Trust me, Panama is a lot cleaner than the DR. Who would you believe, a down to earth German who has lived there 12 years or a $30.000 watch wearing world travelling mack daddy BK hamburger flipper from Chi town?
Good point. Germans shouldn't be trusted.
Lol.
Seriously (and to get back to the OP), I fully agree with Dolores. The notions of "paradise" and "home" are entirely subjective and ever-changing. Yes, the DR has more than it's fair share of issues, but there's a lot of upside as well.
I suspect many of those who feel "trapped" are limited-income pensioners who recognize there is no way to replicate the lifestyle they enjoy in DR back in their home countries. Assuming that's true, I'd count my blessings. I've visited folks in state-subsidized senior housing. Unless you are a veteran, you're likely far better off in DR.
Other than that, you can always do something about the trash. Here in Atlanta, my firm is responsible for cleaning up the trash at an off-ramp near the office. We volunteer, because we care about the neighborhood. Other folks do the "adopt-a-highway" thing as well.
Because, we have tons of trash in the U.S. as well. Go figure.
My point is, if you have the means to maintain a home and submit posts on DR1 in the middle of the day, it probably isn't all that bad for you. Enjoy the clean(er) air, the fantastic scenery (both landscape and the two-legged variety), the music, the kids, and all the other stuff that makes DR a great place to visit and/or live.