Our medical mission was born of a dream conceived by Rose Jensen, Nurse Director of the Police Neighborhood Resource Center in Rolling Meadows, IL, which serves a mostly Hispanic enclave in the Northwest suburbs of Chicago. Rose had gone before with a group from her church, Willow Creek, to Peralta on a mission trip supported by the church. She often talked with enthusiasm to Dr. Juan, Barbarita and I when we volunteered with her in the clinic; and we began thinking it would be great if our whole team from the clinic could go together on a medical mission. That’s how it all began two or three years ago.
The dream became reality and the date was set for us to go. Rose, Juan, Barb and I were on board and Rose began seeking more doctors. The timing wasn't the best for Alan and I because our daughter, Bethany is getting married on May 16 in Italy! We'll only have six weeks until the wedding when we return from the DR. On well, sometimes ya gotta do what ya gotta do!
Our group came to the Dominican Republic on a wing and a prayer, really. We had only had one meeting and not all in the group attended that meeting. Some in the group weren’t even on board at the time, so our complete group had not all been together before we landed in the DR. About three weeks before our departure date, Rose’s 12 year old daughter Amanda who was also scheduled to be with us, was diagnosed with Leukemia! Thank God, during our trip Amanda was officially diagnosed as in remission. Two weeks before we left, Kate was named as our nurse leader and received a lot of help from Dr. Juan. We were all committed to come and to work no matter what and that’s how it happened. Read on to learn more about each of us.
Saturday March 29, 2008
I’ll start with the factual first and get to the emotional later because I know you are all anxious to hear that we arrived safely in Santo Domingo, Dominican Republic. Yes, we arrived all in one piece on two planes, one from Boston and one from Chicago O’Hare. The people who came via Boston, Dr. Juan, Dr. George, Dr. Manjeet and her daughter, Sehaj, and Kate, our nurse leader, were delayed there for 5 hours due to mechanical problems. Barb and I were a little late, so we all arrived together, which was a good thing, as we could take the hour ride to the hotel together. Our guide from Endeavor, Alfredo, has beautiful English and took good care of us. Because it was late and we were starting dinner at about 9:00 PM after a long, long day, he dropped us off at a sort of grilled chicken drive-through and then went to the hotel to drop our bags and pick up Alan and John who had arrived much earlier.
We were very hungry and the chicken was delicious along with yellow rice, brown rice with guandules, plantain chips, cooked yucca with onions and cold, cold beer! I was glad to see Alan as he has been here since Tuesday working with his distributor. The temperature even this evening is around 78 degrees and somewhat humid with nice sea breezes. Santo Domingo is a port town with a developing cruise ship industry. There is room for three cruise ships in the port at one time and the booming sound of the ship’s horn can be heard throughout the day.
Getting to our room some time after ten was a welcome sight and we still had to organize our suitcases to condense the medicines we loaded into them and separate that from our clothes to take to our first clinic in the morning. Alan and I had a good night’s sleep and we didn’t wake for anything all night. Our hotel is in the colonial part of the city and its lobby is quite pleasant and belies the simplicity of our room.
Sunday March 30, 2008
We were told to meet for breakfast in the lobby at 9:00 for a continental breakfast, but were happily surprised that a breakfast buffet was awaiting us on the fourth floor rooftop. The air was fresh, sun bright and the coffee very good. This is important to Alan and I and pretty necessary to get our day started right. We had some scrambled eggs, watermelon, pineapple and melon and were ready for what waited for us a few blocks away in our host church. Alfredo was there promptly after breakfast to help us load the medicines into the van and we were on our way, anxious to know how the day would enfold.
Alfredo works for Endeavor and it is an organization that handles the transportation and logistics for many groups that come to do service, medical as well as other types.
We were met at the church by Dee and Tom Yaccino who are from the Chicago suburbs, are community development specialists with Masters Degrees and have lived in Latin American for 16 years (four in Bolivia and twelve in the Dominican Republic).
They spent an hour with us in a conference room orienting us to their work in Santo Domingo and the interconnection between their church, Del Camino and Endeavor. They gave us an idea of the types of cases we would see that day among the mostly homeless population.
We began work by setting up our work spaces in the vestibule of the church. We had some not so private spaces for the doctors to set up their stations to examine the patients and one room with a door in case we needed privacy for someone.
Barb and Kate did triage at the entrance to the lobby and sent them to the most appropriate doctor.
John, Alan and Sehaj spent the whole time organizing the seven suitcases plus two boxes of meds we had all brought. Alan also took a written inventory of the medicines in the storage closet that the church keeps on hand for their weekly clinics so that the doctors would better know what they had to work with.
I translated the whole time with Dr. Juan as we are used to working together. The church provided some translators, one of which is a medical student. They worked with Barb and Kate and another with Dr. Manjeet. Dr. George has enough Spanish that he got along pretty well with the help local translators when need be. We saw patients from about 11:00 until 2:00, and encountered many, many cases of alcoholism and crack cocaine abuse with their various symptoms and maladies. Dr. Juan found this very frustrating because the resulting vague symptoms of pain and aching are difficult to diagnose without tests to analyze and equipment to confirm. At two we took a lunch break had pizza and coke (not of the crack variety) waiting for us upstairs in the conference room and we were famished.
The homeless people show up at the church for lunch, so after that they head on their ways. With lunch over for ourselves too, we had some free time and Alfredo offered to take us on a tour of the colonial area of the city. We opted to do this on foot and it was a pleasant sunny afternoon of about 75 degrees. We saw the first church of the Americas dating from 1524, Independence Hall where the three founders of the D. R. are buried: Trujillo, Mella and Duarte. We entered .the Plaza Colonial and military church where important people are buried. Finishing with the tour and on our way to the hotel, we came across a coffee shop: perfect timing coffee and flan at 4:00 PM!
We were invited to attend the evening church service where we had the clinic during the day, but only 4 of us were intrepid worshippers: Barb, George, Kate and me. It was like a mini-Willow Creek, Latino style, with a modern rock band. There is a strong connection to Chicago and Willow Creek Church here. Back at the hotel after church, we had dinner provided by one the minister’s wife:: lasagna, coleslaw and rolls with coke. It was carb-laden but filled a void before bed!
Monday, March 31, 2008
Dr. Keith had arrived last night at 11:00 PM and he joined us to meet everyone at breakfast. We got an early start to travel to the Northwest side of Santo Domingo, about an hour’s trip in a lot of traffic to a very poor neighborhood nestled in among affluent housing. Now that we are a group of ten, we have another van and driver, Tito.
It’s a pre-school where we set up the clinic to treat the children and their parents from the school and the neighborhood. The Director of the school, Dona Maria, met us. She was very helpful and welcoming and provided us with much assistance and with some volunteers to work on crowd control and translating. First thing we did was pass through all the classrooms and say” hi” to the little kids with smiling faces. They seem to be used to digital cameras and wanted to have their pictures taken and then see the photo. I guess enough mission groups come through there that they have had some experience posing for digitals in the past!
By ten, we had our stations set up and were ready to start seeing patients. I translated for Dr. Mangeet and Alan worked with Dr. Juan.
John B and Sehaj had worked out some of the kinks in the pharmacy yesterday and we beginning to have a handle on the kinds of drugs we had to work with. Inventorying the existing meds in the church pharmacy was a tedious task for Alan yesterday; he was ready for something different.
Dr. Juan has a handle on his Spanish and I thought Alan’s medical Spanish might be a bit rusty; so, I thought that they would be a great match. Kate and Barb took care of triage again and John and Sehaj re-organized the pharmacy in its new space. Dr. George had plenty of patients of the “kid” kind to see and Dr. Keith played soccer in the yard to keep the waiting kids entertained. He also did his part in the pharmacy and passed out the many pencils he had brought along for the kids.
For Dr. Juan this was a much more satisfying type of clinic because many of the patients had specific symptoms that he was able to do something about. He thought Alan was a great translator and they made a great team. Alan was impressed as well Dr. Juan’s grasp of what the patients were saying. I really enjoyed seeing all the doctors working with the “healing touch” using minimal diagnostic tools and no egos. They would stop and ask each other when need be if they had a questions or confusions about a diagnosis or language. Working in an atmosphere with less than ideal communication didn’t seem to phase them and they were picking up Spanish words pretty quickly.
Dr. Juan expressed his sadness when he saw a young woman of 23 who had been shot by her boyfriend 6 times at the age of 18 and has remained paralyzed from the waist down every since. Barb vented her frustration because she may be stricken with lice in a few days as a result of posing non-stop for pictures with all the cute little kids she loved to hug! One adorable little girl with a head full of tight ringlets also had a head full of lice and even some maggots!
We had quite a few elderly patients, some with cataracts and many with diabetes and high blood pressure. The difficult part is that in these church settings we have no diagnostic tools and we are not able to do follow-up for these chronic illnesses. Dr. Manjeet was amazed at the amount of patients who were telling us that they have recurring flu/cold symptoms but at this moment at our diagnostic station, they have no symptoms! We wondered if they just wanted to stock up on meds for the inevitability of the return of symptoms at some later date.
We worked until 2:00 PM when a hot lunch was brought in to the same area where we were working by some of the mothers of the pre-school. It was delicious and about the third time for chicken: fried chicken pieces, chicken stew, rice, coleslaw and coke. After we finished eating, they brewed some coffee, which smelled delicious and tasted wonderful, as well. I had brought along some small gifts, some of which I had crocheted, so I gave each of our cooks a small crocheted coin purse. They were quite appreciative and joked about how they would keep their "five pesos savings" (about 14 cents)in there! The Dominicans, even though extremely poor, really seem to have a light-hearted view of life. They have wide smiles, welcome Americans and have senses of humor about their poverty and politics. Maybe this is all just a symptom of a helpless or hopeless attitude that is endemic in Latin America. Here they are posing in the hats Dr. Keith brought along.
From there, it was back to work from 3:00-5:00. Dr. George kept extremely busy all day with the number of kids that needed to be seen. He pitched in to see adults too, of course, when the ratios shifted to adults!
As we were finishing up, Kate went to speak at a short meeting with the mother’s of the school to educate them about head lice and how treat it and how to clean everything and everyone at home. We broke down the pharmacy, packed up everything in our trusty suitcases and loaded the vans.
We had horrible traffic getting back and arrived just in time for the arrival of our dinner, prepared by the pastor’s wife from the church where we had worked yesterday. It was tasty and carb-laden spaghetti and meatballs, rice, chicken and a cabbage salad which some took a chance on, being assured by Alfredo that it was okay. They orange juice that was served was superb. Pastor Roberto, whose church we had visited the night before, joined us for dinner. It turns out he is also from Chicago, a Dominican who was born there. He showed his appreciation of our work and was glad we had enjoyed his service. After dinner, Kate, Barb, George and Keith went out to explore. The rest of us who were beat headed up to our rooms to get some sleep. Apparently, we had worked harder all day than the revelers!
Tuesday, April 1, 2008
Our breakfasts on the rooftop have continued to be quite delightful. Even though a little cloudy today, the air was pleasant. We started earlier today because of our 2-hour trip to the town of Santa Rosas de Bani´. It is an improvised community on the outskirts of Bani´ that grew from a squatters community to a large barrio over the last ten years.”
Great coffee is my ideal day-starter and the watermelon, pineapple and cantaloupe is fresh and sweet. Everyone is enjoying the delicious fresh-squeezed maracaya´ juice. We also had pancakes today; we are not starving!
Our trip took two hours and Pastor Edsras greeted us. He is part of the Del Camino connection, and he and his wife are doing all they can through the church to serve the community which was hit very hard back in November by Hurricane Noel. The Del Camino Network is a “movement of communities of faith and Christian Organizations that are committed to compassionately serving people and contexts of need in order to bring about hope and transformation.” Esdras oriented us to the work of the church and the plan for the day in his passable English and we set to work.
In the bathroom, there was a toilet, but no running water, so a bucket of water was provided for us to flush! Luckily, we did have electricity for the overhead fans!
We are getting the hang of set-up by now and quickly got our three stations and pharmacy set up, again using speakers for tables! The patients were beginning to gather outside as we got ready and today we had to be a bit more discriminating as to who we could see as we were already running short on some meds. One ticket per family was given out before they got to triage and it was up to the mother to decide who in the family had the priority to be seen, only one per family. We will return here tomorrow and see those who weren’t seen today.
The sanctuary was spacious but offered no privacy. There is one small room off the altar area where someone tacked up a sheet for us to cover the door. We had a chair there in case any doctor needed to do a more private exam. The team is already developing its habits and we all worked alongside the same people as yesterday.
Dr. Juan found a huge breast mass on a young woman today that was probably malignant. With some local help, we sent her immediately to another facility for a biopsy. The vast majority of the people we are seeing seem to have vague symptoms or complain of “gripe” which is more like a cold than flu but could include some flu-like symptoms. Dr. Manjeet is convinced that many of them are not even sick, but since we are in town, they are coming up with some symptoms in order to stock up on some medicines in case they get sick in the future. It is not easy for them to get medical care.
We worked from 11:00-2:00, at which time we walked a few blocks to the pastor’s house where his wife, Helen, had been cooking our meal all morning. The building also serves as the pre-school. We ate a delicious meal of coconut rice, ground beef, sautéed sweet bananas and salad. Fresh lemonade was served as well. The rice that sticks to the bottom of the pan and becomes crunchy is served as a separate side dish. Interesting!!
Barbarita, la loca, hitched a ride back from lunch
Back at the church, we began to work again at 3:00 and finished right at five when the doors had to be closed until tomorrow. We were real thrilled to know that we could leave everything just as is because we will work the same routine there tomorrow. Our ride back home took well over an hour and we are pretty well spent for the day. I came down with a cold today (like our patients!) and helped myself to some Sudafed from the pharmacy for the ride home to try and stop the “faucet” from running.
In retrospect, I believe that our giving is a blessing to all the people of this town. Our healing touch and the few minutes of attention we give to them brings light into what would otherwise be a very touch life filled with drudgery and despair. “Americanos” looking into their eyes and touching their “hearts” gives them a sense of hope and joy for a day. Right before lunch the first day, even Helen and her mother became our patients. Headaches and vague pains were the symptoms. It is so hard to tell what might be the cause without the facilities to do further testing, but poverty and depression can manifest itself with aches and pains.
As we were leaving at 5:00, Alfredo decided to take an alternative route back to the hotel to avoid some traffic. We are not sure it worked but we did see some new and beautiful scenery as we traveled along the boardwalk by the Ocean. Back at the hotel by 7:00, we took a quick breather before our orders of Cuban sandwiches, pizza and lasagna arrived.
At our rooftop dining spot, Tom and Dee joined us. They seemed pretty excited about the work we have been doing and really foresee that we will start working on building some kind of formula that will work for multiple visits from Teams from Northwest Community Hospital (NWCH). Tonight we took up a collection among us and Maralynn and William will buy $500.00 worth of meds that the doctors think we need. They are the in-country coordinators for Endeavor and “work side by side planning short-term trips and serve as a bridge for families and groups that come to directly serve Del Camino Network churches and the communities they reach out to.” Very tired after a long, long day, we didn’t tarry long and headed to our respective rooms.
Today we received an email from daughter Bethany saying she is sure we are doing fine but “WHERE’S THE BLOG?” Bethany, Rose and Amanda: I apologize that I haven’t been sending the Blog. I have faithfully been writing my thoughts each night inWord documents so that I can upload them into the Blog the first chance I get. Our hotel has one tiny room off the lobby with one compter and we have just had such long days that we haven’t had a chance with the very slow Internet to get this task done. Good night!
Wednesday, April 2, 2008
We’re off to another early for our trip back to Bani’. People were waiting for us at the door of the church when we arrived. We were happy to get right to work as everything was still set up for us. The morning went smoothly but it was pretty much the same scenario of symptoms. I enjoy working with Manjeet as her interpreter and it is amazing how fast she has picked up several key words she can say in Spanish and I can tell she understands more of what the patients are seeing.
She is of the belief that we are not practicing very good medicine; without diagnostic tools and basic equipment it is difficult. Really all that we are using are electronic blood pressure cuffs, otoscopes, thermometers, and we can do urine dipsticks and finger sticks for blood sugar. She thinks that we, or any group, could be so much more effective if some local people would make a plan of what they see as the need and start formulating a plan that can be carried out by the various groups. Her thoughts are, “For all the money we have spent on our expenses and travel, plus the donations of medicines, the same amount could we used for building infrastructure.” Looking in the very long term, I agree and believe that if a bright and dedicated woman could be identified and sent to training for nursing, she could become the stabilizing factor that could interface with doctors, groups, the community and donors. We are basically a “band-aid” in this community for people who only have medical care a few times a year.
At one o’clock, we went around the corner to Esdras and Helen’s house again for a good lunch of chicken, rice, cucumbers and cooked carrots, salad and fried plantains plus lemonade. When we finished, we had a few free moments to enjoy the sun and the people in front of the clinic. George taught Manjeet a dance!
In the church, I noticed that there was a lovely hand-crocheted cover for the lecturn and a couple of other crocheter doilies and I asked Helen’s mom if any ladies do crochet and knitting in the Dominican; and she replied that Helen likes to do it. Helen proudly showed me the chair covers she makes out of nylon yarn imported from Mexico. I told her about my love of crochet and gave her one of the crochet gifts I brought along plus several others to share with her mother and the ladies helping her cook They seemed genuinely pleased to receive thess small gifts.
At 2:00 we started seeing patients again. When we had seven patients left to see, Alfredo made the decision that we would pack up and head to Peralta at 3:00 in order to get there before dark and have a bit of time to unpack and get organized for the next day. Cleaning up and packing is getting easier and easier as our supplies dwindle, but I think we felt a bit uneasy not having the closure of seeing all the patients who were waiting for us. George was allowed to play fifteen minutes of basketball with one of the guy volunteers who had been acting as “door control” for two days as we packed up.
We received a very warm welcome in Peralta as we rolled in about 5. Happy faces and big smiles abounded in children women and men, not only at the church but also in the streets. The set up here is so much different and much improved over what we have just come from. This community and the church worked very hard to provide for themselves. They obtained a four-year federal grant, which enabled them to build the clinic and equip it with real examining tables. The pharmacy is permanent, but we will be setting up our own with our meds. The people that use this pharmacy can get their meds cheaper but they are still charge 20 pesos per med and this income is put back into the many needs for the clinic and pharmacy. The belief is that if they pay it will have more value and importance. Another aspect of the church's social activism is a sewing workshop. We were given a quick tour where we learned that Willow Creek Church in Barrington, IL set them up and this process provides work for the local townspeople. We saw them working on an order of 500 t-shirts for Willow Creek which will be sold to that congreation.
A little girl was hanging around outside and was clinging to Barb and I. She spontaneously held our hands and we asked her if she wanted to go on a walk with us. She said “yes,” but we felt we should ask her mother. She told us that her mother is in Spain working, but her father is living here. She took us to her house and we were greeted by another family member. His eyes showed a great surprise at the arrival of two “gringas” with the little girl yet he readily gave her permission to go with us. She wanted to show us the park so that’s where we went. We became like “pied pipers’ as we gained a few little boys on the way and Alan caught up with us too.
This was the night of the “great debate.” We were not really oriented well as to the plan for sleeping and most of us expected that we would be on bunks in the church. Alfredo told us he had arranged for some of us to sleep at the house of some families also. We were taken by surprise because we had had no preparation as to what this might mean: cold showers? Flush toilets? Bed? Clean or not? We huddled before dinner and handled it democratically. Alfredo checked out the houses that were offered for our use and some of us decided to go that route while the rest stayed at the church. Kate went to the house of Wendys, who Rose had told us to be sure and look for as her outgoing personality was not to be missed. Alan and I were in another house but pretty much on our own. We met the mother as she was on her way to the Pastor’s house to cook our dinner and the son ran in and out of the house, but didn’t introduce himself. I believe the lady of the house was very shy and was just as happy to stay occupied while we were there. John and Juan were together in another house.
Before dinner, Alan and I walked along the street our house was on after dropping our bags. We, again, accumulated children like Pied Pipers. At the end of the street we watched a young man doing carpentry work, making chairs and beds. He was very happy to have us watch his skills as an artisan.
After a good dinner of ham, beans and rice, fried plantains and some salad, we retired to our respective sleeping situations. We met Pastor Francisco Roso whose house we were dining at and had been told he and the two local doctors would join us for dinner. It didn’t happen but maybe tomorrow we will have a chance to share ideas. The Pastor and his team have been pioneers in a church based regional health and the church is operating a community health clinic that serves the town of Peralta.
Alan and I used the mosquito netting as I had noticed a couple of bugs flying around while I was typing in the dark by lantern light. The electricity went out shortly after we arrived at the house after dinner and luckily, Alan used his lighter to explore and took one of two lanterns he found in the living room, still no family to be seen. I tried to read by lantern light while under the netting. That didn’t last long and I fell asleep by 9:00. I was awakened again as the mother and daughter returned from their work at the Pastor’s and all of a sudden the house was flooded by light. Electricity had returned and our bedroom door was covered only by a curtain. They turned on the t. v. and the blast of was quickly quelled and I went about trying to return to sleep.
Thursday, April 3, 2008
Although I didn’t hear it, Alan said that a donkey began to bray at about 5:00 AM. I was awakened by the rooster at 6:00 AM. There does not seem to be enough water in the system and consequently there are buckets of water for our use to flush the toilets. I was in no mood to take a cold shower so I opted to just pop into fresh scrubs and not worry about it.
We arrived at the Pastor’s house at 7:00 and were the first ones there. We encountered the door locked, so we waited on the porch a while and then went in the back doorAbout the time we got in, the rest of the group arrived. Breakfast consisted of coffee and cheese bread, which I just couldn’t handle that early in the morning. We also had a delicious juice of something mixed with watermelon. I tried to engage the Pastor in conversation as he stood by the table, as he was wearing a shirt with a Honduran flag. He didn’t have too much to say and seemed shy and sat at his laptop computer across the room as we ate.
The waiting room for the clinic was already filling up when we arrived and once there, we got to work setting up our stations. I introduced myself to the woman doctor who looked like she was about 22! She told me she had studied for seven years. The other doctor, a male, was around all day, but I never really met him.
Dr.Juan decided I would work with him today as he would be in a private room off the main room and it would not be good for Alan and him to be in that room outnumbering any woman patients Alan teamed up with Manjeet in the main room and George was in an alcove off the main room. John and Sehaj had a great room with lots of sunlight to organize their meds. Keith was no longer part of our team, as early in the morning Alfredo had driven him to the next town to catch a bus to the border of Haiti, via Santo Domingo. He plans to visit a friend who is running an orphanage there.
This clinic is permanent and run by the church. Rush Memorial Hospital from Chicago has a strategic relationship with this church and regularly visits about 4 times a year. They have a plan and they have a routine for the townspeople, not just the members of the congregation. We were all amazed at the quantity of people we were seeing with hypertension, diabetes, and general malaise from flu-like symptoms aches in every part of their body! Barb had one woman tell her at some point that the word got around that patients with diabetes and hypertension were given priority so that’s what she told the screeners outside to be able to get a ticket to be seen Our goal was to see 100 people during the day-long clinic.
We liked the set up that the local volunteers have established. They did an actual type of pre-triage and decided what kind of doctor, pediatric, cardiac, or general, the patient needed to see. They were given cards that were color-coded for the specialty. Many of the people that Juan and I saw were already on medicine for diabetes and/or hypertension, but told us that they didn’t take their pills that morning because they were coming to the clinic! Thus, when we had an elevated blood sugar or blood pressure, it was hard to know whether the dose was enough or this was just due to the lack of meds for the day. We also deduced that many of them figured that since we were in town, they might as well come to see us and stock up on any meds that we might we willing to give them for future use to save having to buy the meds themselves.
There were some truly genuine needs however, like the young man of 36 who had tried to commit suicide by cutting himself in the neck with a broken bottle. He needed psych drugs but apparently the law in DR doesn’t allow doctors except psychiatrists to prescribe them. Alfredo helped us out and suggested to him that he return to the psychiatrist who had released him 6 months ago. We also saw a young pregnant woman with an enlarged thyroid, high blood pressure and a bulging carotid artery that could almost be seen pulsating from across the room. Juan referred her to Manjeet who decided that less treatment is the best way to go with her, as the patient told her that she has had this pulsating artery from a young age. We also saw a woman of 103 years of age who had born 21 children! She had high blood pressure and was accompanied by her 70-something daughter who also wanted to be treated for the same!
During lunch at the Pastor’s house, we had to make a decision whether to stay the night in Peralta and leave very early in the morning to get the team to the airport or to cut short the number of patients and leave in the afternoon. After lunch Alan and I got our bags from our host house and I took the opportunity to take a photo of a crocheted chair cover, probably made by the lady of the house in the same nylon I had seen before in Bani. Too bad she wasn't around so I could photograph her in the chair!
Alfredo thought that if we could see 30 more patients between 2 and 4 (10 for each doctor) we could leave at 4:30 on the dot and get back to Santo Domingo before dark. The roads are dangerous after dark, especially with construction in many spots. We all agreed that was the best scenarios even though our families were prepared to give us their homes for another night. We accomplished our goal, worked very hard in the afternoon heat and were able to leave on schedule.
Juan and I saw more than our share of patients; we lost count after about 13. It was getting hotter and hotter in our room and our fortitude was wearing out towards the end of our long week. Mostly out of frustration that we were not using our time and talents the best advantage, Juan was beginning to get “crabby.” He called himself Juan, “el craboso.” He is a great example of what is wonderful and amazing about our Team. None of us take ourselves too seriously and we are all there to give and to learn. Learn we did!
Alan and Manjeet were accompanied by the male doctor all afternoon, as he was interested in learning all he could about cardiology. Alan found his translating to be taxing as the two doctors were talking in very technical details. However, he found the Dominican doctor, who spoke no English, to be quite patient and appreciative of Manjeet’s knowledge. George was seeing adults when he ran out of kid-type patients and Juan was exhausted from seeing the same vague symptoms in a dark and stuffy room with an examining table lamp as our best source of light.
We had no intentions of leaving any meds behind, so it was nice to just leave them as they were in our makeshift pharmacy with what Rush had left behind the last time. Alan and I abandoned two old suitcases we had used to bring the meds with us, so our load will be much lighter going home. We were loaded on the bus and ready to go with 10 minutes to spare.
The drive home was not so bad and we made several stops. One was a special spot for Alfredo to buy a “coconut milk” dessert for his mother. He says he must never pass that spot without bringing her some! Last but not least was a stop at Pollo Fiorino to pick up our supper consisting of chicken (yet again), fries and coke. It was cold by the time we got to the hotel and unloaded our entire van, but it filled a void and we were exhausted with thoughts of lice and parasites yet to be discovered on our minds!
Not wanting to say our final goodbyes to the rest of the team, Barb, Alan and I promised to meet the group for breakfast at 7:30 to wish them “feliz viaje.” Alan and I got a different room this time in Hotel Europa, much improved, larger and with hopes of a warm shower. NOT!!
Friday, April 4, 2008
Breakfasts of coffee, fresh watermelon, pineapple and melon plus scrambled eggs or pancakes can be counted on at our rooftop breakfast spot. We lingered with the group sharing memories and laughs and making plans to share photos and to have a reunion. Juan is going to make a turnaround in Chicago and then be off to Florida for R& R; John has to go to work tomorrow; Kate, Barb, Manjeet and George on Monday. Sehaj is back to school on Monday and will graduate in May.
Barb, Alan and I gave them all warm hugs on the street and then watched their van head off to the airport while cheering inside that we have a full leisurely day ahead of us in the Dominican sun! We also had a huge “abrazo” (hug) for Alfredo who was such an important part of our trip. We depended on him and he carries great responsibility for the groups he leads virtually handling anything and everything that comes up, including pitching in during the clinics with translation and crowd control. There are local volunteers all along the way, but Alfredo knows when to step in and how to keep it organized.
Overall, I think we all felt good about our experience in the Dominican Republic this week. We had our ups and downs and at times felt like we were just putting on "bandaids" to problems that will continue to exist with our without us. We had to remind ourselves at times that Rose's original vision was for us to be an exploratory group that would see the situation and the problems and start work on a solution for an on-going program. It could be modeled after what Rush Memorial has done, but in a different locale. She hopes that some, if not all of us, have been biten by a desire to return sometime and to continue to think about how we could make a more lasting impression on the health and daily lives of these wonderful people.
To Alan and I, the experience was a like a mini-Peace Corps without the component that is such an essential part of the Peace Corps philosophy: "Don't do it for them, but teach them and leave skills behind to sustain them." We had to remind ourselves at times that this is a first visit and we were there to explore as well as to do. We felt good about what we did; we left behind a lasting impression, but oh, there is so much more to do!
No doubt about it, a fabulous group of people spent the week together, not having known each other very well before. We all rolled with the punches and were there for each other. Rose would have been proud!
Alan checked email and I spent a leisurely time having more coffee and croissants with apricot jam and went back to the room to read my book. About 11:00 we headed up the hill to the Museum where we wanted to see the photography exhibit of Frida Kahlo and Diego Rivera photos. As we passed by the coffee shop to buy water, Barb noticed the flan and hoped that there would be some left by afternoon coffee time. I asked the owner if he would save back a piece for Barb and he obliged. Only in Latin America! At the museum, we encountered a small but wonderful display of their revolutionary activities in Mexico and other parts of the world. We enjoyed the other exhibits in the museum and the lush sun-filled courtyards, as well. Then it was time to walk the “Calle de Las Damas,” a 10-block pedestrian walkway. We just enjoyed the sights, the sun and our explorations.
It’s a local custom that men will come up to visitors and start explaining local sites in the hopes of becoming your tour guide. For me the visit to the Cathedral was special. We were greeted by a potential guide and he assured us that his talk to us was free, and went on to explain that zzzzz’we are all free because we are alive!” No one assumes that we speak Spanish and seem to become friendlier when realize that we do. When he knew that we were working on a medical mission and not vacationing, he told us that we are giving back what God has given us; it made sense. He showed us steps that led to a tunnel, which the nuns used centuries ago to cross underground to reach the house of the Cardinal. After the tour of the Cathedral, he further took care of us by showing us where we could buy coffee at an upscale souvenir shop.There he introduced us to the sales person as “workers” not “visitors” and said we would be given a nice discount and not have to pay tax.
Heading back toward the hotel, we were hungry and ready to have a nice meal (no chicken, please!) in a nice restaurant. We used Barbarita’s guide book and decided on Restaurante Altarazante, near the fort and home of Cristopher Colon’s son, Diego. We learned something surprising: most people eat early at 11:30 or 12:00 depending on “what time they get up.” So, we were pretty much the only ones in the restaurant at the end of the lunch service. No problem, we enjoyed “Presidente” beer, Sea bass and pasta with shrimp plus a delicious casserole of mashed eggplant with lots of garlic and covered with melted Gruyere cheese. Yum; it was leisurely and a refreshing change. After lunch, strolling home we swung by the coffee shop we liked for dessert and coffee before our afternoon nap!
About 7:00, we headed out to the Plaza, not really hungry but wanting to “people-watch” and eat a bite anyway. The restaurant at the Hotel Conde seemed very lively with lots of people at the outdoor tables. The air was fresh and warm still and we found a table outside. Beer again and a mixed appetizer plate was just what the doctor ordered. I could get used to this routine of eating our main meal in the early afternoon and just noshing at night. We required fried plantains one more time and the waiter forgot to substitute them for French fries, so he brought us another plate of plantains, freshly cooked!
We “people-watched” for a while noticed that there were no tourists in site at this place. A little later, a couple speaking English approached us. They were asking for a recommendation on the restaurant and it turns out they were from Vancouver, B.C. and had sailed down from there!. It was just the two of them on the boat and they told us that they took two-hour shifts during the night; one sleeping, one steering the boat. (more adventurous than I would want to be!) They had been in Santo Domingo for a week waiting on the weather to improve so they could continue on to Puerto Rico. We wished them well and headed back to the hotel for a good night’s sleep after a very pleasant day!
Saturday, April 5, 2008
We got up at a leisurely pace today with breakfast at 9:30 and over more coffee made a plan for the day. We started off by walking to the Central Market to see if we could find any souvenirs of the unique kind. Both Barb and I had vowed not to bring back chintzy little things this time! Walking there, we were in the thick of local shoppers doing their Saturday morning errands. We felt safe but remained vigilant.
Once there, we found the market to be shades of the many, many souvenir markets throughout Latin America. Nevertheless, there was plenty to hold our attention for a couple of hours. Pungent spices were displayed in open gunnysacks. The vibrant colors of the oil paintings were like a blast of sun as we rounded the corners from booth to booth. Barb and I got “taken under the wing” of a saleslady who really wanted to sell us some jewelry. We were looking when she saw us and ushered into a more formal jewelry shop nearby. We got a tutorial on amber and its various types; and she showed us how it turns blue when put under a blue light. She explained that this is how you tell the difference between amber and plastic! More appealing to me is the light blue stone, Larimar, which is unique to Dominican Republic.
This young lady immediately offered us a 50% discount and coffee and explained her philosophy that we are “not the usual tourists” and if she treats us well she believes we will send more groups her way thus resulting in future sales. We had fun making our purchases with her and she was out-going and full of personality.
Our walk, which was a big circle, was about two miles. As we passed through the pedestrian walkway one last time, I spied a woman sitting on a doorway crocheting! Whenever I come across a crocheter in another culture, it really makes my day. There is an instant bond and whatever the language, crochet becomes the international language that translates into sharing and understanding. Again, she also was using the imported nylon, which she said comes from China. She had a pile of finished pieces and was working on a skullcap. I told her about my love of crochet and she let me take some pictures. I bought a stylish black and white cap from her for $12.00 and she really wanted to sell me another one, but none of the others measured up. Coming home with this hat is a thrill for me and hopefully will fit Amanda. Yeah, Amanda, the hat model!
This day is jam-packed. We negotiated with a taxi driver to take us to the beach at Boca Chica, about 45 minutes from Santo Domingo and a very popular spot for the locals to spend the weekends. For $80.00 he took us there and brought us back; no charge for waiting; and we could stay as long as we wanted. We were “starving” by now and walked along the beach looking for a restaurant with a lot of people so we could feel comfortable with what we might eat there. We settled on the “Boat House.”
We had our drinks but after 45 minutes of waiting for the meal, we questioned the waiter and he told us there wasn’t enough help in the kitchen. Finally, the meal arrived and it was satisfactory to fill the void, but not the greatest. Oh well, we had great scenery of the beach and a fellow sail boarding endlessly back and forth off the shore using amazing skills to stay on the board and catch the wind to take him in the right direction.
We returned to the designated spot, and Manuel our driver was waiting. Back at the hotel we made a beeline for our “coffee spot” and now the workers there were beginning to think we were comical. Barb took pictures of her friends behind the counter. We thoroughly enjoyed our last opportunity for leisure in the sun and the coffee and bread pudding was particularly good today!
Back down to the plaza for something light, we had to sit inside tonight because of gusty wind had come up. We were all tired and not in the mood to be chilly. We enjoyed just an asparagus soup and beer and were headed back to watch t.v. in the room. Our flight the next day was not until 4:00 PM and we would have plenty of time in the morning to pack. We parted for the night, agreeing to meet for breakfast at 9:30 on the rooftop.
Sunday, April 6, 2008
Another delightful morning and when we were packed, we decided to nosh a bit because being intrepid travelers we know the airlines are trying to starve us! This time on the plaza, we decided to branch out and try another outdoor café. Just a few doors down, we choose a pleasant one next to the Hard Rock Café. As we munched, Alan got a phone call from American Airlines telling him that our flight out of Santo Domingo had been delayed, thus causing us to miss our connection in Miami AND that the airline would be putting us up for the night! Barb was doing a “happy dance” right there in the plaza because it meant she wouldn’t have to go to work on Monday!
We had been sipping on very cold beer which was kept cold with wooden “carafes” that insulated. They are rustic but unique and we had decided to buy some for our kids. The restaurant was selling them and we had just spent the last 20 minutes sending the waiter back and forth to find tops that fit perfectly on the bottom parts. Finally, with a set of four all settled, Barb and I decided to leave those behind and not buy them, since now we had more time to go to a artisan market and find some cheaper and some more for her.
Now with even more leisure time, we felt no rush. Remember that Hardrock I mentioned? They were blasting American music next door and Barb and I got inspired when "YMCA" came on! Talk about a "Happy Dance!"
Alan went back to the hotel to check us out on time and Barb and I headed to a market. A “guide” who had helped us earlier in the morning to find cinnamon sticks met us and he happily took us on a wild goose chase to at least 4 locations where he thought we might find the bottle covers. I found 3 in one spot and after some fierce bargaining go them for $10.00 each instead of the $12.00 the restaurant was asking. COUP! Right across the street we found the fourth one for my set and Barb never did end up finding enough. We had our exercise and were glad to get back to the hotel to cool down a bit before heading to the airport.
The rest of our trip was really uneventful and that was fine with us. American put us up at a lovely JW Marriott hotel with a partial view of Biscayne Bay and we lamented that we only had 8 hours to enjoy it! So by now, reading this you should understand why I call my blog entry, "Dominican Republic Gift." As always when one volunteers, more is received than is given. We gave our hearts and our skills and we received warmth, smiles and friendship in return, as well as some partial understanding of a world that was new to us. It's a gift to touch other lives and to have them touch you in return!
We were back at our house by 2:00 PM on Monday with a renewed appreciation of what it means to be an American citizen!
The dream became reality and the date was set for us to go. Rose, Juan, Barb and I were on board and Rose began seeking more doctors. The timing wasn't the best for Alan and I because our daughter, Bethany is getting married on May 16 in Italy! We'll only have six weeks until the wedding when we return from the DR. On well, sometimes ya gotta do what ya gotta do!
Our group came to the Dominican Republic on a wing and a prayer, really. We had only had one meeting and not all in the group attended that meeting. Some in the group weren’t even on board at the time, so our complete group had not all been together before we landed in the DR. About three weeks before our departure date, Rose’s 12 year old daughter Amanda who was also scheduled to be with us, was diagnosed with Leukemia! Thank God, during our trip Amanda was officially diagnosed as in remission. Two weeks before we left, Kate was named as our nurse leader and received a lot of help from Dr. Juan. We were all committed to come and to work no matter what and that’s how it happened. Read on to learn more about each of us.
Saturday March 29, 2008
I’ll start with the factual first and get to the emotional later because I know you are all anxious to hear that we arrived safely in Santo Domingo, Dominican Republic. Yes, we arrived all in one piece on two planes, one from Boston and one from Chicago O’Hare. The people who came via Boston, Dr. Juan, Dr. George, Dr. Manjeet and her daughter, Sehaj, and Kate, our nurse leader, were delayed there for 5 hours due to mechanical problems. Barb and I were a little late, so we all arrived together, which was a good thing, as we could take the hour ride to the hotel together. Our guide from Endeavor, Alfredo, has beautiful English and took good care of us. Because it was late and we were starting dinner at about 9:00 PM after a long, long day, he dropped us off at a sort of grilled chicken drive-through and then went to the hotel to drop our bags and pick up Alan and John who had arrived much earlier.
We were very hungry and the chicken was delicious along with yellow rice, brown rice with guandules, plantain chips, cooked yucca with onions and cold, cold beer! I was glad to see Alan as he has been here since Tuesday working with his distributor. The temperature even this evening is around 78 degrees and somewhat humid with nice sea breezes. Santo Domingo is a port town with a developing cruise ship industry. There is room for three cruise ships in the port at one time and the booming sound of the ship’s horn can be heard throughout the day.
Getting to our room some time after ten was a welcome sight and we still had to organize our suitcases to condense the medicines we loaded into them and separate that from our clothes to take to our first clinic in the morning. Alan and I had a good night’s sleep and we didn’t wake for anything all night. Our hotel is in the colonial part of the city and its lobby is quite pleasant and belies the simplicity of our room.
Sunday March 30, 2008
We were told to meet for breakfast in the lobby at 9:00 for a continental breakfast, but were happily surprised that a breakfast buffet was awaiting us on the fourth floor rooftop. The air was fresh, sun bright and the coffee very good. This is important to Alan and I and pretty necessary to get our day started right. We had some scrambled eggs, watermelon, pineapple and melon and were ready for what waited for us a few blocks away in our host church. Alfredo was there promptly after breakfast to help us load the medicines into the van and we were on our way, anxious to know how the day would enfold.
Alfredo works for Endeavor and it is an organization that handles the transportation and logistics for many groups that come to do service, medical as well as other types.
We were met at the church by Dee and Tom Yaccino who are from the Chicago suburbs, are community development specialists with Masters Degrees and have lived in Latin American for 16 years (four in Bolivia and twelve in the Dominican Republic).
They spent an hour with us in a conference room orienting us to their work in Santo Domingo and the interconnection between their church, Del Camino and Endeavor. They gave us an idea of the types of cases we would see that day among the mostly homeless population.
We began work by setting up our work spaces in the vestibule of the church. We had some not so private spaces for the doctors to set up their stations to examine the patients and one room with a door in case we needed privacy for someone.
Barb and Kate did triage at the entrance to the lobby and sent them to the most appropriate doctor.
John, Alan and Sehaj spent the whole time organizing the seven suitcases plus two boxes of meds we had all brought. Alan also took a written inventory of the medicines in the storage closet that the church keeps on hand for their weekly clinics so that the doctors would better know what they had to work with.
I translated the whole time with Dr. Juan as we are used to working together. The church provided some translators, one of which is a medical student. They worked with Barb and Kate and another with Dr. Manjeet. Dr. George has enough Spanish that he got along pretty well with the help local translators when need be. We saw patients from about 11:00 until 2:00, and encountered many, many cases of alcoholism and crack cocaine abuse with their various symptoms and maladies. Dr. Juan found this very frustrating because the resulting vague symptoms of pain and aching are difficult to diagnose without tests to analyze and equipment to confirm. At two we took a lunch break had pizza and coke (not of the crack variety) waiting for us upstairs in the conference room and we were famished.
The homeless people show up at the church for lunch, so after that they head on their ways. With lunch over for ourselves too, we had some free time and Alfredo offered to take us on a tour of the colonial area of the city. We opted to do this on foot and it was a pleasant sunny afternoon of about 75 degrees. We saw the first church of the Americas dating from 1524, Independence Hall where the three founders of the D. R. are buried: Trujillo, Mella and Duarte. We entered .the Plaza Colonial and military church where important people are buried. Finishing with the tour and on our way to the hotel, we came across a coffee shop: perfect timing coffee and flan at 4:00 PM!
We were invited to attend the evening church service where we had the clinic during the day, but only 4 of us were intrepid worshippers: Barb, George, Kate and me. It was like a mini-Willow Creek, Latino style, with a modern rock band. There is a strong connection to Chicago and Willow Creek Church here. Back at the hotel after church, we had dinner provided by one the minister’s wife:: lasagna, coleslaw and rolls with coke. It was carb-laden but filled a void before bed!
Monday, March 31, 2008
Dr. Keith had arrived last night at 11:00 PM and he joined us to meet everyone at breakfast. We got an early start to travel to the Northwest side of Santo Domingo, about an hour’s trip in a lot of traffic to a very poor neighborhood nestled in among affluent housing. Now that we are a group of ten, we have another van and driver, Tito.
It’s a pre-school where we set up the clinic to treat the children and their parents from the school and the neighborhood. The Director of the school, Dona Maria, met us. She was very helpful and welcoming and provided us with much assistance and with some volunteers to work on crowd control and translating. First thing we did was pass through all the classrooms and say” hi” to the little kids with smiling faces. They seem to be used to digital cameras and wanted to have their pictures taken and then see the photo. I guess enough mission groups come through there that they have had some experience posing for digitals in the past!
By ten, we had our stations set up and were ready to start seeing patients. I translated for Dr. Mangeet and Alan worked with Dr. Juan.
John B and Sehaj had worked out some of the kinks in the pharmacy yesterday and we beginning to have a handle on the kinds of drugs we had to work with. Inventorying the existing meds in the church pharmacy was a tedious task for Alan yesterday; he was ready for something different.
Dr. Juan has a handle on his Spanish and I thought Alan’s medical Spanish might be a bit rusty; so, I thought that they would be a great match. Kate and Barb took care of triage again and John and Sehaj re-organized the pharmacy in its new space. Dr. George had plenty of patients of the “kid” kind to see and Dr. Keith played soccer in the yard to keep the waiting kids entertained. He also did his part in the pharmacy and passed out the many pencils he had brought along for the kids.
For Dr. Juan this was a much more satisfying type of clinic because many of the patients had specific symptoms that he was able to do something about. He thought Alan was a great translator and they made a great team. Alan was impressed as well Dr. Juan’s grasp of what the patients were saying. I really enjoyed seeing all the doctors working with the “healing touch” using minimal diagnostic tools and no egos. They would stop and ask each other when need be if they had a questions or confusions about a diagnosis or language. Working in an atmosphere with less than ideal communication didn’t seem to phase them and they were picking up Spanish words pretty quickly.
Dr. Juan expressed his sadness when he saw a young woman of 23 who had been shot by her boyfriend 6 times at the age of 18 and has remained paralyzed from the waist down every since. Barb vented her frustration because she may be stricken with lice in a few days as a result of posing non-stop for pictures with all the cute little kids she loved to hug! One adorable little girl with a head full of tight ringlets also had a head full of lice and even some maggots!
We had quite a few elderly patients, some with cataracts and many with diabetes and high blood pressure. The difficult part is that in these church settings we have no diagnostic tools and we are not able to do follow-up for these chronic illnesses. Dr. Manjeet was amazed at the amount of patients who were telling us that they have recurring flu/cold symptoms but at this moment at our diagnostic station, they have no symptoms! We wondered if they just wanted to stock up on meds for the inevitability of the return of symptoms at some later date.
We worked until 2:00 PM when a hot lunch was brought in to the same area where we were working by some of the mothers of the pre-school. It was delicious and about the third time for chicken: fried chicken pieces, chicken stew, rice, coleslaw and coke. After we finished eating, they brewed some coffee, which smelled delicious and tasted wonderful, as well. I had brought along some small gifts, some of which I had crocheted, so I gave each of our cooks a small crocheted coin purse. They were quite appreciative and joked about how they would keep their "five pesos savings" (about 14 cents)in there! The Dominicans, even though extremely poor, really seem to have a light-hearted view of life. They have wide smiles, welcome Americans and have senses of humor about their poverty and politics. Maybe this is all just a symptom of a helpless or hopeless attitude that is endemic in Latin America. Here they are posing in the hats Dr. Keith brought along.
From there, it was back to work from 3:00-5:00. Dr. George kept extremely busy all day with the number of kids that needed to be seen. He pitched in to see adults too, of course, when the ratios shifted to adults!
As we were finishing up, Kate went to speak at a short meeting with the mother’s of the school to educate them about head lice and how treat it and how to clean everything and everyone at home. We broke down the pharmacy, packed up everything in our trusty suitcases and loaded the vans.
We had horrible traffic getting back and arrived just in time for the arrival of our dinner, prepared by the pastor’s wife from the church where we had worked yesterday. It was tasty and carb-laden spaghetti and meatballs, rice, chicken and a cabbage salad which some took a chance on, being assured by Alfredo that it was okay. They orange juice that was served was superb. Pastor Roberto, whose church we had visited the night before, joined us for dinner. It turns out he is also from Chicago, a Dominican who was born there. He showed his appreciation of our work and was glad we had enjoyed his service. After dinner, Kate, Barb, George and Keith went out to explore. The rest of us who were beat headed up to our rooms to get some sleep. Apparently, we had worked harder all day than the revelers!
Tuesday, April 1, 2008
Our breakfasts on the rooftop have continued to be quite delightful. Even though a little cloudy today, the air was pleasant. We started earlier today because of our 2-hour trip to the town of Santa Rosas de Bani´. It is an improvised community on the outskirts of Bani´ that grew from a squatters community to a large barrio over the last ten years.”
Great coffee is my ideal day-starter and the watermelon, pineapple and cantaloupe is fresh and sweet. Everyone is enjoying the delicious fresh-squeezed maracaya´ juice. We also had pancakes today; we are not starving!
Our trip took two hours and Pastor Edsras greeted us. He is part of the Del Camino connection, and he and his wife are doing all they can through the church to serve the community which was hit very hard back in November by Hurricane Noel. The Del Camino Network is a “movement of communities of faith and Christian Organizations that are committed to compassionately serving people and contexts of need in order to bring about hope and transformation.” Esdras oriented us to the work of the church and the plan for the day in his passable English and we set to work.
In the bathroom, there was a toilet, but no running water, so a bucket of water was provided for us to flush! Luckily, we did have electricity for the overhead fans!
We are getting the hang of set-up by now and quickly got our three stations and pharmacy set up, again using speakers for tables! The patients were beginning to gather outside as we got ready and today we had to be a bit more discriminating as to who we could see as we were already running short on some meds. One ticket per family was given out before they got to triage and it was up to the mother to decide who in the family had the priority to be seen, only one per family. We will return here tomorrow and see those who weren’t seen today.
The sanctuary was spacious but offered no privacy. There is one small room off the altar area where someone tacked up a sheet for us to cover the door. We had a chair there in case any doctor needed to do a more private exam. The team is already developing its habits and we all worked alongside the same people as yesterday.
Dr. Juan found a huge breast mass on a young woman today that was probably malignant. With some local help, we sent her immediately to another facility for a biopsy. The vast majority of the people we are seeing seem to have vague symptoms or complain of “gripe” which is more like a cold than flu but could include some flu-like symptoms. Dr. Manjeet is convinced that many of them are not even sick, but since we are in town, they are coming up with some symptoms in order to stock up on some medicines in case they get sick in the future. It is not easy for them to get medical care.
We worked from 11:00-2:00, at which time we walked a few blocks to the pastor’s house where his wife, Helen, had been cooking our meal all morning. The building also serves as the pre-school. We ate a delicious meal of coconut rice, ground beef, sautéed sweet bananas and salad. Fresh lemonade was served as well. The rice that sticks to the bottom of the pan and becomes crunchy is served as a separate side dish. Interesting!!
Barbarita, la loca, hitched a ride back from lunch
Back at the church, we began to work again at 3:00 and finished right at five when the doors had to be closed until tomorrow. We were real thrilled to know that we could leave everything just as is because we will work the same routine there tomorrow. Our ride back home took well over an hour and we are pretty well spent for the day. I came down with a cold today (like our patients!) and helped myself to some Sudafed from the pharmacy for the ride home to try and stop the “faucet” from running.
In retrospect, I believe that our giving is a blessing to all the people of this town. Our healing touch and the few minutes of attention we give to them brings light into what would otherwise be a very touch life filled with drudgery and despair. “Americanos” looking into their eyes and touching their “hearts” gives them a sense of hope and joy for a day. Right before lunch the first day, even Helen and her mother became our patients. Headaches and vague pains were the symptoms. It is so hard to tell what might be the cause without the facilities to do further testing, but poverty and depression can manifest itself with aches and pains.
As we were leaving at 5:00, Alfredo decided to take an alternative route back to the hotel to avoid some traffic. We are not sure it worked but we did see some new and beautiful scenery as we traveled along the boardwalk by the Ocean. Back at the hotel by 7:00, we took a quick breather before our orders of Cuban sandwiches, pizza and lasagna arrived.
At our rooftop dining spot, Tom and Dee joined us. They seemed pretty excited about the work we have been doing and really foresee that we will start working on building some kind of formula that will work for multiple visits from Teams from Northwest Community Hospital (NWCH). Tonight we took up a collection among us and Maralynn and William will buy $500.00 worth of meds that the doctors think we need. They are the in-country coordinators for Endeavor and “work side by side planning short-term trips and serve as a bridge for families and groups that come to directly serve Del Camino Network churches and the communities they reach out to.” Very tired after a long, long day, we didn’t tarry long and headed to our respective rooms.
Today we received an email from daughter Bethany saying she is sure we are doing fine but “WHERE’S THE BLOG?” Bethany, Rose and Amanda: I apologize that I haven’t been sending the Blog. I have faithfully been writing my thoughts each night inWord documents so that I can upload them into the Blog the first chance I get. Our hotel has one tiny room off the lobby with one compter and we have just had such long days that we haven’t had a chance with the very slow Internet to get this task done. Good night!
Wednesday, April 2, 2008
We’re off to another early for our trip back to Bani’. People were waiting for us at the door of the church when we arrived. We were happy to get right to work as everything was still set up for us. The morning went smoothly but it was pretty much the same scenario of symptoms. I enjoy working with Manjeet as her interpreter and it is amazing how fast she has picked up several key words she can say in Spanish and I can tell she understands more of what the patients are seeing.
She is of the belief that we are not practicing very good medicine; without diagnostic tools and basic equipment it is difficult. Really all that we are using are electronic blood pressure cuffs, otoscopes, thermometers, and we can do urine dipsticks and finger sticks for blood sugar. She thinks that we, or any group, could be so much more effective if some local people would make a plan of what they see as the need and start formulating a plan that can be carried out by the various groups. Her thoughts are, “For all the money we have spent on our expenses and travel, plus the donations of medicines, the same amount could we used for building infrastructure.” Looking in the very long term, I agree and believe that if a bright and dedicated woman could be identified and sent to training for nursing, she could become the stabilizing factor that could interface with doctors, groups, the community and donors. We are basically a “band-aid” in this community for people who only have medical care a few times a year.
At one o’clock, we went around the corner to Esdras and Helen’s house again for a good lunch of chicken, rice, cucumbers and cooked carrots, salad and fried plantains plus lemonade. When we finished, we had a few free moments to enjoy the sun and the people in front of the clinic. George taught Manjeet a dance!
In the church, I noticed that there was a lovely hand-crocheted cover for the lecturn and a couple of other crocheter doilies and I asked Helen’s mom if any ladies do crochet and knitting in the Dominican; and she replied that Helen likes to do it. Helen proudly showed me the chair covers she makes out of nylon yarn imported from Mexico. I told her about my love of crochet and gave her one of the crochet gifts I brought along plus several others to share with her mother and the ladies helping her cook They seemed genuinely pleased to receive thess small gifts.
At 2:00 we started seeing patients again. When we had seven patients left to see, Alfredo made the decision that we would pack up and head to Peralta at 3:00 in order to get there before dark and have a bit of time to unpack and get organized for the next day. Cleaning up and packing is getting easier and easier as our supplies dwindle, but I think we felt a bit uneasy not having the closure of seeing all the patients who were waiting for us. George was allowed to play fifteen minutes of basketball with one of the guy volunteers who had been acting as “door control” for two days as we packed up.
We received a very warm welcome in Peralta as we rolled in about 5. Happy faces and big smiles abounded in children women and men, not only at the church but also in the streets. The set up here is so much different and much improved over what we have just come from. This community and the church worked very hard to provide for themselves. They obtained a four-year federal grant, which enabled them to build the clinic and equip it with real examining tables. The pharmacy is permanent, but we will be setting up our own with our meds. The people that use this pharmacy can get their meds cheaper but they are still charge 20 pesos per med and this income is put back into the many needs for the clinic and pharmacy. The belief is that if they pay it will have more value and importance. Another aspect of the church's social activism is a sewing workshop. We were given a quick tour where we learned that Willow Creek Church in Barrington, IL set them up and this process provides work for the local townspeople. We saw them working on an order of 500 t-shirts for Willow Creek which will be sold to that congreation.
A little girl was hanging around outside and was clinging to Barb and I. She spontaneously held our hands and we asked her if she wanted to go on a walk with us. She said “yes,” but we felt we should ask her mother. She told us that her mother is in Spain working, but her father is living here. She took us to her house and we were greeted by another family member. His eyes showed a great surprise at the arrival of two “gringas” with the little girl yet he readily gave her permission to go with us. She wanted to show us the park so that’s where we went. We became like “pied pipers’ as we gained a few little boys on the way and Alan caught up with us too.
This was the night of the “great debate.” We were not really oriented well as to the plan for sleeping and most of us expected that we would be on bunks in the church. Alfredo told us he had arranged for some of us to sleep at the house of some families also. We were taken by surprise because we had had no preparation as to what this might mean: cold showers? Flush toilets? Bed? Clean or not? We huddled before dinner and handled it democratically. Alfredo checked out the houses that were offered for our use and some of us decided to go that route while the rest stayed at the church. Kate went to the house of Wendys, who Rose had told us to be sure and look for as her outgoing personality was not to be missed. Alan and I were in another house but pretty much on our own. We met the mother as she was on her way to the Pastor’s house to cook our dinner and the son ran in and out of the house, but didn’t introduce himself. I believe the lady of the house was very shy and was just as happy to stay occupied while we were there. John and Juan were together in another house.
Before dinner, Alan and I walked along the street our house was on after dropping our bags. We, again, accumulated children like Pied Pipers. At the end of the street we watched a young man doing carpentry work, making chairs and beds. He was very happy to have us watch his skills as an artisan.
After a good dinner of ham, beans and rice, fried plantains and some salad, we retired to our respective sleeping situations. We met Pastor Francisco Roso whose house we were dining at and had been told he and the two local doctors would join us for dinner. It didn’t happen but maybe tomorrow we will have a chance to share ideas. The Pastor and his team have been pioneers in a church based regional health and the church is operating a community health clinic that serves the town of Peralta.
Alan and I used the mosquito netting as I had noticed a couple of bugs flying around while I was typing in the dark by lantern light. The electricity went out shortly after we arrived at the house after dinner and luckily, Alan used his lighter to explore and took one of two lanterns he found in the living room, still no family to be seen. I tried to read by lantern light while under the netting. That didn’t last long and I fell asleep by 9:00. I was awakened again as the mother and daughter returned from their work at the Pastor’s and all of a sudden the house was flooded by light. Electricity had returned and our bedroom door was covered only by a curtain. They turned on the t. v. and the blast of was quickly quelled and I went about trying to return to sleep.
Thursday, April 3, 2008
Although I didn’t hear it, Alan said that a donkey began to bray at about 5:00 AM. I was awakened by the rooster at 6:00 AM. There does not seem to be enough water in the system and consequently there are buckets of water for our use to flush the toilets. I was in no mood to take a cold shower so I opted to just pop into fresh scrubs and not worry about it.
We arrived at the Pastor’s house at 7:00 and were the first ones there. We encountered the door locked, so we waited on the porch a while and then went in the back doorAbout the time we got in, the rest of the group arrived. Breakfast consisted of coffee and cheese bread, which I just couldn’t handle that early in the morning. We also had a delicious juice of something mixed with watermelon. I tried to engage the Pastor in conversation as he stood by the table, as he was wearing a shirt with a Honduran flag. He didn’t have too much to say and seemed shy and sat at his laptop computer across the room as we ate.
The waiting room for the clinic was already filling up when we arrived and once there, we got to work setting up our stations. I introduced myself to the woman doctor who looked like she was about 22! She told me she had studied for seven years. The other doctor, a male, was around all day, but I never really met him.
Dr.Juan decided I would work with him today as he would be in a private room off the main room and it would not be good for Alan and him to be in that room outnumbering any woman patients Alan teamed up with Manjeet in the main room and George was in an alcove off the main room. John and Sehaj had a great room with lots of sunlight to organize their meds. Keith was no longer part of our team, as early in the morning Alfredo had driven him to the next town to catch a bus to the border of Haiti, via Santo Domingo. He plans to visit a friend who is running an orphanage there.
This clinic is permanent and run by the church. Rush Memorial Hospital from Chicago has a strategic relationship with this church and regularly visits about 4 times a year. They have a plan and they have a routine for the townspeople, not just the members of the congregation. We were all amazed at the quantity of people we were seeing with hypertension, diabetes, and general malaise from flu-like symptoms aches in every part of their body! Barb had one woman tell her at some point that the word got around that patients with diabetes and hypertension were given priority so that’s what she told the screeners outside to be able to get a ticket to be seen Our goal was to see 100 people during the day-long clinic.
We liked the set up that the local volunteers have established. They did an actual type of pre-triage and decided what kind of doctor, pediatric, cardiac, or general, the patient needed to see. They were given cards that were color-coded for the specialty. Many of the people that Juan and I saw were already on medicine for diabetes and/or hypertension, but told us that they didn’t take their pills that morning because they were coming to the clinic! Thus, when we had an elevated blood sugar or blood pressure, it was hard to know whether the dose was enough or this was just due to the lack of meds for the day. We also deduced that many of them figured that since we were in town, they might as well come to see us and stock up on any meds that we might we willing to give them for future use to save having to buy the meds themselves.
There were some truly genuine needs however, like the young man of 36 who had tried to commit suicide by cutting himself in the neck with a broken bottle. He needed psych drugs but apparently the law in DR doesn’t allow doctors except psychiatrists to prescribe them. Alfredo helped us out and suggested to him that he return to the psychiatrist who had released him 6 months ago. We also saw a young pregnant woman with an enlarged thyroid, high blood pressure and a bulging carotid artery that could almost be seen pulsating from across the room. Juan referred her to Manjeet who decided that less treatment is the best way to go with her, as the patient told her that she has had this pulsating artery from a young age. We also saw a woman of 103 years of age who had born 21 children! She had high blood pressure and was accompanied by her 70-something daughter who also wanted to be treated for the same!
During lunch at the Pastor’s house, we had to make a decision whether to stay the night in Peralta and leave very early in the morning to get the team to the airport or to cut short the number of patients and leave in the afternoon. After lunch Alan and I got our bags from our host house and I took the opportunity to take a photo of a crocheted chair cover, probably made by the lady of the house in the same nylon I had seen before in Bani. Too bad she wasn't around so I could photograph her in the chair!
Alfredo thought that if we could see 30 more patients between 2 and 4 (10 for each doctor) we could leave at 4:30 on the dot and get back to Santo Domingo before dark. The roads are dangerous after dark, especially with construction in many spots. We all agreed that was the best scenarios even though our families were prepared to give us their homes for another night. We accomplished our goal, worked very hard in the afternoon heat and were able to leave on schedule.
Juan and I saw more than our share of patients; we lost count after about 13. It was getting hotter and hotter in our room and our fortitude was wearing out towards the end of our long week. Mostly out of frustration that we were not using our time and talents the best advantage, Juan was beginning to get “crabby.” He called himself Juan, “el craboso.” He is a great example of what is wonderful and amazing about our Team. None of us take ourselves too seriously and we are all there to give and to learn. Learn we did!
Alan and Manjeet were accompanied by the male doctor all afternoon, as he was interested in learning all he could about cardiology. Alan found his translating to be taxing as the two doctors were talking in very technical details. However, he found the Dominican doctor, who spoke no English, to be quite patient and appreciative of Manjeet’s knowledge. George was seeing adults when he ran out of kid-type patients and Juan was exhausted from seeing the same vague symptoms in a dark and stuffy room with an examining table lamp as our best source of light.
We had no intentions of leaving any meds behind, so it was nice to just leave them as they were in our makeshift pharmacy with what Rush had left behind the last time. Alan and I abandoned two old suitcases we had used to bring the meds with us, so our load will be much lighter going home. We were loaded on the bus and ready to go with 10 minutes to spare.
The drive home was not so bad and we made several stops. One was a special spot for Alfredo to buy a “coconut milk” dessert for his mother. He says he must never pass that spot without bringing her some! Last but not least was a stop at Pollo Fiorino to pick up our supper consisting of chicken (yet again), fries and coke. It was cold by the time we got to the hotel and unloaded our entire van, but it filled a void and we were exhausted with thoughts of lice and parasites yet to be discovered on our minds!
Not wanting to say our final goodbyes to the rest of the team, Barb, Alan and I promised to meet the group for breakfast at 7:30 to wish them “feliz viaje.” Alan and I got a different room this time in Hotel Europa, much improved, larger and with hopes of a warm shower. NOT!!
Friday, April 4, 2008
Breakfasts of coffee, fresh watermelon, pineapple and melon plus scrambled eggs or pancakes can be counted on at our rooftop breakfast spot. We lingered with the group sharing memories and laughs and making plans to share photos and to have a reunion. Juan is going to make a turnaround in Chicago and then be off to Florida for R& R; John has to go to work tomorrow; Kate, Barb, Manjeet and George on Monday. Sehaj is back to school on Monday and will graduate in May.
Barb, Alan and I gave them all warm hugs on the street and then watched their van head off to the airport while cheering inside that we have a full leisurely day ahead of us in the Dominican sun! We also had a huge “abrazo” (hug) for Alfredo who was such an important part of our trip. We depended on him and he carries great responsibility for the groups he leads virtually handling anything and everything that comes up, including pitching in during the clinics with translation and crowd control. There are local volunteers all along the way, but Alfredo knows when to step in and how to keep it organized.
Overall, I think we all felt good about our experience in the Dominican Republic this week. We had our ups and downs and at times felt like we were just putting on "bandaids" to problems that will continue to exist with our without us. We had to remind ourselves at times that Rose's original vision was for us to be an exploratory group that would see the situation and the problems and start work on a solution for an on-going program. It could be modeled after what Rush Memorial has done, but in a different locale. She hopes that some, if not all of us, have been biten by a desire to return sometime and to continue to think about how we could make a more lasting impression on the health and daily lives of these wonderful people.
To Alan and I, the experience was a like a mini-Peace Corps without the component that is such an essential part of the Peace Corps philosophy: "Don't do it for them, but teach them and leave skills behind to sustain them." We had to remind ourselves at times that this is a first visit and we were there to explore as well as to do. We felt good about what we did; we left behind a lasting impression, but oh, there is so much more to do!
No doubt about it, a fabulous group of people spent the week together, not having known each other very well before. We all rolled with the punches and were there for each other. Rose would have been proud!
Alan checked email and I spent a leisurely time having more coffee and croissants with apricot jam and went back to the room to read my book. About 11:00 we headed up the hill to the Museum where we wanted to see the photography exhibit of Frida Kahlo and Diego Rivera photos. As we passed by the coffee shop to buy water, Barb noticed the flan and hoped that there would be some left by afternoon coffee time. I asked the owner if he would save back a piece for Barb and he obliged. Only in Latin America! At the museum, we encountered a small but wonderful display of their revolutionary activities in Mexico and other parts of the world. We enjoyed the other exhibits in the museum and the lush sun-filled courtyards, as well. Then it was time to walk the “Calle de Las Damas,” a 10-block pedestrian walkway. We just enjoyed the sights, the sun and our explorations.
It’s a local custom that men will come up to visitors and start explaining local sites in the hopes of becoming your tour guide. For me the visit to the Cathedral was special. We were greeted by a potential guide and he assured us that his talk to us was free, and went on to explain that zzzzz’we are all free because we are alive!” No one assumes that we speak Spanish and seem to become friendlier when realize that we do. When he knew that we were working on a medical mission and not vacationing, he told us that we are giving back what God has given us; it made sense. He showed us steps that led to a tunnel, which the nuns used centuries ago to cross underground to reach the house of the Cardinal. After the tour of the Cathedral, he further took care of us by showing us where we could buy coffee at an upscale souvenir shop.There he introduced us to the sales person as “workers” not “visitors” and said we would be given a nice discount and not have to pay tax.
Heading back toward the hotel, we were hungry and ready to have a nice meal (no chicken, please!) in a nice restaurant. We used Barbarita’s guide book and decided on Restaurante Altarazante, near the fort and home of Cristopher Colon’s son, Diego. We learned something surprising: most people eat early at 11:30 or 12:00 depending on “what time they get up.” So, we were pretty much the only ones in the restaurant at the end of the lunch service. No problem, we enjoyed “Presidente” beer, Sea bass and pasta with shrimp plus a delicious casserole of mashed eggplant with lots of garlic and covered with melted Gruyere cheese. Yum; it was leisurely and a refreshing change. After lunch, strolling home we swung by the coffee shop we liked for dessert and coffee before our afternoon nap!
About 7:00, we headed out to the Plaza, not really hungry but wanting to “people-watch” and eat a bite anyway. The restaurant at the Hotel Conde seemed very lively with lots of people at the outdoor tables. The air was fresh and warm still and we found a table outside. Beer again and a mixed appetizer plate was just what the doctor ordered. I could get used to this routine of eating our main meal in the early afternoon and just noshing at night. We required fried plantains one more time and the waiter forgot to substitute them for French fries, so he brought us another plate of plantains, freshly cooked!
We “people-watched” for a while noticed that there were no tourists in site at this place. A little later, a couple speaking English approached us. They were asking for a recommendation on the restaurant and it turns out they were from Vancouver, B.C. and had sailed down from there!. It was just the two of them on the boat and they told us that they took two-hour shifts during the night; one sleeping, one steering the boat. (more adventurous than I would want to be!) They had been in Santo Domingo for a week waiting on the weather to improve so they could continue on to Puerto Rico. We wished them well and headed back to the hotel for a good night’s sleep after a very pleasant day!
Saturday, April 5, 2008
We got up at a leisurely pace today with breakfast at 9:30 and over more coffee made a plan for the day. We started off by walking to the Central Market to see if we could find any souvenirs of the unique kind. Both Barb and I had vowed not to bring back chintzy little things this time! Walking there, we were in the thick of local shoppers doing their Saturday morning errands. We felt safe but remained vigilant.
Once there, we found the market to be shades of the many, many souvenir markets throughout Latin America. Nevertheless, there was plenty to hold our attention for a couple of hours. Pungent spices were displayed in open gunnysacks. The vibrant colors of the oil paintings were like a blast of sun as we rounded the corners from booth to booth. Barb and I got “taken under the wing” of a saleslady who really wanted to sell us some jewelry. We were looking when she saw us and ushered into a more formal jewelry shop nearby. We got a tutorial on amber and its various types; and she showed us how it turns blue when put under a blue light. She explained that this is how you tell the difference between amber and plastic! More appealing to me is the light blue stone, Larimar, which is unique to Dominican Republic.
This young lady immediately offered us a 50% discount and coffee and explained her philosophy that we are “not the usual tourists” and if she treats us well she believes we will send more groups her way thus resulting in future sales. We had fun making our purchases with her and she was out-going and full of personality.
Our walk, which was a big circle, was about two miles. As we passed through the pedestrian walkway one last time, I spied a woman sitting on a doorway crocheting! Whenever I come across a crocheter in another culture, it really makes my day. There is an instant bond and whatever the language, crochet becomes the international language that translates into sharing and understanding. Again, she also was using the imported nylon, which she said comes from China. She had a pile of finished pieces and was working on a skullcap. I told her about my love of crochet and she let me take some pictures. I bought a stylish black and white cap from her for $12.00 and she really wanted to sell me another one, but none of the others measured up. Coming home with this hat is a thrill for me and hopefully will fit Amanda. Yeah, Amanda, the hat model!
This day is jam-packed. We negotiated with a taxi driver to take us to the beach at Boca Chica, about 45 minutes from Santo Domingo and a very popular spot for the locals to spend the weekends. For $80.00 he took us there and brought us back; no charge for waiting; and we could stay as long as we wanted. We were “starving” by now and walked along the beach looking for a restaurant with a lot of people so we could feel comfortable with what we might eat there. We settled on the “Boat House.”
We had our drinks but after 45 minutes of waiting for the meal, we questioned the waiter and he told us there wasn’t enough help in the kitchen. Finally, the meal arrived and it was satisfactory to fill the void, but not the greatest. Oh well, we had great scenery of the beach and a fellow sail boarding endlessly back and forth off the shore using amazing skills to stay on the board and catch the wind to take him in the right direction.
We returned to the designated spot, and Manuel our driver was waiting. Back at the hotel we made a beeline for our “coffee spot” and now the workers there were beginning to think we were comical. Barb took pictures of her friends behind the counter. We thoroughly enjoyed our last opportunity for leisure in the sun and the coffee and bread pudding was particularly good today!
Back down to the plaza for something light, we had to sit inside tonight because of gusty wind had come up. We were all tired and not in the mood to be chilly. We enjoyed just an asparagus soup and beer and were headed back to watch t.v. in the room. Our flight the next day was not until 4:00 PM and we would have plenty of time in the morning to pack. We parted for the night, agreeing to meet for breakfast at 9:30 on the rooftop.
Sunday, April 6, 2008
Another delightful morning and when we were packed, we decided to nosh a bit because being intrepid travelers we know the airlines are trying to starve us! This time on the plaza, we decided to branch out and try another outdoor café. Just a few doors down, we choose a pleasant one next to the Hard Rock Café. As we munched, Alan got a phone call from American Airlines telling him that our flight out of Santo Domingo had been delayed, thus causing us to miss our connection in Miami AND that the airline would be putting us up for the night! Barb was doing a “happy dance” right there in the plaza because it meant she wouldn’t have to go to work on Monday!
We had been sipping on very cold beer which was kept cold with wooden “carafes” that insulated. They are rustic but unique and we had decided to buy some for our kids. The restaurant was selling them and we had just spent the last 20 minutes sending the waiter back and forth to find tops that fit perfectly on the bottom parts. Finally, with a set of four all settled, Barb and I decided to leave those behind and not buy them, since now we had more time to go to a artisan market and find some cheaper and some more for her.
Now with even more leisure time, we felt no rush. Remember that Hardrock I mentioned? They were blasting American music next door and Barb and I got inspired when "YMCA" came on! Talk about a "Happy Dance!"
Alan went back to the hotel to check us out on time and Barb and I headed to a market. A “guide” who had helped us earlier in the morning to find cinnamon sticks met us and he happily took us on a wild goose chase to at least 4 locations where he thought we might find the bottle covers. I found 3 in one spot and after some fierce bargaining go them for $10.00 each instead of the $12.00 the restaurant was asking. COUP! Right across the street we found the fourth one for my set and Barb never did end up finding enough. We had our exercise and were glad to get back to the hotel to cool down a bit before heading to the airport.
The rest of our trip was really uneventful and that was fine with us. American put us up at a lovely JW Marriott hotel with a partial view of Biscayne Bay and we lamented that we only had 8 hours to enjoy it! So by now, reading this you should understand why I call my blog entry, "Dominican Republic Gift." As always when one volunteers, more is received than is given. We gave our hearts and our skills and we received warmth, smiles and friendship in return, as well as some partial understanding of a world that was new to us. It's a gift to touch other lives and to have them touch you in return!
We were back at our house by 2:00 PM on Monday with a renewed appreciation of what it means to be an American citizen!
Comments
Carino,
Sheila
Tu espanol es maravilloso. Debe estar practicando mucho en el hospital de tus estudios. Nos vemos el sabado.