The following are reflections on some of the experiences trip participants had during the January medical service trip.

Sandra Marzella, MD

Once again I am shocked and amazed at what I see here. The conditions people live in are deplorable. Babies crawling around in the dirt, trash everywhere, no running water, etc. Tonight on the phone my son asked about Skylanders. How do you explained to him that not only do they not have this, but they don’t have a Wii, only few have a TV, and for some, their problem can involve where to get their next meal. It truly is living in another world. I can only imagine that they would laugh if I mentioned things such as car seats (here infants travel on laps on the back of motorcycles,) baby gates and safety locks. I am certain no one in the low income communities owns a crib with matching sheets. They all co-sleep with their infants as with many of the older children. Their homes don’t have room for much. Many have large families.

Sandra plays “Muscles” with a boy in Pancho Mateo.

The unemployment rate is 90% in the towns we have been working in. They have no options for work. However, they are very happy people. Seems kind of strange but most seem content. Most people here don’t complain of depression or anxiety. Much different from home. Also there is livestock all along the now muddy, ditch filled roads. No shock absorbers around here! Our truck has to beep to get the cows to move. There are sugar cane fields everywhere that are no longer used but people are not allowed to farm them. When I work with these people I feel very thankful for all I have. When I get back to my room, I most appreciate the running water, a/c, and electricity which we are not seeing in their communities. Can you imagine living in place with so little? This is personally rewarding and yet emotionally difficult at the same time. They need so much and yet we can only offer a small amount.

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Kimbely Tschetter, Physicians Assistant Student, QU

After a day of training, we headed out into the communities and set up clinics in churches and an empty home. Most were one-room buildings with a tin roof, no air and lots of little kids crawling through the windows. Beds sheets were strung up for makeshift exam rooms. We had a crude check-in area and triage space. I ran the lab which consisted of a small table, a window ledge or the pulpit in the church…whatever space I could find. I ran blood glucose tests, urine analysis and pregnancy tests. During the last two days, I also worked with the doctors in the exam rooms, asking patients questions through the interpreters, doing the physical exam and making a healthcare plan.

Kim, with Board Doctors Brad and Craig in the clinic.

The main chronic care conditions were high blood pressure, diabetes, asthma and epilepsy. HHI serves four communities in the northern part of the DR. A few years ago, the sugar refinery shut down suddenly, which has led to very high unemployment in the area.

I could not have been more impressed with HHI, the non-profit I’ve been fund raising for for the past few months. They squeeze every penny out of ever dollar that is donated. The American staff, all of whom are accomplished professionals with master’s degrees in different areas of healthcare, live without hot water or reliable electricity. Theirs is truly a labor of love.

One of the highlights of the trip was getting to know my classmates better, away from the pressures of school. There was zero complaining the entire week, everyone worked extremely hard and I was so proud to be a part of this team. In four days, we saw 423 patients. I look forward to working with HHI during future volunteer clinics in the DR once I am a licensed physician assistant.

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Brad Wilkinson, MD, Vice Chair, HHI Board of Directors

Brad and Sandra evaluate a sick infant Pancho Mateo.

This January’s Operativo was the best of the eight times I have been to the DR. It is enormously rewarding to see the Chronic Care program finding its legs and actually having a positive effect on many many patients. To share in the teamwork of the Cooperadores and the International Program Team members, the enthusiasm and dedication of the QU and Tufts students, the compassion and skill of the physicians is truly a moving experience. And that doesn’t even touch the most wonderful feature of all– the privilege of helping to take care of hundreds of lovely people suffering under the burden of an inadequate, expensive, distant, and episodic health system. I would go back tomorrow if I could.


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