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Our Brigade Clinic in Higuey, Dominican Republic.
Ohio

Providing Respectful Care on a Medical Mission Trip to Dominican Republic

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By: Contributing Author: Lucinda Cave, MSN, RN, NPD-BC

In the summer of 2023, I stepped out of my comfort zone and into the vibrant, yet underserved community of Higuey, Dominican Republic for a life-changing medical mission brigade. MedWish, a Cleveland-based non-profit organization that collects and donates medical supplies to people in need throughout the world sponsored our brigade of both medical and non-medical volunteers.  MedWish equipped each brigade member with a 50-pound suitcase filled with essential medical supplies and equipment that would be used to treat patients during our clinic days. Any remaining supplies were donated to local healthcare facilities in the Dominican Republic. 

Establishing the Clinic

MedWish joined forces with Mission Possible, a Northeast Ohio-based organization with deep roots in the Dominican Republic. Through this partnership, we were able to collaborate with local churches and community groups in the Dominican Republic to secure essential resources including clinic space, storage facilities, publicity materials, security personnel, and medications (MedWish does not collect/distribute donated medications). These groups also played a pivotal role in connecting us with local healthcare organizations to provide on-site support and ensure follow-ups and continuity of care for patients. To enhance our cultural understanding and sensitivity, representatives from these groups shared valuable insights into the local culture, lifestyle, health beliefs, religion, living arrangements, and other relevant factors.

Meeting the Challenges

Our arrival coincided with a violent thunderstorm that knocked out the power in a region already facing unreliable electricity. Our initial task, sorting through hundreds of Spanish-labeled bottles of antihypertensives, antibiotics, antiparasitics, vitamins, and pain relievers, was made even more challenging by the dim light of our phone flashlights. 

The clinic itself was a stark departure from any healthcare facility I’d ever encountered in Ohio. It was guarded by an armed officer and inundated with a crowd of people who greeted us with prayers and hymns of praise. The open windows, protected by metal bars, offered little respite from the stifling heat. While the occasional breeze provided temporary relief, it also sent papers and supplies flying. Our security officer, though diligent in limiting access to pre-registered patients, struggled to deter curious dogs.  

Plaster peeled off the ceiling, ferns sprouted from cracks in the walls, and patient privacy was arranged by stringing blankets from ropes. Yet it worked. Energetic nursing students from the Dominican Republic greeted each patient, initiated records and collected important contact information. We wanted to be sure that any patient who required follow-up care after we left received it.     

Providing Nursing Services

My fellow nursing colleague and I worked side-by-side recording vital signs, heights, and weights for each patient. My colleague, a certified wound care specialist, skillfully dressed sores and wounds using the medical supplies we had brought. We were fortunate to have the assistance of Alex, a talented high school student who served as our interpreter for Spanish and French. When patients spoke Haitian Creole, we relied on a combination of sign language and facial expressions to communicate. 

Over the course of the clinic, we provided care for a variety of medical conditions. We assisted patients in need of new glasses, assistive devices, blood pressure medication and monitoring, prenatal care, and treatment for gastrointestinal parasites. Some patients required hospitalization for more serious conditions. One particularly unusual case involved a patient who arrived with severe machete wounds, the weapon still securely fastened to his body.

Over the course of three days, our brigade clinics provided care to 400 patients. Successful collaboration with local Dominican Republic partner organizations was crucial in ensuring that we provided respectful and equitable care, as emphasized by Tracey et al. (2022). We encountered a diverse range of patients with a wide variety of health conditions, including those requiring vision correction, assistive devices, prenatal care, and treatment for hypertension and parasitic infections. While providing medical care, we also prioritized patient comfort and dignity. Non-medical brigade members engaged children in creative activities, allowing their parents to receive care in private. 

Despite the challenges of working long hours in the heat and the need to be conscientious of water consumption, the impact of our efforts was significant. We were able to provide essential supplies, such as eyeglasses and canes, and address critical health needs, including prenatal care and hypertension management. As we left, we knew that we had made a lasting difference in the lives of the people we served.

To donate or learn more about MedWish go to https://medwish.org/procurement/

Reference

Tracey, P., Rajaratnam, E., Varughese, J., Venegas, D., Gombachika, B., Pindani, M., Ashbourne, E., & Martiniuk, A. (2022). Guidelines for short-term medical missions: Perspectives from host countries. Global Health 18(19). https://doi.org/10.1186/s12992-022-00815-7

Content of this article has been developed in collaboration with the referenced State Nursing Association.

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