Each weekday Mertie Potter and the nurse practitioner students are visiting a different batey to support a mobile health clinic. The staff at Casa Pastoral orchestrate the intricate schedule. A yellow school bus picks up each of the three mission groups around 8 am to transport us to a work site. We carry all our supplies including medicines, lunch, and toys to give away.
Today’s destination was a batey called Campinas de Lechuga, about 45 minutes drive from La Romana. The bus also carried a team of Dominican doctors, translators, a dentist, and staff. The stalks of sugarcane soared above the roof of the bus as we traveled on dirt roads cut out of the fields and crisscrossed by occasional train tracks. A health promoter connected to the hospital had alerted the residents to our arrival, so a crowd was already forming when we pulled the bus up to a modest cement church.
Because this was my first day away from the surgical team, I was struck by how efficiently the clinic came together. The venue might differ from batey to batey, but the system requires only a few tables, chairs, and bins of medication. It wasn’t clear to me how much the patients paid. Once they did, two women at the registration table filled out an intake form with the patient’s name, age, and complaints. Children passed to a deworming station, which most drank with a quiet grimace.
At the church threshold, another staffer weighed the patient and referred her to Mertie or Erika for a blood pressure check. If their complaint was medical, the patient moved to a waiting area to consult with one of two Dominican doctors or an NP student (with a translator). If the complaint was dental, the patient waited in another corner for the dentist. After meeting with a provider, the patient took the recommendations to the pharmacy team for processing.
The students at the pharmacy filled many prescriptions for high blood pressure, pain, and glasses. Nearly everyone received a month’s supply of a multivitamin. It was impressive watching the students build rapport with the patients despite the language barrier. No condition or situation seemed to fluster them, not even when children peered through the window slats to watch them work. I mostly filled in for translators where needed and helped steer the flow of traffic.
We shut down for a lunch break. Even though the afternoon crowd was much sparser, the team saw 132 patients in all, 10 more than yesterday. Looking at many of the patients, I would never have guessed how sick they felt from their stoic faces. It reminded me of the marathon surgical case I observed yesterday of a woman who waited patiently all day to have her gall bladder removed. When the surgeons put in the laparoscopic camera they found she had an acute case of colecystitis with her gall bladder inflamed and full of stones. Human physiology may be the same across the world, but how people express sickness seems culturally defined.