Where to from here?

Residents are encouraged by the clean-up effort, but many do not believe that regular collection will follow.  We move through the community to talk and listen and learn.  Many complain that they need trash bags to collect their trash and the collection effort will fail without them.  We resolve to determine empirically the availability of bags and see quickly that discarded grocery sacks line the streets and are used by children to fashion kites.

The clinic continues to go well and we have attracted the attention of the mayor’s office.  The vice-mayor (and former runner-up to Miss World) visits, offers her appreciation, and poses for photos with Dr. Mark (aka “rising rock star”).  The mayor’s office delivers on a promise to provide a Dominican doc for the clinic, and Joanna Weeks (2nd SOMOS year and clinic coordinator) has emerged as a skillful manager.  Stationed in the pharmacy, she has a keen eye for developing issues and asserts herself gently to find solutions.

The day ends with a sense of accomplishment but developing fatigue.  The bus ride back to the hostel provides an opportunity for our resident cheer squad (Kaveh Sadeghian; Lindsay Schleifer, 1st year; and Taylor Hurst, 1st year) to spring into action.  A rousing version of Hark Upon the Gail startles the bus driver, nearly lifts the roof of the bus, and introduces us all to innocents on the street from the clinic nearly to our destination.  Nearly.  Other sing-alongs follow, including Sound of Music and Mamma Mia. We arrive refreshed — and hungry.

The trash truck that was promised as a follow-up did not come, but we received a promise that twice-weekly collection would begin on Friday.  Our mission now is to find ways to help residents believe that this will happen and prepare their trash for pick up.  Many have heard the promise before and are uncertain.  They say they’ll continue to burn trash — undermining the prospects for regular collection and continuing the contribution to upper-respiratory health problems.

There is much work left to be done.  In the clinic, the mood is light and joyful.  The day has gone well; we’ve seen more patients than we had imagined we could; the roving medical team (mostly Dr. Mark, but also our 4th year medical student Morgan) has made many and potent house calls; and the mayor’s office has invited us to a reception in appreciation.  I’m a little worried because I can’t quite see how we will end our work in the community with one precious day remaining.

The reception (hosted by the mayor’s community health director, Dr. Hernandez) is a pleasant and heart-warming affair, but the clock is ticking.  We will need to meet when we return to the hostel, and we’re starting to flag — or maybe it’s just me.  In any event, we’ve been at it since 7:00 am and the day began as many others have with half-a-dozen of us pushing the bus so that the driver could pop the clutch to start the motor!

I should not have worried.  The power that is W&M and SOMOS prevailed.