Here is a hospital, but forget your water.
Santo Domingo is home to the first trauma hospital in the Dominican Republic. Haitians and Dominicans come from all over the country with severe wounds and sickness. The hospital was transformed into an aesthetically pleasing building as part of a presidential project. The care received at the hospital is free, but patients pay a cost of waiting in line for hours in hopes of receiving 1 or the 250 beds available. There are nine intensive care beds that are manned by two on staff doctors. When asked about morality rates of those who wait for a bed the doctor and administrator said that no one dies while they wait. Each case is received based on severity. While a clean hospital is a step in the right direction, the shortage of rooms and doctors leaves the Dominican Republic in a standstill. Communities continue to not have clean water and consistent electricity making general health difficult. Residents do not have much access to a healthy diet that would help keep them out of the hospital, and prescriptions are difficult to obtain due to shortage. The doctor at the Santo Domingo hospital said that they always have what a patient needs in terms of medicine, but we saw first hand that they do not. A man staying at our hotel was having a heart attack and could not even receive basic antibiotics because the hospital was out of them. There is also no food, bed linens, toilet paper or other basics provided so patients must provide their own. While the hospital was important to see the access were received was a red flag. Our group was dirty, sweaty, and dressed for exploration. The administrator providing our tour offered access into a surgery and the intensive care unit. Places where contamination is a matter of life or death. We did not go into those areas, but offering provided a view into what issues there are with access. The Santo Domingo hospital was more “high tech” than other pubic hospitals, but basic necessities and care are still flawed. To make the hospital impactful one must turn to other public health needs not being met. Where does this begin? Could education be the answer or maybe it is deeper than that.
Lack of Opportunity
The city of Santiago is a different destination compared to the already visited destinations thus far by the group. Although there were some similarities to the previously visited Santa Domingo there were also many differences. It appeared that this city’s trash was disposed of in a more efficient manner and not as much filled the streets as it did in Santa Domingo. The city did not appear as congested with people in the streets, however the nightlife in Santiago is much louder and the streets had more activity. The streets had people who were walking to the casinos, but they were also filled with women who are prostituting to do what they can to make enough money to get themselves by. Not only are young women on the streets at night trying to make money, but there are also little boys and girls walking the streets during the day selling miscellaneous items, or providing services such as shoe shinning to make money to keep living. There are not enforced child labor laws here to keep the kids off the streets and get them into schools. There are too few schools and too many children here to for all of them to get to go to school. Although there are efforts to change this, it appears that nothing will change in the near future for these poor children to get a chance for them to attend a school too.
Some will say that it is their parent’s fault for their lack of opportunity; others may say that it may be their own fault, and some may ask how has it gotten to this point? There are many people that could be at fault however, a family who was born into poverty cannot be blamed when the next generation cannot make it out of the poverty level because poverty is a viscous, endless cycle. Children born into poverty haven’t been given a chance to break the cycle themselves, and without chance to attend school and receive an education they will continue to have to resort to selling their services or themselves. A place where blame could be placed is within the government. The Dominican Republic does generate money from industry, the very high tax rate of 18%, and then finally tourism which produces millions of dollars a year. This money is then used to in multiple ways, but not always the best. There are multiple government officials who are overpaid, but yet the country doesn’t have an adequate energy, water, or educational system for its citizens. This is a place that could be a place to start when placing blame. The United Nations decided that all people had certain rights that every government needs to provide for its people called the Declaration of the Rights of Man, and currently a portion of these rights are not being provided for by the Dominican Republic Government, and as a result not giving their citizens the opportunity to provide for themselves or their families.
The lack of opportunity for many Dominican Republic citizens is something that causes families to have to have their young children to go to work. The lack of opportunity can also cause a young women that has very little to prostitute herself to men and women for many years to be able to support themselves. This government does not have a government assistance plan where they can assist people when they are disabled, laid off, or cannot work. Be in a place where you were not given the ability to make a livable wage and as a result, you had to have your kids work, and your daughter, wife, or sister had to prostitute to pay the bills.
Human Catastrophe in the Western Hemisphere
Sharing the island of Hispaniola is the country called Haiti. Haiti is a nation with multiple influences, mainly African and French. In recent years Haiti has been in shambles, and has struggled to provide anything for its people. There is much disease and sickness that plagues the island with both domestic and foreign influences. There is little aid to help those that get sick with malaria, dengue, other diseases, and now most recently and prominently cholera. On the boarder of both the Dominican Republic and Haiti is the town of Tilorri. This town has a market that people from all over will come to buy and sell goods. Anyone from any other country would say that the living conditions in this town were absolutely horrendous. There was raw sewage in the streets, flies landing and contaminating the food both the meat and vegetables, poor people everywhere who were struggling to get by, and little children begging and pulling on you to try and give them money. The children kept pointing to their stomachs saying ‘hungry, and would give you a look that insinuated they wanted help and that they had nothing. Some of the children would walk up and hold your hand and have the most innocent look on their faces basically asking for help, and then there were other kids who would come slap your pockets for money, and even a few were so desperate enough to try and pick your pockets. These kids tried any and all topics to get whatever they could to get money out of you.
At one end of the community was the local hospital that had a very lacking hospital, with a horrific birthing room, a full waiting room, a room with a handful of beds, four filling all of their medical records, and one doctor for the whole community of 17,000+ people. Next to the hospital was the cholera ward, which was a wood building with on one side a room that looked like a torture chamber to take blood samples, and on the other side was where people who had cholera were left to recover. Again the state of the room was disgraceful.
The Commencement of Life and Death
In the modern world most children are born in maternity wards in hospitals. In Tilori, Haiti, the public hospital was small, understaffed, lacked of medicine, and was unsanitary. By no means does the Haitian government fund this hospital properly. The building that the hospital occupied looked like an abandoned house that serves a community of 17,000 residents. There were members of the group that opted out of touring the hospital, as they did not want to risk contamination or seeing any shocking sights. I was not one of them; I went ahead with the others in the group to see the reality of the medical facility that residences of Tilori had to use. As we walked through we approached a maternity ward. The door opened, we could not believe that we were seeing. The room appeared to be falling apart as the two beds that were slowly rusting away, posters falling of the wall, no running water, and etc. This is room where mother bring newborns into the real world. However, the innocent newborns are unaware of the hardship that they will have to go through in their lives. Furthermore, the ward is not equipped with machines in case of an emergency. It was hard for all of us to comprehend that this is where babies are born. This ward should be a place where a mother feels safe that her baby will be fine. Nonetheless, health standards between the U.S and Haiti are incomparable.
Once we left the maternity ward, we ventured out to a separate building that was for cholera patients. The week before we arrived there were four people that had cholera and two weeks before six people where infected by this disease. It is evident that his is still a major problem in Haiti, but in the western world we turn a blind eye to a disease that was brought by the United Nations after the earthquake in 2010. We went into a room that had wooden walls and wooden beds with holes, in order to put a bucket there in case the patient had to the bathroom. This room emphasized the horrendous conditions that cholera patients had to stay and be treated in. Patients are potentially on deaths doorstep if they are not treated properly. Furthermore, the hospital might not have the right medicines to treat these patients. It is a human disaster.
Moreover, the lack of resources this hospital has to disinfect these rooms where cholera patients are housed has the potential to infect the entire community. This is if the hospital does not have correct supplies, which it does not. The lack of supplies creates a public health crisis in Tilori that is out of their hands with respect to the limited supplies they receive from the national government. It is almost inevitable that cholera will never be eradicated from this town unless certain measures are taken to break the cycle of infection. Long-term solutions are needed in order to improve the general health care in this community. However, these solutions always lead back to the heart of the problem that is funding. Funding that is needed to buy vital resources never makes it to hospitals like the one in Tilori.
Relationships between Dominicans and Haitians
Ever since the Dominicans declared independence from Haiti in 1844, tensions have been razor sharp. While the Dominicans say that they are not racist towards Haitians, actions and body language seem to say otherwise. The generalization that every Dominican is racist towards Haitians is just false. That would be like saying that every American is racist, still stuck in the Jim Crow mindset. In a city named Dajabon on the Dominican border, however, the tense relationship between the countries is apparent. When the marketplace in Dajabon is open, Dominicans allow Haitian merchants to come into the country to trade and sell goods. This does not mean that the tensions between the two countries has settled in any way. Haitians attempting to come into the Dominican Republic for the market have to cross over a gridlocked bridge with the Massacre River below them, a grim reminder of the past when the river ran red with Haitian blood after Trujillo put thousands to death by machete.
To this day, when looking into the river, you can see Haitian women and their children sitting on the water’s edge washing clothes and bed sheets for their families. As one looks down and eyes interlock, a feeling of helplessness washes over the soul. It is important to think about cultural differences in this sort of situation. Just because a different culture is doing something that seems strange does not mean that it is wrong. Perhaps washing clothes in that river is a tradition for the Haitians. Therefore, who are we to judge these people based on their traditions?
When exploring the market, we were able to observe Haitians dealing with the Dominican military. A Haitian man attempting to get past the final checkpoint to the market met a Dominican soldier, dressed in old United States Military Desert Storm fatigues, who shoved the man back and did not let him pass. On the other end of the spectrum, we Americans were able to walk freely through the market and the bridges because of our skin color. After observing the checkpoints some more, it was obvious that soldiers were letting the lighter-skinned people into the market area while rejecting those had darker skin unless they had identification.
A holding area for Haitians attempting to get in shows a man being processed by the military. The Dominican guard holds the identification card next to the Haitian, observing and questioning with deep intensity. Upon leaving the market place, Dominican soldiers grabbed one of our bodyguards thinking he was Haitian. After quickly explaining that the man was protecting us and was not Haitian, we were able to leave with everyone we came in with. No one else was stopped by the guards, not one American was questioned by the soldiers.
After a few close calls and extremely tense moments comes the realization that racism is still very much alive between these two countries. Men and women with darker skin are almost always considered Haitian and a treated differently than those with lighter skin. As an American bystander, the feeling of helplessness cannot be ignored. There’s a realization that there is absolutely nothing you can do but write down your experience and hope that someone reads this and it makes an impact on them.