Nestled in the Atlantic Ocean just two hours south of Miami, the Dominican Republic is frequented by many as a tropical vacation. But even in “paradise” there is a great need for health care.
In January, the first full Family Medicine Cares International (FMCI) delegation traveled to the Dominican Republic to support local physicians and health care providers in making health care more accessible to local Dominicans and the Haitian population that has settled there.
Up until 2018, the focus of FMCI was on the health care and medical education needs of Haiti.
“We’ve had to shift a lot of our work and thinking from Haiti over to the Dominican Republic because of the political unrest and challenges [in Haiti],” says Anna Doubeni, MD, FMCI consultant for six years and lead consultant for the program for 18 months. “But we’ve really tried to keep the core values and core structure in place as we develop and expand it in the Dominican Republic.”
Delegates traveled to bateyes, an area made up mainly of settlements centered around a sugar mill. Not all these communities still have active sugar cane farms, but they continue to be predominantly populated by Haitian immigrants. While the program serves all people in these communities, the Haitian population in particular has trouble accessing health care because they usually are not Dominican Republic citizens.
That’s why FMCI has partnered with One World Surgery, a nonprofit with a mission of partnering with communities, healthcare providers, and leaders in health care to increase access to the primary and surgical care people in these communities need. Together, they work within the healthcare system to provide care in the gaps.
For example, Doubeni recalls an elderly gentleman they met during a pilot delegation trip with mental health needs who was blind and suffered from other significant health challenges. They offered treatment and attempted to set him up with support programs.
When they returned in January, they found that while the community was trying to take care of the man, he had not been successful in getting all the services he needed. Because they visited the same community, they were able to get him the health care he needed as well as connect him with a local clinical team who can check on him.
“I think this highlighted for us some of the benefits of continuity, some of the challenges of access to care,” Doubeni says. “It was just really nice to see him again.”
FMCI is a nested program, Doubeni explains. The primary goal is workforce capacity building through medical education and clinical team development, with short-term global health experiences for the AAFP constituents that are tied with a local clinical team for sustainability in longitudinal clinical care.
Between 22 and 25 delegates participate in the trip each year, and Doubeni says she hopes to expand the program. About three and a half days of the trip are dedicated to patient care, and then they spend a day and a half on medical education in collaboration with the Universidad Central del Este (UCE).
The medical education component may include:
The AAFP Foundation is currently recruiting for the next delegation trip in February 2024. The Foundation offers a resident and early career physician scholarship that is open for applications until August 31. General volunteer delegates have until October 31 to apply.
The next delegation trip is scheduled for February 10-17, 2024.