“There was one Haitian guy that was helping us and he was always serious, he never smiled,” Permashwar said. “And at the end of the visit — we were about the same size — ... I took all my clothes and I gave them to him. I gave him my clothes and I gave him a travel toothbrush. And then he started smiling and I realized he didn’t have any teeth.”
Permashwar, a physcian at Lumberton Medical Clinic, went to Cevico in the Dominican Republic last month with about 20 other doctors, nurses and volunteers to run a free clinic.
“When we went back to the clinic on Sunday, we got there at nine in the morning and we had to shut the gate,” he said. “There were already over 450 patients lined up waiting. There were people from four in the morning outside waiting to see us.”
The group saw roughly 1,200 patients during the three-day stay.
“They would come in by families,” he said. “ ... Sometimes it would be grandparents, parents, and the grandkids. Everybody came together. So when you are seeing them, you are seeing like 10 people at one time.
“It’s different because we are accustomed to seeing one person at a time and then there’s the privacy issues. ... But they didn’t care because it was free health care and they weren’t getting any.”
While there is a local hospital, most residents cannot afford the medications. Everything at the clinic was provided free.
The group dispensed about $2,000 of medicine they brought and $900 purchased locally. The medicines provided were antibiotics, antifungals and antiparasitics.
Most of the patients were children.
“All of the kids we saw, most of their problems were hygiene,” he said. “All the kids were given worm medicines and vitamins ... and all the kids, when they left, they had a goody bag of school supplies.”
The school supplies were purchased by volunteers who came on the trip. Everyone who went paid for his or her own airfare, but food was provided by the village.
“They would go in the morning and kill a chicken,” he said. “They provided what they could.”
The Dominican Republic is about 2,000 miles from Robeson County. The country, which borders Haiti, is the second largest Caribbean nation after Cuba with a population of about 10 million people.
The life expectancy in the Dominican Republic is 68 years. While most of the patients were young, Permashwar said they did see one 91-year-old man.
“There weren’t too many old people,” he said. “Most people who were in their 40s looked like they were in their 60s. They looked pretty aged.”
The group operated from a high school, using classrooms as examination rooms, and provided movies in a nearby room for those who had long waits. Southeastern Regional Medical Center, Southeastern Home Health and Drugs America donated nebulizers and medicine bottles. Permashwar said they left the nebulizers for the local doctors to use.
Permashwar said he was surprised by some home remedies used in the village. Many children he saw had cuts on their feet from walking around barefoot on broken bottles. The common treatment was mixing bark from a tree with olive oil and stuffing it into the wound.
“So when you see it, it’s all infected and it’s smelling, but for them they say that’s normal, that’s how it heals,” he said. “So we were doing a lot of cleaning it out and putting them on antibiotics ... Over here we would consider that a medical emergency when it’s infected. Over there it’s just that’s what they do.”
Some of the volunteers who joined the doctors and nurses were teenagers whose parents are from the Dominican Republic. As first-generation Americans, they had a chance to see life where their parents grew up.
“Then they see how kids in other countries are living,” he said. “They come to the clinic just with a little trouser on, no shirt, no shoes or anything. It was rewarding for us to see the kids appreciate what they have over here.”
Although the Dominican Republic’s economy is one of the fastest growing in the region, 30 percent of its citizens live below the poverty line, according to the United States Agency for International Development. Permashwar said that although the school had toilets, there was no water going to them.
The teens helped with controlling the lines, getting supplies for doctors, and checking blood pressure and blood glucose levels at the registration station.
Most of the group was from New York. Permashwar’s wife, Juana Hernandez, works at Lutheran Medical Center in Brooklyn and planned the trip. The mission trip was her second to the Dominican Republic, but she has organized several to other countries.
The missions are part of a not-for-profit foundation, Call to Serve, that Permashwar, his wife, and three other people established. They hope to do at least two mission trips each year that concentrate on children, education and vaccinations in the Dominican Republic and Guyana in South America.
“We want to do a lot more education, which we didn’t get to do this time,” he said. “We plan to make our own videos on like hygiene, hand washing ... things that would help people who live in the village. And we’d make our own CDs and instead of sitting after registration watching a movie, we’d take them in bunches to watch a 10-minute presentation.”
The group stayed in rented villas in the countryside of Cevico and were joined by four local doctors.
Permashwar does not speak Spanish, and had his sister-in-law translating for him during the trip. The language barrier caused some confusion — and levity.
“Every time I would finish my station, she would shout out ‘proximo’ and this police officer would stick his head in the door and smile and then he would bring the next family,” Permashwar said. “I didn’t know it meant ‘next,’ so at the end of the night, I was looking for Sgt. Proximo.”
Permashwar, who grew up in Jamaica and Guyana, said the circumstances in a Third World country make medical care more challenging since supplies are scarce.
“It teaches you to be resourceful,” he said. “I mean, you have to use the supplies that you have. You can improvise. Over here, with all of the problems with litigation and all these rules, you are not allowed to improvise. It allows you to think outside the box.”
This was Permashwar’s first mission trip outside of medical school, and he hopes to do more.
“You feel more satisfied as a physician,” he said. “You know you work here, you practice medicine to a certain standard, you have a good life and it allows you to help people in other countries who are not as fortunate.”
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