Health on wheels in the Dominican Republic
Reaching the most vulnerable populations
Dr. Hector Montero and the mobile health unit team inch the medical van down a five-kilometer dirt road riddled with potholes on their way to Buenos Aires in the Dominican Republic. To his left, he can see the rolling hills and tranquil waters of the Sierra Prieta nature preserve; to his right, the deserted medical offices of SESPA, the country’s Ministry of Public Health and Social Assistance. SESPA should be bustling with doctors, nurses and medical professionals. Instead the darkened windows serve as a reminder to Dr. Montero and the mobile health unit team. If the van doesn’t make it to Buenos Aires, the community of Haitian people who live there will have no access to health care.
Montero is the coordinator for the IPPF/WHR Mobile Health Unit (MHU) Project in the Dominican Republic, operated by Member Association, Profamilia. Like similar mobile health units in Bolivia, Colombia and Guatemala, Profamilia overcomes barriers created by geographical and cultural isolation to bring much-needed health care and education to impoverished, underserved and marginalized communities. In the Dominican Republic that means Haitians and their descendents—an estimated 500,000 to 1 million strong population that lives in utter poverty, suffers from severe discrimination and displays disproportionately high levels of illiteracy, infant and maternal mortality, fertility rates and infectious diseases. Undocumented Haitians and their descendents are ineligible to receive public health services—even in the case of extreme emergency.
While sexual and reproductive services, such as contraception, gynecological exams and HIV testing make up the majority of services, the mobile health unit offers community-specific educational talks and materials on practicing breast cancer self examinations, violence prevention and family planning, as well as basic health care for common infections and for young children suffering from recurring stomach illnesses. In 2008, the MHU Project in the Dominican Republic provided 18,767 HIV-related services, 11,214 services pertaining to sexually transmitted infections, and 15,820 services concerning gender-based violence. They distributed more than 3 million condoms and more than half a million IUDs and hormonal contraceptives.
But the services offered by the MHU aren’t just providing care, they’re changing minds. For example, a study of sexual and reproductive health knowledge among Dominican Haitians found that the percentage of women who could identify three ways to prevent sexually transmitted infections and HIV/AIDS jumped from 28 percent when the MHU Project began in 2005 to 60 percent in 2008. The mobile health unit team’s work is hard, but Montero says, “We are increasing awareness and providing access to quality health services to socially and economically vulnerable populations; giving forgotten people the tools for a better life.”