This summer I had the opportunity to spend five weeks working with American Youth Understanding Diabetes Abroad (AYUDA) in the Dominican Republic teaching local youth and adults about how to live with their diabetes. Among others, the experience was educating, humbling, and unforgettable. Although I could never include every memory from my time there, I’ve tried to summarize the trip the best I can below.
I arrived in Santo Domingo in mid-June for AYUDA’s Campo Amigo program. Last year I participated in Campo Amigo as well, thus this year I was able to come back as a VMIT, taking on greater responsibility and helping lead one of the two subgroups of volunteers. After all the volunteers arrived amid delayed flights, unexpected storms and all the other joys of airport travel, we were able to kick off our program the first weekend with a tour of Santo Domingo’s colonial zone and a dinner at a local restaurant called Conuco. Conuco offers traditional Dominican food including moro (Dominican rice and beans), mangu (mashed up plantains), tostones (plantain fries), and various types of chicken and beef. After eating a handedly American portion of food, we all showed off our gringo side by trying our hand at bachata and merengue dancing. All I’ll say is that I think I had the locals convinced I have at least un chin of Dominican blood in me.
After this initial weekend we began our first week of work. At the beginning of the week we went over presentations about health & safety, diabetes in general, and diabetes treatment in the Dominican Republic. This coupled with a visit to the local hospital, Robert Reid Cabral, gave us an in depth glance at heath care in the Dominican Republic. Robert Reid is a public hospital, which means that all care offered there is completely free. As one might expect, it is absolutely packed with people. The waiting room is a logistician’s worst nightmare and the file system is a cavernous room filled to the brim with manila folders. As we toured the hospital, the doctors talk very openly and candidly about patients’ conditions right in front of their faces. This cultural difference is unsettling at first but is part of the status quo in the DR. As we toured the emergency room, we came across a girl that had been diagnosed with diabetes only minutes before. When well over half of our group raised our hands to show that we too had diabetes her eyes lit up in delight. However, at this same moment an ear-piercing cry rattled the room. As we looked across the room we noticed a mother crying over her infant daughter. After our guide ushered us out of the room she explained that the little girl had passed away only moments before from congenital heart issues. The doctor explained that the little girl’s condition could have been treated but it was so costly and resource-intensive that she would have had to been sent to the US for care. For the rest of the tour, I was rather shell-shocked at having been in the room as this little girl passed and felt an overwhelming sense of helplessness that we could not do anything to assist her. Furthermore, I felt like we had so grossly violated the mother’s privacy by being in the room when she was experiencing such grief. Unfortunately, this was the reality in which we found ourselves in a resource-poor country.
For the rest of the week, we continued to plan and revise our activities for Dia de la Familia the coming Sunday. Along with the AYUDA volunteers, we had many of the local volunteers from our partner organization AAV staying with us in the hotel. This week gave us the chance to hang out with them and really get to know them.
During Dia de la Familia, we finally enacted the activities that we had been working so hard on. This first day of camp was aimed at returning campers and their families that work with AAV during the year. Camp is split up into 3 groups: verde, azul, and Amarillo, with the youngest campers in verde and the oldest in Amarillo. Last year I was in grupo verde and enjoyed getting to play games with the little kids. However, this year I was in groupo amarillo. In lieu of tag and coloring books, we were able to facilitate candid discussions with our campers and their families about the challenges and stigmas of living with diabetes. The local leaders took the lead in our activities because they could share stories that were very relatable for the campers. As a group, we were able to combat prominent myths around diabetes in the country, for example that people with diabetes cannot have children or might go infertile by taking their insulin. I think we were able to fix these misconceptions and show the campers that they can live happy, healthy lives with diabetes.
After Dia de la Familia, we had two days of outreach: San Pedro then San Cristobal. In each city, we had to opportunity to do home visits to some of the campers’ houses to see how they live. Although impoverished, these families graciously welcomed us into their homes and explained how they travelled to see their doctors and how they managed their diabetes without even a glucometer at times. After a beach day, the rest of the week was spent revising our activities from Dia de la Familia and planning more activities for Campo Amigo the coming weekend.
On Saturday, we awoke far too early in the morning to kick off the first day of Campo Amigo—a two-day camp aimed at newly diagnosed youth. Over Saturday and Sunday, we did different activities ranging from teaching about proper nutrition and how to assemble a “perfect plate” of food to playing banderita, the Dominican version of capture the flag, to having another discussion about breaking the social stigma and myths around diabetes. We had many of the same campers over all 3 days, including one camper named Roberto who was from San Cristobal. The first time we met Roberto was when we visited his house earlier in the week during our outreach to his city. His family was very poor and he did not have sufficient money to always buy his insulin. Roberto showed up at camp on Saturday very timid and shy, however as the weekend progressed and we played more and more pick-up basketball games he started to open up about his life with diabetes. In my opinion, Roberto left camp with a deeper understanding of his diabetes and the knowledge that there was a readily accessible community of people living with diabetes awaiting him at the AAV foundation in Santo Domingo.
After the second weekend of camp, the rest of the Campo Amigo program flew by. We spent the final few days enjoying the beach and evaluating the program then the Campo Amigo volunteers left the following Wednesday. After working at Campo Amigo last year, I knew more of what to expect for this year’s camp and thus felt better prepared to handle the curve balls that the DR inevitably throws at you. The mix of old friends who returned from last year and new friends who were volunteering with AYUDA for the first time made the experience truly unforgettable. The days spent planning, nights spent watching movies as a group or dancing, and weekends and outreach days spent working left us all exhausted but with a feeling of pride that we had impacted the youth of the community in which we were working.
After the Campo Amigo volunteers left, the staff and the remaining Volunteer Mentors had the rest of the week for some R&R and brunch before the new group arrived on Saturday for En El Camino.
En El Camino
En El Camino was a new program that AYUDA piloted this year that was aimed at reaching communities outside of Santo Domingo where we do not ordinarily work. After an initial weekend similar to that of Campo Amigo filled with presentations and another welcome dinner at Conuco, we began a jam-packed week of outreach. We had a day of planning at the beginning of the week then went into 5 days of back-to-back outreach: Baní to San Pedro de Marcorís to San Cristóbal to La Vega to San Jose de Ocoa. Each day we rose between 5 and 6 in the morning, hopped on a guagua (Dominican bus) for an hour or two, then did clinics with local adults for 4 hours. After the clinics, we would do some type of cultural activity in the area then hop back on the guagua to Santo Domingo.
For each clinic, we would divide the participants into three groups then cycle them through our three activity groups: nutrition, exercise, and insulin/medication. I worked in the insulin/medication group for the week where we taught diabetes basics, how insulin and pills work, and the importance of sticking to a medication regiment.
Our first outreach clinic was in Bani. The day was filled with unforeseen difficulties as we discovered the flaws and strengths of our activities. For our group, we had not anticipated the lack of literacy among the people with which we were working. Many of our activities involved some degree of reading or organizing steps to something and then having a discussion. However, since the participants couldn’t read we had to improvise and explain diabetes by drawing pictures and illustrations rather than reading steps.
Our second day of outreach was to San Pedro, where we had done home visits during Campo Amigo. This day went smoother because we had a day of practice under our belt and we had a group of almost 70 to work with. For our third day, we went to San Cristobal—the second town that we had travelled to during Campo. San Cristobal is a small town in the foothills of the mountains with a clinic that was hot and cramped. Although we were more practiced at our activities, each group was jammed into a small room with thin walls and stale air. Despite the conditions, I think we were still able to effectively make an impact on the community.
The following day we awoke terribly early to travel north through the mountains to La Vega. Although early, the drive was stunningly beautiful and also unexpected since I had not realized that the DR also has mountainous regions. On the way, we even had the opportunity to stop at a renowned local restaurant for coffee and mangu (a weird breakfast food in my opinion) with a view. Once we arrived at the local hospital we discovered that only a handful of locals had shown up. Nonetheless, we worked as a big group for the day and had the opportunity to participate in the other groups’ activities. Since the group was so tractable, I thought that our activities went the best on this day out of any. However, the small group left us with the sense that we hadn’t made as large of an impact on the community as a whole.
Our final day of outreach was to another town in the mountains called San Jose de Ocoa. The drive was similarly beautiful (and also lengthy). Once we arrived we discovered that the diabetes clinic was stationed within a local assisted living home. At first, this clinic was frustrating because some of the people were not very responsive due to their age and it felt like we weren’t impacting the overall community very much. However as the day progressed we noticed people starting to become more engaged and several of the younger participants in each group were heavily engaged in our activities.
These days of back-to-back outreach left us feeling exhausted but with a strong sense of accomplishment. The Sunday after our final outreach, we had to opportunity to go to one of the local volunteer’s beach house at Boca Chica to relax and recuperate. The following days we did program evals and a final trip to the colonial zone before the En El Camino volunteers headed back stateside amid another flurry of tears and hugs.
Between last year and this year, AYUDA has had a tremendous impact on my life. The people that I’ve been able to meet both from the states and the DR, the work I’ve gotten to do, and every other moment with the organization has been an absolute pleasure. I am incredibly grateful to have had the opportunity to work with AYUDA and I hope to remain engaged with the organization for many years to come. Thank you to all that donated to my fundraising to give me this opportunity to travel and work on a cause that is very near and dear to me.
As AYUDA’s motto goes:
¡Juntos Somos Mas Fuertes!
Together We Are Stronger!
To learn more about AYUDA please go here.
To donate, please go here.