Cabral. Mixed feelings...

Trip Start Jan 29, 2011
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25
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Trip End Feb 26, 2011


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Where I stayed
ILAC Center

Flag of Dominican Republic  , Santiago,
Tuesday, February 15, 2011

Happy Valentines Day!!!

Today we went to breakfast At 7:30am and I ate a big bowl of fruit loops. I made a PB & J sandwich using crunchy Skippy peanut butter and pineapple jam. Packed it in a ziploc bag to eat later in the day.

We took the same Windstar to Cabral (the large community hospital) and put our white coats on to get ready for our day. Amy, Sarah and I were set and apprehensive for our day at the same time.

We walked upstairs with Leah and we found Dr. Melanie Porter. We had run into the wife of that half Filipino doctor from a couple of weeks ago who texted Dr. Porter to come out. She showed us to the resident area and we changed into scrubs.

Then, we went to prepartum where we saw a bunch of doctors and residents blowing up red balloons and Sharing candy in celebration of Valentine's Day!

The residents all stood up to greet us, then after that they didn't pay us much attention.
We waited around awkwardly because there were no other people besides Dr. Porter who spoke English, and so we waited around until this Older male doctor came in and everyone started paying attention. We figured, correctly, that this was the beginning of rounds. Our eyes followed as one doctor presented all the patients as we watched and not understanding.
Afterwards, Dr. Porter showed us how to tell the difference between a contraction and a softer uterus as this lady was contracting.

This same lady was the firs patient we saw go for a C Section. She had been given a neuro consult because she was inappropriately answering questions. Supposedly, she was "mentally challenged" and this was her baseline. It was under these circumstances that this lady was taken back to the OR. Sadly, this 19 year old first time mom was the victim of something so horrible - the male resident doctors made the decision to tie her tubes and sterilize her because she was mentally challenged. They also, as just residents, didn't know how to properly tie a tube, so they tied suture around the tube once and then replaced the uterus, telling each other not to tell the attending.

It was the hugest breech of patient autonomy and human rights I have ever seen. And the worst was that I felt I couldn't say anything because I was a visitor and observer in this hospital. Dr. Gray talked with us about how she has seen. Such terrible things at Cabral - people denied care because of being Haitian versus Dominican, people with dayed diagnosis of sepsis - and that it would be so hard to not go around touting how things should be done because we are not back in the States and we are guests.

This experience put me in a sad mood for the rest of the day. Further, the fact that the residents had no attending, were not doing the procedure correctly, and were singing and So loud while the patient lay naked on the table was appalling.

So, I am still at a place where I feel uncomfortable with the idea of being in a hospital outside of the US.

We got Off at 12:30 and found a bus stop bench to eat our lunch on. Prior to that, we stopped by the cafeteria to get bottled drinks (practically the only things we could buy in th cafeteria). Dasani makes this agua fresca here that they don't sell in the states. It comes in all sorts of flavors- apple, mandarin, grapefruit... They are all awesome! Wish they carried this in the states!
We sat and ate out PB and Js on the bus stop and talked for our almost two hour lunch.
We got back and saw two more C Sections. They were both different and both had tubes that were tied differently. Another thing that was interesting was that when the babies came out, they hold them upside down, and then lay them down back of the head first.

The last C Section was done by Dr. Porter and it was the oy one where music was played during the entire surgery. This surgery was also different because it no only used suction, there was a Bovie as well. We were commenting that this lady potentially had more money than the other women as she had both suction and Bovie!

Then, about 5pm, we excused ourselves and changed then got on the guagua back to the ILAC center. We had dinner (spaghetti with meat and corn sauce) and pineapple.
Then, we grabbed Dr. Pietro's Valentines Day gifts to us - a whole box of rich dark and milk chocolates - and had a recap of or day and the trip with Leah.

Then, shower and waiting for Helado Bon to be delivered!
~M
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