When undocumented families emigrate from Haiti to the Dominican Republic to find work, they often land in communities that are just as impoverished as those they left behind. Immigrants who work on the country's sugar cane plantations often end up living near the fields, in ghetto-like communities called bateyes.

In March, seven executives from U.S. Catholic health organizations visited several bateyes in Quisqueya, in the eastern Dominican Republic, on an immersion trip organized by the Catholic Consortium for International Health Care. They saw the deplorable living conditions firsthand and learned about the health care needs of the batey dwellers. The leaders hope to use the experience to develop ideas for helping the world's poor.

"The work and the living conditions [in the bateyes] are among the worst in the world," said Eugene Smith, executive director of the Seton Institute of Daly City, Calif. The institute is sponsored by Ascension Health and the Daughters of Charity Province of the West. Smith said the immersion trip enabled him and other participants to "briefly enter the reality that exists for over a million Haitian people who have migrated to the Dominican Republic. They have lived for generations in virtual slavery - many without legal status and identity."

As is typical, the bateyes in Quisqueya lack the most basic infrastructure. Residents have limited access to clean water. According to the Batey Relief Alliance, it is common for the workers' shacks to be built near large dumps or open sewers. While the adults labor in the fields, children often must fend for themselves and it is common for teenagers to prostitute themselves to earn a living, said the alliance.

"I am overwhelmed at how much we were exposed to in just a week," said trip participant Pamela L. Hearn, executive director of the Catholic Healthcare West Foundation for International Health in Pasadena, Calif.

The batey dwellers traditionally lacked access to basic health care services, so ailments that are common in the community - malnutrition, diarrhea and HIV, for instance - often remained untreated. Aid agencies are working to address the gaps.

Women religious have established mobile health programs and clinics to provide basic care to people living in these conditions. The Daughters of Charity mobile health clinic makes monthly visits to 32 bateyes. Two teams of doctors and nurses staff the clinic. The U.S. health care executives shadowed the teams.

The delegation also visited the Divine Providence Health Clinic in nearby Consuelo. A Grey Sister established the clinic to provide care and health education. Maureen Sullivan, director of performance improvement for Exempla Lutheran Medical Center of Wheat Ridge, Colo., was impressed with the clinic's efforts to train local people to be health promoters. Equipping promoters to educate their neighbors about health and to provide basic care "is such a fabulous way of growing independence, pride and self-esteem," Sullivan said.

Group member Robert Wuillamey saw that progress is being made in meeting people's needs, but he thinks more could be achieved if aide groups worked together. "It struck me that there are many organizations doing varied work in the bateyes. I am of the opinion that the individual work of these organizations would have greater impact if we could find a way to work more collaboratively," he said. Wuillamey is deputy director of philanthropy for the Catholic Medical Mission Board of New York City.

While the delegation has not developed formal plans for addressing the needs of the sugar cane workers in Quisqueya, it is enthusiastic about the possibilities. "Together I believe we might save more lives and create systemic change for those who need it most in our world," said Susan Nestor Levy, chief advocacy officer of St. Louis-based Ascension Health.

Catholic Consortium for International Health Care organizes an annual immersion trip. The 2008 trip was hosted by Seton Institute and Medicines for Humanity. Information about future immersion trips is available from Smith at (650) 757-2655.