It has been two weeks since my last post, and I know I said I would be posting on my blog weekly, but I decided not to post last weekend because I wanted to wait until I had photos. I got the photos a few days ago, so here we go!
The HHI team is a mix of American staff who live in the Dominican Republic year-round (like me!), local Dominicans who work with HHI, and American health professionals who travel to the Dominican Republic three times per year to treat patients at week-long operativos (primary care field clinics).
May 7-11 was one of HHI’s tri-annual operativos, and I intentionally arrived in the Dominican Republic a few days before the start of the operativo so I could participate. By Sunday, May 6th everyone on our medical team had arrived from the States, and we met at their hotel in the morning for orientation and to discuss logistics for the upcoming week. On Monday we would set up a field clinic in the town of Negro Melo, on Tuesday in Severete, and on Wednesday and Thursday in the town of Pancho Mateo. On Friday we would do house calls for patients too sick to travel to our field clinics. Planning these tri-annual operativos is a logistical nightmare, but everything went very smoothly all week long. The HHI staff who planned our May operativo did an incredible job.
During the operativo we woke up early each morning to set up our field clinic. Our medical team traveled on large rugged trucks from HHI headquarters in Montellano out into the countryside to the towns we serve. We brought many large boxes filled with medications and supplies, plus enough food and water to get us through the long hot days. When we arrived at our destination we worked as a team to unload the trucks.
Once the trucks were unloaded we set up a pharmacy and hung sheets from the ceiling to divide the interior space into separate consultation rooms. Churches are good venues for field clinics because the interior is spacious and well-ventilated (ideally).
Our patients started lining up outside the field clinics early in the morning, waiting to be seen. During the weeks leading up to the operativo HHI’s community health workers had given out appointment cards to patients who needed to be seen.
My role in the May operativo was to help run the pharmacy and interpret for HHI’s medical providers. In the pharmacy I counted pills, filled prescriptions written by our doctors, and explained to patients how to take their medications. As an interpreter I worked with physicians, physician assistants, a diabetes expert and a mental health nurse practitioner. The first day I interpreted was only my fourth day in the country, and my ears were still adjusting to the unique Dominican accent. I found that I could understand most of our patients very well, but older and less-educated patients spoke with an accent that was too thick for me to understand. I ended up recruiting one of the community health workers to assist me. She would repeat what they said in an accent that was easier for me to understand, and I would interpret that into English for the doctor. Whew!
We saw about 100 patients per day during each of the first four days of the operativo. HHI’s focus is on primary care, so most of our patients were seen for conditions such as diabetes, hypertension and asthma. However, we also treated many patients for intestinal parasites, malnutrition, skin infections and urinary tract infections. On Friday morning we did house calls for patients who were too sick to come to our field clinics. We saw three patients who needed transportation to a hospital to receive immediate medical care, one of whom was very close to death. All three patients are now doing well.
On Friday afternoon I spent some quality time with the HHI medical team on the beach in Cabarete and at their beachfront hotel in Playa Dorada. After a week in the DR I was still feeling pretty homesick, but being among such nice people helped a lot. While at the hotel in Playa Dorada I took advantage of the luxuries not available at my apartment in Montellano: really good food, time on the beach, and a long hot shower.
On Saturday, May 12th the visiting medical team returned to the U.S., and now my job is to help our patients with follow-up care and referrals to specialists. On Tuesday I went on my first motorcycle ride into the countryside, to deliver medications and to network with our community health workers. On Wednesday I accompanied a 96-year-old lady to a consultation with an orthopedic surgeon to discuss the possibility of an amputation for two toes that are necrotic and tremendously painful. On Thursday I spent all day in the public hospital with a 52-year-old man who suffered an ankle fracture when he was hit by a motorcycle. In my next post I will talk more about this aspect of my work here.
None of the stores are open today, and you cannot buy alcohol today. For today Dominicans are voting in their presidential elections. They say tomorrow the streets will be alive with celebrations and protests, regardless of whether the victor is Danilo Medina or Hipólito Mejía.
In my free time I am playing pool with new friends, reading a good medical fiction called Cutting for Stone, and writing essays for my medical school applications.
HHI is doing great things in the Dominican Republic, and it is an honor for me to be here volunteering with them.