Vulnerability in the Dominican Republic

October 20, 2026 | Dominican Republic

Today I was out with our mobile clinic in a very remote Haitian community in the Dominican Republic.

It was pouring rain. Absolutely pouring.

We were working inside this tiny church—basically four cement walls with an aluminum roof. When the rain hits the roof, it's so loud you can barely hear the person sitting across from you.

At one point there were probably 30 people packed inside, waiting to see the doctor or me.

And in the middle of all of this, I met a 23-year-old woman.

She came to the Dominican Republic from Haiti when she was very young, but last year she was deported back to Haiti. Two months ago, she made it back to the Dominican Republic.

She has a two-year-old daughter.

She came to see us today because she wanted contraception.

Something that should be incredibly simple.

But she doesn't feel like she can go to a clinic or hospital because she's afraid she'll be deported again.

So she came to us.

We did a pregnancy test. Negative.

And I was able to start her on contraception.

But as we talked, it became pretty obvious how vulnerable she actually is.

The father of her daughter was incredibly abusive. She's no longer with him. She doesn't have a job. She doesn't have a reliable way to make money. She's sexually active and really worried about becoming pregnant or getting an infection.

I asked her about exchanging sex for money or other things she needs. She told me she isn't doing that.

And maybe she isn't.

This was also the first time I've ever met her.

One of the things I've learned doing this work is that you don't expect someone to tell you everything the first time you meet them. Especially when you're asking about things like abuse, exploitation, sex, drugs, or survival.

Trust takes time.

So I'm not going to decide her story for her.

What I do know is that she has a lot of the vulnerabilities we see in people who are exploited: displacement, poverty, an abusive relationship, a child to care for, no reliable income, immigration insecurity, and fear of accessing healthcare.

So we talked.

We did a lot of education around pregnancy and sexually transmitted infections. We started her contraception. And we added her to the group of patients we're going to keep following.

We also need to take care of her daughter.

Maybe over the next several visits she'll tell us more about what's happening in her life. Maybe she won't.

But that's part of why we keep coming back.

Today wasn't about identifying her as a trafficking victim or getting her to disclose something to us.

Today was the first encounter.

It was sitting in a tiny cement church, with rain pounding so loudly against the aluminum roof that we could barely hear each other, and giving a young woman healthcare she was too afraid to get anywhere else.

Sometimes that's where trust starts.