at the local pharmacy. It was a very rewarding day (photo attached of our group - with Teresa Narvaez, the Country Director for Project HOPE, along with Ruben, a very active volunteer for them.) They plan to begin construction on a 3rd clinic in November.
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Leo
non-member comment
Very interesting.