General Nursing, graduate school, Holidays, International Nursing, Nurse Practitioner

Transcultural Nursing Course – Dominican Republic – Part 4

January 1995

Over the next few days, Dr. Elaine assigned me to work in the Mennonite clinic which was hosting us in comfortable simple motel-like rooms on their campus. I watched Dr. Nancy examine patients all day long in much the same fashion as US physicians. She speaks some English and many of the medical terms are the same in Spanish, so I was able to understand some.

One mother brought her newborn to Cora, NP. We looked at the baby with sadness who was born with a micro tongue, stubs for feet, and a lobster claw for a hand. Cora instructed the mother to pump her breasts and feed the baby girl with a syringe and referred the baby to the specialty clinic in the capital, Santo Domingo. I also met Dolly, the clinic sheep, that supplies blood for the agar used in the laboratory plates for microbiology cultures.

Dolly, the lab sheep who supplied them blood for their agar plates.
Dolly, the lab sheep who supplied them with her blood for their agar plates.

At 11 a.m., a group of clinic workers started singing hymns and everything stopped. Then the Pastor preached a fifteen-minute gospel message. We thanked God as one young man prayed and received Christ as his Savior. Johnny, a young volunteer,  enjoyed practicing speaking English with me. I also observed the surgeons in the operating room which seemed to be done the same way we do it in the States.

Each student was required to prepare a health topic to teach the patients. I chose to teach them how to prevent getting worms since it is endemic in tropical countries. I remembered treating it when I was in Honduras.

I studied Cora’s tropical medicine book and then taught the patients with the help of Cora’s poster while she translated for me. The main thing I emphasized was hand-washing after using the bathroom and before eating. This is challenging when many of them don’t have access to clean water as I discovered in the village where we stayed and in the city hospital. If one doesn’t have running water, one has to get it from the river, boil it after building a fire, and then let it cool, a tremendous amount of work.

Teaching the patients on how to prevent getting worms.
Teaching the patients on how to prevent getting worms.
Round worms are widespread in tropical countries.
Roundworms and other parasites are widespread in tropical countries.

On our last evening, I watched a lady weave her baskets and hats. All the children gathered around, and she let them model her hats as I took a photo. I will miss these children. We closed tonight by sharing how this trip has changed us. I said it had increased my observation skills, and that I now realized that we didn’t need as much expensive equipment to get the same health results. The most positive experience for me was delivering the baby. The most negative experience was dealing with the filthy outhouse in Pan Dia.

Cora thanked us for being culturally sensitive. She is such a sweet godly lady. She has been so sick all week with recurrent typhoid fever. I pray for God’s healing hand upon her.

Cute village children model the hand woven hats!
Cute village children model the hand-woven hats.

Santo Domingo

We have returned to the capital city for our final few days. I was blessed in worshiping with the brethren at the city church started by Pastor N. and his wife 30 years ago. On Monday, they took us to see their daughter, Dr. Marilyn, and the impressive clinic, church, and school she started. The people have a much higher standard of living here than they did in the western city of San Juan where we worked earlier.

Then we went to the national Peace Corps offices housed in a stately old white colonial building. The Chief Nurse gave us a lecture on her role. There are 7500 Peace Corps workers worldwide. The overall attrition rate is 30%, but only 14% leave the D.R. Contracting HIV is a problem among the volunteers. They are given birth control and condoms, but some of the women still get pregnant. They are counseled and flown to Washington DC for an abortion. If they have more than two abortions, they are dismissed. Everyone must take anti-malarial medicine weekly and wear a helmet when riding on a motor scooter or they are dismissed.

These facts broke my heart. I thought to myself about how much better it is to follow God’s way of only having sex within the marriage relationship between one man and one woman.

“Marriage is honorable in all, and the bed undefiled, but fornicators and adulterers God will judge.” Hebrews 13:4 (KJV)

Then we toured a city clinic where Mary, a Peace Corps volunteer, has worked for 18 months doing health promotion. She started out in San Juan but was in two bus accidents. In the second accident, the driver and all the people riding toward the front of the bus were killed when the bus rolled over. Mary broke her cheekbone and was flown back to the USA for surgery. She lives here in a poor slum area where the houses are close together on a hill with many steps. When we saw a huge rat, a woman ran after it and smashed it with a big rock.

The clinic nurse attended a vocational school for six months after she finished the eighth grade. They are taught how to take vital signs, give injections, and a few other basic things. She is equivalent to somewhere between a certified nurse’s aide and a licensed practical nurse in the USA.

Then Dr. Elaine gave us a lecture on Culture Shock. She said there are three stages. The first is the Honeymoon stage where everything is exotic and wonderful about your new country. It usually lasts 1-6 weeks. The second stage is the Frustration stage where everything is awful, backward, and makes no sense. The third stage is Stabilization where the person appreciates the new country and learns to be flexible with its flaws. One missionary told me the best way to get through culture shock is to stop comparing the new country with one’s country of origin and accept the new country as it is.

On January 6, Three Kings Day, all the stores closed for this major holiday. This is when the Dominicans exchange gifts rather than on Christmas day. I think they calculate that it took the wise men about twelve days to travel from the east and find the Christ child to present their gifts of gold, frankincense, and myrrh.

On this holiday, we enjoyed touring the 500-year-old colonial part of the city and seeing the oldest cathedral in the New World, and the oldest Protestant church started in the Dominican Republic in 1922. I also had my photo taken next to the statue of Christopher Columbus who discovered the island in 1492.

The oldest protestant church in D.R. built in 1922.
The oldest Protestant church in D.R. built in 1922.
Pam and Christopher Columbus who discovered D.R. in 1492.
Pam stands beside Christopher Columbus who discovered D.R. in 1492.

Julie and I had a scary experience as we left D.R. at the international airport. A strange man nearly tackled me, saying he would get us to the front of the long check-in line. We told him “NO” and checked our baggage, but he would not leave us alone and said he would get our departure tax for us. We told him “NO” again, but he would not go away. Julie gave him 5 pesos and he gave it back and almost spit, “That is only 5 cents in the USA!” She asked him how much he wanted, and he didn’t answer. He kept badgering us, so I put 4 pesos in his hand and ran to the locked gate and told Julie to run too. I heard him throw the coins on the floor in disgust. I was thankful he couldn’t follow us through the security gate. I was glad when the plane took off and then later landed in Miami, back in the good ‘ole USA.

And so ended my two weeks in the Dominican Republic. I thank God for all I learned about other cultures during this journey which helped me in my encounters with patients from other countries over the years. I enjoyed telling my patients from the D.R. about my two weeks in their country.

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