Dominican Republic

The Dominican Republic’s (DR) San Pedro de Macoris province is east of Santo Domingo, and it is an area that reflects the disparities between Dominican families living in urban communities and those living in peri-urban “batey” communities. Bateyes are informal communities that were started by workers of the sugar cane plantations just outside of San Pedro. While most of the plantations have closed, these communities still exist and are home to many marginalized, vulnerable residents. Unemployment is high and even people with the opportunity to work typically earn approximately $2.00 per day.  Infrastructure and services are very weak in these communities. Most people living in the bateyes are unable to reach government services in other areas and lack access to healthcare facilities, public sewer systems and reliable water sources. It is the children who suffer the most because of the poverty and infrastructure problems. Child mortality rates (CMRs) in the bateyes are nearly double the country’s national average. (In San Pedro de Macoris, 45 out of 1,000 children do not reach their fifth birthday while nationally 26 out of 1,000 do not.)  

The mobile clinic team consists of a physician, nurse, pharmacy technician, and driver who travel to the bateyes daily. The team provides clinical consultations and medications from their mobile clinic vehicles or in local community centers. They offer basic medical care for anyone who comes to the clinic, but specifically target women and children under 5. They also screen for malnutrition and non-communicable diseases such as diabetes and hypertension among adults. The medical team conducts home visits to patients who cannot walk to the clinic and to new mothers and their babies. The mobile clinic teams also work closely with community health workers (CHWs) who have been trained by MFH.  These CHWs follow up with patients and provide individualized health education through home visits. CHWs provide essential preventive health education to families who are struggling to keep their children healthy and encourage the modeling and adoption of healthy behaviors. CHWs also identify patients who need medical or nutrition services and collaborate with the medical team to ensure these patients receive care.  CHWs focus on families with children under 5, pregnant women, and new mothers and their newborns to ensure each child has a healthy start to life.