We arrive in the evening in Barahona after a five-hour bus ride from Santo Domingo. We are a mixed mission group here to help for a week. I have never been outside North America and coming to the Dominican Republic is both a culture shock and an awakening. The bus drops us at the bottom of a rising dirt road. A truck is waiting for us and we climb into the back and hang onto the rails and overhead bars as we drive upwards toward a house. We pass through a village of, what at first looks like lean-to, shacks. Some are wood and some are cinderblock—all look in need of repair. There is no grass. The earth is pale and dry except for the runoff from spills into the roadway. These homes have no plumbing and no electricity. Some have cement floors and some just dirt floors. The children come out to yell and wave as we go by, some of the grownups do to. The tiny children are naked. There are dogs, skinny dogs, lying in hollows here and there. They do not bark or wag their tails at the children’s activity.
We are staying at the Grace and Peace Mission run by Karen and Bill Rumple. Our housing is more than adequate. We are warned not to eat or drink outside the compound. We are not to even brush our teeth with the water. Bottled water is available and it is important to stay hydrated in such a hot climate. There are 20 of us ranging in age from teens to late 60’s. Standing on the stairs looking toward the ocean we can see first the beautiful palms and flowering bushes with a variety of color, then the blue of the Caribbean Ocean, and lastly the endless mountains. The house is in a walled compound with locked gates and guards and five Rottweilers in the yard. Looking down from those stairs I can see the living conditions of the people who waved to us when we arrived.
The medical group is from MCI Concord: the medical director Dr. Ruze, nurses Nancy, Julie, Laura, Jen, Sam and myself, and mental health worker Angela. Also with us is Dr. Jenkins, a pediatrician, and his nurse Nancy from Concord Hillside Medical Assoc. The “Fun Team” is comprised of Nancy’s daughter Tracy and her friend Julie, Nancy’s friend Joann, her daughter Regan and Regan’s friend Matty and Nellie, a teenager who goes to Dr. Ruze’s church. Also on the Team are Dr. Ruze’s husband, daughter Nicole, and son Paul. Nancy’s husband Dave is a helper to everyone and took pictures of all events and situations.
The first day is spent preparing for the four clinic days to come. We are eager for information that will help us to be useful. We don’t speak Spanish or Creole—the two languages of the Dominican Republic and Haiti. We learn we will be provided interpreters when needed.
We are giving out what is called a “family pack”—vitamins, Tylenol, and a treatment for intestinal parasites. The complaint of abdominal pain is common because living with a dirt floor allows infection from parasites. We are also dispensing a “child pack”—vitamins, and treatment for parasites. If we have an infant the medicine would be specific to the need and for a condition like scabies, or fungus or temp, and we would ask Dr Jenkins to OK the treatment.
In the evening we walk through the village just below the mission house. The children are excited when we use cameras and they want to see themselves. They are beautiful and cheerful. They look surprisingly healthy. There is no sound of TV or radio as we walk. We don’t hear loud children’s games being played. We don’t hear music. The dogs don’t jump up to check us out. There are chickens scattered about, some with baby chicks in tow. There are a few goats tied in a grassless area. Litter is everywhere. It is accepted behavior to toss trash at will, wherever. There are no barrels anywhere.
The temperature cools toward evening. We see mosquitoes and a fruit fly type insect that plagues some with ankle bites. We use sprays and have been cautioned to take malaria pills before and during our stay. We turn back toward the mission house. The dorm rooms have A/C and fans and sleeping is comfortable.
Friday morning we have breakfast at 7:00 and aim to leave between 8:00-8:30. We are going to a church Karen’s friend attends. We all pitch in dragging heavy bags of supplies and medicines to the trucks. We board the open truck again and hang on as we go down the rutted dirt road and then onto the paved town streets. Stop signs are rare and the few stoplights we see are virtually ignored by drivers. What works is blowing the horn when approaching the intersection letting others know you are coming. There are many motorbikes with sometimes three or four passengers and some carrying supplies or propane tanks. A cow or dog or person may heedlessly walk into the street. By the end of our stay I had enormous admiration for the truck driver.
At the church we see a semi-finished large cinderblock building with no finished windows or doors. We set up booths to receive people and try to figure out how to dispense what we have to those who need it. The doctors each have a booth; there are two nurse’s booths as well as a space for what we call “the pharmacy.” The Fun Team sets up in a house across the road (which is where we go to use the restroom).
The families come in, each has a slip with their name and age, and later the temp and BP. Duarte is our interpreter. He is gentle and friendly and the moms tell him the complaints or problems. We process each member including the mom then tell her to go to the pharmacy to get the bags of meds that are appropriate. Treatment for parasites is the most common issue. I had some anxiety about record keeping. Later I found out Jen, working in the “pharmacy,” kept all the ID slips.
We break for lunch then do another couple of hours. During the day a large number of equipment and activities goes missing from the Fun Team supply. Karen closes the door and announces she would not open it again until the soccer balls come back. When they do, the door is open again. We need to see these events to learn about behavior here. No one is going to form a line and wait his or her turn. Karen tells of giving a washing machine to one lady and a bed to another and finding out that a family member had taken them to be sold. She denied visits until the items were returned, and they did return. The high walls and barred windows and locked gates are necessary. It is a harsh lesson with severe poverty at its source.
In the afternoon I notice uniformed guards nearby. They carry guns and wear flack vests. However there are no major problems this day. We served 250 people. The most serious medical issue was a hydrocephalic baby who would have been treated much earlier in the US. At this point in his life, there is not much to be done. We also saw a little four-year-old boy walking on his right heel and refusing to wear his shoe because of the pain from a plantar wart. We could not help that condition and could only refer him to a doctor.…
That evening we discuss the day’s events and try to figure out how to be more efficient. Listening to others experiences and points of view is always helpful.
On Saturday we go to a well-established Catholic School. They are prepared for us and we are better organized. We all notice the parents and children at this clinic are better dressed and look, in general, healthier. Duarte explains the school serves meals and they are good meals. He said he would like to be back in school to get the food.
At our clinics there is no mention of milk and we never saw any being served. There is no refrigeration, so it makes sense not to risk illness. I notice the wandering cows about the villages. They don’t look like milkers and there is no grass for them to feed on. They look skinny and are probably used for meat.
We see about 500 people at this clinic. Later we all agreed that they were generally a healthier population and most if not all of those who came to our booth were also connected to a doctor’s care. Before we leave the school, we count and pack up the meds to lessen the pharmacy confusion for the next clinic.
Seeing young teens age 13, 14, 15, 16, 17, with babies,… and grandmothers—one 92—looking after very young grandchildren. An elderly diabetic with neuropathy who said the open areas on her toes were because the rats nibbled them while she was sleeping. There are no instant solutions for these issues and I am left with a feeling of “job unfinished.”
We are all exhausted and feel oddly we as though we have been immersed in this country for a long time. There is so much to understand. The culture, the language, the expectations of the people, what is acceptable, what is usual, and overriding all is the incredibly hot climate.
Back at the house we are told not to feed the dogs or pet them. Most of the time they are quietly laying about the landings and we walk by without a response from them. They look thin and the dog sympathizers in the group cannot resist and give them the leftovers from a chicken meal. They eat the leftovers—bones and all—only to later have episodes of diarrhea, which their handlers were not so pleased about. I learn that these dogs take care of their own tick infestations. They bite the ticks off one another, finding the engorged parasites by the scent of the blood. Nature has found a way to teach survival in this climate.
Sunday we head for the beach along the southern coastline. The view is so beautiful—the blue ocean on our left and the endless peaks of mountains on the right. We are not far from the border of Haiti here on this southern shore. At the beach there is a canteen and a shaded area where we set up our tables. The portable kitchen serves a tasty meal of rice, beans, and fish with sauce. There is no sand at this beach. Walking barefoot is punishment because the stones of all sizes are burning hot. Trying to keep a foothold when standing ankle deep in the surf is difficult because the waves pull the stones from under your feet as they flow out. There are no sailboats, no ships and no seagulls. Perhaps it is the season, perhaps it is the area, I could not find an answer. As with all beach trips, we return exhausted by the sun sporting various shades of pink.
Driving to and from the beach is another feat of expertise for the driver. Occasionally, there are lines on the road. There are again many, many motorbikes and they pass, seemingly, without concern or consideration for oncoming traffic or upcoming bends in the road. Meeting a huge truck or bus is a breath-holding event. On the way to the beach, Sam has a large bee go down the front of her bathing suit and gets stung. She is able to flip it out onto the bed of the truck where it is flattened by one of Karen’s helpers. We are lucky to have dealt with the sting and the bee without ending up in a pile as a result of a sudden bump in the road. We return our grip to the overhead bars and continue on, bravely learning about what the risks are as we go.
We return, have supper, then leave to attend church. This is an evangelistic service in Spanish. We ladies are told to wear skirts or we cannot go. There is no piano or stringed music. A young lady plays a traditional drum and is accompanied by a young man scraping a metal tube. For me the rhythm is not easy to follow. The congregation is small, mixed with both parents and children. They have a number of speakers and stand for singing. When it is over they all pass by us to shake hands. We had been in this building for Friday’s clinic and they welcome us again.
On Monday we are up early again and heading for another school in the city of Barahona.We again travel via the open truck and pass a very large construction project. A new University is being built. This area of the city is more developed and older. Some, but not so many unfinished buildings.
The school is older but well maintained. They have made space available and we set up our booths. We see mostly healthy children and adults. The children look well dressed and cared for. Still there are the chronic problems of the area: parasites, impetigo, scabies, fungus. Occasionally someone will need an antibiotic, or a treatment for a vaginal infection. Clean water seems to be a problem. The toilets not working are not a surprise, and there is the omnipresent trash….
In the evening we walk around the city common to look and to shop for trinkets. There are street children who hang out near the common and beg for whatever they can get. One little boy, so incredibly filthy, is a deaf mute and we do what I suppose so many others have done—buying him food and drink—but it does not seem enough. I don’t know about orphanages there but apparently the government has closed those that it supported saying there was not money enough. I would suspect there are church associated orphanages, but I do not remember seeing any.
The day is filled with new experiences and information and when I finally get to bed, I cannot sleep.
Tuesday is our last clinic day. It is in a Pentecostal church school in another part of Barahona. Our spaces are decreased and separated by sheets, which cuts into the available light and prevents air movement. It is hot. This population has older people. A mother taking care of a 22-year-old male with Parkinson’s,… a daughter caring for a mom with Alzheimer’s—the daughter is afraid of having the disease also. The general health is good and it is not unusual for the person to say, “yes” when asked if they have seen a doctor. The group is the smallest we have treated and we are finished about 1pm.
We have received a request to stop at a home in the same community. There are nine children and an unclear number of grownups at this house. Two of the men have foot issues that have been treated and are at risk of increased infection. The neighbors crowd around to watch the doctors assess the wounds.
We meet the current family pet, a black pig, who comes when called and likes to have her belly scratched. We are told she will be dinner at Christmas time.
When talking with Duarte, he tells us there are a number of missions that come to the area. He has helped others with translating. He and his wife are starting a school/church in their community. He has a number of children who come everyday. That evening we go to his home/school/church and pass out clothes of various sizes mostly, for young children. We leave the remainder with him to pass out to his community.
With gratitude, admiration, best wishes, and hope we say good buy to Duarte.
The next morning, very early, we leave for the airport in Santo Domingo. We need extra time to allow for any type of hold up that may occur during the drive. After our final ride in the open truck we travel by bus for the five-hour ride to the city. Twice during the trip we are stopped and inspected by police who are looking for Haitians in the country illegally. I am told if they had found any they would have been taken off the bus and pressed to pay money to be allowed to continue.
On the ride to Santo Domingo we pass green fields of sugar cane, crops of bananas, plantains, mangos, coconuts, yams and potatoes. Sugar is the main export. Coffee is also harvested in the Barahona area and a number in our group bought it for return gifts.
There are two seasons in the Dominican Republic. The dry season is from December to April and the wet season lasts from May to November. Hurricanes usually occur from June to November. The temperature is hot all year. The wet season is the hottest, making the air very muggy.
We spent our time in the southern part of the country in an especially poor area. We could see the tall smokestack of the sugar factory in the distance. In these poor areas near the city of Barahona there is no consistent attention to water, health, education, roads, rubbish, or electricity. These poorly built communities suffer from what looks like hopelessness. The lethargy is as evident in the animals as in the people. I did not see any children from the community near us going to school. Only once did I see a few boys wearing blue shirts and carrying books walking along one of the city streets.
I feel like any amount of help is worth giving. But I leave feeling there is so much more to do.
Sharon works as a nurse at MCI. She had taken an earlier Handcrafted Words workshop