Informing Medical Mission Preparation: A Needs Assessment of Patient Encounters in Barahona, Dominican Republic

Informing Medical Mission Preparation: A Needs Assessment of Patient Encounters in Barahona, Dominican Republic | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Informing Medical Mission Preparation: A Needs Assessment of Patient Encounters in Barahona, Dominican Republic Makell Brown, Joel Bruggen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9517504/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: People born in low-income countries have an average life expectancy approximately 15 years shorter than those born in high-income countries, reflecting persistent global health inequities. Short-term medical missions (STMMs) have emerged as one strategy to improve access to basic medical care in underserved communities while providing opportunities for health assessment and treatment. Barahona, a city in the southwestern region of the Dominican Republic, is a rural Caribbean area where healthcare access is limited and where STMMs frequently serve vulnerable populations. Many residents are Haitian migrant sugarcane workers who live in settlements known as Bateyes . These communities often experience significant socioeconomic barriers to care. Over 90% of Haitian migrants and approximately 80% of their descendants in the Dominican Republic lack health insurance and remain in unresolved legal status, further limiting their ability to access formal healthcare services. Goals: The aim of this study was to evaluate the clinical impact and scope of care delivered to an underserved population in Barahona, Dominican Republic during a short-term medical mission conducted in 2024. Methods: This needs assessment used a mixed-methods approach incorporating both quantitative and qualitative data collected during patient encounters. The mission team consisted of three physicians, one clinical pharmacist, one nurse, one interpreter, and eleven medical students. During clinic operations, patient demographics, chief complaints, diagnoses, and prescription data were documented and subsequently entered into Microsoft Excel for descriptive analysis. Results: The team evaluated 312 patients, including 134 adults and 178 children. Intestinal helminthiasis was the most frequently encountered condition among children, while hypertension was the most common diagnosis among adults. Among adult patients, only 26% were male. In total, 751 prescription medications were dispensed. The most frequently provided medications included multivitamins, acetaminophen, ibuprofen, amoxicillin, and albendazole, reflecting both symptomatic treatment and management of infectious diseases. Conclusion: This short-term medical mission provided an opportunity to address healthcare disparities in Barahona. The clinical presentations observed largely resembled those encountered in primary care settings in developed countries, with the notable exception of intestinal helminthiasis. Adult males were the least represented group, highlighting a potential barrier to healthcare access and an important consideration for future outreach efforts in this region. Program & Project Purpose This project was housed under the Christian Medical Dental Association (CMDA) at Wake Forest University School of Medicine. CMDA was founded in 1931 by Drs. George Peterson and Kenneth Gieser at Northwestern University Medical School . 1 Due to unique difficulties of being one of few Christians on their medical school campus, the two student doctors started to meet regularly. 1 Their assembly quickly drew the attention of other medical students, and their group grew significantly. 1 Ultimately, CMDA, originally known as Christian Medical Society (CMS), was born. 1 The intent of the organization was to provide a network of Christian healthcare professionals, ultimately evolving to provide both care to those involved in the organization and those in need. 1 To help carry out its mission, the program facilitates medical service mission trips both for medical students and health care professionals such as physicians, physician assistants, nurse practitioners, and nurses. In 1968, the organization sent its first team to the Dominican Republic on a medical mission trip. 1 Today, medical students are increasingly participating in medical service trips through this organization, and their lasting impact is evident. The purpose of this project is to evaluate the benefit provided to patients in Barahona, Dominican Republic, on a medical service trip with CMDA in an attempt to inform future medical service trips to this or similar areas. Program & Project Purpose This project was housed under the Christian Medical Dental Association (CMDA) at Wake Forest University School of Medicine. CMDA was founded in 1931 by Drs. George Peterson and Kenneth Gieser at Northwestern University Medical School . 1 Due to unique difficulties of being one of few Christians on their medical school campus, the two student doctors started to meet regularly. 1 Their assembly quickly drew the attention of other medical students, and their group grew significantly. 1 Ultimately, CMDA, originally known as Christian Medical Society (CMS), was born. 1 The intent of the organization was to provide a network of Christian healthcare professionals, ultimately evolving to provide both care to those involved in the organization and those in need. 1 To help carry out its mission, the program facilitates medical service mission trips both for medical students and health care professionals such as physicians, physician assistants, nurse practitioners, and nurses. In 1968, the organization sent its first team to the Dominican Republic on a medical mission trip. 1 Today, medical students are increasingly participating in medical service trips through this organization, and their lasting impact is evident. The purpose of this project is to evaluate the benefit provided to patients in Barahona, Dominican Republic, on a medical service trip with CMDA in an attempt to inform future medical service trips to this or similar areas. Background People born in low-income countries have an average life expectancy 15 years shorter than individuals born in high-income countries. 2 Low-and-middle income countries (LMICs) account for 90% of the global burden of disease, driven in large part by lack of access to healthcare. 3 This is reflected in profound infrastructural gaps—low-income countries average only 9 hospital beds per 10,000 people compared to 57 in high-income countries. 4 The disparities in infrastructure and access to care contribute directly to preventable morbidity and mortality in these regions. 4 In response to such inequities, short-term medical missions (STMMs) have emerged as one strategy to provide healthcare access to underserved populations, with the number of trips increasing annually. The aim of this study was to evaluate the clinical impact and scope of care delivered to an underserved population in Barahona, Dominican Republic during a short-term medical mission in 2024. STMMs are defined as trips that consist of volunteer medical providers from high-income countries to provide healthcare in low-income countries. 5 STMMs typically last 1–2 weeks, and comprise physicians, nurses, medical students, pharmacists, and other healthcare personell. 5 The primary goal of STMMs is to address unmet health care needs of low and middle-income countries. 4 The group of volunteer medical providers will typically bring medicine and medical supplies in an effort to work with local health providers to provide care within the community– free of charge. The type of MST can vary from general medicine to specialty-focused (surgery, ophthalmology, dental, orthopedics, etc.), with the most common being primary care. 6 Over the years, these trips have grown increasingly prevalent, with up to 2 million Americans participating annually, spanning greater than 1,000 mission trips each year. 4 Although STMMs have shown to have a significant positive impact on healthcare disparities, a major critique of the trips is their long-term impact. Many critics argue STMMs do not address the core issue that drives health disparities in the developing world: poverty and overstretched healthcare infrastructure. 5 Even so, millions of dollars are invested in STMMs yearly, bringing into question if efforts produce a return on investment within the area served. 5 However, emerging evidence suggests that capacity-building STMMs, or trips that seek to educate existing healthcare workers, result in lasting benefits. 7 One prospective study in Serra Leone demonstrated retained knowledge and improved hospital practices among local staff up to 2.5 years after the STMM. 7 Another barrier to providing lasting, positive impacts during STMMs is finances. It is estimated that annual expenditure on STMMs exceed 250 million dollars per year. 8 A single trip requires airfare, supplies and equipment used in direct patient care, lodging, ground transportation, and the opportunity cost that represents the income missed during absence from practice. 9 One of the most significant financial requirements is supplies and equipment used in direct primary care, emphasizing the necessity of minimizing superfluous supplies. The following paper will further characterize the impact of medical mission trips by reviewing the needs addressed in a trip to Barahona, DR, including documentation on conditions encountered and medications prescribed. This will aid in understanding the impacts of STMMs and help with STMMs preparation to similar areas. Barahona, Dominican Republic Barahona is a city located in the southwest region of Dominican Republic. It is approximately 90 miles from the Haitai, Dominican Republic border. Due to Barahona’s geographic proximity to Haiti, a substantial population of Haitian-descent residents reside there, many of which were born in the Dominican Republic. Their unique location has resulted in significant disparities, as they are unrecognized by Haiti and marginalized by Dominican Republic. 10 Many of the Haitian residents are migrant sugarcane workers and reside in rural sugarcane settlements known as bateyes. 11 Bateyes are typically small shelters that house several families, without proper sanitation and often lack running water, electricity, and adequate garbage disposal. 12 Over 90% of Haitian migrants and 80% of their descendants in the Dominican Republic lack health care insurance and have an unresolved legal status. 13 Relative to the broader Dominican Republic, Barahona represents a population with disproportionate healthcare needs. Structure/method/design Study design This needs assessment was conducted using a mixed-methods approach, incorporating both quantitative and qualitative data collected during patient encounters. The trip consisted of 3 physicians, 1 clinical pharmacist, 1 nurse, 1 interpreter, and 11 medical students. There were three teams: Triage, Medical, and Pharmacy. A local physician was also a part of the team. Each medical student rotated with a different team each day. The chief complaint was originally taken by the triage team as the patient entered the clinic. Diagnosis and prescription information were collected by the medical team. The final prescription was verified and delivered by the pharmacy team. Setting and population The assessment was conducted at Barahona, Dominican Republic during a 6-day medical service trip. The clinic was set up within local churches and buildings, with the team moving to a new location each day. All of the patients were of Haitian descent. This population was selected due to lack of access to medical care and significant disparities that existed within the area. Data source Data was collected directly from patients during the Medical Service Trip. Data collection procedures This data was handwritten on data collection sheets. Each team verified that the correct information was recorded for each paper. A Spanish and French interpreter were used throughout each visit, as majority of the patients did not speak English. Data analysis All data collected during the medical service trip was input into Microsoft Excel for analysis. All quantitative survey data were imported into Microsoft Excel for analysis. Data cleaning procedures included checking for missing responses, removing duplicate entries, and standardizing categorical variables. Descriptive statistics (counts, percentages, means, and ranges) were generated using Excel formulas. Visualizations, including bar charts and tables, were created using Excel’s chart tools. Ethical considerations This project was conducted as part of a quality improvement and educational assessment initiative. All data collected were anonymized, and no identifiable information was linked to patient responses. Participation was voluntary, and all respondents were informed of the purpose of the assessment and their right to decline participation without consequence. Because the project focused on program improvement and posed minimal risk to participants, it was reviewed by the institutional review board and determined to be exempt from full review. All procedures followed ethical principles outlined in institutional policy regarding confidentiality, data protection, and respectful treatment of participants. Results As evidenced in Table 1 , our team encountered a total of 312 patients in Barahona, Dominican Republic. Of these patients, 134 were adults and 178 children (less than 18 years of age). The overall age ranged from 4 months to 100 years. The average among the adult group was 56 and 49 for males and females, respectively. The average age among the pediatric group was 4.6 and 7.2 for males and females, respectively. Gender distribution was also analyzed. Among the adult group, 99 (74%) were female. The range of age among the adult female group was 19–100 years of age and 22–95 in the adult male group. In contrast, among the pediatric group the ages ranged 4 months to 18 years among females and 1 month to 17 years among males. Of all the children, 87 (51%) were female. Diagnoses Adult As evidenced in Table 2 , hypertension was the most common clinical condition encountered among adults treated in Barahona, Dominican Republic, with 37 out of 134 (21%) patients diagnosed with hypertension. The second most common clinical condition was headache and GERD each accounted for 21 patients (12%). 17 (9%) patients presented with upper respiratory infections. 16 (9%) patients presented with degenerative joint disease. 13 (7%) patients presented with diabetes. The remaining clinical encounters were worms, back pain, myalgia, cataracts, rash, allergies, and osteoarthritis. Pediatric As evidenced in Table 3 , intestinal Helminthiasis, colloquially known as “worms,” was the most common clinical condition encountered among children treated in Barahona, Dominican Republic. 55 out of 178 (29%) patients diagnosed with intestinal helminthiasis. The second most common clinical condition was upper respiratory infection with a total of 54 patients (28%). 19 (10%) patients presented with headaches. 14 (7%) patients presented with a cough. 12 (6%) patients presented with a rash. The remaining clinical encounters were tinea corporis, dermatitis, impetigo, and acute otitis media. Treatment A total of 751 prescription medications were given throughout the trip. Table 4 displays the top 20 medications dispensed, which represents 89% of total. The most popular medication was a multivitamin, with 114 (15%) given. The second most common was acetaminophen, with 101 (13%) dispensed to patients. 76 (10%) patients received ibuprofen. 73 (10%) patients received amoxicillin. 64 (9%) patients received albendazole. 37 (5%) patients received diphenhydramine. The least common medications were A&D ointment, acyclovir, cetirizine, Crestor, docusate, enalapril, and ofloxacin eye drops, each accounting for a less than 1% of total prescriptions given. Pediatric vs adult summary The most common prescription among children was albendazole with a total of 61 prescriptions. The most common prescription among adults was amlodipine, with 16 total dispensed. Table 1 Study Population Characteristics Male Adult, n = 134 Child, n = 178 35 (11%) 87 (28%) Female 99 (32%) 91 (29%) Age, average Male 56 4.6 Female 49 7.2 Table 2 Adult Diagnoses Diagnosis No (%) HTN 37 (21%) Headache 21 (12%) GERD 21 (12%) URI 17 (9%) Degenerative Joint disease 16 (9%) Diabetes 13 (7%) Helminth infection/intestinal helminthiasis 11 (6%) Back Pain 10 (6%) Myalgia 9 (5%) Cataracts 9 (5%) Rash 6 (3%) Allergies 5 (3%) OA 5 (3%) Table 3 Pediatric Diagnoses Diagnosis No (%) Helminth infection/intestinal helminthiasis 55 (29%) URI 54 (28%) Headache 19 (10%) Cough 14 (7%) Rash 12 (6%) Tinea 10 (5%) Fever 9 (5%) Dermatitis 6 (3%) Impetigo 6 (3%) Acute Otitis Media 5 (3%) Table 4. Medications Prescribed (top 20) N (%) 751 Multivitamin 114 (15%) Acetaminophen 101 (13%) IBU 76 (10%) AMOX 73 (10%) Albendazole 64 (9%) Diphenhydramine 37 (5%) OTC Cold and Flu 27 (4%) Omeprazole 23 (3%) Amlodipine 16 (2%) Hydrocortisone 16 (2%) Triple ABX 16 (2%) Cough Drops 15 (2%) Cipro 14 (2%) HCTZ 14 (2%) Cephalexin 12 (2%) Guaifenesin 10 (1%) Pepto Tabs 10 (1%) Cotrimazole 9 (1%) Fluconazole 9 (1%) Liquid Tears 9 (1%) Discussion Barahona, Dominican Republic is a low-resource setting with limited access to routine healthcare, where short-term medical missions (STMMs) represent a primary avenue for episodic care. Our findings indicate that intestinal helminthiasis was the most common pediatric condition encountered, and hypertension was the most common condition among adults. Upper respiratory infection (URI) was the most common condition encountered overall, representing 23% of all diagnoses. Adult males were the least represented among the patients treated, with only 26% of all patients greater than 18 years of age treated identifying as male. A total of 751 prescriptions were dispensed, with multivitamins, acetaminophen, antibiotics, antiparasitics, and ibuprofen being the most common medications required. These findings will inform resource allocation and clinical preparation for future medical missions to similar settings. Intestinal helminthiasis was the most common pediatric diagnosis encountered, with a total of 55 children diagnosed, representing 29% of all pediatric diagnoses. High prevalence of intestinal helminth infections is found throughout the poorest areas of the Caribbean, in particular the Dominican Republic, Haiti, and Jamaica. 14,15 In Haiti alone, there are estimated to be over 7 million cases of Ascariasis, Trichuriasis, and Hookworm infections, the three major intestinal helminth infections, representing approximately 86% of the total population. 14 There are estimated to be over 1 million cases of helminth infections in the Dominican Republic (DR), with the DR population totaling approximately 9.1 million. 14 The helminth infections are soil-transmitted, and inadequate water and sanitation, crowded living conditions, lack of access to health care, and low levels of education make these areas particularly susceptible to infection and disease. 14 Future STMMs should expect to encounter a high prevalence of intestinal helminthiasis, and ensure an adequate supply of antiparasitics such as albendazole and incorporate deworming education. Hypertension was the most common condition encountered among adults, with a total of 37 diagnoses, representing 21% of all adult conditions. Hypertension is a common condition within the Dominican Republic, with an estimated prevalence of 33%. 16 However, when evaluated among adults living in the rural, remote regions of the DR, the prevalence increases to 57%. 16 The presence of governmental neglect, anti-Haitian sentiment, and decline in the Dominican sugarcane industry, historically a primary source of income for these communities, has led to underdiagnosis and lack of hypertension treatment. 17 Ensuring adequate supply of antihypertensives such as amlodipine and addressing modifiable risk factors that contribute to chronic diseases, such as tobacco use and obesity, is paramount for STMMs trips to this area. 18 The most popular diagnosis encountered overall was upper respiratory infections (URI). URIs were the 2nd most common pediatric diagnosis, 4th most common diagnosis among adults, and represented 23% of all diagnoses encountered. A retrospective review of an STMMs to Haitian migrant worker communities in the DR by a North American institute also found that URIs were one of their most common diagnoses seen. 19 Crowded living conditions and limited access to primary care are well-documented contributors to the prevalence of upper respiratory infections. 17,20 Future STMMS should expect to encounter URIs in high prevalence and prepare to educate patients on handwashing, respiratory hygiene, and when to seek follow-up care. Our team treated a total of 99 females, which made up 74% of our total adult population, despite 50.5% of Barahona’s population being male. 21 In many countries, men underutilize established healthcare—even when services are provided at no cost—resulting in greater morbidity and mortality when compared to women. 22 A study conducted by Dowden et al. found that it is common for men to seek care during emergencies or in the later stages of preventable illnesses, often avoiding preventive care. 23 Due to this, many men in these countries remain undiagnosed for HIV, STIs, hypertension, and diabtes. 24 Reasons for avoidance of healthcare include self-treatment, fear of knowing their health status, use of traditional healers, and adherence to cultural values. 25 A study conducted in Sauri, Siaya, a county located in western Kenya, found that by establishing “male-friendly clinics,” which consisted of established male health days with designated male health workers, male preventive care visits increased. 23 It is important that future trips to resource-limited areas expect decreased adult male preventive care visits, and prepare for late-stage presentations of diseases. Additionally, implementation of factors such as male health workers and male health days to increase likelihood of adult male visits should be strongly considered. There were several limitations within this study. In terms of the study design, all information was collected during one point in time with no subsequent patient follow-up. Additionally, the short mission trip duration limits generalizability. Due to lack of confirmatory lab testing, the majority of the diagnoses made were based on clinical presentation alone. The study population was relatively small, with only 312 patients. Lastly, only patients who sought care were seen, increasing likelihood of selection bias. In conclusion, our short-term medical mission provided a meaningful opportunity to address longstanding health inequities in Barahona, Dominican Republic. Overall, the adult population presented with conditions similar to those commonly encountered in primary care settings in developed countries. The pediatric population showed comparable patterns as well, with the notable exception of intestinal helminthiasis, likely reflecting the community’s limited-resource environment. Adult males were the least represented group, highlighting a potential barrier to healthcare access and an important challenge that future short-term medical missions may need to address in this region. Future directions: Future STMMs should aim to increase adult male participation by ensuring clinic hours outside of work time and increasing awareness among men in Barahona, DR. Declarations Acknowledgements: Ethical approval for this study was obtained from the Wake Forest University School of Medicine Institutional Review Board. Funding source No funding source was utilized for this project. References About CMDA. Christian Medical & Dental Associations® (CMDA). Accessed March 7, 2026. https://cmda.org/about-us/ World Bank Open Data. World Bank Open Data. Accessed February 15, 2026. https://data.worldbank.org George G Pablo,Schieber. Health Financing Revisited: A Practitioner’s Guide . Accessed February 15, 2026. http://documents.worldbank.org/curated/en/87401146831378237 Poverty and Access to Health Care in Developing Countries - Peters - 2008 - Annals of the New York Academy of Sciences - Wiley Online Library. Accessed February 15, 2026. https://nyaspubs.onlinelibrary.wiley.com/doi/10.1196/annals.1425.011 Sykes KJ. Short-Term Medical Service Trips: A Systematic Review of the Evidence. Am J Public Health . 2014;104(7):e38-e48. doi:10.2105/AJPH.2014.301983 Martiniuk AL, Manouchehrian M, Negin JA, Zwi AB. Brain Gains: a literature review of medical missions to low and middle-income countries. BMC Health Serv Res . 2012;12(1):134. doi:10.1186/1472-6963-12-134 Tran Y, Jarrett J, Gardner S, Fernando J, Milliron M, Hong L. Long-Term Impact of Interprofessional Medical Mission Service Trips in Sierra Leone. Front Med . 2021;8:742406. doi:10.3389/fmed.2021.742406 Maki J, Qualls M, White B, Kleefield S, Crone R. Health impact assessment and short-term medical missions: a methods study to evaluate quality of care. BMC Health Serv Res . 2008;8:121. doi:10.1186/1472-6963-8-121 Caldron PH, Impens A, Pavlova M, Groot W. Economic assessment of US physician participation in short-term medical missions. Glob Health . 2016;12(1):45. doi:10.1186/s12992-016-0183-7 Keys HM, Noland GS, De Rochars MB, Taylor TH, Blount S, Gonzales M. Perceived discrimination in bateyes of the Dominican Republic: results from the Everyday Discrimination Scale and implications for public health programs. BMC Public Health . 2019;19:1513. doi:10.1186/s12889-019-7773-2 Powers J, ContributorDirector, Team DRM. Life in a Dominican Batey. HuffPost. May 25, 2012. Accessed March 10, 2026. https://www.huffpost.com/entry/dominican-bateyes_b_1547082 Hon-chung Ho G, A. K. P, Sethna CB. The prevalence of hypertension and associated risk factors in a Latino subgroup: A rural Batey population in the Dominican Republic. Science . 2014;2(5). doi:10.11648/j.sjph.20140205.26 U.S. Department of State P. Dominican Republic Strategic Direction Summary. Published online 2021. de Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol . 2003;19(12):547-551. doi:10.1016/j.pt.2003.10.002 Hotez PJ. Holidays in the Sun and the Caribbean’s Forgotten Burden of Neglected Tropical Diseases. PLoS Negl Trop Dis . 2008;2(5):e239. doi:10.1371/journal.pntd.0000239 Nguyen D, Shargo R, Jain N, et al. Community-Based Evaluation of Hypertension Awareness and Knowledge Among Underserved Bateyes in the Dominican Republic. Clin Med Insights Cardiol . 2025;19:11795468251350224. doi:10.1177/11795468251350224 Conley T, Enriquez M, Cheng AL, et al. The Jonas Hypertension Program: An Academic-Community Partnership to Address Hypertension in Four Dominican Bateyes. Hisp Health Care Int Off J Natl Assoc Hisp Nurses . 2019;17(1):11-17. doi:10.1177/1540415318819487 Islam SMS, Purnat TD, Phuong NTA, Mwingira U, Schacht K, Fröschl G. Non‐Communicable Diseases (NCDs) in developing countries: a symposium report. Glob Health . 2014;10(1):81. doi:10.1186/s12992-014-0081-9 Ferrara BJ, Townsley E, MacKay CR, Lin HC, Loh LC. Short-Term Global Health Education Programs Abroad: Disease Patterns Observed in Haitian Migrant Worker Communities Around La Romana, Dominican Republic. Am J Trop Med Hyg . 2014;91(5):871-875. doi:10.4269/ajtmh.14-0012 Exploring the health care status of two communities in the Dominican Republic - Carman - 2004 - International Nursing Review - Wiley Online Library. Accessed March 10, 2026. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1466-7657.2003.00207.x Oficina Nacional de Esadistica (ONE). Resumen de Resultados Generales Del Censo 2010 . 2012. https://www.one.gob.do Moon DG. Changing Men’s Health: Leading the Future. World J Mens Health . 2018;36(1):1-3. doi:10.5534/wjmh.18101 Dowden J, Mushamiri I, McFeely E, Apat D, Sacks J, Ben Amor Y. The impact of “male clinics” on health-seeking behaviors of adult men in rural Kenya. PloS One . 2019;14(11):e0224749. doi:10.1371/journal.pone.0224749 Giguère K, Eaton JW, Marsh K, et al. Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data. Lancet HIV . 2021;8(5):e284-e293. doi:10.1016/S2352-3018(20)30315-5 Chavalala L, Lebese TR, Makhado L. Men’s views on factors contributing to their poor health-seeking behaviour in Limpopo Province, South Africa. BMC Public Health . 2025;25(1):83. doi:10.1186/s12889-025-21283-9 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9517504","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":629007574,"identity":"f36f6216-5fe8-4a06-94f6-ef816108f76a","order_by":0,"name":"Makell Brown","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIiWNgGAWjYFACNgaGBwUMCWD2BwY5iCAPIS0JBhAtjDMYjEnUwsxDjBbd9mOJD4Ba8szbe8we27YZJM6fdoDxwds23FrMzqQdNgBqKZY5c8bcOBeoZcPtBGbDufi0HEhvkwBqSZwhkbtNOnfbn8QN0gls0rz4tJx/3v4DrsVyG9BhsxPYf+PVciPtGANcCyNQS8PtBDZm/FqeJQMdJlEswXP+m2TvPwPjDbcTmyXnnMPnsDTDDx8qbPIk2NvSJH6cMZCdPzv54Ic3Zbi1QIEEMoexgaD6UTAKRsEoGAX4AQCrHlFPkP231wAAAABJRU5ErkJggg==","orcid":"","institution":"Wake Forest University School of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Makell","middleName":"","lastName":"Brown","suffix":""},{"id":629007635,"identity":"68a02201-af2e-42e3-9730-4f27be71f67e","order_by":1,"name":"Joel Bruggen","email":"","orcid":"","institution":"Wake Forest University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Joel","middleName":"","lastName":"Bruggen","suffix":""}],"badges":[],"createdAt":"2026-04-24 12:58:27","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9517504/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9517504/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108007064,"identity":"3dc30082-b642-4c2a-be69-d158bc9f828c","added_by":"auto","created_at":"2026-04-28 12:58:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":266922,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9517504/v1/cfd76e91-6715-4240-b3f5-110ab8a9652c.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eInforming Medical Mission Preparation: A Needs Assessment of Patient Encounters in Barahona, Dominican Republic\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Program \u0026 Project Purpose","content":"\u003cp\u003eThis project was housed under the Christian Medical Dental Association (CMDA) at Wake Forest University School of Medicine. CMDA was founded in 1931 by Drs. George Peterson and Kenneth Gieser at Northwestern University Medical School .\u003csup\u003e1\u003c/sup\u003e Due to unique difficulties of being one of few Christians on their medical school campus, the two student doctors started to meet regularly.\u0026nbsp;\u003csup\u003e1\u003c/sup\u003e Their assembly quickly drew the attention of other medical students, and their group grew significantly.\u0026nbsp;\u003csup\u003e1\u003c/sup\u003e Ultimately, CMDA, originally known as Christian Medical Society (CMS), was born.\u0026nbsp;\u003csup\u003e1\u003c/sup\u003e The intent of the organization was to provide a network of Christian healthcare professionals, ultimately evolving to provide both care to those involved in the organization and those in need.\u0026nbsp;\u003csup\u003e1\u003c/sup\u003e To help carry out its mission, the program facilitates medical service mission trips both for medical students and health care professionals such as physicians, physician assistants, nurse practitioners, and nurses. In 1968, the organization sent its first team to the Dominican Republic on a medical mission trip.\u003csup\u003e1\u003c/sup\u003e\u0026nbsp; Today, medical students are increasingly participating in medical service trips through this organization, and their lasting impact is evident. The purpose of this project is to evaluate the benefit provided to patients in Barahona, Dominican Republic, on a medical service trip with CMDA in an attempt to inform future medical service trips to this or similar areas.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Background","content":"\u003cp\u003ePeople born in low-income countries have an average life expectancy 15 years shorter than individuals born in high-income countries. \u003csup\u003e2\u003c/sup\u003e Low-and-middle income countries (LMICs) account for 90% of the global burden of disease, driven in large part by lack of access to healthcare.\u003csup\u003e3\u003c/sup\u003e This is reflected in profound infrastructural gaps—low-income countries average only 9 hospital beds per 10,000 people compared to 57 in high-income countries. \u003csup\u003e4\u003c/sup\u003e The disparities in infrastructure and access to care contribute directly to preventable morbidity and mortality in these regions.\u003csup\u003e4\u003c/sup\u003e In response to such inequities, short-term medical missions (STMMs) have emerged as one strategy to provide healthcare access to underserved populations, with the number of trips increasing annually. The aim of this study was to evaluate the clinical impact and scope of care delivered to an underserved population in Barahona, Dominican Republic during a short-term medical mission in 2024.\u003c/p\u003e \u003cp\u003eSTMMs are defined as trips that consist of volunteer medical providers from high-income countries to provide healthcare in low-income countries.\u003csup\u003e5\u003c/sup\u003e STMMs typically last 1–2 weeks, and comprise physicians, nurses, medical students, pharmacists, and other healthcare personell.\u003csup\u003e5\u003c/sup\u003e The primary goal of STMMs is to address unmet health care needs of low and middle-income countries.\u003csup\u003e4\u003c/sup\u003e The group of volunteer medical providers will typically bring medicine and medical supplies in an effort to work with local health providers to provide care within the community– free of charge. The type of MST can vary from general medicine to specialty-focused (surgery, ophthalmology, dental, orthopedics, etc.), with the most common being primary care.\u003csup\u003e6\u003c/sup\u003e Over the years, these trips have grown increasingly prevalent, with up to 2\u0026nbsp;million Americans participating annually, spanning greater than 1,000 mission trips each year.\u003csup\u003e4\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAlthough STMMs have shown to have a significant positive impact on healthcare disparities, a major critique of the trips is their long-term impact. Many critics argue STMMs do not address the core issue that drives health disparities in the developing world: poverty and overstretched healthcare infrastructure.\u003csup\u003e5\u003c/sup\u003e Even so, millions of dollars are invested in STMMs yearly, bringing into question if efforts produce a return on investment within the area served.\u003csup\u003e5\u003c/sup\u003e However, emerging evidence suggests that capacity-building STMMs, or trips that seek to educate existing healthcare workers, result in lasting benefits.\u003csup\u003e7\u003c/sup\u003e One prospective study in Serra Leone demonstrated retained knowledge and improved hospital practices among local staff up to 2.5 years after the STMM. \u003csup\u003e7\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAnother barrier to providing lasting, positive impacts during STMMs is finances. It is estimated that annual expenditure on STMMs exceed 250\u0026nbsp;million dollars per year.\u003csup\u003e8\u003c/sup\u003e A single trip requires airfare, supplies and equipment used in direct patient care, lodging, ground transportation, and the opportunity cost that represents the income missed during absence from practice.\u003csup\u003e9\u003c/sup\u003e One of the most significant financial requirements is supplies and equipment used in direct primary care, emphasizing the necessity of minimizing superfluous supplies.\u003c/p\u003e \u003cp\u003eThe following paper will further characterize the impact of medical mission trips by reviewing the needs addressed in a trip to Barahona, DR, including documentation on conditions encountered and medications prescribed. This will aid in understanding the impacts of STMMs and help with STMMs preparation to similar areas.\u003c/p\u003e\n\n \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e\n\n\n\n\n\n \n\n"},{"header":"Barahona, Dominican Republic","content":"\u003cp\u003eBarahona is a city located in the southwest region of Dominican Republic. It is approximately 90 miles from the Haitai, Dominican Republic border. Due to Barahona’s geographic proximity to Haiti, a substantial population of Haitian-descent residents reside there, many of which were born in the Dominican Republic. Their unique location has resulted in significant disparities, as they are unrecognized by Haiti and marginalized by Dominican Republic.\u003csup\u003e10\u003c/sup\u003e Many of the Haitian residents are migrant sugarcane workers and reside in rural sugarcane settlements known as bateyes.\u003csup\u003e11\u003c/sup\u003e Bateyes are typically small shelters that house several families, without proper sanitation and often lack running water, electricity, and adequate garbage disposal.\u003csup\u003e12\u003c/sup\u003e Over 90% of Haitian migrants and 80% of their descendants in the Dominican Republic lack health care insurance and have an unresolved legal status.\u003csup\u003e13\u003c/sup\u003e Relative to the broader Dominican Republic, Barahona represents a population with disproportionate healthcare needs.\u003c/p\u003e"},{"header":"Structure/method/design","content":"\u003ch2\u003eStudy design\u003c/h2\u003e\u003cp\u003eThis needs assessment was conducted using a mixed-methods approach, incorporating both quantitative and qualitative data collected during patient encounters. The trip consisted of 3 physicians, 1 clinical pharmacist, 1 nurse, 1 interpreter, and 11 medical students. There were three teams: Triage, Medical, and Pharmacy. A local physician was also a part of the team. Each medical student rotated with a different team each day. The chief complaint was originally taken by the triage team as the patient entered the clinic. Diagnosis and prescription information were collected by the medical team. The final prescription was verified and delivered by the pharmacy team.\u003c/p\u003e\u003ch3\u003eSetting and population\u003c/h3\u003e\u003cp\u003eThe assessment was conducted at Barahona, Dominican Republic during a 6-day medical service trip. The clinic was set up within local churches and buildings, with the team moving to a new location each day. All of the patients were of Haitian descent. This population was selected due to lack of access to medical care and significant disparities that existed within the area.\u003c/p\u003e\u003ch3\u003eData source\u003c/h3\u003e\u003cp\u003eData was collected directly from patients during the Medical Service Trip.\u003c/p\u003e\u003ch3\u003eData collection procedures\u003c/h3\u003e\u003cp\u003eThis data was handwritten on data collection sheets. Each team verified that the correct information was recorded for each paper. A Spanish and French interpreter were used throughout each visit, as majority of the patients did not speak English.\u003c/p\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eAll data collected during the medical service trip was input into Microsoft Excel for analysis. All quantitative survey data were imported into Microsoft Excel for analysis. Data cleaning procedures included checking for missing responses, removing duplicate entries, and standardizing categorical variables. Descriptive statistics (counts, percentages, means, and ranges) were generated using Excel formulas. Visualizations, including bar charts and tables, were created using Excel’s chart tools.\u003c/p\u003e\u003ch3\u003eEthical considerations\u003c/h3\u003e\u003cp\u003eThis project was conducted as part of a quality improvement and educational assessment initiative. All data collected were anonymized, and no identifiable information was linked to patient responses. Participation was voluntary, and all respondents were informed of the purpose of the assessment and their right to decline participation without consequence. Because the project focused on program improvement and posed minimal risk to participants, it was reviewed by the institutional review board and determined to be exempt from full review. All procedures followed ethical principles outlined in institutional policy regarding confidentiality, data protection, and respectful treatment of participants.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eAs evidenced in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, our team encountered a total of 312 patients in Barahona, Dominican Republic. Of these patients, 134 were adults and 178 children (less than 18 years of age). The overall age ranged from 4 months to 100 years. The average among the adult group was 56 and 49 for males and females, respectively. The average age among the pediatric group was 4.6 and 7.2 for males and females, respectively. Gender distribution was also analyzed. Among the adult group, 99 (74%) were female. The range of age among the adult female group was 19\u0026ndash;100 years of age and 22\u0026ndash;95 in the adult male group. In contrast, among the pediatric group the ages ranged 4 months to 18 years among females and 1 month to 17 years among males. Of all the children, 87 (51%) were female.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eDiagnoses\u003c/h2\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003eAdult\u003c/h2\u003e \u003cp\u003eAs evidenced in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, hypertension was the most common clinical condition encountered among adults treated in Barahona, Dominican Republic, with 37 out of 134 (21%) patients diagnosed with hypertension. The second most common clinical condition was headache and GERD each accounted for 21 patients (12%). 17 (9%) patients presented with upper respiratory infections. 16 (9%) patients presented with degenerative joint disease. 13 (7%) patients presented with diabetes. The remaining clinical encounters were worms, back pain, myalgia, cataracts, rash, allergies, and osteoarthritis.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003ePediatric\u003c/h2\u003e \u003cp\u003eAs evidenced in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, intestinal Helminthiasis, colloquially known as \u0026ldquo;worms,\u0026rdquo; was the most common clinical condition encountered among children treated in Barahona, Dominican Republic. 55 out of 178 (29%) patients diagnosed with intestinal helminthiasis. The second most common clinical condition was upper respiratory infection with a total of 54 patients (28%). 19 (10%) patients presented with headaches. 14 (7%) patients presented with a cough. 12 (6%) patients presented with a rash. The remaining clinical encounters were tinea corporis, dermatitis, impetigo, and acute otitis media.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eTreatment\u003c/h2\u003e \u003cp\u003eA total of 751 prescription medications were given throughout the trip. Table\u0026nbsp;4 displays the top 20 medications dispensed, which represents 89% of total. The most popular medication was a multivitamin, with 114 (15%) given. The second most common was acetaminophen, with 101 (13%) dispensed to patients. 76 (10%) patients received ibuprofen. 73 (10%) patients received amoxicillin. 64 (9%) patients received albendazole. 37 (5%) patients received diphenhydramine. The least common medications were A\u0026amp;D ointment, acyclovir, cetirizine, Crestor, docusate, enalapril, and ofloxacin eye drops, each accounting for a less than 1% of total prescriptions given.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003ePediatric vs adult summary\u003c/h2\u003e \u003cp\u003eThe most common prescription among children was albendazole with a total of 61 prescriptions. The most common prescription among adults was amlodipine, with 16 total dispensed.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy Population Characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult, n\u0026thinsp;=\u0026thinsp;134\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChild, n\u0026thinsp;=\u0026thinsp;178\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35 (11%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (28%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99 (32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91 (29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge, average\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAdult Diagnoses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (21%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeadache\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (12%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eURI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDegenerative Joint disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHelminth infection/intestinal helminthiasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBack Pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMyalgia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCataracts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAllergies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePediatric Diagnoses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHelminth infection/intestinal helminthiasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55 (29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eURI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (28%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeadache\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCough\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTinea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDermatitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImpetigo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcute Otitis Media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTable\u0026nbsp;4. Medications Prescribed (top 20)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003cp\u003e751\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultivitamin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e114 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcetaminophen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIBU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76 (10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMOX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbendazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiphenhydramine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOTC Cold and Flu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (4%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOmeprazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmlodipine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHydrocortisone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTriple ABX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCough Drops\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCipro\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHCTZ\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCephalexin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGuaifenesin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePepto Tabs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCotrimazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluconazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiquid Tears\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eBarahona, Dominican Republic is a low-resource setting with limited access to routine healthcare, where short-term medical missions (STMMs) represent a primary avenue for episodic care. Our findings indicate that intestinal helminthiasis was the most common pediatric condition encountered, and hypertension was the most common condition among adults. Upper respiratory infection (URI) was the most common condition encountered overall, representing 23% of all diagnoses. Adult males were the least represented among the patients treated, with only 26% of all patients greater than 18 years of age treated identifying as male. A total of 751 prescriptions were dispensed, with multivitamins, acetaminophen, antibiotics, antiparasitics, and ibuprofen being the most common medications required. These findings will inform resource allocation and clinical preparation for future medical missions to similar settings.\u003c/p\u003e \u003cp\u003eIntestinal helminthiasis was the most common pediatric diagnosis encountered, with a total of 55 children diagnosed, representing 29% of all pediatric diagnoses. High prevalence of intestinal helminth infections is found throughout the poorest areas of the Caribbean, in particular the Dominican Republic, Haiti, and Jamaica.\u003csup\u003e14,15\u003c/sup\u003e In Haiti alone, there are estimated to be over 7\u0026nbsp;million cases of Ascariasis, Trichuriasis, and Hookworm infections, the three major intestinal helminth infections, representing approximately 86% of the total population.\u003csup\u003e14\u003c/sup\u003e There are estimated to be over 1\u0026nbsp;million cases of helminth infections in the Dominican Republic (DR), with the DR population totaling approximately 9.1\u0026nbsp;million. \u003csup\u003e14\u003c/sup\u003e The helminth infections are soil-transmitted, and inadequate water and sanitation, crowded living conditions, lack of access to health care, and low levels of education make these areas particularly susceptible to infection and disease. \u003csup\u003e14\u003c/sup\u003e Future STMMs should expect to encounter a high prevalence of intestinal helminthiasis, and ensure an adequate supply of antiparasitics such as albendazole and incorporate deworming education.\u003c/p\u003e \u003cp\u003eHypertension was the most common condition encountered among adults, with a total of 37 diagnoses, representing 21% of all adult conditions. Hypertension is a common condition within the Dominican Republic, with an estimated prevalence of 33%.\u003csup\u003e16\u003c/sup\u003e However, when evaluated among adults living in the rural, remote regions of the DR, the prevalence increases to 57%.\u003csup\u003e16\u003c/sup\u003e The presence of governmental neglect, anti-Haitian sentiment, and decline in the Dominican sugarcane industry, historically a primary source of income for these communities, has led to underdiagnosis and lack of hypertension treatment.\u003csup\u003e17\u003c/sup\u003e Ensuring adequate supply of antihypertensives such as amlodipine and addressing modifiable risk factors that contribute to chronic diseases, such as tobacco use and obesity, is paramount for STMMs trips to this area.\u003csup\u003e18\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe most popular diagnosis encountered overall was upper respiratory infections (URI). URIs were the 2nd most common pediatric diagnosis, 4th most common diagnosis among adults, and represented 23% of all diagnoses encountered. A retrospective review of an STMMs to Haitian migrant worker communities in the DR by a North American institute also found that URIs were one of their most common diagnoses seen.\u003csup\u003e19\u003c/sup\u003e Crowded living conditions and limited access to primary care are well-documented contributors to the prevalence of upper respiratory infections.\u003csup\u003e17,20\u003c/sup\u003e Future STMMS should expect to encounter URIs in high prevalence and prepare to educate patients on handwashing, respiratory hygiene, and when to seek follow-up care.\u003c/p\u003e \u003cp\u003eOur team treated a total of 99 females, which made up 74% of our total adult population, despite 50.5% of Barahona\u0026rsquo;s population being male.\u003csup\u003e21\u003c/sup\u003e In many countries, men underutilize established healthcare\u0026mdash;even when services are provided at no cost\u0026mdash;resulting in greater morbidity and mortality when compared to women.\u003csup\u003e22\u003c/sup\u003e A study conducted by Dowden et al. found that it is common for men to seek care during emergencies or in the later stages of preventable illnesses, often avoiding preventive care.\u003csup\u003e23\u003c/sup\u003e Due to this, many men in these countries remain undiagnosed for HIV, STIs, hypertension, and diabtes.\u003csup\u003e24\u003c/sup\u003e Reasons for avoidance of healthcare include self-treatment, fear of knowing their health status, use of traditional healers, and adherence to cultural values.\u003csup\u003e25\u003c/sup\u003e A study conducted in Sauri, Siaya, a county located in western Kenya, found that by establishing \u0026ldquo;male-friendly clinics,\u0026rdquo; which consisted of established male health days with designated male health workers, male preventive care visits increased.\u003csup\u003e23\u003c/sup\u003e It is important that future trips to resource-limited areas expect decreased adult male preventive care visits, and prepare for late-stage presentations of diseases. Additionally, implementation of factors such as male health workers and male health days to increase likelihood of adult male visits should be strongly considered.\u003c/p\u003e \u003cp\u003eThere were several limitations within this study. In terms of the study design, all information was collected during one point in time with no subsequent patient follow-up. Additionally, the short mission trip duration limits generalizability. Due to lack of confirmatory lab testing, the majority of the diagnoses made were based on clinical presentation alone. The study population was relatively small, with only 312 patients. Lastly, only patients who sought care were seen, increasing likelihood of selection bias.\u003c/p\u003e \u003cp\u003e In conclusion, our short-term medical mission provided a meaningful opportunity to address longstanding health inequities in Barahona, Dominican Republic. Overall, the adult population presented with conditions similar to those commonly encountered in primary care settings in developed countries. The pediatric population showed comparable patterns as well, with the notable exception of intestinal helminthiasis, likely reflecting the community\u0026rsquo;s limited-resource environment. Adult males were the least represented group, highlighting a potential barrier to healthcare access and an important challenge that future short-term medical missions may need to address in this region.\u003c/p\u003e \u003cp\u003eFuture directions: Future STMMs should aim to increase adult male participation by ensuring clinic hours outside of work time and increasing awareness among men in Barahona, DR.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Wake Forest University School of Medicine Institutional Review Board.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding source\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding source was utilized for this project.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbout CMDA. Christian Medical \u0026amp; Dental Associations\u0026reg; (CMDA). Accessed March 7, 2026. https://cmda.org/about-us/\u003c/li\u003e\n\u003cli\u003eWorld Bank Open Data. World Bank Open Data. Accessed February 15, 2026. https://data.worldbank.org\u003c/li\u003e\n\u003cli\u003eGeorge G Pablo,Schieber. \u003cem\u003eHealth Financing Revisited: A Practitioner\u0026rsquo;s Guide\u003c/em\u003e. Accessed February 15, 2026. http://documents.worldbank.org/curated/en/87401146831378237\u003c/li\u003e\n\u003cli\u003ePoverty and Access to Health Care in Developing Countries - Peters - 2008 - Annals of the New York Academy of Sciences - Wiley Online Library. Accessed February 15, 2026. https://nyaspubs.onlinelibrary.wiley.com/doi/10.1196/annals.1425.011\u003c/li\u003e\n\u003cli\u003eSykes KJ. 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Accessed March 10, 2026. https://www.huffpost.com/entry/dominican-bateyes_b_1547082\u003c/li\u003e\n\u003cli\u003eHon-chung Ho G, A. K. P, Sethna CB. The prevalence of hypertension and associated risk factors in a Latino subgroup: A rural Batey population in the Dominican Republic. \u003cem\u003eScience\u003c/em\u003e. 2014;2(5). doi:\u0026lt;p\u0026gt;10.11648/j.sjph.20140205.26\u0026lt;/p\u0026gt;\u003c/li\u003e\n\u003cli\u003eU.S. Department of State P. Dominican Republic Strategic Direction Summary. Published online 2021.\u003c/li\u003e\n\u003cli\u003ede Silva NR, Brooker S, Hotez PJ, Montresor A, Engels D, Savioli L. Soil-transmitted helminth infections: updating the global picture. \u003cem\u003eTrends Parasitol\u003c/em\u003e. 2003;19(12):547-551. doi:10.1016/j.pt.2003.10.002\u003c/li\u003e\n\u003cli\u003eHotez PJ. Holidays in the Sun and the Caribbean\u0026rsquo;s Forgotten Burden of Neglected Tropical Diseases. \u003cem\u003ePLoS Negl Trop Dis\u003c/em\u003e. 2008;2(5):e239. doi:10.1371/journal.pntd.0000239\u003c/li\u003e\n\u003cli\u003eNguyen D, Shargo R, Jain N, et al. Community-Based Evaluation of Hypertension Awareness and Knowledge Among Underserved Bateyes in the Dominican Republic. \u003cem\u003eClin Med Insights Cardiol\u003c/em\u003e. 2025;19:11795468251350224. doi:10.1177/11795468251350224\u003c/li\u003e\n\u003cli\u003eConley T, Enriquez M, Cheng AL, et al. The Jonas Hypertension Program: An Academic-Community Partnership to Address Hypertension in Four Dominican Bateyes. \u003cem\u003eHisp Health Care Int Off J Natl Assoc Hisp Nurses\u003c/em\u003e. 2019;17(1):11-17. doi:10.1177/1540415318819487\u003c/li\u003e\n\u003cli\u003eIslam SMS, Purnat TD, Phuong NTA, Mwingira U, Schacht K, Fr\u0026ouml;schl G. Non‐Communicable Diseases (NCDs) in developing countries: a symposium report. \u003cem\u003eGlob Health\u003c/em\u003e. 2014;10(1):81. doi:10.1186/s12992-014-0081-9\u003c/li\u003e\n\u003cli\u003eFerrara BJ, Townsley E, MacKay CR, Lin HC, Loh LC. Short-Term Global Health Education Programs Abroad: Disease Patterns Observed in Haitian Migrant Worker Communities Around La Romana, Dominican Republic. \u003cem\u003eAm J Trop Med Hyg\u003c/em\u003e. 2014;91(5):871-875. doi:10.4269/ajtmh.14-0012\u003c/li\u003e\n\u003cli\u003eExploring the health care status of two communities in the Dominican Republic - Carman - 2004 - International Nursing Review - Wiley Online Library. Accessed March 10, 2026. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1466-7657.2003.00207.x\u003c/li\u003e\n\u003cli\u003eOficina Nacional de Esadistica (ONE). \u003cem\u003eResumen de Resultados Generales Del Censo 2010\u003c/em\u003e. 2012. https://www.one.gob.do\u003c/li\u003e\n\u003cli\u003eMoon DG. Changing Men\u0026rsquo;s Health: Leading the Future. \u003cem\u003eWorld J Mens Health\u003c/em\u003e. 2018;36(1):1-3. doi:10.5534/wjmh.18101\u003c/li\u003e\n\u003cli\u003eDowden J, Mushamiri I, McFeely E, Apat D, Sacks J, Ben Amor Y. The impact of \u0026ldquo;male clinics\u0026rdquo; on health-seeking behaviors of adult men in rural Kenya. \u003cem\u003ePloS One\u003c/em\u003e. 2019;14(11):e0224749. doi:10.1371/journal.pone.0224749\u003c/li\u003e\n\u003cli\u003eGigu\u0026egrave;re K, Eaton JW, Marsh K, et al. Trends in knowledge of HIV status and efficiency of HIV testing services in sub-Saharan Africa, 2000-20: a modelling study using survey and HIV testing programme data. \u003cem\u003eLancet HIV\u003c/em\u003e. 2021;8(5):e284-e293. doi:10.1016/S2352-3018(20)30315-5\u003c/li\u003e\n\u003cli\u003eChavalala L, Lebese TR, Makhado L. Men\u0026rsquo;s views on factors contributing to their poor health-seeking behaviour in Limpopo Province, South Africa. \u003cem\u003eBMC Public Health\u003c/em\u003e. 2025;25(1):83. doi:10.1186/s12889-025-21283-9\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Wake Forest Baptist Medical Center","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9517504/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9517504/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePeople born in low-income countries have an average life expectancy approximately 15 years shorter than those born in high-income countries, reflecting persistent global health inequities. Short-term medical missions (STMMs) have emerged as one strategy to improve access to basic medical care in underserved communities while providing opportunities for health assessment and treatment. Barahona, a city in the southwestern region of the Dominican Republic, is a rural Caribbean area where healthcare access is limited and where STMMs frequently serve vulnerable populations. Many residents are Haitian migrant sugarcane workers who live in settlements known as \u003cem\u003eBateyes\u003c/em\u003e. These communities often experience significant socioeconomic barriers to care. Over 90% of Haitian migrants and approximately 80% of their descendants in the Dominican Republic lack health insurance and remain in unresolved legal status, further limiting their ability to access formal healthcare services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGoals:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe aim of this study was to evaluate the clinical impact and scope of care delivered to an underserved population in Barahona, Dominican Republic during a short-term medical mission conducted in 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis needs assessment used a mixed-methods approach incorporating both quantitative and qualitative data collected during patient encounters. The mission team consisted of three physicians, one clinical pharmacist, one nurse, one interpreter, and eleven medical students. During clinic operations, patient demographics, chief complaints, diagnoses, and prescription data were documented and subsequently entered into Microsoft Excel for descriptive analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe team evaluated 312 patients, including 134 adults and 178 children. Intestinal helminthiasis was the most frequently encountered condition among children, while hypertension was the most common diagnosis among adults. Among adult patients, only 26% were male. In total, 751 prescription medications were dispensed. The most frequently provided medications included multivitamins, acetaminophen, ibuprofen, amoxicillin, and albendazole, reflecting both symptomatic treatment and management of infectious diseases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis short-term medical mission provided an opportunity to address healthcare disparities in Barahona. The clinical presentations observed largely resembled those encountered in primary care settings in developed countries, with the notable exception of intestinal helminthiasis. Adult males were the least represented group, highlighting a potential barrier to healthcare access and an important consideration for future outreach efforts in this region.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProgram \u0026amp; Project Purpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project was housed under the Christian Medical Dental Association (CMDA) at Wake Forest University School of Medicine. CMDA was founded in 1931 by Drs. George Peterson and Kenneth Gieser at Northwestern University Medical School .\u003csup\u003e1\u003c/sup\u003e Due to unique difficulties of being one of few Christians on their medical school campus, the two student doctors started to meet regularly. \u003csup\u003e1\u003c/sup\u003e Their assembly quickly drew the attention of other medical students, and their group grew significantly. \u003csup\u003e1\u003c/sup\u003e Ultimately, CMDA, originally known as Christian Medical Society (CMS), was born. \u003csup\u003e1\u003c/sup\u003e The intent of the organization was to provide a network of Christian healthcare professionals, ultimately evolving to provide both care to those involved in the organization and those in need. \u003csup\u003e1\u003c/sup\u003e To help carry out its mission, the program facilitates medical service mission trips both for medical students and health care professionals such as physicians, physician assistants, nurse practitioners, and nurses. In 1968, the organization sent its first team to the Dominican Republic on a medical mission trip.\u003csup\u003e1\u003c/sup\u003e Today, medical students are increasingly participating in medical service trips through this organization, and their lasting impact is evident. The purpose of this project is to evaluate the benefit provided to patients in Barahona, Dominican Republic, on a medical service trip with CMDA in an attempt to inform future medical service trips to this or similar areas.\u003c/p\u003e","manuscriptTitle":"Informing Medical Mission Preparation: A Needs Assessment of Patient Encounters in Barahona, Dominican Republic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-27 08:49:26","doi":"10.21203/rs.3.rs-9517504/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2d2f96c2-c7ea-49f4-9fe1-c093516e96e7","owner":[],"postedDate":"April 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-27T08:49:26+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-27 08:49:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9517504","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9517504","identity":"rs-9517504","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}