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DOMINICAN REPUBLIC Galavanting the Caribbean

April 6, 2018

MARCH 17-24, 2018

So, for those who tried to get in to see me the previous week and were rebuffed, you might have been tempted to ask “where on earth is Dr. Brus when we need him???” Well…I’m glad you asked. Take a brief journey with me…to adventure, tropical warmth, poverty, a loving and kind people, medical missions, and new friendships…

 

Six months ago my daughter, Olivia, and I were deep into planning a medical mission trio to the central Amazon in Brazil when we received an email from the organization called Volunteers In Medical Mission in South Carolina asking for help in their upcoming outreach to the Dominican Republic in March. We considered, prayed, discussed over the issue, and ultimately changed our destination from Brazil to DR. We had both worked with VIMM in the past traveling to Nicaragua and Honduras so knew this was a well run outfit. 

 

On D-day, we flew out from Boise and met the rest of the team at the Atlanta Airport – international terminal where we submitted passports and got cleared through the various security screenings set up for international travel. The team consisted of 38 members, the majority of which were undergrad nursing students and graduate NP students from Clemson University in South Carolina, along with some of their instructors. Several of us were from other parts of the country, Indiana, Idaho, etc, so initially seemed a bit like “outsiders”. This was short lived, however, as the Clemson “family” adopted us quickly as their own. 

 

Saturday and Sunday were spent flying out to DR, getting introduced to the team, orienting to the tasks of the coming week, organizing the medical supplies, and driving 5 hours on two buses into the interior of the island. The warmth was a welcomed change from the freezing temps of this past winter on the mainland. Medical supplies and luggage were squeezed into the back of the busses and the trailer that looked more like a caboose 😉

The trip up was made up of an impromptu “conference” on functional medicine!! Ahahah!! I was pleasantly surprised at the tremendous interest in this type of medicine by not only the nursing instructors but both grads and undergraduate students. As I experience with you folks, my patient families, it is so much more an enjoyment for me when talking with folks who have an interest and knowledge about the subject at hand 😉

 

We were greeted at the compound by our Solid Rock International hosts. The compound is surrounded by a 12’ wall crowned by a spiral of barbed wire. A guard lurks in the shadows 24 X 7. 

Accommodations were relatively comfortable. Fans were in order as there was no AC. Water is not drinkable, even for the locals, due to parasites. It amazes me that a government will not or cannot set up a regional purification system. Toilets were only to be used for liquids and solids, but NOT for paper! If one should be forgetful on this detail, a handy tool was available to remedy the oversight. The septic system is made of 3” rather than 4” pipe.

Electricity was readily available, whether public or private. Frequently there was a 5-10 second loss of power which would then be restored by the automatic powering up of the backup generator. The food was locally grown and scrumptious. Our hosts were those of Solid Rock International who host a team weekly for medical excursions around the country. They provide food and lodging for the teams and keep the compound safe and operational. They are also in the thick of building a massive hospital complex that will provide most of the modern equipment and staff to support a large part of the interior’s population. 

Trauma constitutes a large part of ED and surgery admissions due to the significant use of motorcycles in the country; very dangerous here. We were advised to NEVER ride any motorcycles when offered if we valued our lives! It was not unusual to see 3 or 4 people riding on one cycle, and, at times, within inches of our bus! Due to the price of gas, it is the only way some of these folks get to work in reasonable time. When accidents occur, the scars can be long-standing. This patient sported a granulating burn from a motorcycle wreck from 10 years prior.

The four days of clinic were spent in school auditoriums out in villages ½ hr to >1 hr drive out from the compound. Each AM, bus loading would be reminiscent of an organized mayhem. Roads could be paved or not; those that were not could even present a river crossing 😉 They made us get out of the buses and watched as the drivers had animated discussions as to whether or not we should make the crossing, mostly due to the possibility of dragging the rear frame. In spite of dragging and spinning, we did make it to the village where over 150 kids and parents awaited care. 

Upon setting up medical stations, typically six or eight of them, and the pharmacy, the line would form outside the school building. Except for lunch break of ½ hr or so, we would work until there was no more line. 

We found the older population suffering mostly from hypertension and osteoarthritis. Dr. Scott, the team leader, trained the NP students joint injections of both shoulders and knees.

Generally, our impression was that the children and teens were likely in better overall health than their counterparts in the States!! Of the 675 patients seen in 4 days, we only saw ½ dozen ear infections. There was some smattering of allergy and asthma, but most required treatment for parasites. Each patient received 1 month supply of multivitamins and a single dose of antiparasitic medication. An occasional antibiotic and asthma inhaler was given.

My theory is that the immune strength of the children is stronger due to long breast feeding and relative immune naivete to antibiotics. This is in spite of a very high C/S rate of 60% in the country! When you look at these kids, you could imaging being in Nampa, ID, or Lebanon, MO, or a school in Clemenson…

When walking through the neighborhood around the compound, the kids would swarm and offer hugs, games of tag, and even demonstrate their expertise in hair braiding…These kids LOVED their American visitors. 

Back at clinic, Dr. Scott and I mostly supervised the students in their exams and signing off on notes and prescriptions. Each workstation had an interpreter that worked for Solid Rock International. One strong young man who was used to working as a construction foreman seemed to one of the NP’s as not being able to focus as if not interested in his job.As I got to know him, he bemoaned the fact that his energy level was such that it made it difficult for him to sit still and focus on the task at hand! 😉 He needed to be out and moving about at the construction site, not sitting still inside a building translating! Ahahahaah!!

The medical record was quite user friendly, unlike our systems back home! 😉

Home visits were part of our schedule at each village. These were the most satisfying experiences that we encountered. It allowed us into the lives and hearts of the local people. Life is simple. Walls are mud and brick crowned by metal or thatched roofs. Floors are mostly dirt with some partial concrete slabs that families kept neatly swept. Homes typically had 2 or 3 small rooms separated by curtains or none at all. Common in almost ALL homes, both in the villages and in town was the ubiquitous TV dish! Ahahahah! (faces are blurred to comply with HIPAA requirements)

We were privileged to attend flag raising ceremony at one Christian school build with American money. It was a tear jerker as the kids lined up with mostly good behavior, sang several patriotic songs as three flags were raised, one of which was the US flag!...the US flag…in a foreign country!! The relations with the US is extremely cordial. This is evident all around. These folks were so very gracious to us wherever and however we traveled. 

The last couple days were spend traveling back to Santo Domingo where we were treated in a 5 star hotel to hot showers for the first time in a week and soft pillows and beds! We also had the privilege of visiting the first cathedral build in the New World in the name of Christopher Columbus. Remember, he was the first to land on Hispaniola (present Dominican Republic). The intensity of interaction in a brief time allowed us to forge relationships that will span time and distance. We now consider ourselves officially part of the Clemson and VIMM families. Parting ways from our coworkers as well as these precious people certainly has left holes in all our hearts that will be difficult to fill. If you are looking for ways to spend charity dollars, consider VIMM in your Amazon purchases. 

PS: We were graced by the presence of a retired couple, both retired navy chemists. They put their professional skills to work on behalf of the Dominicans in the north. Several years ago they started a soap making training class as part of the school curriculum for those who have aptitude for business and sales. Their story was totally heartwarming!!

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