We have completed interviews in nearly half of the homes in Esfuerzo, the most remote of the neighborhoods of Paraiso. We are beyond collecting information now. We understand our work as involving active efforts to help community members identify shared understandings about common problems. We look for opportunities to support collective, community efforts. In our interviews, three people spoke passionately about the promise of collective action and cooperation. We feel empowered as our efforts to locate and promote community capacity gain momentum.
By day’s end, we have seen a total of more than 350 patients this week. The clinic is operating efficiently and with a level of compassion that is apparent to all. The team has become whole. We have fully trained pharmacists, including one with the doctorate (Ben Kamrad) to organize our formulary, to incorporate health education into the delivery of prescriptions, and to provide better experiences for students who move through the project’s assigned stations. We have a nurse to organize the triage and registration process, providing for the first time a model for this portion of clinic. Our roving medical team, assisted by experienced undergraduate team members, is moving effectively through the community, identifying those who are too sick or immobile to get to the clinic site. One home visit finds a man near death, desperately in need of antibiotics and much more continuous care than we can provide. The doctors are able to provide acute care and increase his chances of recovery – but it is likely that he will not survive unless some arrangements can be made for much more invasive and holistic treatment – and that seems unlikely.
The tradition of late-night decompression on the plaza has continued. We may have a late dinner together back in Santo Domingo, or we may go our separate ways for a while, but we will all meet on the plaza around 11 pm each night. Sitting on concrete steps in a far and dark corner of the open area, we’ll share the good and the bad news of the day. We’ll be interrupted regularly by locals with the most desperate and compelling stories of need: late stage aids, missing limbs and advanced cancers, the long-term effects of hunger and unemployment. With broken hearts, we’ll do what we can, extending ourselves beyond the day’s efforts while understanding that spontaneous charity represents no meaningful or sustainable solution.