Our last day in the Dominican Republic began with a now familiar routine. Everyone met in the dining hall for breakfast at 7 am and then prepared for the day. The medical team checked the contents of their bins, adding more vitamins or relabeling ziploc bags. The surgical team went over their schedule for the day and wrote down what supplies they would need.
I joined the nursing students on the yellow school bus for the ride to Soco, the site of our morning clinic. Unlike the bateyes we had visited Monday through Thursday, Soco is a more urban community, about 15 km from La Romana along the highway to the airport. Although it sits next to a modern tourist development, Soco seemed as underdeveloped as many bateyes.
Patients lined up with their yellow tickets as soon as we had arranged the chairs in the community center. The nursing students took their stations amongst the Dominican health providers and staff members. Our supply of medicines and glasses had dwindled by today, but the clinicians showed their improvisation skills by preparing cups of Vaseline in lieu of anti-fungal cream.
Their flexibility reminded me of a story from the surgical team on Wednesday. The cauterizing pencil failed during an operation. After the technicians tried for several minutes to get it going again, the surgeons decided to use nursing student Aurora Stevens as a human instrument. Instead of using the foot pedal, the surgeons would ask Aurora to activate the pencil for their laparoscopic instruments.
Today the surgical team followed up on their patients from the previous day, all of whom were given the go ahead to return home. They also drained a cyst from a woman’s wrist and nearly operated on the gynecologist whom they had helped with a hysterectomy earlier in the week when she showed signs of appendicitis. They had all the instruments ready when she declared that she would try antibiotics first. In total, the three surgeons participated in 25 operations including hernias, lipomas, gall bladder removals, and Caesarean sections. They became so close with the OR staff that two of the scrub techs drove to the Casa Pastoral and gave the surgeons victory laps on their motorcycles around the town plaza.
The medical team ended up seeing 87 patients today for a week-long total of 413 consultations. One constant pleasure was interacting with the children who, despite their sickness, maintained a playful sense of humor. We had our own play in the afternoon when all the mission groups visited a public beach called Bandera Azul (Blue Flag). The water temperature was mild, and the depth shallow enough to walk 100 feet without getting your chin wet. As the sun set, we formed a circle on the beach and shared some of our lasting impressions of the week. We agreed that the experience of working in a low-resource environment and acclimating to new team members are skills that will extend to our practice in the United States.