Stories From the Field:

DOMINICAN REPUBLIC

Nursing in the Dominican Republic

Nicole Hart, RN

The day was February 8, 2016, but this morning’s commute looked a lot different than my usual silent and snowy trek into Boston. I struggled to stay seated as a non-descript school bus bounced its way down a dirt road. I had been a nurse for four years, accustomed to never knowing how each shift would unfold, but I couldn’t help feeling unnerved by the new unknowns before me. I was participating in my first service trip to La Romana in the Dominican Republic with the Good Samaritan Mission Council. We were on our way to one of the bateyes, or villages, in this region where we would provide care to an impoverished Haitian community. The people in these bateyes, who emigrated from Haiti to work in the sugarcane fields, have minimal access to healthcare, food and education from their employers.

We took a right turn and suddenly, rows upon rows of small, colorful concrete buildings were before me. People began to emerge from their homes and children started chasing our bus, waving and smiling. The woman next to me explained how the mobile medical clinics we were about to set up only take place several times a year. Without these visits, many Haitians would have zero access to healthcare. I began unloading the bus, eager to get started and practice an entirely new style of nursing. I did not anticipate exactly how inspiring this week would be.

Upon arrival to La Romana, our group was split into medical and construction teams. I served on a medical team that included physicians, nurses, a dentist, a physician assistant, a nursing student, and a physical therapist. We set up mobile clinics in the village’s churches or schools, and within a matter of minutes, lines of 50 or more people would form outside. One by one, we would check each person’s blood pressure and weight, then direct them toward the physicians. After assessing these patients, the physician would order medications and interventions such as blood sugar checks, wound care, or physical therapy consults. We saw patients with a range of medical conditions from hypertension and urinary retention to scabies and hemochromatosis.

As a nurse, I had several different roles and I learned to contribute in any way I could. My primary responsibility was working in the pharmacy and dispensing over 50 different kinds of medications to both adults and children. Many people had chronic wounds related to working barefoot in the sugarcane fields; they would come in with homemade bandages in an attempt to keep their wounds clean. I provided wound care and supplies to these patients, and with the help of interpreters, educated them on how to care for their wounds at home. In the bateyes, the water sources are contaminated and the community often develops parasites such as worms. I passed out different doses of anti-parasite medications to the pediatric population, which is effective for approximately six months. Frequently, people arrived severely dehydrated. We would offer them water with rehydration salts and request they rest at the clinic. It didn’t take long for me to realize things like shoes, bandages and clean water were luxuries not frequently seen in the bateyes.

Some days we provided care to over 300 people in a mere six hours. The environment was fast-paced, and I was amazed how a group of 15 people could accomplish so much with such limited resources. Beyond the mobile medical clinics, our group provided clothing, shoes, and enough food to feed families for over a week. Over the past 20 years, the Good Samaritan Mission Council has assisted in the construction of a hospital and a school in the La Romana region, and established scholarships for students in the bateyes to get a college education. Being a part of this team wasn’t simply replenishing medications and cleaning wounds, it was providing these communities with access to healthcare, education and hope.

Despite limited supplies, difficult working conditions, and language barriers, I could see we were making a difference in this community, and in the faces of the people we were treating each day. I feel privileged to have been a part of this team and to be a part of the team here at Mass General, both of whom demonstrate their dedication to the health and well-being of the global community.