Here’s a bit of background. Prior to my first trip to the Dominican Republic with SGU, I was just like many of my classmates – I’d always been interested in global health and had always longed to volunteer for at least one mission trip as a student, but I just didn’t know how to do such a thing. (Which organization should I go through? Where would I stay? How would I get there? Would it be safe?) Finding a safe and legitimate way to volunteer abroad was much more difficult than I thought it would be.
Interestingly, though, I knew that I wasn’t alone in this interest in global health and the eagerness to volunteer. I once casually polled a bunch of my colleagues and found that nearly all of them wished they could do an international mission trip prior to starting residency, all for various reasons (which ranged from some wanting to pursue global health during their careers, some just wanting to find ways to give back, and some simply as just a “bucket list” item). However, almost none of them were ever able to do a trip because, just like me, no one knew how.
I first found out about SGU’s pilot mission trip to the Dominican Republic in the spring of 2018, near the end of my 4th year. It was the first collaboration between the SGU Alumni Association and Centurion Medical Missions. Their goal was to utilize SGU’s massive student and alumni network to provide sustainable, recurrent access to medical care for some of the most impoverished parts of the country. And by some stroke of luck, I was selected as one of the 4 medical students to for this pilot trip, joining two SGU alumni physicians and an entire team of volunteers for 5 days in the DR.
And let me tell you, to say that this experience was worth my while would be an absolute understatement. The things that I witnessed – from the medical conditions, to the issues with housing/sanitation/drinking water, to even the psychosocial impacts of this “culture of scarcity” on children and adults alike – it was an experience like none other I’d ever had. Topping all of this off with the amazing team we worked with, and I couldn’t have imagined a better, more impactful time in the DR.
Here’s how it went: We were flown in to stay in the province of La Vega (in the heart of the Dominican Republic) for 5 days, which included 4 full days of clinics in various locations within La Vega, as well as a half day before and after for preparation/debriefings/etc. The team organizing the details of the trip took care of us literally every second of the way, from all of the preparation emails beforehand, to the transportation, to the housing, and even to every single meal (which were absolutely divine, by the way). The CMM team made it known to us that, as the medical team, we were there for our skills, compassion, and medical knowledge – and that they would take care of the rest. (We were nurtured so well that I’m pretty certain I never even stood up from the dinner table to grab my own drinks or food during the week, now that I think about it).
The 4 medical students were composed of 2 guys and 2 girls, so the girls roomed together and so did the guys – this ended up being one of the best parts of the trip. There’s just something about being able to share this experience with a roommate who is equally as nervous/excited about what’s in store in this foreign country. It forms a really unique bond between the two of you, and that same bond goes for the entire team we were lucky enough to work with.
Each clinic day was held in a different area of La Vega, so every night prior, we were given a brief overview of the types of socioeconomic and healthcare challenges we’d likely encounter. The team was composed of 2 attending physicians, 4 medical students, 1 nurse pharmacist, 2 counselors, a team of local Spanish-speaking translators for each station, and a separate team ensuring that all stations were running smoothly. The attendings were always stationed in the patient care areas, while the medical students adapted roles throughout each day between patient care, intake, and the pharmacy, as needed.
As a medical student in the patient care stations, we had full autonomy in seeing our patients with our own translators, diagnosing them, prescribing the necessary medications/dosages, and documenting our findings for future patient visits. We were given a list of medications we had in our pharmacy that we could choose from, and anytime we were unsure about anything, our attendings were always readily available each time to help.
The types of conditions we encountered sometimes varied each day depending on the population we were treating. For example, we spent Day 2 in the barrios of Maria Auxiliadora, an inner city population with severe sanitation and water issues. We saw a dramatic increase in the number of acute infectious diseases (both parasitic and bacterial) on this day, compared to more chronic issues we saw on other days. In fact, many young children were developing bacterial superinfections from the pruritic rashes all over their bodies, and a few times, the common complaint of “el gripe” (translated as “cold or flu,” but often used for anything involving a mild cough) actually ended up being community acquired pneumonia requiring a full course of antibiotics. We quickly learned that we had to be very astute with our physical exams, since, unlike in the hospital, our exams were the only findings we could go by.
Each day, we saw somewhere in the range of 200 to 250 patients, with an overall estimate of at least 900 patients in 4 days between the 2 attendings and 4 medical students. Despite never knowing what we were in store for each day, we’d quickly adapt to the volume, the fast pace, and each new environment, diagnosing both simple and complex complaints while still counseling patients through a Spanish translator. Each time, the team became like a well-oiled machine, and we were able to see every single patient that walked through our doors, while also getting home on time every evening for a delicious dinner over some wine and good company. It was pretty amazing what we realized we were capable of accomplishing when we were pushed beyond the limits we thought we’d had.
All in all, this trip was an experience that will be cherished for the rest of my career. As a student who always wanted to pursue global health in my lifetime (background info: I matched into Emergency Medicine and plan to pursue an International Emergency Medicine fellowship after residency), I knew that I wanted to witness international healthcare disparities firsthand prior to starting residency. I wanted to get my feet wet in the global health realm, and to be able build on that experience throughout residency/fellowship/beyond. I could think of no better way to have done my first trip than doing it with SGU and the Centurion Travel Assistance team.
To be honest, though, even if international public health wasn’t in my career foresight, and even if this trip was more of a “bucket list” item for me, this still would have been a trip to treasure forever. As medical students and future physicians, we often forget that there is a world of medicine out there that is far less privileged than American healthcare. To be able to witness this disparity at least once in one’s career should be a bucket list item for every future physician out there – it is humbling, shocking, and gives you a unique perspective & appreciation for medicine as we know it.
So, to return to my very first line in this letter to you: do it. Don’t think twice about it, just do it. You won’t regret it.
Nathalie
SGU alumnus
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