In 2001, Dana Shepherd, CPNP, traveled to the Dominican Republic for 3 weeks through the South American Missionary Society. She lived with a Dominican family and worked with two American missionary doctors in several different settings. At a Christian rural health clinic, Dana saw the pediatric patients for well care, acute infections, dehydration, skin infections, malnutrition, trauma, and parasitic infections. Dana writes of her experience:
Hygiene and sanitation in many parts of the Dominican Republic is a public health nightmare. This photo is of part of the pipeline for the city water supply in San Pedro de Macrois. I would see children playing barefoot in this area on a regular basis. Thus it was vitally important that we were able to teach local health workers about the importance of hygiene in preventing communicable diseases.
Sometimes we would do it by traveling to sugar cane plantations to do spot-checks for some of the more isolated and poor migrant Haitian workers. I was able to teach a group of local women who were to be health promoters in their villages about dehydration, hygiene, hand washing, water sterilization, and signs and symptoms of more severe illness that would warrant a trip to the clinic. These ladies would then go door-to-door to educate local moms about the things they learned.
I was also privileged to work in a nutrition center for extended observation of kids with more severe malnutrition and issues of neglect or abuse. The center was run by a group of Dominican nuns. One little girl had lived for several years at the infant and child nutrition center. According to the staff, she was unable to straighten her legs and resorted to scooting herself along the floor. She was able to do it quite efficiently and pulled herself up on furniture very well. The staff was unsure of her underlying condition and unfortunately, we were unable to offer her a great deal of aid other than connecting her with some physical therapists locally.