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Department: STUDENT VOICES

Lessons learned from a service trip to the Dominican Republic

Cicci, Maria ADN; Snyder, Kathleen MS, RN

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doi: 10.1097/01.NURSE.0000743056.38656.ea
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THE NURSING PROGRAM at Montgomery College, based in Takoma Park, Md., participated in an inaugural study abroad trip to the Dominican Republic in 2019. The trip was coordinated by an educational tour organization that provided a tour director and arranged all of the activities and travel. A group of nursing and biology students; a criminal justice student; a retired Army soldier; and faculty from Montgomery College, Hampton University in Hampton, Va., and Normandale College in Bloomington, Minn. attended. This article captures the excitement and anticipation surrounding the trip and discusses the lessons learned by those in attendance.

Background

The Asociación para el Desarrollo de San José de Ocoa (ADESJO) empowers local provincial communities to provide healthcare, renewable electricity, sustainable farming, and other community projects. ADESJO organized multiple service projects and provided an itinerary and Spanish language translators who captured the meaning, emotion, and culture behind the words.

At the airport in Santo Domingo, the group was met by Tasha Gough, the tour director for the trip and a marine biologist who runs a nonprofit to preserve the beaches and mangroves of the Dominican Republic. Born to an American father and a Dominican mother, Gough demonstrated deep cultural knowledge about both countries and a genuine connection to the work of the tour groups in San José de Ocoa.

Service experiences

The students worked at a local primary care clinic and completed home visits in a nearby community. They also toured the hospital in San José de Ocoa to see healthcare in action and provide some physical and emotional support to patients through massage and conversation. ADESJO also organized a panel discussion with two experienced nurses in which the students were encouraged to ask questions about nursing practice and the national healthcare system.

The communication barriers were challenging, and supplies were limited. Before the students got to work in the primary care clinic, the ADESJO translators taught the group several useful medical terms in Spanish to ease conversation with the patients and staff. The students bridged communication gaps with the help of the translators, gestures, and simple words. They formed cohesive teams and provided care to 50 patients with only two glucometers, three BP cuffs, very few cotton balls and alcohol wipes, and one size of gloves.

Home visits were another unique experience. Coming from the US, the students were humbled to see people living in homes constructed from basic materials with dirt or concrete floors and without running water or electricity. The group divided into teams and knocked on neighborhood doors to offer BP and glucose screening. Supplies and space were limited, but the homeowners were grateful and hospitable. They invited the students into their homes, offered fresh fruit from their gardens, and made the teams feel welcome rather than intrusive.

Making connections

The service trip to the Dominican Republic allowed the group to connect with the people and see places beyond the tourist districts. The students learned about the country's culture and history, including the enduring effects of colonization and slavery, as well as the effects of government policies on health in both urban and rural communities. For example, waste removal services were limited throughout the country. Massive rainstorms wash trash into the rivers and oceans, creating sanitation issues and increasing the risk of exposure to diseases such as water-borne illnesses.

The trip reinforced the importance of investigating health problems and performing thoughtful cultural assessments to create individualized plans of care. One of the most impactful learning experiences for the students was understanding the effects of social, residential, and environmental history on patient health. Although this content is taught in the classroom, the group's firsthand experiences translated the theories into action. The trip pushed the students out of their comfort zones, allowing them to develop relationships with people from the Dominican Republic and across the US and increasing their understanding of global health issues.

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