timeline

So I’ve bought my return ticket. In just over two months (June 24, to be exact), I’ll be heading home. And I’m about ready. I’m coming to terms with leaving the things that I love here, and as for everything else…well, I’m not so torn up about leaving the things I don’t love.

For example, Dominican elections are in less than a month, which means that the entire country is becoming increasingly filled with apparent flashmobs of people cheering for one politician or another, backed up by huge posters that all have the same catchphrases below their candidates’ beaming faces (“change…now!” – “friendly and capable” – “honest and trustworthy” – “the people’s Senator!”). Of course there is ridiculously loud merengue, some of it made-up political songs and some of it incongruous Omega tunes that are meant more for hip-to-hip grinding in a Presidente-filled colmado than for a political rally. A lot of people tell me that these mobs of “supporters” are just random people that candidates pay to stand around waving flags and acting like they are very excited. Given the general attitude of most Dominicans about politics, this isn’t hard to believe. The vast majority of people are skeptical of politicians – not difficult to understand when higher-ups in the government are known for corruption, from money laundering to narco-trafficking, and in decades of elections promising monumental change the government somehow still cannot manage to guarantee electricity and access to clean water for everyone. Oh, and in case that wasn’t clear, Dominican elections count as something I don’t love because I can’t stand social inequality or excruciating noise.

Here is another anecdote that I think epitomizes why life in this country has lost some of its charm: the other day a washing machine crashed into the guagua (public transportation in the form of a beat-up bus that violates all environmental and safety standards for probably every other country in the world) I was on. No, seriously - I was sitting up front and I saw the whole thing happen. We were driving through the barrios on my way to the clinic when, as if in slow motion, a washing machine came hurtling down the road toward us. It skidded into the left side of the guagua, and everyone who hadn't seen what it was swore we'd hit one of the ubiquitous motorcyclists. The driver got out and, cursing, dislodged the washing machine from the bus fender and deposited it on the side of the road. It's difficult to explain why my next thought was, only in the Dominican Republic. I hope it's not hard to understand why I'm a bit homesick for a country where washing machines do not routinely crash into vehicles in the middle of the road.

One of the most important questions about leaving, however, is what I’ll be leaving behind, work-wise. One of the TB patients today (the man with MDR-TB about whom I wrote a few entries ago) asked me what the outcome of my research would be. “What are you actually going to do if we tell you that we aren’t treated well? That we have problems here?” I felt ridiculous saying, “well, the hope is that what I learn will help to inform future TB programs, but I can’t promise concrete changes in the way things are run at this clinic.”

What am I actually going to do? One of the good things about my timeline is that I feel only a pressure to get all the data collected, but not necessarily to analyze it. That next research step is something I can always do from the U.S. While this might be completely delusional given the fact that I am going to be a first-year medical student as of this August, it makes me feel better about June’s approach. It also gives me the freedom to do a few other things I want to make sure I get done before I leave – things that can’t be done from home. I have at least a few friends coming to visit me before my time here is up, so I plan to squeeze in the last bit of traveling I want to accomplish when they arrive. And of course there is spending time with the people I won’t be seeing regularly once I move to Tennessee.

Research-wise, I have much to accomplish and the work will not end with the end of my grant. In case you weren’t thoroughly convinced of the urgency of it by the last few entries, here’s a recent article in one of the main Dominican newspapers. If you don’t read Spanish, allow me to summarize: According to the Pan-American Health Organization, the DR is the country with the third-highest rate of TB incidence in the Americas. Factors responsible for the high incidence of TB include concurrent disease incidence such as HIV/AIDS, diabetes, and cancers, malnutrition and hunger, socio-economic inequality, and poor living conditions – all of which are prevalent in the DR.

So thanks for the challenge, MDR-TB guy. Let’s hope something useful comes out of all this.