Hernia Repair for Dominican Mother
Maselene, a 35-year-old Haitian woman, suffered a hernia several months ago. A mother of seven children, Maselene delivered her youngest child in fall 2013, and complications from the C-section may have weakened her abdomen and contributed to the hernia. She was initially consulted by Dr. Kerolle, a Haitian-Dominican physician serving as Timmy’s medical leader in communities along the northshore zone in the Dominican Republic.
A common procedure, Maselene’s surgery was scheduled within two weeks of Dr. Kerolle’s consult. Malfunctioning anesthesia equipment delayed the “quick-fix” by two weeks though. Had it not been for Dr. Kerolle and the initiative he took to create a partnership with a private hospital, Maselene might be waiting for surgery still to this day. The promise of a surgery at the new referral hospital was a step-up for patients because of its new facilities.
However, the location switch presented new logistical challenges. With the help of Dr. Kerolle and a community health agent named Junior – an EMT and electrical engineering student – Maselene and her husband were transported to the hospital on the morning of the surgery. According to the two surgeons, the surgery was a success – though they were surprised to find a second small hernia. Both were fixed. Maselene’s husband, who is currently unemployed, stayed at the hospital throughout the day and the children arrived during the early evening to stay the night. Maselene is recovering at home now. Dr. Kerolle visited her at her home – in a community called La Redemption – three days after the surgery, and he cleaned and rebandaged the wound. Another community health agent named Fosley, a nurse and medical student, has been instructed to return daily to check-in. Dr. Kerolle and Fosley are already discussing ways to strategically manage Maselene’s care and assist her family during the next four weeks to ensure that her abdomen heals properly.
I served as a long-term volunteer with Timmy’s new partner in the Dominican Republic this summer, and I had the chance to follow Maselene’s story. On one hand, her story underscores Timmy’s focus on referral programs and continuity of care. In developing countries like the Dominican Republic, having a patient advocate is the difference between health and helplessness. Maselene is an example of the former. On the other hand, patients like Maselene are victims of structural inequalities, and her journey through the referral program unveiled some of the barriers to health care that too many patients face on this island. Lack of access to physicians, malfunctioning medical equipment, untimely care, and logistical along with cultural challenges are ubiquitous.
Despite the Dominican government’s decision to offer universal health care coverage to Haitian immigrants (a decision that has flooded Dominican hospitals), quality assurance in hospitals is limited. For this reason, Dr. Kerolle’s work in the communities – door-to-door medicine – is extremely important. I’m hopeful for Timmy’s newest partnership. I’m excited to watch Dr. Kerolle’s work grow, specifically as he formalizes and scales-up a community health agent program, which has the potential to tear down barriers to access and create a new standard for timely access to health care in Timmy communities in the DR.
By Drew Morrow
Drew served as a long-term volunteer with Timmy’s newest partner 7 Elements in the Dominican Republic over the summer. While he was there, he met a patient referred from a partner clinic in the North shore that received a hernia repair surgery over the summer. His blog post highlights how Timmy’s patient referral system works, and tells the story of the patient – who is now under the care of her family and a local community health agent.