Pequeños Pasitos

The first time we went to Pequeños Pasitos was in that orientation period. It’s up in the mountains by Santiago—a 40 min. or so guagua ride—in a campo called las Bajones (which means afros—it’s a reference to the shape of a type of grass that grows there).

The clinic is run by A Mother’s Wish Foundation, and it primarily serves women and children.

Diego told us the story of how the foundation came about. He and his wife Rita are from Kansas or somewhere around there. Their daughter was extremely ill several years ago and needed a transplant—kidney, liver, something like that. Anyway she was very close to death, and the doctors said they would take anything that remotely matched at that point to give her more time. Then at the last minute an organ turned up that was exactly right—a perfect match. Their daughter lived, and is now raising her kids somewhere in the states.

After experiencing this miracle, the couple felt they needed to do something drastic. Rita is originally from Santiago and has family there, so they moved to the DR and found the poorest area in the region of Santiago. They set up in las Bajones and after not too long opened Pequeños Pasitos for the first time.

The clinic has a large waiting room—which is good because there’s always a lot of people. There are two consultorios, a triage room for the nurse, and a small washroom/lab area. I think they have a microscope in there. I’m trying to see if we can get the blood analyzer up and running for them. Then there are a couple of other buildings—one, the most important one, Diego says, holds the generator and backup power supply. The other one has a living area for students who stay long-term, an office, and I think has a room for classes. Daniel and Micah the med student are teaching an English class and Mollie and Stacy help out the girl’s group. I can’t stay late to help out with that stuff as I have class Tuesday afternoons.

But we do get to spend all of Tuesday morning there. Two weeks ago I went out with Ana and a few other students in the community. It was too large of a group, really, for only one consejera (Ana, our teacher) and two stethoscopes. But it was super interesting nonetheless. At each house we gave a little spcheel about Dengue fever (I have it memorized now) and tood people’s blood p

ressures. I took the pressure of one guy who turned out to have pretty high blood pressure. Even though the clinic primarily treats pregnant women and children (the goal is to raise a generation of healthy children), they treat other people too if they live in the community. We noted names and addresses of all the people we checked for the clinic records, and referred the ones with hypertension there. Then we went by the school just as they were getting out of recess, so we stopped in and gave a talk about Dengue. Throwing something like that together isn’t quite as fun when you’re with too many type A’s. But it was pretty cool, and more importantly, I think those kids actually learned the most important bits of information. The school, by the way, was in some kind of old warehouse building.

The kids were separated by ages and each group was set up in one corner or another with chairs, sometimes desks (the wooden kind attached to benches, painted in garish pink or teal), and if I remember

right, a blackboard. I would guess there were a hundred or so kids. It was probably the saddest setup for a school I’ve ever seen. And the kicker was that every kid was dressed in a pristine black and blue school uniform. I really had trouble understanding that one.

Last week I spent the morning with the doctor and Micah. One of the more significant things I learned was that I shouldn’t go into primary care. After about 10 or 15 diagnoses of gripe I was ready to bang my head against the wall from boredom. But other than that it was awesome. We listened to a lot of kid’s chests and I learned the basic list of questions the doctor runs through with every sick kid. With one patient, I figured out the had run our or spilled the antibiotics the kid was supposed to have been taking,

and the doctor gave them another bottle before they left. So I felt kind of special about that. They buy the drugs they use most commonly in bulk and repackage them so they can give them out for free.

I’m not sure which type of work I liked more. It was exciting to

deal with actual diseases in the clinic, but at the same time, out in the community there is a sense of actually preventing diseases, not just fixing them. I’m sure I’ll have a better idea after I’ve gone through all the rotations.

Every time we go I think about the rez more. Something about the goals and values of the clinic clicked with me the first time I went, and now I keep thinking to myself about how badly I want to be doing this work on the rez. It’s starting to get to me—I think I’m homesick. But it’s also good, because I feel like I’m on the right track; I can actually see myself doing this in the future.