Rainy Season

I sit under the shade of Estela’s palm-roofed patio, waiting for her to change her clothes and brush her hair before we go on a patient home visit.  Rainy season has come early this year, and my trek up to Negro Melo had already been delayed three days due to the swollen rivers. Today has brought the relief of a sunny afternoon, however, and Estela’s neighbors have collected themselves on her patio as if to dry themselves out: a Haitian woman is washing her clothes, a cigarette dangling from her mouth.  A young man tinkers with his motorbike nearby, shirtless and covered in grease.

Lunchtime in Negro Melo

Clemente is also here, talking about the eye surgery he desperately needs. Clemente is missing his right eye (it “fell out” after a “blow”: so go patient medical histories in this country) and in a cruel twist of fate, the vision in his left eye is quickly deteriorating due to retinal detachment.  I know his story; we took Clemente to an ophthalmologist two weeks ago, where we learned that the only hospital that performs the eye surgery he needs is in Santo Domingo and costs $750.  And that is where we reached an impasse with Clemente: because Negro Melo, surrounded by acres of sugarcane and the greenest hills I have ever seen, is six hours away from the hospital and ten years away from any of its inhabitants having $750.

My phone rings; it’s my colleague, Nicole, in Santiago with a patient’s family.  Their 4-year-old son was just diagnosed with leukemia.  Her voice comes over the line fraught and rushed, anomalous in these quiet rural environs. “I tried to donate my blood to Amadito because his dad was rejected as a donor, and the hospital’s blood bank is empty, but now they’re telling me my platelets are too low.  Why are my platelets too low?  How can I raise my platelets?  And what kind of hospital has an empty blood bank?!?”

I take a deep breath. I came to the Dominican Republic expecting to help provide primary care to underserved populations, to help train a corps of community health workers, and to initiate public health projects in rural and batey communities.  What I didn’t expect, however naively, were the myriad obstacles that would present themselves along the way.  I knew there would be poverty, yes, but I was not ready for the complicated patient cases; the impassible roads; the institutional racism; the desperate needs for patient advocacy and education; and the dearth of basic healthcare necessities from toothbrushes to x-ray machines.  It’s not just the logistical nightmares that prove frustrating: it’s also the ethical ones.  Is our time better spent teaching 20 children how to brush their teeth, or sitting at the bedside of one very sick little boy?  Is our money better spent buying trash cans for an entire community or buying eye surgery for one blind man? Prevention and education may be more cost-effective in the long run, but this is a zero-sum game, and the losses in the short run are heartbreaking.

Estela and Meg on a home visit in Negro Melo

Estela appears at last, in a clean shirt, with her hair smoothed back into a ponytail. She has a pencil stuck behind her ear and a bag of medicines to deliver in her hand.  “Lista?” she asks, “Ready?”  I take another deep breath and nod.  Sometimes, things work out: Nicole was eventually able to find a friend in Santiago, a kindhearted man from Connecticut, who miraculously had the same blood type as Amadito and rushed to the hospital that night to donate his platelets.  However, Clemente is still waiting up in Negro Melo for his surgery, and tomorrow, the rains may come again.  But for now, right this moment, it is sunny and warm, and together, Estela and I step out into the light.

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  1. Wes Williams
    Posted November 5, 2010 at 5:02 am | Permalink

    Chin up Meg. As you’ve noted, the sun WILL eventually come out, and it’s always darkest just before the dawn, and all it takes is one candle to Iight a dark room, and the sun’ll come out tomorrow, and there’s got to be a morning after, and all the other cheesy, hackneyed phrases pertaining to light and hope I can think of to send your way. Really, they’re all relevant. Just keep your nose to the grindstone, one day at a time. God, I can’t stop once I get started! But you know what I mean, hang in there!

  2. Leah Kang
    Posted November 5, 2010 at 5:05 am | Permalink

    Gorgeous and moving. I’m rooting for you and hoping there are more victories headed your way: brief patches of sunniness, kind blood donors, passable roads.

  3. Melissa
    Posted November 5, 2010 at 2:16 pm | Permalink

    and here I was feeling bad because I don’t have time to get my pants dry cleaned 🙂 I can’t imagine anyone else that is better suited for this job than you. I am so proud of you. And I miss you.

  4. Liz Ortiz
    Posted November 5, 2010 at 4:09 pm | Permalink

    Hello Nicole and Meg. The last two posts are beautifully written – they clearly expresses some thoughts I had myself. I’m one of the PA students from Quinnipiac that traveled to DR for the past 2 years. I greatly admire Angi and Laura for the work they started and admire the both of you as well as you continue this difficult yet rewarding mission. Words really can’t express…it’s a bit overwhelming. But it looks like you’re both doing a grea tjob because you’re both working hard in keeping up with your duties. And as it is with most healthcare issues – one person taking their medication correctly, or getting a much needed operation, or getting healed – is much better than none at all. Be encouraged in that when you feel overwhelmed. THANK YOU for what you’re doing 🙂

    Que dios las bendiga mucho y les de buena salud para seguir adelante!

    • healthhorizonsinternational
      Posted November 29, 2010 at 1:12 pm | Permalink

      Hi Liz,

      Thank you so much for your kind words. As you can see in our most recent posts, while things still aren’t the easiest, there’s always a silver lining. Thank you for following our blog and for your continued commitment to HHI. We look forward to meeting you in person!


  5. Posted November 6, 2010 at 3:49 pm | Permalink

    Hi NIcole and Meg,
    I’m one of Laura and Angi’s friends who honestly was entirely skeptical that anyone could do the job as well as them (just because I think they’re superhuman). However, I’ve been so impressed with your thoughtful writings and ability to sort through the endless stream of obstacles that cross your path….I think you both may be superhuman too!
    Keep at it; remind yourself every day that you’re making a difference and really advancing the mission of a phenomenal organization.
    Hope to meet you both someday.

    • healthhorizonsinternational
      Posted November 29, 2010 at 1:16 pm | Permalink

      Hi Jen,

      While Meg and I certainly are far from superhuman, we are trying our best and certainly appreciate your words of encouragement. It’s great to know that there are people back home who care about our patients and the communities with which we work here. Thank you again!


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