I was visiting one of my project partners today.
She has two daughters, the youngest of them 6 years old. While we were talking the girl from next door, about the same age, came over to play with the daughter.
I couldn't help but notice the fresh dime-sized scabs and scars all over her lower legs. It was some sort of skin disease.
What is it from? No one knows. Has the mother seen a doctor about it? No. Why not? No tiene dinero.
It's as simple as that. This is the Dominican Republic. This is a third-world country. There is no real public health care system. It is almost totally private, and thus inaccessible to most of the population.