Our first trip to DR was in 1998 following Hurricane George since then we have returned 11 times to work our friend and colleague Dr. Marc Pinard.  The challenges are quite a contrast depending on which population you are working with.

On the Dominican side we deal with chronic diseases associated with aging and in some cases over nutrition in a population that cannot afford the necessary medication to control hypertension and diabetes or to relieve arthritic pain.  We give each individual a one year supply of each of the chronic medications they require and we return annually to each clinic site to reevaluate and resupply our patients.  All medications are labeled in Spanish, with clear instruction and indications.

 Many of our Haitian patients on the frontier are malnourished and live in extreme poverty.  Their dwellings are mud and wattle huts and they have neither clean water nor functional latrines.  The children are infested with intestinal parasites and scabies and few are adequately vaccinated.  This area has one of the highest maternal neonatal death rates in the world.  The death rate due to neonatal tetanus is higher than most of the developing world with ninety reported deaths per year.  All children are wormed at least semi annually and vitamins are given as needed to both children and to expectant and nursing mothers.  Haitians are genetically predisposed to malignant hypertension which begins at an early age and is unrelated to body mass or activity.  We attempt to accomplish stroke prevention in this population by supplying adequate medication to control the blood pressure in year supplies as well.  All medications are labeled in Creole and pictorially as well if the patient cannot read or write.

We also provide eye care and cataract surgery when an eye team is available for both Dominicans and Haitians.