Behind-the-scenes with Jacqueline Lagman
Jacqueline poses with patients at the hospital in Peralta, DR.
In October, I joined Rush and Community Empowerment’s primary care and surgical teams in the Dominican Republic, my seventh trip in total. What we do is never supposed to be about us. My goal has always been to give everything and take nothing, and yet whenever I leave, I feel like I’m the one coming away with more.
As with many systems throughout the world, there is corruption in the Dominican Republic’s healthcare system. In an attempt to address this, the government made public healthcare free. But with less than 5% of the national budget dedicated to healthcare, little reaches the poorest and rural regions of the country. Because the government provides low wages, most physicians and surgeons choose to work in the private sector. As a result, public hospitals are only staffed a few days out of the week.
I then spent a week working with an orthopedic team in Azua, one of the most under-resourced provinces. At Hospital Taiwan, patients with broken bones often wait months while their family members try to earn enough money to pay for the plate and implants needed for their surgery. In the US, if you break your femur, you’re operated on almost immediately, allowing you to return to normal life rather quickly. However, in the DR, you wait months and what would have been a simple procedure becomes complicated because the bones have already begun to heal incorrectly. In the meantime, you can’t work, care for your family or tend to your usual routine; your quality of life is greatly affected.
During this week, what struck me the most was the resiliency – resiliency of the Dominican and US surgeons who worked demanding 14-plus hour days, resiliency of the patients that declined pain medication after having their bones reduced and realigned. Our volunteers from Peralta would drive 40 minutes to and from the hospital, their days even longer than ours. Jose, one of our team members, worked all day and then stayed at the hospital through the night to look after our patients. Our surgeons gained immense experience working in a developing country with limited resources. As expected, many things went wrong. For example, one day the autoclave broke down and our instruments had to be taken to other hospitals, some 40 minutes away, to be sterilized. Instead of giving up, we worked until 2am! These trips can push your body beyond its physical and mental limits. During the exhaustion, it’s difficult to process anything other than getting the job done. However, once it’s over, you reflect and begin to recognize all that you were able to accomplish, considering the circumstances, and all the lives you were able to improve.
One of the surprising takeaways was the diversity of beliefs within our group. Our volunteers came from all over the US and brought with them a different lens with which to view important social and political issues. Along with our Dominican counterparts, it was fascinating to see everyone work together to prioritize human connection and civil dialogue above all else. It reminded me that even if someone has an extremely different worldview, they can still be good people that inspire me and that I can admire.
When the surgical team left, I stayed with Wendys and her mother in their home. The doors are always open, friends and family come in and out. With little-to-no electricity, families gather together by candlelight or spend time outdoors enjoying each other’s company. I’d go running in the morning and children would run up to me and give me a big hug. I hiked through the gorgeous Azua mountains, where I got to pick fresh avocados, guava, passionfruit, bananas and more.
Spending this week with Wendys also showed me how much prep work goes into the surgical trips. Groups of volunteers helped us clean the warehouse and gather boxes of supplies. Even children, who saw what we were doing, dropped everything to help. The small hospital in Peralta is even more under-resourced than the one in Azua. We had to ensure the generator was working and there was enough oil to keep the electricity going. We scrubbed the walls and the floors of the recovery rooms, the operating room, the bathroom and the hallways. We transported the anesthesia machine from Azua up to Peralta in the back of a pick-up truck. Wendys followed up with the 50 prospective patients, and ensured the community was prepared for the ENT and General Surgical consults. All of this was done on top of her regular job as a Psychology Instructor at the local school. She expressed to me that she’s willing to push herself to the limit because the most important thing to her is to give back to her community. So that they can receive the care they deserve, but are so often denied. She is an inspiration.
The final week of my stay was with the ENT and general surgical team in Peralta. The highlight was turning the dreaded pre-op room where children get their IVs placed into a fun place with coloring and live music performed by Kelvin and his guitar. The community rallies behind each other in even the smallest ways. Once, I explained to a patient that they needed to crush up their pills and mix them in a cup. They didn’t have a cup so someone from the across the room emptied out her drink and handed it to the patient. Every night the volunteers (who interpreted, cleaned and sterilized instruments, cleaned the hospital, etc) would come and enjoy dinner with us, play dominoes (a favorite Dominican pastime), teach us how to dance merengue, bachata and salsa.
In total, between both surgical teams, we performed 148 surgeries. At the end of my last week, one of our volunteers from the US said to me, “You got here before us, right?” And my response was, “Yea, I’ve been here for 3 and half weeks now.” With a very astonished and surprised look on his face, he then said to me, “Wow. I can see that you love what you do. You’ve been here for almost a month and you still have a huge smile on your face.” He was right. Peralta is a magical place, with the most amazing people. The Dominican Republic may be part of what is considered the developing world, it may be poverty stricken and lacking in the most basic of human rights and health care, but it is rich in culture and community and love.
I am extremely impressed, grateful, and inspired by each and every one of our volunteers. It’s experiences like these that remind me of the importance of our work and our partnership with the community, that refuel and motivate me to continue.
- Jacqueline Lagman
Program Manager
Rush Global Health
Views from Jacqueline’s run in Peralta.
Jacqueline and Dilcia, one of CE’s nurses, in the pre-op room at Hospital Taiwan in Azua.
Raelsy, Jacqueline, Saday and Elizabeth hanging in the house in Peralta.
Jacqueline with Dr. Amada’s daughter and niece.