Medical findings in the bateyes
Health conditions inside Dominican’s sugarcane bateyes
Medical findings in the bateyes are alarming. The major causes of health complications are typically due to the lack of sanitary living conditions and unavailability of potable water. The residents who often drink or bathe from contaminated waters suffer from parasitic/bacterial/infectious diseases. Infant mortality, for example, is very high due to the lack of prenatal care. The infants and children who survive suffer from parasitic diseases and malnutrition; diarrheal illnesses are very prevalent; all, a direct consequence to the lack of hygienic, running water, and the unavailability of access to post natal medical care. Many children are not immunized against the common childhood illnesses such as Diphtheria, Pertussis, Tetanus, Mumps, Measles or Rubella. Under these conditions, they fail to thrive. The children lack clothing and shoes to protect them against the elements. Adolescents and young adults suffer from infectious diseases, most notably sexually transmitted infections. Most men and women know about HIV/AIDS. Yet only a small portion uses protection. There is a lack of education on sexuality and the transmission of STDs. Today, the bateyes have a rate of 5-13% of HIV/AIDS as compared to the Dominican’s national average of only 1%. As with AIDS, Tuberculosis is also a health crisis facing the population.
There is a high prevalence of untreated and uncontrollable hypertension, diabetes and gastrointestinal disturbances in the adult population. Anemia is common among the menstruating young women secondary to a diet poor in essential vitamins and minerals such as iron. Headache is also quite common. For the women, the more common pain complaint is epigastric in nature mainly from gastritis followed by headache, and generalized body ache. Dehydration is not only present in the children population, but also in the adult population who present with complaints of dizziness and vertigo. Virtually all the adults that we have seen during our missions require dental work, a direct consequence of their diet, which contains a high level of sugars from sugar cane consumption.
The World Health Organization (WHO) estimates that blindness affects over forty million people around the world, and that poor vision disables 135 million more. More than ninety percent of these people live in developing countries. Although effective prevention and timely treatment would eliminate eighty percent of global blindness, prevention and treatment of eye problems are inaccessible to many in the developing world, including the Dominican Republic and Haiti. BRA conducted a pilot eye-screening project in 2001 at batey Payabo in Monte Plata, and concluded that the population is severely visually impaired or at risk of becoming blind, and without timely prevention and treatment, it would become legally handicap. Uncorrected refractive error is one of the leading causes of avoidable blindness in the bateyes. The unmet need for prescription spectacles frequently limits adult employment opportunities. Many in the outlying rural areas, additionally, are extremely poor and have no means to afford a pair of eyeglasses.
There is an abundance of the population with cataracts, pinguecula and pterygia resultant from a lifelong exposure to ultraviolet light working and living by the light of the sun. Cataracts, for example, are no longer thought of as a blinding illness in the U.S., but for the batey populations, they produce exactly that effect. Basically all men above age 50 show some sign of cataracts. Women also suffer from this clouding of their vision but less so as they tend not to work in the fields as the men do. Of these, a number of patients are identified to be the level to meet the description of legal blindness. Patients also suffer from glaucoma. Traumatic vision is also prominent with some patients identified as having light perception, hand motion, or no light perception vision in one eye. Most of these are the result of accidents from work on the sugar cane fields where a piece of cane had lashed back. Patients also have amblyopic vision reduction. These are refractive amblyopes where one eye has much more prescription than the other leading the better eye to dominate while the weaker eye does not develop the ability to see detail having never been stimulated with a clear image. Some patients have a constant exotropia (one eye turned out) that prevented the turned eye from receiving visual stimulation and stunted the visual development of that eye. Toxoplasmosis, which is also identified among the population, is a parasitic infection of the retinal tissue in the eye, which leads to scarring, and loss of vision in the affected area. This is generally very common in areas of poor sanitation.