The word batey is defined on the Wikipedia Web site as a company town for sugar cane workers. Situated adjacent to cane fields in the Dominican Republic, bateys are perhaps better described as small villages that are home to the workers and their families. While they vary in size and character, bateys have one thing in common: poverty. These are very, very poor places.
Dwellings range from small cottages to falling-down shacks with tin roofs. Many have no indoor plumbing - the bathroom is a communal latrine. Some families cook their meals over an open fire. Clean water is a scarce commodity.
This morning, the Global Health team is up and out the door early. We will split into two groups for our first day working in two of the bateys. In each, the physicians, nurses and physical and occupational therapists will conduct a clinic for the children who live there. They are accompanied by Dominican clinicians who are the Global Health program's local partners in the outreach effort, as well as several interpreters.
Our bus drives out of town and through luxuriant green fields, then turns into the entrance of our first batey. Some of what we pass is difficult to look at, yet also difficult to turn away from. We pull up in front of a tiny church, our headquarters for the day. Already, a line of children with parents and other caregivers has formed, awaiting the team's arrival. We quickly unload our supplies and figure out how to set up the clinic's traffic flow. Then we invite the patients in.
The next few hours are a complete whirlwind. Children are registered, weighed and measured. Janice Sims, a nurse from Children's Seashore House, takes vital signs then directs kids to one of the three doctors at our site: Mary Fabio, a pediatrician from the CHOP Care Network-University City, Lara Antkowiak, one of the first CHOP Global Health fellows, and Dr. Dulce, a Dominican physician. Many children also receive developmental assessments from occupational therapist Soby Philip, adding an important dimension to the overall picture of each patient. Team co-leader Karen Anderson circulates around the room, directing the activity and pitching in wherever needed. Many kids go home with medicines, dispensed from our makeshift pharmacy, manned by Janice, Karen and yours truly. The interpreters are busy translating doctors' instructions to parents, repeating the information as often as necessary to make sure it's clear. (Many CHOP team members speak excellent Spanish, but the interpreters provide an extra measure of security when communicating about medical matters.)
It is noisy and very hot. We drink Gatorade like it's water (who knew an acid yellow sugar beverage could be so utterly delicious?). The children are beautiful. There are infections and fever and stomach aches and rashes and malnutrition. There's also a great deal of laughter and affection. It is truly remarkable to watch the health providers engage these children, playing and laughing with them, all the while applying superb clinical skills to gain an understanding of the health problems they face. Knowing that their interaction may be the first healthcare a child has ever received.
Hours later, I look up to see that there are no more children in line. Our first day in the bateys is over. An exhausting, exhilarating and humbling day. And tomorrow, we'll do it all over again.