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VOSH-ONE, Dr. Derek Feifke and friends, give their services to those in need in the Dominican Republic
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Medical Mission to Constanza, Dominican Republic, April 28 to May 5, 2012
by Derek Feifke OD
The most recent bi annual medical trip to Constanza, Dominican Republic took place from April 28th to May 5th, 2012 .
Dr Joe D' Amico and I represented VOSH as part of a team of 24, led by medical director, David Rudolph MD. Our team
was comprised of two optometrists, an ENT, pediatrician, internist and dentist as well as five nurses and an optician.
We were joined by 10 other volunteers, including administrative personnel and Rotarians as well as 5 local US Peace Corp
volunteers.
The Constanza Mission was established by Deacon Joseph Vitello 7 years ago to help provide care and support for this severely
underserved area of the DR. In 2007, the mission partnered with physicians from the South Shore Medical Centre to bring
much needed medical care to this area. Their organization has since made remarkable progress in terms of accomplishing many
of their goals. They have been successful in their efforts to expand and modernize the facilities and operating room at the local
hospital. A full time physician has been hired who sees patients on a full time basis. The mission has also successfully implemented
a clean water project thanks to the commitment and help of numerous local Rotary clubs.
After our arrival in Santa Domingo, we made the three hour, winding trip up the spectacular mountains of the North East
DR to the beautiful Valley of Constanza. This region is located in the mountainous North East of the country, which boasts
both the highest mountain and waterfall in the Caribbean. Constanza is a poverty stricken region of the DR where most people
earn a meager wage working the fields. Constanza is considered the bread basket of the DR, providing more than 85% of the
country’s agricultural needs, for both local consumption and especially export.
We travelled to different villages every day, where the clinics were typically set up in local school houses. Patients queued up
from early in the morning. They would be issued numbers and were typically seen in order. Patients were first triaged by the
nurses, and were then directed to the appropriate doctors. Patients generally required care from all medical specialties. As
always, the need for eye care and vision correction was in high demand.
Our Optometric team examined a total of 348 patients. We dispensed over 500 pairs of glasses including distance, near and
sunglasses. There was an unusually high incidence of high astigmatic refractive errors. Rx’s we were not able to provide on
site were brought back to the US to be fabricated by our labs. The glasses have since been shipped back to the DR and to
the patients in the various villages, care of the wonderfully helpful Sister in charge at the local Convent. Some of the eye
pathologies identified by us, included 11 patients with advanced cataracts, including 1 traumatic cataract. A number of patients
presented with corneal leucoma and pterygia with at least three requiring surgical intervention. Other unusual pathologies
included 3 advanced keratoconic patients, I case of toxoplasmosis, and an entire family afflicted with retinitis pigmentosa
Binocular anomalies were also seen, including esotropia and a patient with Duane’s syndrome.
A truly memorable moment on this trip was at the clinic in Sureal, when a young patient paid me a return visit with her mother…..
This was a 25 year old young lady with Downe’s Syndrome who I had first met on my trip last year. She had been diagnosed with
"blindness" since childhood. Despite going to different medical clinics over the years, the answer was always the same, "nothing
could be done to make her see." After a brief retinoscopic scan, it became clear that she was extremely myopic, -14D to be exact.
Holding the trial lenses in front of her eyes and witnessing her and her mother’s reaction as she identified the facial features of the
young boy ( my son) at the other end of the room was a remarkably emotional event… one that I won't soon forget.
Of course, having her pay a return visit to the clinic this year, wearing her new glasses, beaming from ear to ear was a super
surprise.
As always, this was another successful and rewarding mission. The multi disciplinary medical approach proved to be efficient in
that many health issues could be addressed under the same proverbial roof. Next May, it appears likely that an Ophthalmologist
will be joining the Constanza Mission Team for the first time.
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