The patients we help
The patients treated by MACLA Inc. are among the poorest in the Dominican Republic. They have little or no hope for adequate medical or surgical care. The patients come from the hot, tropical cane fields in the coastal plains of the Caribbean. They come from the country’s capital of Santo Domingo where the barrio homes are clapboard, garbage litters the streets, and sewage flows in open gutters. They come from small villages and remote areas with no electricity or plumbing. Open fires for cooking and heating account for the many burn patients. Each patient has a unique history of hardships and suffering. The patients come on foot, on burros, in crowded buses, and in cabs.
Some patients have been preoperatively screened in a distant clinic and sent for surgery or triage. Most patients, however, have had very little preoperative treatment and come directly on their own to MACLA Inc.’s clinics, having heard of us by word-of-mouth, from television or radio, or from their region’s political or religious leaders. For every patient accepted, three are turned down because they are too sick or malnourished for surgery, their problems are too complicated to be treated, or their surgical problem requires other types of medical or surgical specialists.
A third of the patients have cleft lip/palate and cranio-facial deformities, a third have burn scar contractures or deformities, and the rest have hand problems, congenital ear deformities, and a myriad of tumors and keloids. Over half of the patients are children and about 20 percent are returning patients for staged procedures.
MACLA Inc. provides all immediate post-operative care. After our departure, care is continued by host country physicians or local caseworkers. We arrange all long-term post-operative care and provide antibiotics, dressings, suture removal kits, casts, and wound-care items. After MACLA Inc. leaves, we provide consultations by phone and email, and provide recommendations to host country medical personnel on the care of our clinic patients.
Health care systems in host countries are federally regulated, overwhelmed, and destitute. Wealthy residents can purchase satisfactory medical care but the impoverished populace has little or no access to quality care. Hospitals and clinics, with a few encouraging exceptions, are poorly equipped, and some are horrific. Our current facilities at the Padre Billini Hospital in Santo Domingo are vastly better than the facilities of the past.
The physicians and medical personnel in these countries are overworked, underpaid, and generally not respected. Consequently, medicine is not an appealing career for young people. In spite of these handicaps, the indigenous medical communities are eager to learn new medical and surgical techniques, they are generous and considerate in their dealings with patients, and they have come to trust and cooperate with MACLA Inc.
The realistic hope and goal of treatment for these plastic surgery patients is to restore them to the highest level of normalcy possible – physically, functionally, and psychologically. Because the team has returned annually, it has established a long-term, mutual respect with staff and patients. All have learned to adapt, share, give, and receive as a result of bringing medical skills to a third-world country.