Elizabeth's placement took her to La Romana, Dominican Republic, where the population speak a mixture of Spanish and Creole ( Spanish/French ).
The Gap Medics website says of the Dominican Republic that the population, location, and climate of many Caribbean islands plays a huge role in shaping the types of cases that their health professionals are faced with. The heat brings tropical diseases such as dengue fever and malaria, which are important considerations for healthcare providers working in birth medicine.
While the health departments in the Dominican Republic are understandably more traditional than in Australia and resources can sometimes be limited, students who join Gap Medics can expect the same high-quality mentorship as anywhere else. The student will be paired with a dedicated mentor who will be there to answer questions and explain complex cases - what better way to learn while gaining a global perspective on midwifery?
Having spent some time in the local St John of God Hospital in Murdoch, Elizabeth was shocked at the poor conditions and organisation she found in place in the Dominican hospital.The Dominican medical system works on 3 tiers with the 1st tier providing general coverage for those poorer citizens earning up to 5000 pesos ($150 AUD) per month . The 2nd tier covers those earning above 5000 pesos monthly. The final tier, referred to as the "tourist tier", is only affordable by tourists and the very wealthy citizens of the nation. The 1st tier system is not fully funded, so many suffer because of inadequate health services. The Dominican Republic is a poor country, with tourism one of the major earners of foreign currency. The nation allocates less than 5% of its Gross Domestic Product toward basic health care, and this is one of the reasons that their health system is delivering what we in Australia would call "unacceptable".
Elizabeth related the story of a man who had a broken Femur which took 6 months before being surgically repaired. When this man initially presented at the hospital, he was given a number and told to wait to be seen by a doctor. This he did; from 7am to 8:30pm before a doctor attended to him. He was required to return 2 weeks later for the results of his X Rays, only to be then told that he would have to pay for the screws and plates that would be needed when the bone was reset during an operation. He modified a crutch with a wheel attached, which allowed him to work until he could afford the operation; six months later.
The availability of a medical doctor can also be "random" as they don’t work set hours. This may be because the profession is generally not so well paid, and the doctors may be working at a second job.
Following a recent natural disaster in Haiti, many from that country received medical care in the Dominican Republic. However, the birth records of Haitian babies born in the Dominican Republic were not often recorded. The result was that these children were deemed to be "stateless", and having no passport, were often prevented from accompanying their mother when she attempted to return to Haiti.
Elizabeth gave a big "thank you" to the Rotary Club of Pinjarra for assisting her to volunteer for the Gap Medics program, and to have gained this unique experience.
Julie Gray complimented Elizabeth on her captivating talk and the passion she has for her chosen career. Julie wished Elizabeth all good fortune in the future and invited the meeting to thank her with a round of applause.