House-Keeping

I wrote the entry below yesterday, meaning to add more today and send out an update email. There's still plenty of things to say! Unfortunately, I got a fever last night that is persisting through today (not too high - don't worry), and I am taking it easy between chills, sweats, and ibuprofen. (There appear to be no blankets for miles around, so I have all my extra sheets and my bath-towels stacked up on my bed to substitute hahaha.)

You know, I thought I might be homesick if I got sick during this year overseas, but it's not all that bad. My family here checks up on me, and my colleagues called as soon as they found out to order me to rest and to come see our unit's doctor tomorrow if the fever keeps up. They've promised to call back this afternoon to check on me again. To me, these are real signs of membership/acceptance in this community. I have real friends who care about my well-being! Yay! Also on the plus side, I may be better able to face a cold shower with a fever....

And now a quick note about mail: I will be moving to a new city in about a month to start work on a different project here in the DR. To those of you who were/are planning to send mail, it can take three or four weeks to get here, even under the 7-10 day airmail plan. (Sometimes it takes less, sometimes not.) So, now's the time to get a-mailin'. And remember if you're sending bulky things to use the small, green Customs Declaration - CN 22 form (must be less than four pounds). My address is in the right-hand column of this page.

And that's it for now! I'm going to go try to take a nap. Have a good week!

Christmastime!

Advent is here, and we're all busy preparing for Christmas. The weather has cooled down remarkably (finally!) and now we enjoy days of about 84 degrees and nights of about 72. It's become fairly windy here, which Father Guelmi told me is typical of the season. (The winds are called The Christmas Breezes.) Even though we've had our plastic Christmas tree out for weeks, we finally got around to decorating it last week:


It's always fun to decorate a tree, but I felt a little funny doing it in a t-shirt and bare feet! I made a few paper snowflakes with loops of thread to hang on the tree as a decoration contribution. They twist and blow in The Christmas Breezes coming through the open window - a pretty effect.

For supper that night, we had traditional Christmastime food: Pasteles en Ojas (roughly Pies in Leaves). During December, the streets are filled with vendors selling pasteles. Last week, ours came from a batch Grandma made, and they were delicious. The pies are made by mashing plantain with other ingredients like flour to create a semi-gelatinous skin. The inside is stuffed with ground meat, beans, and spices. The whole thing is wrapped in a big plantain leaf, tied with string, and boiled until cooked. Here are some pictures of cooking and eating Grandma's pasteles last week.

Just after boiling - ready to be cut open

Father Guelmi cuts open a pastel

Inside view of the meat and beans... Mmmm.

Advent Calendars are not really done here, so I had my Dad bring a couple in November. Now there's one hanging in our living room and one in the clinic, and everybody seems very pleased with them. It's fun to be able to contribute something different from home, and be able to experience the traditions here in turn. On Christmas Eve (la Buena Noche), we'll have a special meal involving pork (I haven't been able to figure out all the details yet). On both Christmas Eve and Christmas Day, we'll go to special services at church. But big family gatherings and presents are saved for Jan. 6th, El Dia de Reyes, when the three kings arrived bearing gifts. I am so grateful for the wonderful family I live with here - this promises to be a special holiday season!

Catch-Up!

It's been nearly two weeks since I last posted. I can't believe it! There are so many things I want to share - be prepared for a long post.

So I'll start where I left off: The baby is born! His name is Gerald Enmanuel Rosario Pina, but he goes by Enmanuel. He weighed 9 and 1/4 pounds at birth and is a long baby with chubby cheeks and a lot of dark hair. He'll be two weeks old tomorrow, and I just got the chance to take pictures today. (He sleeps ALL the time!) I call this series: Enmanuel Wakes





Notice the single raised eyebrow in that last shot. This baby is suave.

As an added bonus to Enmanuel's birth, Grandma came to stay last week. Grandma is a riot. She comes up to about my shoulder and loves to talk. Grandma taught me the next step in my cross-stitching embroidery. She monitored my evening shower schedule so I would not get la gripe, a general term for colds/respiratory infections. (FYI: Contrary to popular belief, la gripe is caused by germs, not by getting wet.) Grandma force-fed me all week, which was fine with me, though I had to be especially stealthy to avoid the chicken feet in the soup during second and third servings. And now Grandma has invited me to come stay at her house some weekend. Looking forward to it!

At the end of last week, I took two days to do a little sight-seeing with missionaries one town over. We went to La Romana and saw the caves with indigenous drawings, an Italian-style village built by a very rich man for his wife, and spent a day at a beautiful beach in an exclusive, gated community. Being in such beautiful, exclusive places was a little bit of culture shock after the work I do here in San Pedro. I call this series: Wow Is this Different from Villa Faro or What?




But perhaps my favorite part of the trip was trying to get out of the gated community. We made several turns, and were a little uncertain of how to find the exit. So when we found a guard at an intersection, our driver (one of the missionaries from one town over) rolled down the window to ask. "Exito? Exito! Exito?!" she yelled out the window, trying to get a quick point in the right direction and not block traffic. As it turns out, exito means "success" in Spanish. So here's this car-load of Americans frantically yelling "Success?!" out a car window while a puzzled guard looks on. Hahahaha. Finally, the guard figured out what we wanted, provided the correct word ('salida') and directed us out. I laughed pretty hard for a while.

As soon as I got back from that trip, I went to the capital to see my Dad, who was here for a meeting. I took two HOT showers within twelve hours! And he brought Christmas music, pumpkin pie filling, advent calendars... true "necessities". Haha.

Everybody thought we looked exactly alike (a little scary for me.) What do you think?

He left last Tuesday, and so it was back to the clinic for a very busy few days. We have finally raised enough money to get started on the new roof! (We have about 2/3 of the estimated total cost - which has taken years to get - so we're starting with what we have.) The first phase of this project, and what we attacked this week, is cleaning out the unusable upstairs, where we've been storing medicine, equipment, and other stuff. The upstairs is dangerously filled with bat/rat droppings, so everyone has to wear a mask to avoid getting sick. I call this series: Evidence as to Our Dire Need for a New Roof





And then all of a sudden it was Thanksgiving! After a necessary international call to my mother with some questions, I successfully baked three pumpkin pies (one for the family, one for a Tday meal with Americans, and one for the office)! I got a variety of responses to them, though my favorites are as follows: The fourteen-year-old in my family took one bite and said, "This might be my new favorite pastry!" (There's no word for 'pie' here, so we use 'pastry'.) Then, after tasting the pie, two women I work with independently said, "You may get married." Apparently, that's a very high compliment indicating that my cooking is good enough that I can marry and run my own household. (Phew - What a relief! Heehee.)

Since then, I've been snacking on left-over pie, organizing a Health Promoters training on women's health, investigating merengue dance classes, trying to teach English to Enmanuel, and moving furniture in the clinic. I am avoiding cleaning my room as we speak. To close, I'll leave you with my Lost-in-Translation moment for the weekend: The Spanish words for 'piece' (pedaso) and for 'sin' (pecado) are very similar, and I often confuse them. Yesterday, Claribel asked me if I'd like any ice in my glass, and I said, "Yes, I'd like two or three sins please." Whoops....

Happy (belated) Thanksgiving everyone! Have a wonderful last week of November!

babytodaybabytoday!

The new baby is coming today!! Today today today!

Reyna was scheduled to have her C-section this coming Thursday, but her water broke early this morning and I woke to loud knocks on my bedroom door and a fast explanation from the family running out the door to go to the capital. They've been there all day.

I feel like some nervous relative in the waiting room. All of my week-long feelings of laziness have been counter-acted. I've fixed breakfast, been to church, washed all the dishes and cleaned the kitchen, visited another family, done two loads of laundry, and I keep returning to fluff our fake Christmas tree (which tends to clump) whenever there's nothing else to do. And so far no news!

Please keep Reyna and the family in your thoughts and prayers as they welcome this new baby into their lives. I am so excited I could explode. I'll try to post some pictures soon!

Seasons are Different

I have a couple little anecdotes about seasons for your reading enjoyment. Both take place with the fabulous people I work with in the clinic.

Autumn:
We got a new computer in our office! Now we can chart information and sum receipts and print-out signs... lots of good things. During the first days of the new computer, I glanced up and literally gasped out loud when I saw that the desktop background was a picture of autumn in the United States. It's that picture that comes with Windows, you know, the one with the bright red maple leaves overhanging a rustic-looking lane with a wooden fence? Anyway, about a week later the background picture was changed to something else, which made me a little bit sad. I said, "What happened to the picture of autumn?" and one of the girls said, "Oh we can find it again!" She promptly put up a picture of a spring tree with new green leaves. "Autumn, right?" I said, "No... springtime." Next, she put up a picture of yellow tulips. "Autumn?" "No, spring again." At this point I was chuckling and said I could find the picture. I quickly did, and when it was up on the desktop again, she said, "Oh no, that's a picture of a tree with all red blossoms like we have here in the summer." Hahaha. An attempt to explain color-changing leaves and bare winter branches ensued. She couldn't believe that the trees had nothing on them in winter, and I think she mostly chalked up what I was saying to lack of Spanish skills and lunacy. Oh, well - I thought it was pretty funny.

Winter:
We broke out the office Christmas decorations last week. We now have a reindeer in a sweater and holding a pair of skis sitting on the reception desk. There's also purple and gold garlands hung everywhere that remind me more of Mardi Gras than Christmas, but they're festive nonetheless. One slow morning this week, I decided to do my own decoration contribution by cutting a couple snowflakes out of white paper. This has inspired a craze, and now I'm teaching snowflake-cutting to people right and left. Everyone is so pleased when they make a few triangular cuts and out comes a beautifully lacy piece of paper - you gotta admit, that moment of opening a freshly-cut snowflake is pretty thrilling. At the beginning, I took the opportunity to explain that we make these for winter, not necessarily for Christmas, because they represent snow. I went on to say that no two snowflakes are identical, and neither are the ones we make out of paper. Etc. Etc. But then people, and most often the nurse, started asking me why I make them out of white paper, which doesn't contrast enough with the white walls. I reiterated my snow explanation, but after several days of having basically the same conversation I gave up. The nurse wants me to make several extra-big snowflakes out of bright green and red paper and then string them up from their centers and hang them from the ceiling. I think this will have more of a jungle effect than a snow effect... but that's fine! I think I'll call it the Jungle Pointsettia look...

So the moral of the story is: Seasons are different in different parts of the world. I'm having a wonderful time working and learning in a tropical Fall and Christmas season. But please step on a crunchy leaf and eat a falling snowflake for me! xo!

Villa Faro Video

Drs. Michael and Anita Dohn, who work at Clinica Esperanza and Caridad and are in charge of many things, including the Community Health program, shot this video of the Villa Faro neighborhood where we're currently setting up a new Health Promoters program.

I spend a lot of wonderful time in Villa Faro, and now you can get a live-action glimpse of what it's like! Enjoy! (And be prepared to turn up the volume... the narration is sort of soft.)

Noel in the DR

Today is the first day with some sun in a week! It looks like Tropical Storm Noel has finally moved on. Thanks to everyone for your notes and check-ups - my area wasn't hit too badly, and my family and I are fine. The storm was an interesting experience, though, and I'd like to tell you a little about it.

It started raining last Friday, a steady rain that reminded me of chilly October days at home. That's pretty unusual here, since most rains are heavy cloud-bursts that clear quickly, but for some reason I took no particular notice. On Saturday, I went to the capital (about an hour away) to visit friends. The roads were fine despite the rain, and I had no trouble getting to the city. Once there, it rained and rained, until we all started commenting on it: "Wow I don't think it's rained like this since I've been here" and "Oh the power's gone out! How unusual for this neighborhood... I wonder why..." For some reason none of us knew about the Noel weather predictions.

After a lovely, though rainy, 24-hours, I headed back to San Pedro Sunday afternoon. The first bus was lashed with rain, and the sea was crashing against the highway as we drove back to the city. The local San Pedro bus (and by 'bus' I mean deteriorating 9-person van with Saran-Wrap for windows) was doing fine until we came to several blocks of the route covered in about 1.5 feet of water. The cobrador (guy who takes your bus money) slid the van's side-door closed (which I've never seen happen before) and we headed into the water. Water splashed against the windows and leaked in under the door. And still I didn't find this much out of the ordinary.

[Side note here: In retrospect, traveling during a tropical storm is not advisable and I don't think I'll do it again. Also, the flooding I just described is not that uncommon here after a big storm - very few streets have adequate drainage. I think my lack of surprise/shock at all these things, though, is for another reason. My threshold for "surprise/shock" has risen tremendously in these last three-months. Everything is so surprising/shocking, really. Now, I think I over-corrected my dial, because there is plenty surprising/shocking about a tropical storm.]

I got home just fine and had a pleasant evening. (We ate nothing but big bowls of rice pudding for supper, and I am A-OK with that.) The family mentioned TS Noel at the table, but I still didn't think about it until the next morning, when I woke up to no power. I headed down to breakfast and then to the clinic, not thinking that maybe we'd be closed, like the schools and stores in the city. But we were open, despite no power and no public transportation.

Now, the clinic desperately needs a new roof before the upstairs can be human-friendly. Right now, the windows don't close and the whole place is covered in bat/pigeon droppings, which can cause serious illness. Nevertheless, this is where the community health office is, and where we store all our HIV meds. On Monday, three of us headed upstairs to find the boxed meds sitting in an inch of water. We pulled tables away from open windows and leaky ceiling-spots and transferred all the meds to new boxes on elevated surfaces. Luckily, the meds are undamaged. (And I'm thinking of providing some plastic storage shelves....)

The clinic eventually did decide to close for the afternoon, so I spent the extra time in the house, listening to the wind literally howl outside. Just as we were lighting candles to settle down for an evening without power, the lights came back on. We were very lucky to be without power for only a day. (For many people, including the clinic, the lack of power also means no running water, since the pipes are powered by an electric pump, so we're also lucky to not need a pump.)

Tuesday and Wednesday passed with more wind and rain, though the clinic was open both days. On Tuesday word was out about another danger in addition to the storm. A barge carrying 50,000 barrels of combustible gasoline had run aground about ten miles out to sea from the city. In the wind and churning water, the hull was being ground against the sea-floor, causing wear and friction. But nobody could do anything because the storm conditions were too dangerous. Locals were fearing an explosion; some even talked about an explosion-caused "tsunami" that would come drench the shore-line, including our clinic/my house. Officials monitored the ship and waited out the storm for the last two days. And while I haven't officially heard it, I bet they were able to get out there today. So far no massive explosions!

We are all relieved that the storm appears over. While damage in my area wasn't too extensive, other parts of the country truly suffered. As of yesterday, there were over forty people reported dead (mostly from mud-slides) and tens of thousands missing. Schools have been closed for most of the week. Entire crops of rice, tomatoes, and plantains were destroyed, ruining many farmers' livelihoods. And prices for these basic foods will rise in the cities. Telephone lines are down, and officials are worried that water reservoirs have been contaminated in many parts of the country. Rivers are swollen and roads and bridges are washed out. Our team has had trouble getting to communities because of a gas shortage and continued flooding. So even though the storm is over, the disaster continues.

I'm truly thankful for the safety of my family and co-workers, as well as my own. And it was wonderful to hear from you all once the electricity returned! This update has gotten longer than I intended, but I hope it helps all of you appreciate Dominican life in a natural disaster; it certainly opened my eyes to be here during this storm. Please keep this country and its people in your thoughts and prayers!

xo!

Great Goings On

The last ten days have brought many exciting things! Last weekend was the national celebration of the 11oth year of Anglican presence in the DR. I attended Sunday's huge service in the capital - it was a wonderful gathering, with students from all the Episcopal schools, and priests/bishops from the DR, Haiti, Florida, and the Virgin Islands to help celebrate. I'm sorry to say I didn't have my camera, but I might be able to get my hands on some pictures in the near future.

Clinic work continues to be engaging and challenging. We returned to Batey Esperanza last week to deliver test results. Gracias a Dios, we only had two positives out of the 49 tests - a surprisingly low number. While our two counselors sat inside to give results, I was in charge of maintaining order outside. In other words, the afternoon was a crash course in Batey Spanish mixed with some Creole. Late afternoons are a time for socializing, and I made an intriguing spectacle for everyone in the Batey, not just people waiting for results. At the end of the day I had drawn stick-figures with toddlers in the dirt, been told I had "cat-eyes" several times, and garnered two declarations of love. All in a day's work....

This week, the community health team has been working on making teaching aids for breast exams for our Health Promoters. Old bras, backed with fabric and stuffed with cotton and a single rock "tumor," are great - and affordable - dummies for teaching self-breast exams. Promoters can teach without causing discomfort or embarrassment, and the experience is realistic enough to be a great help! Our sewing machine isn't working, so we spent most of one morning sewing the dummies together by hand. But we're not complaining; it was a chance to just hang out and chat!

Today, the team headed out to Villa Faro to continue training our newest Health Promoters there. With the help of the neighborhood school's faculty, we organized a practice session for assessing infant respiratory rate. Nearly twenty volunteer mothers and babies showed up to give our promoters a chance to practice taking respiratory rates on very young children, since that group is often the hardest to assess. Promoters had a chance to work with several babies - some crying, some with colds, some asleep - and compare their findings. As usual, we passed out crackers and juice. We also had a bottle of children's Tylenol and a bottle of Broncochem (similar to Dimetap) to give each mother as a 'thank you' for her participation. The school was noisy and chaotic with promoters, mothers, babies, and other children, but the event was a huge success. Here are some of my favorite shots of the afternoon:

One way to assess breathing is by touching the baby

Another is to put your ear to the baby's chest

Anita teaches

So that's a quick catch-up on work activities. I'm headed into the capital this weekend to visit friends, see the part of the city Christopher Columbus built, and perhaps go to a ballet performance! It's already Christmas here in the DR, as evidenced by the Christmas lights/decorations appearing everywhere, the carols playing in the buses, and (perhaps) the red and green fireworks visible through my window right now. Pretty funny. I guess that's what happens when there's no Halloween or Thanksgiving.... Hope everyone is having a wonderful week! xo

Operativo: Batey Esperanza

An exciting operativo afternoon last week! Some definitions before we get started:

Operativo - an event when our HIV team leaves the clinic to give a couple hours of free HIV-testing and counseling in poor and/or rural communities. Interested individuals go through a small-group charla (chat/discussion) about the test and HIV/AIDS before having their blood drawn. People under 18 must be accompanied by a parent/guardian. We give test-takers cookies and pop as an incentive to take the test and as a way to feed hungry people. We take the blood samples back for analysis at our lab, and then return the following week to deliver results.

Batey - a (usually rural) community associated with farming sugarcane. Most residents are Haitian or of Haitian descent, though most speak an accented Spanish. Some speak Creole, which I can't understand, despite years of French class. Bateys are usually very poor communities.

Esperanza - Spanish for 'hope'


Last Thursday, I went with our HIV team to do my first operativo in Batey Esperanza. We set up in the batey's clinic, using their waiting room as our charla space, and the vaccination room as the testing room. I was put in charge of dispensing cookies and pop, which turned out to be trickier than I thought, given the large amount of persuasive kids eying the cookies.

Greysi and I waited for the first few people to show up. We got there at about 3:30 and were expecting 10-20 people before we closed at 5, but had come prepared with a few extra syringes. At first, it was slow-going, but as people left the clinic with cookies in hand, word spread and more and more people came for a charla and a test.

A charla - not all of the people who heard the talks chose to get tested

As time wore on and the news spread, more and more people showed up. We ran out of syringes twice and had to borrow from the clinic! We finally closed up shop around 6:45, after testing 49 people! As dusk fell on the batey, I was happy to finally be able to hand out the few left-over cookies we had.

We loaded up the car and headed home, all talking excitedly about the afternoon. The feeling on the ride home - five of us crammed in the Jeep, bachata music turned up loud, excited conversation in Spanish, night falling over San Pedro - was wonderful. We are all still excited about the number of people we reached through charlas and the number of tests we did.

Delivering results on Thursday will be harder. This diagnosis is life-changing. I am a little comforted to know that we can at least provide free treatment, free transportation, and some food to any people with positive results. And I'm hoping for many negative results. Please keep this vibrant community in your thoughts and prayers.



*all photos taken by our wonderful driver for use by our funding charity organization.

La Boda de Elena

Last weekend was the very exciting and long-awaited wedding of Elena. There's been a lot of questions about it, so here's a short description with some pictures:

I helped set-up the hall during the day, mopping, moving tables, slicing cake.... I even learned how to tie balloons! After all these years of thinking it was a secret talent of my mom's!

We used a reception hall upstairs in the clinic for the ceremony and reception

The cake - I was shocked when one of the girls pretended to eat some until everyone told me it was a fake cake used as a prop for pictures. They thought it was pretty funny that I had thought it was real....

Ada taught me to tie balloons.

The wedding was scheduled to start at 5:30. We were still decorating in our jeans at 5:50, and nobody had arrived. I rushed home to get ready and was back by 6:20, just in time to see Elena walk down the aisle (for the first time). A stereo blared out the wedding march as Elena went to meet her groom, and they both sat down at a table with a judge. While the three worked out the legal side of marriage, the "congregation" listened to music on the stereo and chatted. After about half an hour, the wedding march played again and Elena walked back down the aisle to a pastor waiting at the other side of the room. Here the bride and groom exchanged vows and had a religious blessing. The congregation tried to listen to music and continue chatting until the pastor glared at everyone to hush. After the final kiss, the congregation clapped and cheered, the wedding party gathered next to the cake for photos, and the reception began!

El novio y la novia

The clinic colleages wait for our photo with the bride and groom

Clinic girls! (None of us caught the bouquet)

A light fare of Dominican appetizers was served during the reception: empanadas, shish kabobs, dumplings... Mmm. The newly married couple socialized while background music played on the stereo. Surprisingly, there was no dancing, and most guests left soon after the food was finished. I had been looking forward to my first try at merengue and bachata, but it was not to be. Now I'm seriously looking into dance classes!

The wedding was one of the first social events here where I felt like I really belonged. I knew the bride and groom and was able to congratulate them, and I had all my colleagues to hang out with. Despite the lack of dancing, I had a great time and feel so fortunate to have been invited. Yay! Felicidades, Elena!

The Social Life

Saludos everyone! After weeks of settling in - and it's an ongoing process - I had a fun, social afternoon and thought I'd share it with you. I think it's a good glimpse of DR culture and my experience living in a different country. So, in terrible detail, here's the story:

Today, the house phone rang and it was for me, which never happens. I picked up and someone started speaking Spanish - it took me a few minutes to realize it was my new friend, Paola. We met at the retreat weekend in Jarabacoa and have run into each other a couple times since then, each time saying we needed to get together at some point. I warned Paola then that it is close to impossible for me to understand native Spanish speakers on the phone - much more difficult than face-to-face. In fact, the first time Paola called a couple weeks ago, she had to repeat everything twice at an incredibly slow pace, and I was still startled when the phone went dead and I realized the conversation had ended and she'd hung up!

So this time, I listened very carefully and she spoke very clearly and we had an entire conversation making plans for the late afternoon. Thrilled that I actually knew when the conversation was over, I hung up and ran upstairs before I stopped to think about what I'd said. As far as I could tell, I had agreed to meet Paola at an ice cream shop an hour later to....watch people dance salsa together on top of a wooden table while on bicycles. What? I figured there was nothing for it but to go, so I asked my family how to get to this ice cream shop and changed clothes.

Then I started to get nervous. I was going to be walking by myself (granted, only about five blocks) to a busy ice cream store on the ocean-front boulevard, which is famous for loud music, large crowds, and general confusion. And it was getting closer to dusk. I asked my family if it seemed safe to walk there and they said it was. Even though I trust their judgment and know they care a lot about me, I was hesitant. And then there was the question of time: If Paola said 5pm, did she mean right at 5 or did she mean a more Dominican 5 a la 5:20? I didn't want to be waiting at the ice cream shop alone for 20 minutes.... The more time passed, the more nervous I got, until even I could recognize that it was probably out of proportion to the event at hand.

Knowing that in all likelihood this was going to be fun and I would be fine, I got ready and decided to leave the house at 5, hoping Paola would already be there. Even though the day was cloudy, I donned my big sunglasses (I find I get less attention on the street this way - I think because people can't see where I'm looking and can't tell that my eyes are blue) and struck out with a confident walk. I reached the ice cream shop with no problem and looked around for Paola.

She was nowhere to be seen. Still nervous, I leaned against a column and tried to blend in. A little girl, about five, stood on a chair to be eye-level with me, leaned in to my face, and started chatting in pristine Spanish. Between scampers over to her grandparents, she pointed out all her family members, including a description of how unimpressed she was by her five-year-old boy cousin. Then she proudly counted to five in English. I hadn't wanted to attract any attention, but I was so grateful to have this uninhibited little girl for company. Sure enough, at about 5:20, Paola walked in and we did the Dominican cheek-kiss greeting.

This was the first time Paola and I had successfully met up, so our conversation was of the basic get-to-know-you type, which, thankfully, is usually in present tense. Paola asked if I wanted ice cream and I said, sure. Dominican ice cream is served in really squat waffle cones and, regardless of the flavor, covered in a thick strawberry syrup and often sprinkled with that Fruity Pebbles cereal from the States. There was a little confusion when I ordered only a single scoop of sherbet (chinola - my favorite Dominican flavor) without any of the toppings. (Hey, if I saw a girl walk in at 5:30 on a cloudy day wearing sunglasses and then proceed to refuse the strawberry syrup, I'd be confused too.) Paola insisted on paying, since she had invited me - another cultural custom.

Finally, with ice in hand, we headed out to see the salsa-ing bicyclists. It turns out it was a performance of bicycle tricks on a huge wooden ramp in the middle of the street. (So I had correctly caught the words bicycle, wooden, and tricks, though I still don't know how I got salsa...) As it turned out, Paola and I were both too short to see over the crowd, so we ended up sitting by the water's edge and chatting. She was very patient with my Spanish and we had a great conversation. Paola has also just moved to this city, and we shared our feelings of bewilderment in how to get around, what it was like looking for friends, and how we missed an active social life. It turns out she is really interested in learning to salsa, so we might take classes together once I've learned merengue and bachata. Exciting!

After about an hour, while it was still light, we said good-bye and I walked back to the house, nerves replaced by confidence. Even now, I am still absurdly proud of executing my first "friend-date" by myself - phone call, plan, walk, conversation, return... all of it! It's funny to me how things so simple in the US become such a challenge for me here, and then such an achievement! And now I have wonderful friends in the clinic, someone outside the clinic, and a lovely Dominican family to spend time with.

As Vonnegut writes, "Do one thing everyday that scares you." ....no matter how small! xoxo

Two Patient Stories

I'm particularly drawn to two regular patients at the clinic; we'll call them Jose and Carlos. We see both these babies often, including today, and I'd like to share their stories with you:

Jose is six-months old and weighs 8 pounds today. Last week when I weighed him he was 9 pounds, and the week before that he weighed 10 pounds - his caregiver told me today that he won't eat. Jose's HIV-positive mother abandoned him as a newborn, and he was taken in by an elderly neighbor woman and an uncle who are both very dedicated to his care. As a newborn, Jose was hospitalized five times in as many months before the public hospital referred him to our clinic. Fortunately, we can provide care (and some baby formula) to the family free of charge. Unfortunately, we don't have a big lab and cannot provide many of the complicated tests the baby needs, which means more expense for the family and lots of lost time waiting for results. We can't even do an HIV test, since the more affordable test we have would detect the mother's antibodies in the baby's system and be an automatic positive, no matter Jose's real status. Jose can't sit-up or grasp objects; he breathes poorly and his skin is covered in old and newer scabies scars. But he is alert, makes strong eye-contact, and loves to visually track moving objects. And he has the most wonderful, rare smile (that he usually reserves for his uncle). Holding this serious, tiny baby is unlike anything I've ever done before; my heart breaks for him. Jose is very, very ill. His failure to thrive is possibly due to a positive HIV status, but we can't start treatment until we get two separate, positive results of the expensive, out-sourced test - weeks of waiting. Today, we decided to put him in the hospital for a few days of IV nutrition. Please keep him in your thoughts and prayers - this baby needs all the help he can get.

Carlos is doing only a little better than Jose. At nine-months he weighs in at 14 pounds. His quiet, timid mother weighs 94 pounds (three pounds less than two days ago). She is HIV-positive, but Carlos has definitively tested negative, to everyone's relief. So why is Carlos' growth plateauing? He is a social and engaging child, with a sweet, elfin face and a quick smile. His mother says he eats a lot (rice, beans and even some meat, but almost no milk, which is too expensive and which we can't provide on the donor-program's technicality that Carlos is not HIV+). Mom hesitates to answer our questions; even when Elena, (with her open, non-judgmental, trustworthy, and caring manner) reaches out to her and gently explains how important it is for the baby to eat, and for Mom to eat, too. When Elena asks how things are at home, and if they have any food, Carlos' mother says yes and does not elaborate. Meanwhile, Carlos is malnourished, has chronic diarrhea, and failure to thrive. But, unlike Jose's failure to thrive, Carlos' seems nearly exclusively related to poverty - to little access to clean, affordable, and nutritious food and water, and to a parent who lacks a support-system and education to help her engage and care for her child, physically, mentally and emotionally. But there are encouraging moments: Carlos' mom returned my smile today. She wants to take care of her child, but doesn't really know how. I believe she is slowly warming up to us, which is the best way for us to care for both of them. Carlos and Mom: another family to keep in your hearts.

Even when I'm not at the clinic, I find these two sweet, small babies in my thoughts often. One baby probably HIV-positive and the other not. One with caring, dedicated, and persistent caregivers and the other with a single caregiver who's just starting to learn. Both families are fighting a difficult and terrible battle to raise their children. For me, both children are reminders of why I want to help and of what I need to do. Again, please keep them both in your thoughts and prayers.

Jarabacoa: the adventures continue...

This past long-weekend I went back up to the mountains in Jarabacoa with another woman from the clinic to do some more adventuring. And it was quite the adventure: Several different buses broke down during the weekend; I got on a horse for the third time in my life and ended up on a 20-minute gallop through the country-side with no real saddle and some bumps into trees and fences; I got on a river-raft for the second time in my life - we capsized in a rapid called The Toilet. (I spent a short time floating down-river, but luckily we were all fine.) But perhaps the best adventure came in the form of Manuel and Estrilo, two six-year-old cousins who were daring each other to get closer and closer to our cabin while I was reading. I went out to say hello and the boys and I became fast friends. The next day, more kids showed up at the camp. All of them are very familiar with digital cameras and very excited about photo-shoots. So here are some of our best shots:

Estrilo and Manuel

Part of the group (That fruit that everyone keeps eating is called guayava and is sort of like the Dominican apple)

Girls only!

Muchachos

Group cart-wheel attempt

Group shot

There are several other shots of eating cookies, climbing trees, swinging, and all that good stuff. These kids are enthusiastic about everything and great Spanish teachers! I had an amazing time riding horses, swimming in waterfalls, and rafting this weekend, but sometimes nothing beats some good old-fashioned hangin' around with the kids!

Work Update

Two months in the DR so far! We're having a quiet afternoon in the house. There's some dark clouds rolling in from the east - cross your fingers for a big storm to break this heat. Through my window I can see an animal trotting back and forth on the roof of a building in the next block. Is it a dog? A small goat? A large pig? No matter how hard I squint, I just can't tell.

It's been a while since I've written about work at the clinic, but there's still a lot of exciting things going on! I'd like to answer some FAQ's about the clinic and its services. There are four sections of offices: primary care, HIV/AIDS, physical therapy, and vaccinations/pharmacy/lab. Here's a "virtual tour":

Through the front door is a waiting room and long hallway with several primary care examination rooms and offices. The docs here treat injuries and infections, and do a little bit of prenatal care and a fair amount of gynecological care, though they don't deliver babies. A typical exam room is big and clean with open windows, a desk, and an exam table. Unfortunately, the rooms lack practical things like sinks. (A well-meaning charity didn't ask the docs what they needed before re-doing the rooms.) The best bathrooms are down this hall on the left. And if you time it right, you can walk past the door to the one air-conditioned room in the clinic while it's momentarily open. Great doctors and the occasional AC - the place to be!

The primary care/administration section takes up the short leg of the "L"-shaped clinic. The longer leg starts with the HIV/AIDS clinic, called Esperanza y Vida (Hope and Life) - my home base. In three rooms with green curtains and an ocean breeze, we do HIV testing, counseling, medicine distribution, and doctors' visits. Several of us double up as the community health team and also work out of this space, for lack of our own. We do programs like the Health Promoters in Villa Faro, education/support programs for at-risk groups, and regular home visits. Last week, we did a Health Promoters training session on fever and respiratory diseases and met with the neighborhood association to divide the Villa Faro map into promoter regions. I have to say, I think our section of the clinic has the most fun! We get to develop real relationships with our patients since they come regularly. They bring us their babies to play with and bags of limes from their yards, and we swing by their homes to check-in during the week and bring food or medicines. The staff is entirely young women, except the Drs. Dohn, and we trade language lessons during slower afternoons or sit together to plan Elena's wedding (coming up next month! Yay!). It's like a big extended family!

Down the hall is the physical therapy area. The therapists see a lot of people recovering from motorcycle/work accidents and strokes; and also quite a few babies and small children who need treatment for congenital problems. The kids don't like PT much, but, for some reason, they tend to quiet down when I'm around. (I like to think the children are soothed by my charming and magnetic personality, but more likely they're fascinated by my unusual face and the goofy Spanglish I speak to them.) The therapists have begun to call me in whenever there's a particularly fussy kid and I'm not busy, which I enjoy. And, to add to my role as Child-Soother, they're teaching me to do heat treatments and ultrasounds for pain relief on the patients! Time spent in physical therapy is a great way to practice Spanish, and I get to hang out with kids! A full rotation there might be in the works for later this year.

Finally, at the very end of the "L," are the vaccination room, the pharmacy, and the lab. I don't actually know much about these offices except that babies are often crying in the vaccination room, just like in the States. The pharmacy is very small - it was hoped that it might be a money-maker to help fund clinic needs, but very few of our patients are in a position to pay the full cost of medicine, so we give families the necessary meds and find our money elsewhere. Otherwise, these offices are a mystery. Maybe I should go explore them....

So that concludes our tour. There is a second floor with some offices and storage, but the roof is so hole-y and full of animals that we can't do any patient care or meetings up there. There's also a big, newer room upstairs for group meetings with a big air conditioner right next to a huge hole in the wall to the outside, which sort of defeats the purpose. That room isn't used much, though it has a pretty view of the ocean.

The clinic is a great place to work, with plenty of interesting things to see and do, and lots of ways to help. The people I work with are all incredibly nice and understanding, and we have a lot of fun together. Last week, we community health people received a big shipment of donated food to make our monthly food bags for patients. We formed an assembly line and loaded rice, sugar, pasta, tomato sauce, canned vegetables, salt, chocolate powder, beans, soup mix, toothpaste, laundry soap, and much more into plastic bags to hand out. It took half the clinic space and nearly a full day to do it, but we had fun! Here are some pictures:

Diana, Ana, and I load food on one side...

Stefanie, Elena, and Greysi load food on the other side...

...and, finally, some of the finished product!

Have a good week everyone!

P.S. To answer a question from last week: My camera stayed dry on the river hike because one of the leaders brought a big waterproof bag and carefully carried everyone's cameras/phones in it. Lucky, huh?

The Retreat

So, after a week of sleeping nine hours a night, doing laundry, and cleaning my room, I feel back on track after last weekend's retreat. The weekend was one of extremes; lots of ups and downs. The diocesan camp is beautiful, and there were many lovely new people to meet, but it was frustrating not to understand conversations, plans and instructions... and, I'll admit, I was struck with a little birthday homesickness when people kindly offered me fried plantain instead of cake last Saturday. And I had always thought cake wasn't all that important to me - it's funny to suddenly miss things like that!

On Saturday, we spent most of the day hiking in this beautiful mountain river, to finish with a swim at a big waterfall. Being unable to understand the plan, I first saw the river and thought, Well this is just a glorified Indiana creek! We started wading in and out of the water, moving upstream. Almost imperceptibly, the current grew faster and more and more rocks and rapids began to appear.


People began to slip in the water and grab each other for support. We passed a beautiful waterfall, cascading down the mountainside and into the river. Birthday photo-op: Here's to 23!


We hiked on and on; the water grew rougher with each step. As we alternated between fast rapids and water up to our chests, it became clear that the only way to get through would be to form chains. I learned the Spanish verb for grab right then and there, as everyone yelled at me to grab onto them and reached out their hands to link with me. We were in hysterics fighting our way upstream, clinging to rocks and to each other, and sometimes just waiting to get lifted from one spot to the next by the bigger guys in the group. I, still not understanding the plan, asked in awkward Spanish, "Are we going to return by the same route?" and was met with an uproar of laughter. In retrospect, that is a pretty funny idea!

We hiked this way for two hours. It would suddenly hit me, as I pushed through water, gripped huge boulders, or clambered through jungle plants: I, Kate, am fighting my way through a mountain river and the jungle of the Dominican Republic! Amaaaaaazing! It sounds corny, but there really are no words to describe that feeling of doing the unbelievable. After a while, the current grew so fast that we had to stay to the very edges of the river, where the sides of the mountain had crept in. Here, the river had carved out room for only itself. We pressed ourselves against the rock and inched forward for this final stretch (overhead view):


And after that last hurdle: The waterfall!


We met up with everyone's kids (who, needless to say, had not been part of the hike), and started to swim. Beautiful!




After another hour at the waterfall, we climbed a path up the side of the mountain and had a late lunch before going back to the camp to clean up and rest. I was exhausted, but happy!

The river hike was the ideal ice-breaker. And shrieking and laughing and helping were all things I could do without speaking Spanish! I noticed (and appreciated) how firmly people reached out to help me through the rough parts, even when I didn't ask. I noticed that when I said, "thank you," no one responded with the usual "you're welcome." And I noticed that when I helped people no one said "thank you" to me. It dawned on me that helping each other through the water wasn't a special favor, needing a thank you - rather, it was just what you did. I was touched to be a part of this, and relaxed into its reliability. What a wonderful way to usher in a new year!

Now, a week later, I have just run into two of my newfound friends at church. Even though the retreat was filled with both struggle and joy, it looks like it laid the way for many great new beginnings. Wahoo! Here's to rivers!

Have a great week, everyone!