The Magic Bus: A Week in the D.R.

The Magic Bus: A Week in the D.R.
February 1, 2013 Callie Daniels-Howell

by Dr. Michael Blood

Dr. Michael Blood is a Family Practitioner working in Crawfordsville, IN. For years, he and his team of medical professionals have worked tirelessly to provide access to healthcare to many underserved communities in Haiti. In January 2013, his team partnered up with the Boise State Timmy chapter to provide medical services to a new region–Monte Cristi–which lies just along the northwestern border of Haiti and the Dominican Republic. Below are some of his observations of the highs and lows of providing services to this region.

Baseball is truly the national sport in the Dominican Republic. The central feature of each batey—the rural communities that Timmy serves outside the larger town of Monte Cristi—is a baseball field, complete with backstop and dugouts, and some with rubber-tire seats. The young men practice very hard, while the older men invest much of their time coaching. During my January medical trip, some of our Timmy team jumped in for a game or two. Barbi and Amber (two Timmy volunteers) raised the bar for the gringos when they went up to bat. They really showed what the ladies could do—as both are avid softball players!

On one of my first days in the DR, we visited a batey called Isabel, and saw about 150 total patients. The day was full of highs and lows. Barbi was able to perform 24 ultrasounds with the machine loaned to us by Sonosite—a rare tool for trips to these communities, many of which lack any source of electricity for powering high-level testing machines. We also did several surgeries, and treated a wide variety of sometimes-complex illnesses. In this same community, we also saw three insulin dependent juvenile diabetics and were able to give them insulin and steps to improve their regimen.

None were even remotely well controlled—the list of challenges to managing this disease in a developing country goes on and on. These patients either have no knowledge of or no access to the resources they need to check their blood sugars; they have no refrigeration for the insulin that’s critical to keeping them healthy; and they cannot afford to buy adequate amounts of insulin in the first place. We hope to help them as they follow up with Dr. Miguel Garcia, but we will need to find a source for insulin for them after what we brought runs out. My day in Isabel was a true reminder that we take so much for granted in the US…

In another one of the bateys we visited, we set up our pharmacy in an old bus that, despite the fact that it no longer runs, works surprisingly well as a distribution center! We called it the “Magic Bus” after the old song by the Who. The docs set up clinic in a school building next-door, seeing and treating patients in classrooms. One of my personal high-points on this day was simply giving a pair of sunglasses to a blind man. And then seeing the smile on his face.

We were also able to do an ECG on a man with chest pain using a fully charged laptop and a remotely operated special program. Another patient, a man with a neurogenic (non-functioning) bladder from a spinal surgery, came to us with symptoms from a chronic indwelling catheter in his bladder. He didn’t have any bags to collect the urine.  It was such a simple, but powerful solution when we were able to give him a leg bag and a new cane, and antibiotics for his ever-present urinary infection.  We also made an asthma spacer device out of an old Tums bottle for a young man who needed assistance with his inhaler. We call that MacGyver medicine!

Perhaps the most interesting moment in clinic that week was when Dr. Keith Baird treated a soldier who insisted on keeping his automatic weapon over his shoulder. Jose, one of the Peace Corps translators volunteering with Timmy for the week, asked if it was loaded, as it was aimed at his foot. The patient replied…It was loaded! But they were assured there was not a round in the chamber. That night we had a show at the hotel with local Dominican music and dancing. The dancers made everyone participate, including myself, which was not a pretty sight. But it was a lot of fun. The music reminded me of Louisiana bayou music with the accordions and saxophones.

After the dancing we had another pill counting party…we try to count out pills in appropriate quantities the night before our next day of clinic. Every patient with a chronic condition like hypertension gets a 90-day supply of medication, and each patient that comes through one of Timmy’s clinics also gets 90 days of multivitamins and medication for parasites. There is no charge for our services. Things are much better controlled here than on the recurring trips that I usually make to nearby Haiti—with smaller crowds of patients, and less yelling and pushing and shoving. One lady gave me a hug after we saw her yesterday, which is a gentle reminder that these communities are truly gracious for the services that we are able to provide.


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