Health Care in the D.R.

Presentation at a rural clinic on dental care

An essential part of serving as a Peace Corps Volunteer is living with and like the locals. This means cooking with local foods (Examples: yucca, plantains,and auyama), taking part in community events (Examples: church celebrations, dominoes, and chair sitting), and getting used to not having certain amenities (Examples: running water, 24/7 electricity, and Krispy Creme). However, there are other aspects of life which Peace Corps Volunteers will never be able to truly integrate, such as how we take care of our health.

The disparity in the quality of health care I receive versus my neighbors has made me uncomfortable a times. As a volunteer I have access to three doctors, one of whom is always on-call, as well as free medicine and treatment. I never have to worry about the cost of a procedure, if I need it Peace Corps will pay. I probably have the best health care plan of my life right now. My neighbors are at the other end of the spectrum.

Preventive health care is essentially non-existant in my rural community. I do not know of anyone who goes to the doctor and dentist for yearly check-ups. There are no school nurses or yearly eye exams for students. It all costs too much. Aside from brushing ones teeth and eating a balanced diet not much else is done until someone gets sick (And many people do not brush their teeth and eat healthy).

When someone gets sick the first thing people do is wait to see if it gets worse. Have a toothache? Wait until you can't eat. It costs three times as much to get a filling as it does to get a tooth pulled (A cleaning can cost even more). Vision problems? Stand close to the chalkboard. I don't know of any kids of the 300+ I have worked with who wear glasses. When the Chikungunya virus was spreading around the country like crazy, no one went to see the doctor until the pain from their joints made it difficult for them to walk, and even then most of my neighbors didn't see a doctor. Again, seeing a doctor is expensive. Just going to and from town can be expensive for many Dominicans.

Probably in part because of the inaccessibility of doctors, most medicine can be bought without a doctor's prescription (including Prosaic and Viagra - the latter I have seen handed out to men at a bar in the capital). However, rural Dominicans often prefer local plant remedies. Tea made from the leaves of a cotton tree are said to be great for anemics. Alcohol is often also used as a substitute for pain medicine. It is not uncommon for teenage girls with menstrual cramps to take a couple swigs of Mama Juana, a rum-wine-plant root beverage.

When an illness or injury does become very serious Dominicans will go to the hospital, but the results are not always the best. As I mentioned a few weeks ago, sometimes the doctor needed will not be at the hospital and patients end up waiting hours to receive treatment. Once a patient has been admitted to the hospital they typically have to share a room with six to eight other individuals. There are no special wards for different types of injuries just one for men and another for women and children. There are better hospitals located in the capital - you know someone is really sick when they are sent to the capital.

Side note about babies: Due to the unavailability of doctors when it is time to give birth Dominicans with some money prefer to schedule caesarians instead of giving birth naturally, to ensure the doctor will be present for the entire birth. Also, many women go home with their babies the same day they are born, via motorcycles. There are not enough beds for women to stay more than one day, and there are no laws here saying you need a car-seat before you can leave the hospital. Would it even be possible to make one for a motorcycle?)

A lot of improvements are needed in the Dominican health care system. Thankfully, things are slowly headed in the right direction. All medical centers offer free HIV/AIDs testing, and many offer free birth control. This year many hospitals, including the two major hospitals on the Samaná peninsula, are being expanded and remodeled to provide more services and treat more patients. Also this year a national 9-1-1 system was launched. As its next step I would like to see the government begin to provide more health care services at schools. Ensuring kids know how to take care of their personal health from a young age will go a long way to ensuring healthy generations to come.

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Library Update: The library now has a cement floor! We plan to install the floor tiles and paint over the next two weeks. Tentative inauguration date for the end of November. - It is time to start planning the celebration party!

Now it's time to make it look pretty!

Let's Talk About Sex

Making Condom Balloons

It has been said that you are not a true Peace Corps Volunteer until you have shown your neighbors how to properly use a condom. When I heard that I thought, “Psh, I am going to be working with small children, no way will I end up doing a condom demonstration.” Then last week I held a Fiesta de Cóndones (Condom Party) at my house with over 30 kids screaming, “I want a condom!” Kids as young as 10 made condom balloons, played games to learn about the risks posed by HIV/AIDS, reviewed how to use a condom, and, of course, practiced putting on condoms with the help of some plantains, a carrot, and a wooden phallus I was given by Peace Corps for just such an occasion.

Interviewing President Condom

Many readers back home are probably shocked at the notion of 10 year-olds practicing putting a condom on a vegetable, but I have received no complaints from parents about the event. Why? Because parents here know how important it is for their kids to receive good sex education. Sadly, the D.R. has the highest rate of pre-teen pregnancy (kids 12 years-old and under). News stories about pregnant 9 year-olds are not uncommon. HIV/AIDS is also a big problem in the country. HIV/AIDS is the number one killer of women age 15 to 24 years old.

I don’t want to see any of my young neighbors become pregnant when they themselves are still children. Nor do I want to attend any of their funerals. I will never know how my sex talk impacted all of my students. But I hope it will help them to resist peer pressure, and instead make informed decisions about their sexual lives.