Stories from the Road: Community Empowerment

Tasher A. Losenegger, MD, on behalf of the Humanitarian Efforts Committee

Founded in 2016 by Stephanie Crane, MD, an internal medicine physician at Rush University Medical Center, Community Empowerment is a humanitarian organization dedicated to delivering essential primary care and specialty surgical services to underserved communities in the Dominican Republic. With a commitment to sustainable care, the organization employs local staff and collaborates closely with community leaders, government bodies, and partner NGOs to ensure ongoing impact.

Since its inception, Community Empowerment has had a robust otolaryngology-head and neck surgical program, led in partnership with Ashok A. Jagasia, MD, PhD, and the Otolaryngology Department at Rush University Medical Center. Through twice-yearly surgical trips, the team has performed over 1,000 procedures, addressing a wide range of needs from general otolaryngologic conditions to complex cases in rhinology, facial plastic and reconstructive surgery, and head and neck surgery. This is made possible through not only faculty, resident, and staff volunteers from Rush, but also Dominican medical graduates interested in further learning in otolaryngology-head and neck surgery as well as partnership with local providers.

This work has been integrated into the department further with the development of a dedicated global health track for residents, fostering the next generation of globally minded surgeons. This initiative allows residents to join multiple trips throughout their training, engage in hands-on surgical care, and contribute to quality improvement projects, ensuring that the impact of Community Empowerment continues to grow.

Location and Need

Access to surgical care in the Dominican Republic remains a significant challenge for many, especially in rural and underserved communities. While the country has made progress in expanding healthcare coverage, critical gaps persist in the availability, affordability, and accessibility of surgical services.

One major barrier is the shortage of specialists and surgical infrastructure outside urban centers. Most highly trained surgeons and advanced medical facilities are concentrated in major cities like Santo Domingo and Santiago, leaving rural areas with limited or no access to specialized care. For many patients living in these regions, traveling to a city for surgery is financially and logistically impossible, especially when it requires time off work, transportation costs, and accommodation.

With nearly one in four Dominicans living below the national poverty line, the out-of-pocket expenses for surgery can be overwhelming for families, even when services are technically available. While public hospitals offer subsidized care, they often face shortages of equipment, surgical supplies, and staffing, leading to long wait times or deferred surgeries.

Community Empowerment primarily works in the country’s southwest, where the poverty rate is particularly high.

Reflections on the Experience

Entering the waiting area for clinic on the first day of my first trip to the Dominican Republic, I still remember the mild panic I felt when seeing the hundreds of patients who had lined up since early in the morning to be evaluated by our team. It was a stark transition from conceptually knowing there is a huge need for care and seeing the patients in front of you. What struck me even more was the patience and determination of the people waiting—many had traveled long distances, and many were there not for themselves but to seek help for their children, parents, or loved ones. It was a reminder of how deeply people care for their families and how far they will go to secure care.

From the very start, the Community Empowerment staff and local volunteers set the tone. Faced with an overwhelming number of patients, they didn’t hesitate for a moment. Their commitment to their community and their belief in the mission was inspiring. They kept the clinic running smoothly, ensured patients were cared for with dignity, and supported our team every step of the way.

Over the course of each trip, we performed nearly 100 surgeries—from thyroidectomies and cleft palate repairs to nasal reconstructions and countless tonsillectomies. We worked long hours, but there was an incredible satisfaction in providing care without the financial and bureaucratic barriers that so often complicate our work at home. These trips are a reminder to us all of why we chose medicine in the first place.

I’m so grateful to the staff at Community Empowerment and Rush Global Health for allowing me to be a part of these trips and working tirelessly to get patients the care they deserve.