I just finished my fourth week here in the DR, and every day I find myself so happy, fortunate and proud to be here. Although I had previously lived abroad in a developing country, I am only just now fully understanding the desperate need for medical missions in developing nations. This whole experience reminds me over and over again how grateful I am to live in a country whose medical system, while definitely flawed in its own ways, demands regulation and standardization in the education of our physicians and of the delivery of health care in general.
I know when I go to a hospital in the US that I am going to recieve good medical care – whether I have insurance or not. I naturally assume that the physicians are well-trained and competent. I expect that if I need surgery, the surgeon will be well-educated and will have had years of residency and fellowship before practicing on his own.
Yes, we all have had experiences in the US where we disagreed with the physician. Yes, we have all had experiences where two physicians have given us two completely differing opinions or plans of care. But, in developing countries, the discrepancy between a “competent” and “incompetent” physician is a whole other phenomenon that we usually don’t need to worry about in the States.
At CURE Dominicana, I see patients on a daily basis who were initially treated (or more accurately, not treated) at another hospital by an unqualified surgeon. The patients then find out about CURE after the fact and come to our surgeons later for either initial treatment or for a correction of a first surgery.
For example, last Friday I met a patient named Yemen. Yemen comes from a small town, about 1 1/2 hours from Santo Domingo. He is 17-years old and the bread-winner for his family. In March of this year, Yemen got into an accident while working and was taken to the largest trauma hospital in the country. Yemen had a fractured jaw, broken ribs (?) and a shattered left hip. The physicians at the hospital addressed the fractured jaw and ribs, but did not even take an x-ray of his hip.
When Yemen continued to complain of hip pain, they x-rayed his hip and found it was badly fractured. But, they told him they could not operate since he would likely die on the OR table. So, instead, the doctors put a cast on Yemen’s CALF. Obviously, the cast did nothing for his fractured hip and later the doctors removed the cast and sent him home with a brace for the calf instead.
Luckily for Yemen, he was fortunate to meet Kristin, a missionary here, who had worked with a previous CURE patient, and directed Yemen and his family to CURE. Approximately five months after Yemen’s injury, he finally had surgery to reconstruct his hip. Yemen is now approximately three weeks post-op and he came to physical therapy for the first time last Friday for gait training with crutches. He will be non-weight bearing on the left leg for at least three months, but walk again.