Misc. Photos

Hi everyone! Sorry to be a little behind in updating this site - things have been pretty busy. I can't believe how the weeks have flown by... I'm getting ready to leave the DR this Saturday. It's been so wonderful to be back, and it's so sad to be getting ready to leave all over again. I couldn't think of a cohesive post about the last 10 days, so here's a collection of pictures and stories about all kinds of things:

This is a blurry, sneaky picture of the rooster who lives right outside my bedroom window - and who is my sworn enemy.  The first night I was here, he crowed twice at dawn.  I thought: He's acting appropriately for a rooster!  Perhaps he has changed his ways since two years ago!  But alas, it was not to be.  Since then he has returned to his unfortunate habit of crowing every twenty minutes, starting at 1:30am and lasting til about 6:30am.  Even with earplugs every night, I've only just gotten used to sleeping through it all again.  'Til we meet again, Rooster, 'til we meet again....

All you can do in the afternoon heat....

This little girl, "Luisa," is one of our youngest HIV patients at the clinic.  On the day this picture was taken, she was in for her five-month check-up, and I was chosen to be the model for her monthly photograph.  At only six pounds, Luisa feels like a newborn in your arms.  She was born several months premature to a mother who did not realize she was pregnant - and also did not realize her own HIV-positive status.  Abandoned at birth, Luisa found her way into the care of a neighbor woman with three grown children.  She has been our patient since then, and with the help of HIV medication, donated formula, and lots and lots of loving attention she has been growing and doing well.  It's wonderful to see the staff interact with her - each visit lasts a few hours because at least 9 different people have to hold and cuddle Luisa.  She is passed from lap to lap and smiles for everyone!  Please keep her in your thoughts and prayers as she continues to grow and develop.

We have recently returned to the poultry farm outside Los Conucos (where we were working a year and a half ago) to re-assess the area's health status and water usage.  At this home, young women came out of the woodwork during the survey, curious about what we were doing.  Everybody was excited to have her picture taken!

Here, a girl walks away from the local Gallera - a big, caged stadium where rooster fights are held.  This neighborhood doesn't have a school or a health clinic, but rest assured you can catch a lively rooster match nearby!

My mini-goodbye party - these are great people.

I was sitting in the jeep with the car door open to catch more breeze when I turned around and there was suddenly a small boy essentially in the car next to me (the one with the toothy grin.)  I shook his hand and asked him how he was doing, but he didn't respond.  I thought he was shy until my co-worker said he couldn't speak at all.  His friend on the right came over and the three of us chatted in a mixture of Spanish and sign language.  I never found out the little boy's name because everyone calls him "Mudo," the Spanish word for "Mute."  As we went about our neighborhood business, Mudo tagged along and made himself clear with a variety of specialized gestures.  Once, he disappeared for a few minutes and later returned to show me a mouth full of chewed-up food, shaking a chicken wing in his hand and beckoning me to follow him and get one myself.  I decided not to, and he scampered off for a bit.  When I asked my co-worker, she said it was unlikely he could attend school, since specialized schools for mute and/or deaf children are expensive and not located in San Pedro.  A terrible thing for any child, including one so bright and full of questions.  I really enjoyed my time with this kid, answering questions and trying to decode Dominican gestures (which are different than US ones).  I'm hoping access to a quality education becomes available to him soon, and to all the kids in his area and the DR.

Well, that's it for now!  I'll be back in the States soon, but am hoping to put another couple posts together with things to share from my stay here.  Thanks for reading - Have a good weekend!

Dibujos! Dibujos!

Wednesday morning at the clinic, this little girl - we'll call her Maria Elena - snuck up on me and tugged my sleeve, saying, "Dibujos! Dibujos!" She was so familiar, but I couldn't quite place her, nor could I remember what dibujos means, so I asked her her name. "Maria Elena!" she said, and launched into a description of dibujos, which is when I remembered.

In April of 2008, Maria Elena appeared at our HIV unit to be seen by a specialist in pediatric infectious disease from the US. This doctor was to come with a team of film-makers working on a documentary about something - I really can't remember what, and we never heard any more about it. But that morning the team was running very late, though Maria Elena and her caregiver had arrived very early and were dressed to the nines. To occupy her, I pulled out a stack of paper and a bag of left-over crayon bits that we save for emergencies. When I handed them to her, she looked puzzled and didn't really know what to do; coloring is not an activity most Dominican children engage in, even in school. So I grabbed a magic marker and sat down with her to make pictures and shape outlines on the paper that she could color in.

I asked her what she wanted in each picture, and the requests got more and more complex as the hours passed. Soon I was scrambling to create images that included a bed AND a window AND a boat AND the moon AND a cat AND three pairs of flip-flops AND an apple tree (whose fruit she later colored orange). We spent hours drawing and coloring and had a very fun time getting to know each other.

When the specialist finally arrived, she invited me to shadow her as part of my medical education, so I did. I had known that Maria Elena was thin, and that her skin was covered with large, dark sores, but I was surprised by our examination findings. Maria Elena was extremely underweight for her age, had a chronic and advanced dermatitis, and chronic respiratory problems that she just couldn't seem to shake. We did a CD4 test, which counts the number of a type of immune cell integral to initiating the body's defense systems in her blood. Her CD4 count was 12. We generally admit and start treatment for adults with a CD4 lower than 350.

Here was a child in full-blown AIDS - with a CD4 count that should have kept her from standing - vivaciously coloring and touring the waiting room.

The specialist decided to start anti-retroviral medication right away, and began to prepare more tests for after the lunch break. As the team left for lunch, I went to give Maria Elena a hug, since I had to do community visits in the afternoon. She immediately kneeled down and wrapped her arms and legs around my left leg, telling me I couldn't leave and laughing as I tried to make my way to the door. Once I disentangled myself, I gave her a quick hug and quickly ducked out to avoid further restraint. I never saw her again.

....until Wednesday! What a wonderful thing to see her more than a year later, doing so much better than before! Maria Elena is at a normal weight, her skin has cleared up, and as far as I could tell, no respiratory infection was keeping her from following me up and down the stairs. A true success story!! We unfortunately didn't get to make any more dibujos (drawings) together on Wednesday, but I'm hoping to run into her again in a couple weeks when the regular pediatrician is back.

Running into Maria Elena again was touching on so many levels: She is an inspiring example of the great combination regular care and antiretrovirals can make in an HIV+ child's life. She is smart and fun and on her way to some great experiences in school. And I must admit I teared up when I realized she remembered our one morning together, and wanted to continue it. It's both immensely satisfying and heart-breaking to be back to see everyone, knowing that I have to leave again so soon. I know I will never forget this place and these people - nor will I ever forget again what dibujos means!

Hope your weekend was restful - have a good week!

....I'm back!

The title says it all - I'm back in San Pedro de Macoris, Dominican Republic!

I arrived Saturday night, a few days after finishing exams. The trip had taken shape just in the last couple months of school, as the beginning of the summer opened up to allow some traveling. After months of missing the DR and its people, food, music, etc., I decided to head down here for a few weeks of visiting and volunteering. It's wonderful!

Fortunately for me, my year-long dreams of changed street lay-out, disappearing houses, and increased guagua fare have not come true, and I have arrived to find things comfortingly familiar. I am staying with the Dohns, the missionary family who was so wonderful during my year here, and reveling in mangos, cold showers, very loud merengue music, and portable fans. Today, I hopped on the guagua with Anita and headed to the clinic, where I spent the whole day catching up with my friends and updating the HIV clinic's chart system for lab tests. Tomorrow, we will do some home visits for HIV patients, and plan our workshop on diarrhea for Wednesday. Back in the swing of things - hooray!

But the best part of all is reconnecting with people. I talked for hours today with Santa, Daysi, Rosy, Beljica, Maximinia, and everyone else on the team, showing them current pictures of my friends and family and where I live, and hearing their stories from the year, the new babies in their lives and about the people who have passed away. Even though I'm behind on the news, the relationships feel like I never left. Even the small relationships - patients who remember and greet me, a familiar wave from the security guard - these things warm my heart and make me so happy to be back.

I just wanted to let you all know to expect an update on clinic goings-on, with some pictures of changes and growth accomplished in the past year. Let me know if you have any particular questions you want answered! I hope you all are enjoying the beginning of summer - saludos de la Republica Dominicana!