by Cindy A. Abole, Public Relations

Although both countries share the same hemisphere when it comes to health care, the United States and the Dominican Republic are world’s apart.

“You have to realize that half of the population in these areas live below the poverty level,” said the Rt. Rev. Julio C. Holguin, Bishop of the Episcopal Diocese of the Dominican Republic. “Some people can only afford to eat just once a day.”

In a country that is predominately Roman Catholic whose schools and churches receive government support, Holguin places special emphasis on education and improved health services for the poor through work coordinated in a diocesan program called "Healing Hands." It's described as a social action ministry which today offers positive alternatives to the country’s standardized health care.

Under the leadership of Holguin, the church continues to make great strides in improving programs challenged through programs like "Healing Hands" since his appointment as the country’s third resident bishop in 1991. Holguin's work centers on resource development, education, missionary opportunities and other vital social programs in a country serving 7.5 million people.

Although the Dominican government provides standard medical care to its citizens, the quality of care is limited. This holds true for people living beyond urban areas like the country’s capital, Santo Domingo. Nationally, individuals must rely on the government’s three-tiered hospital system which provides specialized care in three categories: public - normally serving the country’s poor populations; social security - available to workers whose companies or businesses provide limited hospital insurance for workers; and private - usually afforded by the rich and well-to-do. In rural areas where sugar cane workers are paid less than the equivalent of $4 a day, individuals not only struggle with the costs associated with basic healthcare, they are challenged with finding transportation to wherever care is available.

Clinica Esperanza y Caridad, formerly known as Clinica San Lucas, was initiated by Holguin and the diocese. Housed in a converted two-story school building, the clinic is adjacent to St. Esteban Episcopal Church and School in San Pedro de Macoris, a small town 50 miles east of Santo Domingo. It will provide health care to the public living within a 30-mile radius of town. Rev. Mercedes Julian de Rivera, the diocese’s first Dominican woman ordained into the priesthood, oversees the church, school, neighboring Centro Buen Pastor Clinic (a small clinic serving a poor population of 1,000 people) and Clinica Esperanza.

As the church continues to identify its needs for spiritual community and service within specific locations, it applies the same criteria to identifying medical needs for people living in impoverished barrios (neighborhoods) and countryside batays (dwellings).

The Clinica Esperanza project involves six phases of development:

Phase 1 (Completed) General repairs made to the clinic building: painting (interior/exterior), installation and construction of an electrical generator, renovations to create a reception area, business office, record room, small laboratory and patient exam rooms.

Phase 2 (In Progress) Preparation of surgery suites, bathrooms and a physical rehabilitation room to assist in upper body care.

Phase 3 Remodeling of the second floor as medical team dormitories, large lab, dental office, team dining area, bathrooms and temporary lounge.

Phase 4 Remodeling of a house directly behind the clinic. The house would provide accommodations for a resident custodian/guard to the clinic.

Phase 5 Coordination of obtaining medical service vehicles including an ambulance, 12-passenger van to transport personnel and patients and a mobile clinic bus to provide health care services to remote neighborhoods who have no health services.

Phase 6 Expand construction of medical personnel housing across from the clinic. Housing will provide short and long-term housing accommodations.

Already completing phase two in their planning, Holguin now turns his attention to coordinating and inviting specialized medical and surgery teams who could schedule specialty visits during short-term rotations at the clinic. Teams will work with a local group, Cristiano Servicios Medicos, a collection of Dominican medical mission specialists who will provide volunteer medical assistance on a weekly basis. Diocesan intentions are to recruit family medical doctors, medical students and other health care professionals to spend short visits from weeks to months.

“I know visiting students will be especially surprised from the ‘culture shock’ and transition between first and third world environments,” Holguin said. “But I am hopeful of the positive cultural benefits and long-term relationships that could evolve from such an experience.”

In an effort to influence people’s value of good health, medical services provided through the clinic will not be free. For patients to invest in themselves, the church believes that it is important to charge for medical services. Patients will be charged a small fee for services—consultations, medicines, surgery, etc.—based upon their ability to pay. However, no patient will be turned away, because of their personal economic condition or inability to pay.

Total project cost for the clinic is estimated at $36,500. Although the list for funding resources continues to grow, the clinic is primarily supported by several organizations: Episcopal Sisters of the Transfiguration, Esperanza International, Episcopal Medical Missions, Centro Cristiano Servicos Medicos and the Episcopal Diocese of the Dominican Republic.

In support of his long-term social ministry plans, Holguin envisions the construction and establishment of similar clinics throughout the country. Another long-term health care-related project includes the creation of a mobile health clinic bus which could provide one or two-day medical and dental clinics in barrios or remote areas throughout the country. Supplies such as medicines, general equipment, an electric generator and other essential items can be carried within this mobile clinic. The bus could also be available to assist in local and national medical emergencies.

Clinica Esperanza is in need of a variety of medical equipment and hardware to help supply their public clinic for the poor. Among the many items listed include IV poles, hospital beds, laryngoscopes, hospital gowns and masks, surgical blades, lab supplies and medicines. A complete list of medical items can be obtained from Cindy Abole (e-mail, aboleca@musc.edu).