Monday, August 12, 2013

Temper Tantrum

I threw a tantrum yesterday. Yes, a tantrum. I went from a professional- educated, poised, and flexible to what must have been my 4 year old self red as a cherry and pouting that things weren't going my way. Those who know me know I'm an excellent pouter! This took all of about 5 seconds and much of my self control not to scream and cry at the top of my lungs shouting "it's not fair!" Instead I kept repeating "I'm over it, I'm over it, I'm over it" as I paced back and forth outside the centro comunal (quite guilty of stomping my feet, huffing and puffing) where I hold my Community Health Leader (CHL) meetings.  I was hurt- my pride, my self esteem, and most of all my feelings were very hurt.

Yesterday was my last meeting with the CHL's. Although we usually hold our meeting Sunday afternoon, this Sunday (today) a team of Americans were coming to serve as a short term mission team so I have to be with them. Also, we received a small gift of money just enough to treat the women to a day at the local dam and then dinner at a restaurant which is a HUGE deal to them. So we decided to hold the meeting Saturday morning from 9-11 and then rent a bus to take us to the dam for the day and enjoy a nice dinner at the fish restaurant. The plan was to have everyone there, all 10 CHL's, me, Ruben, and Anel, in order to celebrate their successes this summer. I hoped to get a big group picture and spend the day reminiscing and enjoying each other's company, and finally saying goodbye personally to every single one of them.  But God would have it another way that I just wasn't ready to accept.

I arrived to two waiting CHLs (something that has never happened before- they were early what?! this is a miracle by Dominican standards) and had my hopes so high when I saw Wendy and Yesenia waiting. I began to set up for our last class and then waited as usual... most of the time they come about a half hour late. But by 9:30 I only had a handful of the 10 and I was getting worried. I knew one could not come because she goes to University everyday except for Sunday, but all the others I was expecting to go. I came to find out that one was sick, another had unexpected company and was only there for the class, and the other just didn't show up... And for some reason I was absolutely distraught.  It was my very last opportunity to be with them all and we spent lots of money preparing for this special outing and I had lots of information to cover.  I was tired of the excuses and tired of preparing so much for every meeting only to find out every week that one person or another couldn't make it for this reason or that reason...  If it rained before the meeting then they couldn't come because of the roads, if a distant relative passed away they would miss several meetings due to a lengthy mourning period, their ride might not show up or their motorcycle might die, they might be "sick", or  simply there were "circumstances out of their control" that would a plethora of other excuses  But I think it goes even deeper than this. I was taking my frustration that had built up over the months out on this amazing group of women that were doing there very best to spare 3 hours every week, traversing terrible roads and leaving their children and grandchildren with neighbors and relatives and on top of this all they are doing this work voluntarily, something very rare here.

Yes, they should have been here at this last meeting, it is one of the expectations they set for THEMSELVES and motivating adults has been one of my hardest challenges this summer. For that reason I decided to start the teen group as well as it's often easier and has a greater impact to work with children and young adults.

We purposefully had these ladies set expectations for there own group according to what they thought they could do. So I was upset that they weren't necessarily living up to the expectation to attend every meeting, but I think the deeper problem was that my feelings were hurt. I thought they would at least try to make it to this meeting to say goodbye and celebrate.

 This culture is a culture of "mañana." "Mañana we will do it," "mañana it can happen" so many mañanas but never "hoy!" What could be a beautiful reminder of how their faith and trust in God is so interwoven into their lives,"Si Dios quiere"- "If God wills/wants it." has turned into one of the phrases I dread hearing the most here.  It is the most passive, noncommittal response that completely avoids any responsibility and commitment for a future event.  I might say, "Ok, see you tomorrow at the meeting!" and instead of saying "Yes, I will be there!" or  being upfront and replying "I don't think I can make it" they reply "If God wills it." When I first arrived I didn't realize this was an everyday idiom so when someone responded this way my reaction was "Yes of course he wants it!" I thought, why wouldn't He want it? Why wouldn't He want you to come to a meeting to educate yourself and your community on important matters of health?  And so I'm still wondering, why wouldn't He want all of the CHL's to be there for that last meeting? Was it divine intervention or apathy on the part of the women that prevented half of them from attending our last meeting... I'm thinking it was a bit of both.

And to be cliche, this was the straw that broke the camel's back.  I was frustrated at many things. For one, earlier this week I went with the CHL Angelita on a house visit to in the community of Jaguey. We decided to go to one of the families most in need.  Upon arriving I was shocked at what I saw. It was as if I was back in Kenya.  In the DR there is poverty but it is more of chronic, underlying poverty... they have enough food but it's not the right kind of food, they have sturdy hosues but they are not lavishly furnished and often leak a little or are not quite large enough for their very large families, they have education but it's not top quality and many students fail or dropout. However they have food, they have shelter, they have family, and they have their community.  In Kenya the poverty was acute, like acute malnutrition, everyday was a matter of life and death for many. Here it is more a question of quality of life and so we work on how Project Hearts can better the quality of life for the people of Baitoa. However, this family's situation is pretty dire. Their house is falling down, there is trash and filth everywhere, they have no bathroom and not even a latrine, they haven't receive water in over a year from the government and don't have money to buy water,  there are dirty animals everywhere and the baby of one of the oldest daughter was in the dirt naked.  The mother is actually a grandmother at the age of 28 and isn't sure if she herself is pregnant.  The abuse and violence was hanging thick in the air. So palpable and oppressive.  So when we visited them I was crushed. Where do we start? The second oldest daughter was home and was translating what we were saying to the mother who only speaks Creole. Midway through our discussion and assessment the Father came home and began to ask us for help. Both him and his wife have been having health problems and the second eldest daughter smiling and giggling said, "We all drink (referring to herself only 13 years old, her older sister of 15 with the baby, her mother and her father) and who knows if my sister or my Mom or pregnant... they definitely could be!"

We finished our assessment and I left there house wondering where to even begin to help this family or how to guide Angelita to help them in the future.  The next day I was still thinking of this family when Ruben and I went to meet with Profamilia in Santiago about a potential partnership with Project Hearts. They are an organization/hospital that specializes in family medicine, specifically women's health providing education, prevention, need-based health care services, counseling, and follow up.  The meeting was fantastic and it seemed as if God was providing us the answer- they said that we could bring the Mother of the family and the oldest daughter to the clinic for free services and education. It was going to work out perfectly! We were to make another trip to Santiago anyway on Friday so they could ride with us and then we would pay for their transport home. They wouldn't have to pay a dime and they would receive the help that we thought they were asking for!  I joyfully went and talked to the family and they agreed that the Mother and oldest daughter would go with us on Friday. It was a perfect plan. They didn't even say "Si Dios quiere" but merely agreed and their reply, although positive in words was not positive in action.  And sure enough Dios did not quiere... although in my opinion I think it was them that did not want to go... He had other plans I suppose and they certainly had other plans.

 Friday morning they did not show up so I walked the half mile or so to their house on the slippery, muddy road as it started to drizzle.  I thought, just maybe if I can talk to them they will change their mind, but they were "busy." With what, I'm still not sure. They assured me they'd go to a local clinic "mañana" to get a checkup for their Mom but that day they were "busy." The daughters didn't want to translate my plea to the mother to go and that was that. I failed.  I can't speak Creole, and I couldn't get the importance of going to the Doctor across or the fact that this was such an amazing opportunity.  But I know that the basis of community development and lending help is that the people have to want it. I guess I mistook their pleas for help, recalling that it seemed as though the Father really wanted fiscal help more than anything.  And I walked back dejected. The perfect plan was not so perfect after all.

This week I had also left one of my teen health classes feeling dejected and frustrated. I'd had pretty good responses in my teen class and felt like I was really breaking down barriers and mounting enthusiasm. And then last week only 4 students came and they were on their cell phones the whole time taking advantage of the internet access.  I spend a long time preparing for these classes and had a dynamic lesson planned, but I don't blame them for wanting to use the internet since they rarely have access.

The planned trip to the river that everyone had talked about for weeks with the neighboring community of Mocan failed. It had rained too much to go as the roads were washed out.

One of the projects that the team of Americans is supposed to complete this week is on the verge of failure despite weeks of planning.

It was as if all the failed plans from this summer hit me at once as I stood outside the centro communal yesterday trying to calm myself down.  And then Ruben came outside to talk to me.  He said "the fact that we even have one person here is a miracle, Meghan.  We have a CHL group, we have women here dedicated to their community's and there's nothing we can do about the rest. God has a different plan so let's make the best of what we have and keep going with what we had planned. He has made it how it needs to be today. We are doing the work that we are supposed to do so let's keep going." So I took a deep breath, plastered a smile on my face, entered the room and began what was sadly my last lesson with the CHL's and what turned out to be a very enjoyable day!

The Dominican Republic can be the worst nightmare for a planner like me unless you realize that there is a greater plan happening. The best moments here for me have been the ones that have been unplanned or resulted from altered plans.

For instance, the week that Matt came to visit I dropped all of my plans and just went with the flow. We ended up working at a children's camp that week, making the best of friends here, hiking in a canyon, dancing the nights away in Santiago, and holding awesome classes!

Another was when dinner plans fell through so Chiquita ended up coming up to my house and I decided to fix dinner for her and I. I poured her drink, cooked her dinner, cleaned up after us, and didn't let her lift a finger. She is the most hard working woman I have ever met and it gave me the most pleasure to SERVE her. Chiquita LOVES to read but told me that when she tries to read tears run down her eyes from the strain. I had a book to give her but upon finding this out I didn't want to give it to her because I knew she would want to read it but really couldn't and that it would probably be more like torture to give her something she loved but couldn't use. When I mentioned this to Ellen, my American neighbor who had come over when she saw Chiquita and I sipping wine on the porch, she exclaimed that she had dozens of eyeglasses that had been donated. We ended up laughing and giggling as she gave Chiquita eyeglasses to  figure out which pair worked best for her.  Chiquita was beaming.

I can't forget the spur of the moment dance party at my house with half of San Jose Adentro. Or the hysterical game of charades demonstrating disease routes of transmission in my CHL class. I could go on and on.

What really matters is the fact that the successes and amazing moments far outnumber the challenges and failures and that we continue to persevere through which ever moments we face next. I even turned my temper tantrum into a moment of learning and clarity as I later saw that the day was exactly as it was meant to be despite only having half the group.  Seeing the women playing in the dam as if they were children again, pigging out on our amazing picnic lunch (Nina, one of the women exclaimed "Meghan you sure will break our bad diets!" because I only bring healthy food to the meetings and to the picnic) and eating at a restaurant for the first time was incredible. I asked them about their highs and lows and what amazed me was that the only low moments they had with the new CHL program were the difficulties and barriers to them attending the meetings. My jaw dropped. I thought they might say they hated the quizzes, or how long the meetings were.  Despite any negatives, they remain focused on the positives of the CHL program just as I am focusing on the positives of my experiences this summer.

Chiquita at my house with her new book and eyeglasses! 

Some of the Community Health Leaders at the Dam.

Yera, a CHL and leader in her community, enjoys the fish fry

All of us at dinner

The teen health class

Me giving a class at Ruben's cousins house because the centro comunal, where we usually hold class, had another activity going on.  Always have to be flexible here! Thank goodness these people let us hold the class at their house.

Matt and I hiking in the guarda raya river gorge.

Thursday, August 8, 2013

How I Spent My Summer

Do I really only have 6 more days left? How is that even possible? Where has my summer gone? What have I accomplished?

Yes, I only have 6 more days left, whether I like it or not and it's possible because the seasons are changing. Today was my last teen health class and Saturday is the last community health leader (CHL) class which will be followed by a trip to the local dam for swimming and dinner to celebrate a successful summer. My time is drawing to a close and I am beginning to pass the baton of this program to Jewel, the nurse practitioner that is coming at the end of August to replace me. But I want to be selfish and keep the baton and keep doing what I'm doing! I keep thinking and constantly repeating "It's not fair, my work has just begun!" And although I feel like my work is finally starting here-the walls are finally coming down, my relationships are finally growing deeper and more rooted in trust and friendship, the way of life here becoming more normal, the direction of this program and my work more clear and focused- I must return to the US and finish my Master's in Public Health Program strong.  As much as I want to believe that my work has just started here, the seasons are changing and there is a time for everything. It's Jewel's time to continue this work and my time to continue to prepare myself by studying and working so that I may become even more equipped and prepared to continue work such as this.

 1There is an appointed time for everything. And there is a time for every event under the heavens—
2A time to give birth and a time to die;  A time to plant and a time to uproot what is planted.
3A time to kill and a time to heal;  A time to tear down and a time to build up.
4A time to weep and a time to laugh;  A time to mourn and a time to dance.
5A time to throw stones and a time to gather stones;  A time to embrace and a time to shun embracing.
6A time to search and a time to give up as lost;  A time to keep and a time to throw away.
7A time to tear apart and a time to sew together;  A time to be silent and a time to speak.
8A time to love and a time to hate;  A time for war and a time for peace.
 9What profit is there to the worker from that in which he toils?10I have seen the task which God has given the sons of men with which to occupy themselves. 11He has made everything appropriate in its time. He has also set eternity in their heart, yet so that man will not find out the work which God has done from the beginning even to the end. I know that there is nothing better for them than to rejoice and to do good in one's lifetime; 13moreover, that every man who eats and drinks sees good in all his labor-- it is the gift of God.…
Ecclesiastes 3:1-13

I turn to this passage often as I find myself anxious about getting my life "started" and continuing the work that I believe I am called to do. But for now I know it's time to return to Birmingham and to school and finish my Masters degree strong and then see where life takes me and where God directs me! 

So as I attempt to reflect and better put into words my experiences here this summer, please read the below report that I actually submitted to UAB to receive credit for my internship:

Working as a public health intern with Project Hearts this summer has been one of the most rewarding experiences of my life.  Living and working here in the Dominican Republic I often feel as if I’ve been caught up in the rhythm and passion of the country, swinging from positive to negative, from challenge to success, from excitement to tranquility and all of the emotions and outcomes in between.  It’s as if my sentiments emulate the sway of my hips when I dance merengue or the ever-changing tropical weather.  This way of life is a little unsettling at first if you aren’t prepared for the turbulence, but after awhile you find the rhythm that reminds you to be patient, celebrate your successes and persevere through your hardships; a constant undulation.
Upon my arrival I immediately learned that flexibility and patience would be key to my success here.  I came to the Dominican Republic knowing very little about the organization I was going to work for and believing I would be doing a “water project.”  I thought I would be preparing the local communities of Baitoa through education and community assessments for the installation of wells after my departure.   As is typical here, this was the original plan, but when water began to flow (however sporadically and unreliably) from the city through their pipes to the local houses, constructing wells was no longer the greatest need.  However, based on the data collected by local organizations and the work of Kristin Olson (the intern last year) it was evident the people were still concerned about their quality of water and sanitation in the area so our attention shifted to a more sustainable way to address their water issues and any other future issues and concerns. The solution was the development of a community health leader program for the area.
As this became the new focus of my internship I immediately shifted my attention to creating the basis for the program, the basic infrastructure and ability for it to become a sustainable program with the aid of grants, local and international organizations, educational materials, and most importantly community ownership.  This fits into the mission of Project Hearts (which we refined and developed the three pillars as a team while I was here- I was able to help with organizational development and training in addition to my public health focus) to develop individual and community awareness and leadership through participatory community projects and activities to better the quality of life in Baitoa.  Our foundation is supported by the 3 pillars of HEALTH, EDUCATION, and ECONOMIC DEVELOPMENT around which all community projects and activities are centered. Our Vision is simple: To better the lives of the people of Baitoa so they may live dignified and fulfilled lives and learn to help themselves.
I started with the goals and objectives of the program which are as follows:
The goal of this project is to improve the overall health of the Baitoa communities and develop community leadership skills. The CHL program also serves to advocate and organize community health leaders. This will be accomplished by completing the following objectives:

• Educate and train approximately 10 community health leaders (two elected by community leaders in each community)
• Develop specific education modules in community water, hygiene and sanitation, nutrition and cooking, maternal and child health, family planning, first aid, cardiovascular health, etc.
• Provide 3-4 monthly group education sessions in each community served.
• Establish water and health committees in each community.
• Visit homes with high-risk community members (infants and young children, pregnant women of child-bearing age and pregnant, and the elderly) and the infirm.
• Make the leadership program a sustainable community-driven program for primary health care.
• Educate the community and maintain their health, prevent disease, prevent complications thereof and recognize warning signs of disease, especially in children. (Ex, diarrhea, malnutrition, respiratory illness, febrile diseases, ear problems, eye, and throat diseases, infectious disease etc.).
• Finally, avoid complications and reduce unnecessary hospitalizations and preventable diseases in Baitoa.
            After conducting literature reviews and using local community assessments conducted by Project Hearts’ partners, as well as the little data available by the government on the Dominican Republic I finished creating the framework and potential curriculum of this program beginning with a focus on leadership development, the human right to health and then moving into the most basic and essential determinant of health: access to clean water.  Before I could start with these training sessions I sought the support of the communities to begin the program. I literally went door to door speaking with key leaders in the communities of Baitoa to bring them to a meeting to discuss the programs goals and objectives.  That first meeting I was incredibly nervous but at the end the community leaders received the program well and with lots of enthusiasm! They were to then return to their communities and choose community health leaders.  Almost immediately those leaders had found potential CHL’s and the trainings began every week for 3 hours. As noted above, we began by developing an appreciation and an understanding of the importance of a healthy community, the human right to health, the roles and responsibilities of being a CHL, and their own expectations for the group. We then progressed to talk about water and sanitation, discussing what germs are and how they cause diseases, different routes of transmission and the absolute necessity of clean and healthy water in a community and how it can be used to prevent and even treat diseases. 
Based on my research we then talked about the most prevalent water-borne and water-related illnesses in the Dominican Republic.  We had guest speakers from the company Filter Pure that distributes locally made water filters made of clay, carbon, and silvery powder.  The guest presented the water filter and trained the ladies (the group of CHLs are all women!) on how to sell them.  This is a project that Project Hearts has promoted as an independent project for a while but it is now being nested in our CHL program. This way the CHLs are responsible for educating their communities on water and offering them methods of purification and filtration that they learned in the classes (of which the water filter is the ideal) and give them a more well-rounded understanding water and its necessity. In addition selling the water filters provides the CHLs a bit of income and incentive to reach as many people as possible.
Another powerful experience for the group was when the Director of Project Hope in the Dominican Republic, Teresa Narvaez, came to speak about the CHL program they have in the capital and how important they are in the promotion of health.  Some practical skills they learned were how to combat diarrhea in home with oral rehydration therapy, how to construct a tippy-tap which is an easy hand washing device, and what to look for on a home visit to ensure the family is practicing safe water and hygiene practices among many other things.
After finishing the water module we transitioned to nutrition as a form of disease prevention and promotion of healthy lifestyles. I did this by using the case of unclean water and baby formula as a potentially dangerous and life-threatening combination. This serves as the perfect link between water and nutrition as we began to focus on the first 1000 days of a child’s life and the centrality of clean water and healthy food (breast milk!).  We then moved on to discuss the “plate method” of regulating a person’s diet and conducted a scavenger hunt in the area to try and find foods that contain certain vitamins and minerals that we talked about during the class.  This area is an extreme food dessert with no fresh fruits and vegetables (except for beans, bananas and mangoes) within miles.  The nearest grocery store is 40 minutes away by car, which is financially impossible for anyone here to reach.  The idea of the scavenger hunt was for them to possibly realize that they do not have access to however they have extremely fertile land. 
The problem of the food desert became another side-project of mine as we began to plan for a model community garden to demonstrate how to sow a garden with a variety of appropriate fruits and vegetables here.  We laid the building blocks for this project for when a short-term mission team comes later in August. We finished our discussion of nutrition by discussing healthy body weight and exercise and how you can check to see if a child is developing correctly.  Although I was only able to cover leadership development, water and sanitation, and nutrition, I feel that these subjects really laid a strong foundation and understanding of the completeness of health according to the World Health Organization’s definition that we discussed with the CHLs at the onset of the program. The WHO define health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” of which I think this program has already begun to promote and embody.
The Community Health Leadership Program was my main focus while I was in the Dominican Republic, but I also started a teen health class that was held twice a week where we covered much of the same material that the CHL classes covered but focused more on the science base of health issues as well as self-esteem and leadership skill in the teens. I actually saw some of my greatest successes in this group as my passion is to work with children.  I also wrote a grant proposal for the CHL program and helped with a water filter proposal and a fuel-efficient stove proposal which will be nested within the CHL program.  I had the privilege of meeting with several organizations and individuals who will be essential in the continuation of the CHL program, including working with Project Hope, Filter Pure, Surge for Water, and Profamilia, Peace Corps, local school principals, the local Mother’s club, the Mayor and CORASAAN (local government run water company).  Working together we are starting to create a strong network to support Project Hearts’ pillars of health and education
I obtained my personal goals and objectives by using the present resources and knowledge in the area, my own knowledge and expertise, and resources such as “Where there is no doctor” to establish a stable and long-lasting community health leader program. Some other personal goals I had were to connect local and international organizations, write grants and seek funding, increase community awareness of water and other health issues at all levels of the social ecological model of which I feel extremely successfulI feel successful in the completion of this internship and these MPH competencies but by far my greatest success, which I can not even attribute as my own success, was the discovery and unleashing of each community health leader’s innate potential to be a powerful change agent.  Despite the challenge of not receiving IRB approval from the DR due to time restraints and the irresponsiveness of their IRB, lack of funding and resources, and difficulty in changing ingrained habits and beliefs.  I had to come over physical and figurative barriers such as the terrible roads (no one can go anywhere when it rains here because the roads wash out and the main mode of transportation is by foot or on motorcycles), overwhelming fiscal barriers in a developing country, and of course the language and cultural barriers.  One cultural barrier that was most challenging was the idea of a commitment and a responsibility to be somewhere at a certain time.   Dominican time is always a few hours or even days behind and even if you agree to meet someone somewhere or do something at a certain time and place, it is very likely that someone may cancel last minute or just not show up.  Temporality is a major issue and life here in general takes longer. Despite these challenges and the ups and downs the successes were far greater.
On field visits to the CHL’s houses to discuss their work, visit houses together, and learn more about them and their needs, I was pleasantly surprised to discover that these women had already been taking care of their communities for years before the start of this program. Whether it was going house to house to check on people or organizing community meetings, these women were already leaders but this program allowed them to own a more formal position in their community, learn about specific health issues in their area and provide them appropriate and applied ways to combat them. 
At the end of it all I can look back and see the tangible and intangible progress that occurred while I was here.  I learned about community development as a whole and public health’s integral piece of this very challenging puzzle towards sustainable development.  I have discovered my passion thanks to this internship and believe that this was a real-world public health experience.

Thursday, July 4, 2013

There's Nothing Like the Dominican Beat

Finally I understand the word “community.”  My epiphany came during the big bonfire and live music celebration that our neighboring community, called Mocan Campana, held as the close to their week-long children’s camp.  Community is not a thing, or a location or a closed group of people. It’s a verb. It’s alive. It’s talking (maybe a little too much…) and it’s together whether they like it or not.  I feel as though the word community in the US is a totally different animal. We are able to choose our “communities.”  You might have your church community, your school community, your tennis community, your karate community, a community of people of your nationality, your kid’s community, the community you were born in and the community you are now, but none of those compare to these communities. They didn’t choose to be a community they LIVE their community. Yes, they live it.  It’s a verb for them and it resonates like their music every night being played from one hilltop or another. They are all family in many senses of the word and they are stuck with each other whether they like it or not!
            If only we could learn from them, and them from us.  We (generalizing about Americans) like efficiency and tangible deliverables, which is good in moderation.  On the other hand the tempo here is so laid back that not much gets accomplished on a daily basis besides a lot of visiting with the neighbors. However, Mocan, the community next to my community (which is called San Jose Adentro) has got it going on! Interestingly San Jose Adentro and Mocan have a rivalry because I think both are jealous of the other. San Jose Adentro has Ruben/Project Hearts as well as an American dentist and the Christian Medical Missions (CMM) school so we have lots of opportunities and important people (as they see it). On the otherhand Mocan is poorer and smaller than San Jose Adentro but what they lack in resources they make up for in community organization. They are the only community I have seen here in Baitoa that has organized themselves without any outside influence. They have a “junta de vecinos” which is like a community committee, and a sign announcing their community. Not only that but they have many leaders, young and old, in their community that are moving and working together! It’s amazing really.  If I were in their situation I don’t know that I could be so motivated. But they are and it is amazing.
            They organized a group of local missionaries to come for the week to give a children’s camp.  They organized a collection to help fund this camp and planned activities from morning until late at night, including the parents and other members of the community at night to rally them to support and nurture their children.  Franni, Project Hearts new media relations assistant, is only 16 yet such a leader in his community already! He walks all the way from Mocan most days to the CMM school where my neighbor Ellen teaches English and Computer classes and where I have begun to teach my teen health group classes.  Because of his dedication to his studies and his incredible responsibility we’ve been able to offer him a small position to work with us on media relations because we are desperate to get the word out about Project Hearts. He is receiving a small stipend for a few hours of work a week but I know he is going to go way beyond his hours and what is expected of him.  He and his cousin Yordi (who against many odds will be starting medical school in the fall at the public University) were the ones that invited me to come to their camp and help/participate in the festivities and since then I have fallen in love with their community and have so much admiration for these guys and what they are doing. 
            San Jose Adentro and the other communities of Baitoa have much to learn from Mocan, and I hope that I can continue to cultivate my relationships that I’ve begun to form in that community and that they may serve as an inspiration, not a source of jealousy, to the rest of Baitoa.
            Because their communities are so closely knit here I finally feel like I’m slowly chipping away at that protective exterior in San Jose Adentro and Baitoa in general. To be honest it hasn’t been as easy as I thought it would be.  All the other places I’ve lived I didn’t feel like such an outsider. But here it is so tangible!  I know I will never be IN the community, but I’m slowly easing my way closer and gaining their trust. No one will ever forget I have blonde hair and blue eyes and that my accent’s a little funny.  But sometimes they remember that I’m a normal person like them trying to survive here. I give them a few laughs when I make mistakes with my Spanish, attempt to dance merengue and bachata, or when I crash on my motorcycle. But moments like tonight- when they make sure that I feel comfortable, ask me to dance, and that our conversations finally move beyond “Hola como estas” - help me to understand community.  I felt it as we clapped our hands, swayed our hips, and raised our voices.  There’s nothing like the beat of the Dominican community in your veins!

Here is a video from the bonfire/fiesta tonight. You can't see most of the people there as it was too dark and most of them were sitting around me.  It was so great to see the community to come together like this!

And here's another video!

Friday, June 7, 2013

Morning Melancholy

Here is a video from my front porch overlooking Baitoa in the morning. So peaceful.

 The mornings that come too soon I despise the noises that wake me up (especially the rooster that thinks he's my perpetual alarm clock and cockadoodledoos from 4am-8am right outside my bedroom window), but most mornings I love it.  It's so wonderful to be woken up by the sounds of birds, animals, and workers in the fields who have already started their long days work.  On peaceful mornings like today I like the morning melancholy. I am thankful to have the opportunity to wake up early, drink my coffee and enjoy this amazing view and this amazing country.  The first week has flown by (recap coming your way soon) with many ups and downs, but every morning I have the opportunity to start fresh with a little yoga, prayer, organization, and
The pavilion on the hill where I do my yoga in the mornings.
much needed coffee!

"Then shall your light break forth like the dawn, and your healing shall spring up speedily; your righteousness shall go before you; the glory of the Lord shall be your rear guard." Isaiah 58:8
 Today I am headed out to the local schools to bring them our model of the tippy tap, a simple hand washing station.  None of the schools have washing stations by their latrines, so we are hoping they will be responsive and allow us to come back and install these cheap, easy, and super effective tippy taps, (lavamanos as we will call them here) that will make a huge difference in the hygiene and reduction of disease among the children.  Diarrheal diseases are a huge problem in the DR, but little improvements such as the tippy taps can seriously cut down on diarrheal disease which will in turn keep the children healthier and allow them to focus on what they are at school for- learning! 
Our model tippy tap at Ruben's house.  Notice the cow in the background!

Anel, Project Hearts' program coordinator, gives it a try.  It is made with readily available materials and is simple enough for a child to make and maintain- Perfect for schools!

I will let you know how our meetings at the schools go today as we share the tippy taps and invite the principals of the schools to come to our Health Promoters planning meeting this Sunday! The principals are key stakeholders in our Health Promoters program and we need their support if it is going to be successful.  Wish us luck!

And if you're like me (and my entire family), you start your day off with a lot of singing. Luckily for the communities of Baitoa, I am far enough up on this hill where no one will have to listen to me belt in the mornings.  :)

Here's the song I will be singing all day long in my head:

Peace, Love, and water sanitation!


Thursday, May 30, 2013

Bienvenida a la Republica Dominicana

I made it! I arrived to the Dominican Republic at 3pm on Monday, May 27th after sleeping through both flights and catching up on some work in the airport.  After exiting the airport I was immediately assaulted by unexpected humidity.  I was no longer so thankful for the cool weather we were having in Alabama because now all of a sudden I have to acclimate myself to the hot and humid weather here without access to any AC for some relief. I better get used to sweating!

I found my assigned driver and was soon dropped off unceremoniously at the hotel I would stay at for the next two nights. Zoe Kopp, the President of GRACE Cares (the umbrella organization of the local Project Hearts organization) was to meet me later that evening at the hotel. So, for the first time in over two weeks I found myself by myself and with free time.  I had been accustomed to living with 40 people and having my day planned from from sun up to sun down. I had no idea what to do! I wandered around the hotel (which I found out was all inclusive, oh yeah!), read on the beach with beverage in hand, ate at the buffet, and meandered back to my lonely room to wait for Zoe to arrive. She arrived that evening and I finally got some real rest.

The next day she and I relaxed on the beach and particpated in the aerobics before settling down to make plans for my time here this summer.  My main focus will be the development of the Community Health Leader program in the area of Baitoa. From my understanding, Baitoa consists of about 10 communities that have some leaders that have participated in focus groups last year. These groups identified clean water as their main concern and so my job will be to identify these leaders, train them in leadership skills and as community health workers, whilst focusing on promoting clean water and sanitation in my education sessions with them and the general community.   Zoe and I worked all afternoon and enjoyed a relaxing evening because the next day we were to meet with Teresa Narvaez, the director of Project Hope here in the DR, as well as the rest of our Project Hearts team, Ruben (the president of Project Hearts), Anel (an engineer and Project Hearts community organizer), and Jewel (a nurse practitioner that is currently teaching in a local school but will be taking over my job in August).

Zoe is the president of GRACE Cares, an organization with the sole purpose of finding local "heroes" as they call them, in different countries that have the potential to create small NGO's to empower local communities. The initial role of Grace cares was to simply give a small grant to a local heroe so that they had a launching point for their ideas and then to let them do their thing. However, GRACE Cares has remained intimately connected with Project Hearts as a guide and point of reference for planning of projects.  So technically I will be working for Project Hearts, but I will be referring back to Zoe as well for guidance and support as Project Hearts grows and develops its projects this summer.  As I stated in my previous post, project Hearts does not only focus on health, but this summer it will be my main focus and probably much of Ruben and Anel's focus as well.  We were all to meet at the Project Hope headquarters in Santo Domingo because Project Hope has also served as a mentoring organization for Project Hearts. Teresa Narvaez is one of the most passionate and inspiring women I have ever met and has helped build an extremely successful NGO that provides much need healthcare for women and children. I have much to learn from her and will continue to collaborate with her this summer as well.

So, Wednesday morning we all met at Project Hope to discuss ideas with Teresa and to tour Project Hope. Jewel and I went on a few house visits with their community health worker as we will be the ones developing the program for Project Hearts. We concluded the day at Teresa's house with delicious food and karaoke! It was so wonderful for us to finally meet each other and our group clicked so well. Ruben, Anel, and I will be the backbone of Project Hearts this summer and I have such high hopes.  They are wonderful men and it is going to be such an honor to work with them.

Today, we woke up early and set about forming a strategic plan for the next 6 months for the organization. This took up most of our day, with quick breaks to dip in the pool, have lunch, and run to the store (I now have a dominican phone!) Around 4 we finally wrapped everything up, and said our goodbyes to Zoe and Teresa. Zoe will be returning to the US and Teresa remains in Santo Domingo.  We gave Jewel a lift since she lives in Santiago, which is the big town near Baitoa. I once again slept the whole way and awoke to stunning scenery.   I will be staying at Ruben's for the next few days until I move to the houses on the hill. I've already made good friends with his 2 sweet daughters and am looking forward to getting a good nights sleep tonight before we head out bright and early tomorrow to meet with a local Peace Corps volunteer about fuel-efficient stoves for the area.  I will post pictures soon from the past couple days!



Wednesday, May 29, 2013

Think globally, act locally

How many of us have truly been hungry? How often do we say “I’m sooooo hungry” or “I’m starving” without thinking of what it really means to be hungry or starving. Our fleeting hunger- a mere biological response signifying dropping blood sugar and an empty stomach- is not true hunger.  It is not prolonged. It is not dangerous. It is not life or death.
I’ve been fortunate to never truly go hungry, and I hopefully will never experience it. I gather that most of you that are reading this have never truly gone hungry either. And think about how grumpy we get when we do get hungry!  I can’t imagine constantly feeling that way, watching my body digest itself bit by bit, knowing that there was nothing I could do for myself or anyone else I for whom I was responsible.  Although the SIFAT training did not make us feel this kind of hunger, it forced us to reexamine what it means to be hungry, what the root causes of this hunger are, and how we might find practical solutions to combat hunger.
Although the training focused on malnutrition and hunger, we really examined all of the facets of community development with hunger, water, health, poverty and many other components as integral parts of a holistic approach to community development.  You cannot separate one part from the other. Being malnourished as a child leads to disease susceptibility, reduced productivity and ability to learn in school, therefore less time spent in school which means continued poverty as an adult and continued health problems which limit the ability to succeed and change the community etc etc. This is why I am so excited to be working for Project Hearts this summer as it is not just a health organization. I will be contributing my expertise in public health while collaborating with my companeros, Ruben and Anel who focus more on other types of community projects, like housing and education. 
The training at SIFAT reinvigorated in me my passions for community development and my need to serve.   However, I think the worst and best part about this training course was the self-reflection and assessment of where I might fit in to the world as a future health care provider and my role as a professional and an “outsider.” To be honest, part way through the second week I was actually more disheartened with the bleak outlook for community development. My potential role seemed useless and I was continuously referred to as an “outsider.”  I felt as though the first week gave me so much hope and many practical skills, but the second week was filled with classroom discussion and theory that seemed almost impossible to put into practice and which most often reflected the uselessness of us so called outsiders. 
I hit a wall where I was upset, especially after a particular lecture on evening.  At first I loved his message, relating the need for development to be a holistic approach addressing the integrative parts. Each part can not be arbitrarily separated without addressing the others. I also agreed that development should be in stages where the ultimate goal of any NGO or third party would be to serve as a light -or a flashlight as he put it- for the community to find their way themselves. But his comment saying that our only skill we could offer was our English and that NGOs were not good, etc really disturbed me.  I’ve felt that my whole life I’ve been stuck in the middle. I’m a third culture kid not belonging to the US nor any other country. I’ve always been an outsider.  I belong everywhere and nowhere at the same time. I’m a nomad, an outsider, a rarity, a stranger to all. So it seems sometimes.  However, I know that I have skills and insight to offer and I know that I know how to do so in a culturally sensitive way.  After this particular lecture and the varying opinions of all of the experts and participants throughout the week I felt beaten down and alone.
  After some frustration, a few talks with people, and much needed prayer and sleep I began to find the beginnings of peace. I might never feel like I fit in, literally in a group of people, or theoretically in the scheme of community development, but that’s ok.  I still have some sort of role to play and will continue to be an ambassador and a Christian neighbor to everyone.  My vision remains blurry, but it is coming into focus  and I know this summer will serve as a perfect looking glass into my future and the future of development practices. 
Proverbs 29:18 is one of my favorite verses declaring: “Where there is no vision; the people perish.”  This I staunchly believe.  Even the act of creating a vision is powerful. In this way SIFAT was a powerful experience, even when I was upset and questioned my view of the world and my role and the role of my counterparts. This reflection was the most valuable, and as the founder Ms. Sarah Corson put it, I will not always agree with other people’s development beliefs and practices, but I will always have something to learn from them and should strive to grow and reconcile my struggles and their struggles for what we all believe is valuable.
There were definitely mixed messages throughout the week, where some speakers believed there is a defined place for outsiders, others want limited involvement, yet still others just want money, I found peace.   I realized this was the beauty of SIFAT. It is a place where people from all over can come and share their experiences, beliefs, and skills and learn together. 
I learned the importance of green leaves, fuel efficiency, empowerment, listening, community mapping, sanitation, the deep roots of poverty, micro-financing, rooftop gardening as a new frontier, social capital, asset-based development, the value of insects as a sustainable addition to the human diet, and the list goes on and on. But one overarching theme remains. We must “THINK globally, and ACT locally.”  We are charged with being  better global citizens and should do what we can where we are. 
            On a lighter note below are some of the highlights of my two weeks at SIFAT.
All things good,

learning to make a heat compost pile that can fertilize up to 1 hectare of land. You combine water, brown material, and green material and let sit in the sun until it reaches a certain temperature, turn the entire pile, and in about 3 days you have fertilizer!

Posing with Eva Maria, a SIFAT trainer from Bolivia. She is a real inspiration and an expert in microfinance  techniques. 

Preparing the material to make a fuel efficient stove. Fuel efficient stoves greatly reduce indoor air pollution and cut down on the often strenuous or expensive search for wood and organic matter as fuel for cooking.

Collecting water samples from the nearby creek to test for dangerous e. coli that is indicative of fecal contamination. I will be using these testing skills this summer in the DR.

Making a wick garden that requires no soil. This is a light weight garden perfect for rooftops and low resources settings.

Building a leaf dryer where leaves will be dried by the sun to make nutritious leaf powder.

2 of my favorite people. Left, Sarah Murphree our photographer for the 2 weeks, and right, Kaimba, another role model and strong woman!
A few Honduran students learning about the fuel efficient cookstoves!

Green pasta we made with the moringa  leaf powder.

A few of us taking a break by the garden.

My first time milking a cow at the North farm! That day we also slaughtered 4 chickens, built solar ovens, prepared all our own food from food they grow, built straw model water pumps, and helped prepare a new gardening space. 

Friday, May 17, 2013


The internet is so slow here I haven't been able to upload my blogs posts I've been writing so the following post is actually from Monday, our first day at SIFAT. More to come soon!

May 13th, 2013

If I had to describe my mood in one word it would be happy. My heart is happy. Plain and simple.
I can’t tell you how amazing it is to be here at SIFAT with like-minded people.  I feel so at home.  Already this experience has reinvigorated a part of me that I sometimes forget I have.  However, before I delve into the deep stuff I will give you a brief overview of what we did today and will be doing pretty much everyday:
Everyday we have 5 sessions starting from 8:15am going to around 8:00 pm with brief breaks for meals and snacks. Because the course is centered on the issue of world hunger, all of the sessions are conducted by experts in their respective fields and all pertain to hunger and community development in one way or another.  
            In many of my international studies courses we would briefly touch on the subject of hunger and food security, but never in enough detail to really understand the gravity of the situation. In the first day we began to explore the root causes of hunger and the current state of world hunger in our first session. We split into groups to make lists of what we think are the root causes of world hunger.  I was in a group with one of the girls from Honduras.  We actually have 5 students here from the agricultural university of Honduras, as well as a Zimbabwean, Haitian, Bolivian, Nigerian, a couple and their sweet son from the Democratic Republic of the Congo. We also have a girl from Somalia, Eritrea, and an international trainer and a doctor both from India, 2 students from Auburn University, and 4 students from Kent State in Ohio.  And despite all of this diversity UAB students are still the majority here! This makes for some interesting conversation and a dynamic group.
            Anyway, I digress. In the first session we split into groups and it was really wonderful to realize that at the end of the discussion all of the groups had highlighted many of the same causes of hunger and were able to come up with some that I had never even thought about.  We mostly discussed the roles of disempowerment, gender inequality, war, corruption, and lack of infrastructure and knowledge of good agricultural processes that all cause hunger.
            Our next session was titled the “dimensions of world hunger” by Dr. Kate Thornton (the director of the Hunger Studies department from Auburn University) where we discussed what world hunger really means and the different faces of hunger in different areas of the world. Interestingly, nutritionists and hunger experts consider obesity a type of malnutrition because obese people are actually not getting all of the micronutrients they need and are usually consuming too many carbohydrates and lipids. 
            The afternoon was what I was really looking forward to because we got to get our hands dirty.  The founders of “Leaf for Life,” Dave and Theresa Kennedy, are here to teach us about the value of green leaves and how we can garden for maximum nutrition in low resource settings.  In just an hour and a half our group was able to make an 8 cubic meter heat compost and a small community garden.  They are self proclaimed leaf nerds and for good reason! After talking with them I will probably never buy iceberg lettuce again because of its low nutritional value and the fact that it is grown in deserts in the West. Iceberg lettuce is 96% water and so obviously in order to grow it; it must be supplied with a lot of water. In order to grow them in deserts they irrigate much of the freshwater supplies away from the rivers and aquifers, draining the water to produce a food with no nutritional value whatsoever. Another interesting thing I learned is that the world has gotten exceptionally good at producing food, but the system is failing to produce food that is sustainable, of high nutritional value, and that is equally distributed.  The world actually makes enough food for every person to eat 2,700 kCalories everyday when the average person only needs 2100 kC’s.  So why do people go hungry? If only there were one reason, but the issue is so complex that it seems a bit depressing.
            Unfortunately, I could go on and on about all of the depressing things I learned, but they promised that by the end of our 2 weeks here we will better understand the state of the world’s food situation, but they will also equip us with powerful tools to help combat this.  In the meantime, I’m gaining so much optimism just being surrounded by this extremely motivated group.  I am making a concerted effort to reach out to every person here.  Even as a person used to meeting new people and travelling, it is still very easy to get wrapped up in one group or another, especially when your classmates are the majority of the group. However, I know the people that are here have so much to share and such a passion for what we are studying. The lady from Bolivia, her name is Eva Maria,  carries her pen and paper around with her, even to the garden, so that she write down every valuable word that our instructors say, as if they are precious jewels.  She often comes to me to translate just so she can be sure she understood them correctly and she is constantly asking me about my experiences and my thoughts. I’ve only known her for a day and I am already so inspired. I know she is going to take what she learns here and bring it to her people and I hope that everyone else is going to do the same.
            Our day ended with a talk from Sebastian Kalinde that is here with his wife (Kaimba) and son (Sante) from the Democratic Republic of the Congo.  They are here to share their story about escaping the Congo to Zambia in the 90’s as refugees during the civil war. They later relocated to the US, but are returning this year to help build a village in the Congo where the refugees are finally able to return to their home country.  You can see the hope in their eyes when they talk about returning and building their new community.  Inspiring does not say enough.

I know this post has been long, so as I get to know them this week I hope to be able to recount their story to you. 
            So, from what I learned today I am challenging you to eat more green leaves and think about starting a garden of your own.  Even I started growing herbs in my house a couple months ago because I think that if we can start taking small steps we will be able to relearn old skills that will serve us well in the future. Because one thing is for sure, the current state of our food system is not going to be able to last and we will need the ability to adapt.

Below are some pictures from our first day!

Peace and green leaves!


A few of us on a hike. (from left to right Me, Letson, Hailey, Kate, Chelsea, Jonathan)