Dr. Fernando Catalina assesses a pediatric patient’s lung sounds at the medical clinic. This child is one of 337 patients that were seen in the three-day medical clinic by the team’s three doctors. (Photo by Lily Alfano)
On June 22, a 25-member team consisting of three doctors who reside in Harvard, two nurses from their practices, nine members of the Harvard Ambulance Service, and 11 other talented volunteers—the majority of whom live in Massachusetts—arrived at the Grace and Peace Mission in the village of Baharona, in the Dominican Republic.
This team represented At Home and Afar, a nonprofit organization dedicated to providing medical and humanitarian assistance to those in need. Each year, At Home and Afar sends four teams to Baharona. These teams are made up of medical professionals and volunteers, including both adults and youths, who are willing to put their time and effort into helping a community in need. In addition to providing medical care, each team brings a new mix of people who share their unique skills and ideas with the community.
Makeshift homes, lack of clean water
As the team and I arrived in Barrio Cassandra, we were struck by the extreme poverty in the community; many houses were one-room shacks made from makeshift materials. They had cracks and weak roofs. Some even had dirt floors, and trash littered the ground around them. We later found that most homes had no electricity or running water; access to clean drinking water was limited.
Our team had a lot to accomplish in its weeklong stay. The first task was to set up a medical clinic with triage and laboratory centers, a pharmacy, and exam rooms where Drs. Patty Ruze, Fernando Catalina, and Amy Silver would see patients. The clinic spanned three days and served more than 300 patients with ailments ranging from chronic illnesses such as diabetes and hypertension, to viral problems such as the chikungunya mosquito virus, internal infections, and parasites. For many locals, the clinic is the only medical care they receive, and they showed great appreciation for the work we were doing.
Following the clinic, focus shifted to health screening and education. Team members screened 83 people for diabetes and hypertension, both of which are prevalent among the village population. For each person screened, we recorded blood pressure, blood sugar, and weight. We then provided written information to help each person understand what these numbers meant with regard to their health.
For the remainder of the week, the team divided into smaller units that changed fluidly to accomplish a variety of goals.
Small teams, a variety of goals
One group worked with the mission and community to provide cement floors for several local homes. Cement floors offer a great improvement in sanitary conditions compared to dirt floors. Cement aids in keeping out rodents and providing a more stable living space. In providing something so elementary, we have the ability to raise the standard of living in these homes. At Home and Afar has been and remains committed to helping residents of Barrio Cassandra obtain and install these floors, hoping to see an improvement in families’ lives and a decrease in illness.
Another group accompanied the doctors, visiting homes of patients who were physically unable to attend the clinic. One patient, an elderly woman, stood out in her need for our support. Two years earlier, a bird bite on her leg led to infection and gangrene, and her leg had been amputated above the knee. Following this, she was primarily confined to her home, hopping around on one foot and unable to easily maneuver the uneven, 14-inch drop from her doorstep. Recognizing this, Dr. Catalina provided her with a walker and coordinated with the cementing group to build a ramp to provide easy access in and out of her home. It was inspiring that an hour of our time could change her lifestyle so dramatically.
First aid classes for youths
Seven Bromfield student EMTs and one adult Harvard EMT organized and executed a three-day first aid program, teaching local youths about basic assessment, how to manage bleeding wounds and splint breaks, ways to prevent or treat choking victims, as well as care for burns. The goal was to empower these individuals with skills that would help them serve their community. The class began with a group of nervous teenagers, but they quickly became engaged, excited about their participation. For them, completing the program became a source of pride. For us, it brought an incredible feeling of accomplishment.
Another goal of this trip was to support an ongoing project that At Home and Afar is working on with the help of Grace and Peace Mission. Over the years, volunteers have treated recurrent cases of infections and parasites from unclean water. To provide a long-term solution for such health problems, At Home and Afar has purchased a piece of land with the intention of building a well that will provide clean water to the community. There is much work to be done to ensure this project is implemented in a way that is accepted within the culture of the community.
Members of our team traveled door-to-door to identify where people get their water, if and how they purify it, where the nearest bathroom was in relation to their house, how many people lived in each house, and if any were sick. This information allows future volunteer groups to understand current water conditions and habits in the community, allowing for the new water systems to be integrated in a way that the locals are comfortable and familiar with.
A focus on clean water
To help promote clean water awareness, some volunteers presented information on a water filtration system made from a bucket. In addition, we crafted a mural and explained the importance of clean water to a group of community members. We described the differences between unfiltered water, bleach-treated water, and filtered water in regard to bacteria and viruses. We placed emphasis on the ways in which clean drinking water may reduce the likelihood of illness.
Team member Dr. Charles Agosta, who has experience with solar-energy projects, took a leading role in planning the well project and cistern logistics. He and one of the Grace and Peace Mission heads actively searched for solar units and visited the governor’s office to determine when the well would be drilled.
In addition to the goals set by At Home and Afar, four of Harvard’s students chose to design their senior community service project around helping people of the Baharona community. Sofia Catalina collected more than 100 pairs of shoes to distribute to the local children. Elyza Agosta is developing a program to consolidate patient information electronically, rather than keeping written documentation, which would significantly improve organization and efficiency. Nicky Chapman and Allison Rizzo identified a young man who is in need of hearing aids and purchased them for him, as he could not afford them.
Bittersweet departure
As our week in Baharona came to a close, we took time to reflect on all that we had accomplished. With the need still so great, our accomplishments felt bittersweet. We all agreed that we wanted to do more and reflected on what we were inspired to do next. I was sad to leave Baharona, but I look forward to returning as part of another team in the future.
Please consider sharing your time and talents with At Home and Afar by joining one of the four teams sent to the Dominican Republic each year. See www.athomeandafar.org for more information. For more information on Grace and Peace Mission, see www.gracepeacemission.com.
Lily Alfano is a student at the University of Connecticut, Storrs, and a member of the Harvard EMT crew.
