First Letter from Republica Dominica
Arrived 3/29, Saturday night, and have been incredibly busy ever since. On Sunday we divided into groups and had a
Scavenger Hunt walking all about Santiago which is very, very hilly. The city is really beautiful and much cleaner than
Haiti. Monday we toured all the clinical facilities and on Tuesday we began work - each day from 8- 12 then back to the
ILAC Center for lunch and “service” or Spanish class in the pm.
A little about what I’m doing here: The ILAC Center (International Latin American Concern) in the Dominican Republic
is an international, collaborative health care and educational organization that began at Creighton University with the
vision of two Jesuit priests. All of Creighton's ILAC programs emphasize the importance of global vision. Creighton's
ILAC programs offer dental, medical, nursing, pharmacy, law, physical therapy and occupational therapy, undergraduate
and high school students, and also to faculty-led groups, medical/surgical teams and other colleges/universities' students,
the opportunity to learn, to serve and to be served in the Dominican Republic. I am a volunteer clinical instructor in the
DPT (Doctor of Physical Therapy) Program supervising 3 senior students during their final 4 week clinical rotation at
Hospital Los Ninos.
We have been incredibly busy. Breakfast at 7:00 then leave at 7:30 on the guagua
(crowded beat-up van with up to 25+ people on it – costs 15 pesos, about 5 cents)
then catch a taxi the rest of the way to the children's hospital (12 pesos). Hospital
Los Ninos has 280 patients (mas o menos), 90% of whom are indigent. The head
nurse/ hospital administrator is Megalina and she is most supportive. Dr. de LaRosa
is head of orthopedics and loves us to come in as he loves to teach. We pretty much
just roam around the hospital into orthopedics, neurology and ICU looking for
patients – there is no physical therapy at this hospital. We have picked up 9 kids
so far and one went home Friday through our efforts. Our patients include many
with head injuries and fractures from motos (motorcycles). These kids are so stoic even when they're in much pain - they
may beat the bed with a free hand but they don't move about and stay still for the procedure (we are not the ones doing
these painful procedures - these are open wards with between 8 to 14 kids, both boys and girls, in them). The parents
(moms) stay with them and bring in food, laundry and provide the routine care. The level of care is, of course, much
different than ACH. We stay at the hospital until about 12 then reverse the trip home. After lunch, we have projects.
Two afternoons this week, the students have had to work on short lessons to present at the Campo (rural village) this
weekend. That is followed by 2 hours of Spanish class. It's optional for me but I need all the help I can get. I am getting
better but still far, far from where I want to be. It is so hard at the hospital not being able to speak Spanish. Other
afternoons, we do "service" by going into rural villages and holding PT clinics for anyone with
musculoskeletal problems. Wednesday we went into a Haitian village just outside Santiago and
treated about 15 people and also give the kids medicine for parasites. We will be going there
every week plus holding clinic at the ILAC Center twice a week for walk-ins and people who
have had surgery from the visiting ILAC doctors. Dinner at 6 followed by mass in English several
nights at 9:30.
Friday afternoon we took a 4 hour bus ride to Las Lagunas which is a small village almost 5000
feet up in the mountains. It is one of 120 villages in the “campo” supported educationally and medically by ILAC.
Saturday and Sunday we treated over 30 people plus did 5 programs for the leaders of 7 other villages on preventive
techniques. Saturday night they held a big fiesta for us which was great.
It's been rainy and cool here. I am so glad that I stuck a little blanket
in my bag.
A todos pez y amar,
Pictures: Child at Hospital Los Ninos
Treating a baby at Batey Libertad (Haitian village)
The family we stayed with in Los Legunas.
Two weeks down, two to go. The first week was very difficult as I was surrounded by twenty-something stu-
dents and lots of other people I didn’t know who were only a few years out of school and all knew each other.
After the weekend at the Campo things began to improve – well, everything improved but my Spanish, I am
still so slow. We have had Spanish class twice a week which I enjoy and I’m using it more at work - there is
no choice - but it is so difficult. This weekend was lots of fun as we went to Santo Domingo for two nights.
Went on a historical tour on Saturday morning then got myself lost during the afternoon. It was wonderful just
exploring the city. I felt very safe and was reminded of Old San Juan, Puerto Rico. Lots of good food, Presi-
dente beer, red wine and interesting history. Did you know that Christopher Columbus landed here first and
his son was the first governor of the DR? It had the first fort in the Americas, first hospital, etc, etc. Because it
is the capitol, there are much better facilities than other cities – much to the resentment of the rest of the coun-
try. For example the electric didn’t go off once during the weekend whereas it goes off here at least once a day.
However, the water did cut off a few times. We are here during an election year so we get in on all the political
Work at the Hospital for Los Ninos progressed well this past week and we saw many successes with children
going home quicker because we were able to get them up and going. The general treatment here seems to be
passive. The child is injured or sick, goes to the hospital and is put to bed until “well”. Parents provide all the
nursing care except medications. Most surgical procedures are carried out a bedside, often without anesthetic,
and in a ward with about 8 other kids listening. Not ideal but….. We have intervened by getting the kids out of
bed, up and walking. Two teenage boys with head injuries left this past week just days after we began working
with them. Both were non-responsive when we began and walking independently when they went home, one
of them is shown below. I picked up a bunch of Burger King crowns one day and handed them out to the kids,
anything to bring smiles. Friday we began working in the Burn Unit which is brand new and quite modern. I
have a difficult time dealing with burns but kids are kids so we do our best. It is the ONLY unit in the hospital
which emphasizes hand washing – also the only unit with soap and towels.
Tuesday we went to the Cultural Center to learn some history of the DR. They have a tremendous emphasis
on baseball here and I was amazed to see the number of baseball players from the DR – Sammy Sosa being the
biggest hero. Wednesday we were unable to go to work because of a general strike called by a group in Santo
Domingo over wages. It spread to Santiago also so the guaguas (those vans that carry about 25 people squashed
together) weren’t running and we were told to stay in the ILAC Center for safety. Unfortunately, that meant that
we also couldn’t go to the Haitian Batey but the day was switched to Thursday. This time in the Batey we not
only did PT treatment but also gave out parasite medication to everyone. Total chaos. The Haitian people are
so lovely and so discriminated against in the DR, but I am learning a tremendous amount of history and the rea-
sons for such cultural and economic differences between the two countries. The history here is just fascinating.
A todos pez y amar,
John Carlo and Minnie Mouse
Meagel standing for the first time (with a little help from his friends)
Edy (moto accident/ Head Injury) on discharge Classroom in the Haitian Batey
day with all of us
Doing PT in the Batey (shoulder external rota-
lady in Santo Domingo feeding birds from her tion against a tree for you PTs and OTs)
Santo Domingo harbor with the old fort
Republica Dominica Week Three
Busy but enjoyable week! My three students had to prepare and present a charla (in-service) to present to
the residents and nursing students at the hospital on Thursday last. They really worked very hard on it
and did a very professional Power Point presentation – in Spanish to about 40 people. The subject was
the importance of early movement/ activity and positioning for the children. I mentioned before that care
here is very passive – child is injured or operated on, put to bed and the parents are told to keep the child
still. We come in and say “let’s move!”. The great thing is that the staff are now modeling some of the
things that we have been doing. My students have grown so
as both people and physical therapists this month – makes me
very proud of them. It is so difficult to walk into a totally new
culture with different language and customs, different health
care system and diseases and injuries that are completely new
to them. Additionally, the hospital has never had physical
therapy before so it’s been a remarkable adjustment all around.
We have been spending more time in the brand new Burn Unit
lately. They have running water, soap and paper towels there
plus readily available gloves, gowns and masks. A huge
change from the rest of the hospital. I will never get used to working with kids that have been badly
burnt. Many of the burns are from kids picking up or cutting into electrical lines (they don’t know what
they are) or from falling into the charcoal cooking fires. Stuff one never sees in the States. My students
have now learned how to make resting splints for the burn patients.
Our week consists of 4 hours of work daily in the morning, two afternoons of
“service” working at the Batey or Free Clinic here at ILAC and a cultural
outing. This past week we went to the Museo Hermanas Mirabal. They
were political activists who were murdered by Trujillo in 1960. It’s a
fascinating and tragic story that we never even heard about. I am reading the
book about their lives called In the Time of Butterflies. Good history of the DR.
In the evening we occasionally walk down the road to the local "Cultural Club"
for a few Presidentes and dancing.
This weekend we went to a resort called Sosua By the Sea. It is in Sosua which is 15 miles from Puerto
Plata on the Atlantic coast. Stayed in a huge two bedroom unit for $180 US – price was all inclusive for
meals and drinks (alcohol included). The surf was incredible and quite a few folks went surfing today.
There is an airport in Puerto Plata and I would recommend it highly for a holiday. I know that I’ll come
back to the DR for a vacation. I have learned so much about the history here and why the historical
problems between the DR and Haiti – unfortunately much of it is blatant racism on the part of the
Dominicans. I’ll write more on that in my letter next week.
A todos pez y amar,
Pictures: Bridget, Diana and Jane - To see all my photos go to
Picasa website and put in for both name and password ILACPT2008
Republica Dominica Week Four
How wonderful to wake up this morning in my own soft bed! I slept on a 3” thick mattress (well, 3” when it was new)
placed on a wood platform but when one is tired, one can sleep anywhere!). There were birds singing instead of
roosters crowing. After a shower I was able to walk around without getting all dusty again from polluted, dusty air (dirt
roads with guaguas and motos racing around at 40 – 80 mph). I’m glad to be home but will likely go back with Creighton
next year. It was a good experience and I met my goals of instilling a love of PT in my students and improving my
Spanish, although the latter is iffy. I really will continue in my efforts to improve my speaking over the coming months.
Overall, it was an excellent trip. I was able to watch my 3 students grow as professionals – they will graduate with a
Doctor of Physical Therapy degree from Creighton University in May. By the end of the month, they were conversing
with patients and families in Spanish and demonstrating how to do PT with absolutely no equipment except for their
hands, minds and pieced together donated equipment. We most definitely left the hospital a better place and hopefully
they will hire Physical Therapists as more are graduated from the two PT programs in the DR. Two of our favorite kids
were discharged home as we sadly finished out our last week there. Please keep all these children in your thoughts and
prayers because the homes they return to are the poorest of the poor and the infections and injuries we saw at Hospital
Los Ninos would be unheard of in our country.
I especially want to thank two groups for their generous donations that I took with me. The St. Petersburg Free Clinic
donated a huge box of crutches, 20 used AFO’s (plastic leg braces) which we re‐molded with a heat gun to fit our DR
patients plus lots of other supplies which we used for our PT clinics. Derek Cooper, pastor of Word of Truth Church, sent
a generous check which was matched by the PT’s and students with their left‐over pesos. The money was immediately
put to use in providing nutrition supplements for a family with 3 children who have all had TB. The family’s very limited
resources were completely depleted in paying for the medication and now the children are suffering from malnutrition.
Derek’s donation provided seed money for what will continue as a nutrition project to help this family and other families
in the future. Many US groups come through the ILAC Center and they will be asked to leave their unused pesos for this
project when they leave to return home. Thank you, Derek.
I mentioned last week that I would amplify some of the differences I saw between the Dominican Republic and Haiti.
They are two very different countries in terms of racial backgrounds, religion, government and culture. The DR has
basically closed the border between Haiti and itself. Haitians living in the DR are not granted citizenship but live in
“Transition” and must constantly renew their paperwork to stay there – a costly and time‐consuming proposition for
extremely poor people. There is a definite racial bias against Haitians in the DR and many Haitians live in extreme
poverty although others do quite well. When I was in Haiti last year, the DR was perceived (from my limited
perspective) as doing quite well and not wanting to help Haiti. However, I met many people in the DR who feel badly for
Haiti’s plight and are trying to help as best as they can. The Director of the Physical Therapy program in Santiago has
accepted a number of Haitians into the program (5 out of 22 in this year’s graduating class) and encourages them to
return to Haiti. The salary for a PT in the DR is about $12,000/ year and much lower in Haiti. But, as I mentioned last
year, where does one even start to change things in Haiti? It’s too bad that there is not an ILAC Center there. I was so
impressed at what they are doing to improve conditions in the Dominican Republic.
Now for a very brief history lesson on why there are such disparities between the two countries ‐ Basically, Christopher
Columbus settled La Española in 1492 and it prospered under the Spanish. African slaves were imported and brought a
rich culture to the island. In 1697, Spain ceded what became Haiti to the French and Haiti prospered until 1791 when
the outbreak of the Haitian Revolution began. Haiti was the first republic led by people of African descent in modern
history and the Haitian Revolution was the most successful of African slave rebellions in the Western Hemisphere
resulting in the Haitians controlling the entire island. In 1805, Haiti invaded the DR, reaching Santo Domingo before
retreating in the face of a French naval squadron. In their retreat, the Haitians sacked the towns of Santiago and Moca,
slaughtering most of their residents and helping to lay the foundation for two centuries of animosity between the two
countries. Haiti went directly from being a French colony to self‐governance through a process that has had lasting
effect on the nation. Slaveholders had established a system using violence and force in controlling the majority.
Unfortunately leaders rising in the nascent black republic adopted similar means to keep control, a pattern which has
The twenty two year Haitian occupation that followed is recalled by Dominicans as a period of brutal military rule. There
were large‐scale land expropriations, imposed military service, restriction on the use of the Spanish language, and
elimination of traditional customs. It reinforced Dominicans' perceptions of themselves as different from Haitians in
"language, race, religion and domestic customs." In 1844 the Dominican Republic's first constitution was adopted.
During the first decade of independence, Haiti mounted five invasions to re‐conquer the Dominican Republic. From
1930 to 1961 Trujillo ruled the Dominican Republic. As the DR’s sugar estates turned to Haiti for seasonal migrant labor,
increasing numbers settled in the Dominican Republic permanently. The census of 1920 gave a total of 28,258 Haitians
living in the country, by 1935 there were 52,657. In 1937, Trujillo ordered the massacre of 17,000 to 35,000 Haitians,
citing Haiti's support for Dominican exiles plotting to overthrow his regime and in an effort to make the Dominicans
“whiter”. The massacre of tens of thousands of unarmed Haitians living on the border of Haiti and Dominican Republic
was met with international criticism. This was the result of a new policy which Trujillo called the 'Dominicanisation of the
frontier.' Place names along the border were changed from Kreyol and French to Spanish, the practice of Vodou was
outlawed, quotas were imposed on the percentage of foreign workers companies could hire, and a law was passed
preventing Haitian workers from remaining after the sugar harvest. This history of cruelty and violence has led to
massive distrust and hatred on both sides. Sad and shameful because it is the children who suffer…………………..
Give peace a chance.