La Romana is not in Italy….and other stuff I learned in the Dominican Republic….

La Romana is not in Italy….and other stuff I learned in the Dominican Republic….
Laura Hart - Thu Aug 08, 2013 @ 11:31AM
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La Romana is not in Italy….and other stuff I learned in the Dominican Republic….by Carolyn McCall, R.N.


My voyage to the Dominican Republic started with a simple question from Dr. Bert Hart on a day in late September.  “Do you want to go to the Dominican Republic for a medical mission trip?”  My immediate response was No. It is Thanksgiving and my family will miss me. I can’t afford it. I don’t have enough vacation time.


I am the nurse manager of an acute pain service that provides specialized pain management through peripheral nerve blocks and epidurals. Dr. Hart explained that I would specifically be needed to assist with nerve blocks for mission patients needing AV fistulas for life saving dialysis.  An AV fistula is the connection of an artery to a vein that has a higher rate of blood flow and can last for years for hemodialysis. 


La Hispaniola Medical Charity was founded by Dr. Umbert Hart, Jr. and Dr. Dennis Gore in 2011 after the unexpected death of Dr. Hart’s father (also a dedicated physician). Dr. Hart’s father was beloved by many for his work with impoverished patients in the Dominican Republic.  There is a clinic in Villa Esparanza, which bears his name, Dr. Umbert Hart Messon.  The stated mission of Hispaniola Medical Charity is to provide medical, surgical and dental care to the impoverished people on the island of Hispaniola, the second largest island in the Caribbean.  Hispaniola encompasses the two sovereign nations of the Dominican Republic and Haiti.  


All of this was news to me as I have never been to the Caribbean on anything but a cruise ship.  


I had heard of similar humanitarian trips and had even encouraged my son to participate through our church youth group. I did not realize my own hypocrisy until recently.  I wanted to teach my children about service and yet I was reluctant to serve.  I also used them as an excuse….what thick irony.


After discussing the matter with my husband I decided to go.  I am definitely not an adventurous person as home is where my heart is but this was an opportunity to serve, share my nursing expertise and possibly wear my bathing suit for some beach time in November. 


To preface the reason for my revelations, I need to let you in on a few things that were happening in my life prior to the trip to the DR.  The fall of 2012 was fast and furious in the McCall house.  My husband Mark and I have four children and we both work full time.  Between the Friday Night football games (I am also a volunteer band nurse), homework, church, volleyball, basketball and the general everyday tragedies that befall a large family, we were tapped out. About a week before we were to take flight my father, a 70 year old, retired Radiologist was put on hospice as he was at the end of a valiant fight with Alzheimer’s. 


I debated with family and close friends whether to cancel my trip, ultimately thinking of my parents and their own great generosity in serving others. 


I had all my vaccinations and some medicine to prevent malaria.  I also spent some time preparing my father’s funeral arrangements if he died while I was gone.  


So just a few days after Thanksgiving and with quite a heavy heart, I went to the nursing home to tell my daddy Goodbye.  I was not sure if that would be the last time that we saw each other as he had not moved or eaten much in more than a week.  


Mark drove me to meet my ride to the airport at 2:00am and we journeyed across four states and over an ocean to Santa Domingo, DR.  From there, we piled onto an old school bus, finally arriving in La Romana, Dominican Republic to meet the rest of our team at Hospital Buen Samaritano.   They already had spent a full day setting up the operating rooms and pre-oping patients.  


Our next stop was Casa de Campo.  Casa de Campo is literally a resort destination and our team was split into five separate houses.  My roommate was Katina Baldwin, a new friend and as I discovered, she also was a new Nurse Practitioner.  We ate our meals as a team together every day and enjoyed a devotional in the mornings lead by Dr. Jim Giles.  Over the week I learned that many of our team members were veterans of other mission trips and many were newbies just like me. 

Our first morning of surgery we arrived a little late….we were on Dominican time…and our day was underway with a full slate of patients who needed elective, yet life changing surgeries.  I was a preoperative nurse. The preoperative area was a tiny room with two beds that was usually used as a labor room. I set up the preoperative area so that it was similar to what I used to in the United States although my “block cart” was an infant crib.  The bassinet cradled syringes and needles and the drawer underneath housed medications.  During the preoperative process on the first day a young lady walked through the preoperative area to the tiny bathroom.  She had just given birth in the next room. I didn’t hear a thing.  It was quite surprising. 


Early in the week many of our AV fistula procedures were canceled because the patients were not cleared to have surgery.  Those cancellations changed the “business” that I anticipated and gave me an opportunity to explore the surgery area as well as the recovery room.   The corridor lining the hallway to the operating room was stocked with the 42 trunks that had been carefully packed and cataloged with surgical supplies.



The surgeries our team performed at El Buen Samaritino are done every day in the United States with less planning but more drama.  On Monday, Tuesday, Wednesday and Thursday we saw patients, they had surgery, went to recovery and stayed overnight for observation or went home. Those patients had surgeries that included hernias, tonsillectomies, adenoidectomies, tumor biopsies, vein procedures to heal ulcers, dental procedures and cholecystectomies. In the four days that our team was working we saw 77 patients and performed 105 procedures.  The vein team saw 11 patients and performed 56 procedures and the dental team saw 178 patients and performed 193 procedures.  This total is a total of 266 patients and 354 procedures in four days.  



The dental portion of our team served in the clinic, schools, churches and the batey, the villages that house the sugar cane field workers.  The most memorable picture I saw from the dental team was of a lawn chair reclined back for examinations.  One afternoon I had the privilege of riding a bus to one of the batey.  The small houses were painted an avocado green color with red tin roofs.  Each one had shutters, as there were no glass windows.  There were children everywhere as well as some chickens and other animals milling around.  A little boy names Leo followed me as I explored his town and I took his picture.  His excitement made me wonder if he had ever seen a picture of himself.  Some of the children were eating the raw sugar cane.  The guide told us that there was a school there but that most of the children would work in the batey for their life’s work.  I surmised that the conditions of the village were poor but the guide told us that this particular batey was well maintained.  Back on the bus, the batey disappeared in the field of sugar cane.  Every complaint that I ever uttered about improving my own home back in Bryan, Texas evaporated.  


Every evening our team gathered at one of the houses for a meal and fellowship. I texted my husband daily to see how things were going in Bryan, Texas.  Life in Bryan was ticking along as expected and my brother had arrived to spend some time with our father.  On Wednesday afternoon Mark called and told me that Dad was probably not going to make it through the next hour.  I talked to the hospice nurse, my husband, and my brother and even got to whisper one more “I love you” to my daddy over the phone.  When we hung up the phone, I knew that life would never be the same.  On the bus ride back to Casa De Campo the phone rang again and Mark told me that dad had died.  I just buried my head on my friend Jothi’s shoulder and cried.  When we got back to the house at Casa De Campo I took a nap and joined our group for dinner.  I was unsure if there was anything else for me to do. 


That evening at dinner we met a young woman a named Vianna Denise, a Haitian Medical Student who was awarded a scholarship by the Hispaniola Medical Charity to continue her education in the Dominican Republic. After seeing the batey where many people in the DR are relegated for a lifetime, her education and eventual medical practice will save lives.


The following two days before our return home passed quickly.  I worked in surgery on Thursday. I desperately wanted to work with people who spoke English. I truly needed to be involved in conversations that would distract me from thoughts of home.  In surgery I assisted with some ENT cases.  This was a new experience for me that I did enjoy.  Before my trip to the DR I had no experience in the OR except to duck my head in to ask the anesthesiologists about pain management.  


Friday was a free day for our team.  I spent the day with my new friends Katina and Suzy at the beach.  That night our team met together for a last meal and celebration before our journey home.  We had music, food, dancing, laughter and reunions with our friends from El Buen Samaritano Hospital.  Dr. Umbert Hart and Dr. Hugo Hart dedicated the evening to their mother on her 80th birthday and to their father.  


Stuff I learned:

  1. La Romana is in the Dominican Republic.
  2. It is important to learn some Spanish if you are going to a Spanish Speaking country.
  3. There are big differences working in the United States. We stress out about the minutest issues that seem ridiculous in the light that our personal touch to patients is more meaningful, useful and practical for their survival and good health.  
  4. When you go on a medical mission trip with coworkers, you are privileged to get a glimpse into their lives that you do not see in the United States.
  5. When opportunity knocks on your door and invites you out of your house… should go and check it out.  
  6. We are blessed to live in the freedom of the United States of America.
  7. Our family, spirituality and health are three of the most important things in life.
  8. Coworkers on medical mission trips have diverse backgrounds with a common goal to make a stranger’s life better.
  9. Although I was not present at my father’s death, I did care for him during his life.   
  10. When you come back from a trip, your life is still where you left it even if monumental changes have occurred in one short week.


The trip to La Romana was full of joy and pain for me.  When I go back I will take one of my children each time so that they can serve others, make new friends, and continue to be grateful for our blessings.  I think that Dr. Bert Hart and his brother Dr. Hugo Hart summed a lot of these issues up on our last night in the DR when they honored their mother and dedicated the Hispaniola Medical Charity to the memory of their father.  We are all a living legacy to our parents.  


Isaiah 6:8 Then I hear the voice of the Lord saying, “Whom shall I send? And who will go for us?”  Then I said, “Hear I am Lord, Send me!”

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