As we approach the end of our last full day in the DR, it seems proper to discuss the last few days’ activities.

On Wednesday we switched our work site to the Fundacion Sol Naciente. The Fundacion has been a long-standing partner and we have been working closely with its director, Dr. Ramon Lopez, since 2006. The Fundacion runs an outreach clinic in the eastern part of Santo Domingo, in a barrio called Los Mina. We worked in this clinic Wednesday and Thursday, and provided care to a very different type of patient community. As opposed to in Parsiso, patients in Los Mina tended to be older, have more chronic illnesses, and have more contact with the Dominican health care system. As a result it is more like working in a free clinic back home: we helped manage chronic illnesses, but we still made new diagnoses of hypertension and other chronic illnesses during the clinic session. We only worked two days there, but we were able to provide further opportunies for our students to enhance their patient care skills and clinical judgement while also (successfully) partnering with local Dominican physicians.

Today, we visited some of the barrios in Los Mina to meet the members of Physicians for Peace‘s Resource Mother program (madres tutelares). This program matches pregnant teens with older women who help ensure that the teens make it to prenatal visits and pospartum and well-child check-ups, seeks to improve prenatal care and reduce risks of poor outcomes for newborns, and encourages teens to separate pregnancies at least one year apart. The Resource Mothers also act as lay health promoters, teaching residents of their communities about contraception, sexually-transmitted infections, etc. Currently, there are 20 Resource Mothers caring for nearly 200 teens. It will be interesting to see how the rates of childhood vaccinations, perinatal complications, and spacing-out of pregnancies could be affected by this program.

The barrios we visited are alongside the Ozama River, and have been badly affected by the recent rains and resultant floods. Infrastructure is limited: running water available only three days a week, the need to climb up the adjacent hills alongside the river hill to buy drinking water, and the 30-60 minute walk women must make to reach the local maternity hospital: a trip that must be made on foot as women get closer to term and are unable to ride the local motorcycle taxis–unless they can afford to hire a taxi.

Although our commitment is not as strong to working in the barrios of Los Mina (yet?), it is eye-opening to see the conditions in the barrios and inspiring to work with those seeking to make a difference.