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Well, here we are in Dominican Republic Nov 18 to 30 2018, for a medical mission trip, a project of my Rotary Club, Festival City Stratford and Rotary Wasaga Beach’s Steve Wallace and organization here called AoK, Acts of Kindness Canada, working in Dominican.
We have a team of 23, many around SW Ontario but also Ottawa, Niagara, and Comox BC.  About 2/3 have been on missions before, but the newbies create lots of anticipation and excitement.  We have been packing at the mission depot in Stratford for more than 2 months, because we brought 70 hockey bags, each 50 pounds, and the extreme detail it takes to produce lists of items packed takes a lot of time.  The manifesto of only the medications has 875 items.
All the hockey bags were packed into Brian’s pig trailer (all clean and sanitized) on Saturday, (Thank you Rich, Jack and Kirk and sons) and Sunday morning we car pooled to the airport.  A much better trip this year than last when we had snow squalls and difficult driving. Brian drove the truck with passengers and the trailer.  There has to be a system!  All of the hockey bags are numbered and a list on the bag includes the contents.  As each bag came off the trailer the person who will claim that bag as their luggage loads it (with help) onto their cart, and when everyone has 3 hockey bags and their carry on, we could do a group check in.  Thankfully, Agnes at Blowes Travel had outlined the agreement with West Jet, that we had one bag free with our ticket, one bag free as a Humanitarian bag and the third one we pay $35.00 (plus tax).  Their stated charges were much, much higher, but when the agent looked on the contract, Agnes had our back.
Sadly, we were minus one team member at the airport.  Dianne, our physiotherapist, slipped on the ice at home in Stratford, hit her head and face, bled profusely, injured her arm and insisted she was OK to go on the mission trip, and drove to the airport with her team mates.  Once at the airport, she was obviously not in condition to go, so she returned to Stratford to the ER and we set aside her 3 bags of supplies to return to Stratford. (that was mistake as I will tell you later).  We have since heard that Dianne has a broken nose, a concussion, and an arm that is injured badly, but at this point not fractured.  Dianne, we miss you, and just want you to get WELL.
We were in a long line to get a group check in by one agent because I had to pay for the extra bags with my credit card.  Jim Sillers, a Rotarian from Michigan realized he did not have his passport.  He had come across the border and stayed at my house over night.  At the border he just put his passport in the console of his car.  OOPS!  We called Brian, on his way home, who called Marloes to wake her up and get the passport and drive it to Shakespeare to meet Joyce’s husband, Wayne who had agreed to return to Toronto.  Unfortunately he would not be able to get the passport until 30 minutes past check in time.  So, the agent put Jim’s luggage on our names without charge, and checked Jim in for the  flight she arranged for him the next day.  He got a hotel, had a big nap and arrived the next day.  We are very exact at the depot when we pack the bags to make sure they are 50 pounds, but none of the bags were weighed.  Four of the volunteers donned air casts and 2 had wheel chairs and 2 had rolled walkers.  The wheelchairs and walkers were processed as luggage, thank you West Jet!
The flight was full, and I was suspicious that some of our luggage would not come.  Sure enough, even though 50 hockey bags is pretty impressive, we were short 20.  The next step through customs is always a worry.  But Steve Wallace has brought teams here for the past 5 years, and he took my lists of the contents of each hockey bag and gave it to the Supervisor that he knows.  The first 3 bags were opened, the rest were 
X-rayed and we were on our way!  What a world of difference than the last 2 years in Mexico.  
The luggage was all handled by porters, loaded into a truck, and us into a safari open truck for the 15 minute ride to our hotel, Sosua By The Sea.  Check out  I had previously sent a list of the room mates so check in was quick, we deposited the hockey bags into the storage room, humanitarian at the back, clinic ones in front, had a drink and snack by the pool, got settled, an early dinner and oh, a welcome bed.The rooms are lovely, queen beds and good shower, much needed air conditioning, a drastic change from my first many mission trips, when we slept on the floor on a one inch piece of foam in a school room.
Monday morning, we tackled the hockey bags, unpacking the clinic bags and then repacking into what each department would need, registration, Triage, Fluoride clinic, Nursing and Dr and Pharmacy.  The team meeting that followed was the first time that all of the team members actually got to get to know each other.  We have 11 nurses, counting me, 1 Family Physician, 1 Pharmacist, 1 Pharmacy Technician, 1 PSW, and 7 helpers, a wonderful team.  And we did get to have a swim in the ocean or the pool.  We are joined every day by Homa, woman from Vancouver, who is on vacation here for 3 months.  We met her in Toronto Airport, and she really wanted to come and help, so she will help in Registration with Mary Lou.
Tuesday was our first clinic day.  We are working in the poor villages, some Dominican, some Haitian Bateys (villages) and some mixed.  Some of these villages have had some community development work by Steve Wallace’s teams from Rotary Wasaga Beach and he has laid the ground work along with Terrisita Grant, an 11 month resident here for 7 years, but from Tobermory. 
Our translators are young Haitian descent men from the villages, that Steve has mentored to learn English.  The local language in the Haitian villages is Creole along with French. But the language of Dominican is Spanish, so these young men know all four languages.  John, one of our translators, only had one year of schooling. His father died and he had to go to work to support his family, so despite not being able to read or write, he learned English.  Amazing.  He is the translator in Registration and in the late afternoon, Mary Lou is mentoring him with written language.  We are paying the translators $25.00 a day, a very generous honorarium, but they may not get work for another number of weeks or months.  Haitians are not allowed to work legally or have a bank account.  So, with 2 of our days wages, John bought 2 small pigs as an investment, to raise and then sell or perhaps breed and have more young pigs, an admirable venture.  He took them home and put them in the pen he had and in the morning, both little pigs were dead from stab wounds.  Why?  We were all flabbergasted.  Steve said it would be an act of jealousy by some of his neighbours, they living in the same shacks as he.  How is one to advance himself?  Haitians born in Dominican get a birth certificate, that is pink, different from Dominicans.  But all over the certificate, it sates they are Haitian. Even though they are 3rd generation Dominican, they are still Haitian, born of mothers that never had the opportunity to attend school and this child cannot attend school until they are 8, by which time they are completely undisciplined.  Haitians cannot buy property, so their houses are shacks, side by each.  Dominican homes have some property around for a side garden to grow maize (corn) or flowers or vegetables.  Most of the land here used to produce a huge sugar cane crop, which is why the grandparents were brought here from Haiti in the first place.  Now, it only grows scrub trees and some grass, on which some cows and goats are tied to eat.  Some enterprising Haitians in a Batey planted vegetables on the land, and covered them with black netting against the strong sun.  The local authorities came and ripped it all up, because they do not own the land.  So it just lies fallow ….. for 30 years, while people are starving. Several young translators who have been mentored have jobs on cruise ships, a good job with pay and without having to provide their own living conditions, so saving money for their family.  
The first day, we are in Pancho Mateo, a Haitian (descent) village where Mika from Norway is the long term community advocate, in an organization called Amigitos.  The first building that I see is under construction, a community centre, medical clinic, Montessori school, and beacon of light for the whole community.  Mika requested the deed for the land from the President of Dominican, and got it, and it is being built by a Charity from Norway.  My Rotary club, Festival City Stratford, is a partner with several other clubs in a Rotary District and Global Grant spearheaded by Rotary Wasaga Beach to complete all the furnishings for this building to the tune of $105,000.00.  As part of our luggage, we have packed consumables, supplies like dressings, gloves, an electric examination machine for ears and eyes, masks, vaginal exam specula , etc., for the medical clinic.
Today, we are working in two buildings, about 300 meters apart.  Registration and Triage is in a church, with reading glasses clinic in a corner at the back, and Fluoride is in the safari bus sitting on the street!  The nurses, Dr., lab and Pharmacy are in the 1st floor of the Amigitos school.  The waiting room for treatment is outside under a tree. The waiting room for registration is on the street with everyone crowding the door and refusing to move, lest they lose their spot.  Waiting room for Triage is IN the building as is the waiting line for reading glasses, so a lot of people in a small space.  
Numbers have been given to people who need our care, and Terrisita wanted the numbers on her list to correspond to the numbers on our registration.  Huge problem.  The people did not come in order of their number and they brought along other family members.   So how are the people in each service to know that 54 follows 8?  We had fights over next chair in line, and little discipline.  In the afternoon, we moved a nursing station under a tree and another into one of the safari trucks, and the waiting room down a small alley between 2 buildings, just to create a little more space and a little less noise. 
At noon, we shut down the clinic and asked the patients to return to their exact spot at 1 o’clock.  We loaded into the safari trucks and went to a local small park for some quiet and our lunch, packed for us by the hotel along with ice water.  One of the small train engines that pulled the sugar cane train wagons was left as a statue in the park, evidence of better times long past.  We also saw what remains of the huge sugar cane factory, abandoned.   
Despite the challenges, we saw 204 patients, many of whom got all services.  Linda and Bill Soldan fitted 54 people with Reading glasses, sun glasses and ball caps, settled fights, and tried to tune out the constant din of 20 people speaking at a volume of  80 decibels.
Nursing was chaotic as well in a very small space, seeing patients with colds, fevers, diagnosing a new diabetic, and a new pregnancy.  Dr Eric drained an abscess on an arm, saw several patients that need to be referred for Cataract surgery.  Many people here complain of cough, but Eric diagnosed a patient who’s cough was caused by her Blood pressure pill, called Vasotec. 
Pharmacy is always a busy place and this is Colleen’s first mission.  She has Julie for a technician and she has been on a previous trip.  They found that people wanted medications that were not ordered for them. 
Trish Smith was on a mission with me in Philippines and did fluoride treatments there, so she and Laura, our Rotary exchange student from Brazil manned the fluoride clinic (thank you Dr. Mark Straus), doing 5 or 6 at one time, for a total of 68 children between the ages of 5 and 14.  The kids are not to put anything in their mouths or eat or drink for 1 hour after the treatment and the time is written on their arm.  Did I mention the lack of discipline?  I would find them chewing on their tooth brush, eating small bags of chips , etc.  So, we just encourage the moms to watch their children and do the best we can.
At the team meeting after supper, we had many ideas to improve our approach and organize the clinics.  Steve, however, said we did an excellent job of serving people who are grossly under serviced with care and compassion.  He said each one of us had made an impact on the lives in that village.  We will do better tomorrow. 
Some of the village activities I witnessed as I walked between the two clinic buildings were children running, playing with sticks and stones, and lots of youth just sitting.  One young man spent all day having black yarn braided into his hair as extensions.  Three men spent all day, at least 6 hours loading a truck with scrap metal out of a storage building.  One wore canvas shoes, another flip flops and one had running shoes on.  A man I chatted to said they each would get $2.00 US for the day’s work.  How much better, then, the young men that Steve has mentored and we are paying.  Women were washing clothes in a big basin on the ground and hanging to dry on any surface.  One woman was shelling soy beans (edamame).  The women cook on the ground with a pot sitting on 3 stones or cooking on a charcoal burner on the ground.  No wonder little kids get burned.   
Until next time, Jean