• Great news! Family Medicine Cares International (FMCI) is moving forward with a new program in the Dominican Republic, a program designed with sustainability and continuity of care in mind. The three components of FMCI – medical education, patient care, and service to children – are all integrated into the reimagined program.

    “Our initial FMCI program started in Haiti in response to one of the earthquakes, but Haiti has had its challenges, including political instability,” says Jay-Sheree Allen, MD, chair of the FMC workgroup and treasurer of the AAFP Foundation Board of Trustees. “We had to cancel two trips for safety reasons. We asked ourselves if we could continue a mission program in Haiti with all the unrest in the country, and decided we need some level of stability for a sustainable pathway forward.”

    After in-depth discovery work with global health experts and talks with a number of interested parties, the workgroup hosted conference calls with a number of programs and ultimately chose one for a site visit. After a successful visit to the Dominican Republic in 2021, it was confirmed that we will be working with the team at One World Surgery as we relaunch FMCI.

    Don’t let the name fool you: One World Surgery’s work encompasses more than surgery. A nonprofit organization, One World Surgery appreciates the need for holistic care, and works with communities and healthcare providers to deliver surgical services and primary care to underserved global communities. 

    The new location includes a twist, too: While the program is no longer in Haiti, FMCI will continue to help Haitians.

    “A lot of Haitian immigrants make their way across the border into the Dominican Republic,” Allen says. “They work on sugar farms and live in communities called bateyes, also known as sugar workers' towns. One World Surgery goes out in the different bateyes and hosts outreach clinics at schools and churches; with the help of foreign delegations they might see 200-300 patients in one week. They employ two local full-time doctors and a cadre of community health workers to continue seeing patients who need follow-up after they've been seen by a physician in a delegation."

    The on-site difference

    The family physicians who participate in future FMCI delegations will visit the bateyes with One World Surgery doctors, offering educational support for the health care providers as well as direct patient care.

    “They are so grateful we will go into the communities, where we can see how the social determinants of health really impact the population,” says Allen. “We will meet patients where they are, so we can see the conditions firsthand before creating a treatment plan. If we prescribe insulin, can the patient read the instructions? Can they use the syringe? Do the patients have anyone who can help with their medications? Those issues can have a major impact.”

    Follow-up care also has a major impact. AAFP Foundation funding will support follow-up visits by local physicians to help ensure continuity of care and sustainable progress.

    “I’m delighted to see the preparations for relaunching FMCI in this sustainable way,” says David R. Smith, MD, MPH, FAAFP, president of the AAFP Foundation Board of Trustees and a two-time FMCI delegate. “Our work will help the existing team extend their reach, we’ll still be serving expatriates from Haiti, and we’ll continue our education efforts. By helping early-generation physicians in the Dominican Republic enhance their skillsets, we can bend the arc of care for years to come in the bateyes and other communities.”

    The relaunch will begin this summer with a delegation that includes family physicians who had signed on for the two Haitian trips that were canceled. The pilot program with our new partner will focus on medical education and faculty development; the delegation team represents a spectrum of expertise in global health, medical education, and research. In addition to participating in a medical education symposium and providing direct patient care, the delegates will take part in a community project to support Nuestros Pequeños Hermanos, a home for children in need. 

    Want to be a part of a future FMCI delegation?

    It’s an exciting opportunity! Next year’s trip to the Dominican Republic is planned for the first quarter of 2023. Look for more information and applications this fall. If you have questions now, please contact Sharon Hunt, programs strategist at the AAFP Foundation, at 913-906-6006 or shunt@aafp.org

    Photo credit: Jay-Sheree Allen, MD

    FMCI in the Dominican Republic

    The fall 2021 delegation trip included a visit to One World Surgery and patient care in the bateyes.

    Family Medicine Cares International Delegation in Dominican Republic
    Patient Services in Dominican Republic