Health Care in the D.R.

Presentation at a rural clinic on dental care

An essential part of serving as a Peace Corps Volunteer is living with and like the locals. This means cooking with local foods (Examples: yucca, plantains,and auyama), taking part in community events (Examples: church celebrations, dominoes, and chair sitting), and getting used to not having certain amenities (Examples: running water, 24/7 electricity, and Krispy Creme). However, there are other aspects of life which Peace Corps Volunteers will never be able to truly integrate, such as how we take care of our health.

The disparity in the quality of health care I receive versus my neighbors has made me uncomfortable a times. As a volunteer I have access to three doctors, one of whom is always on-call, as well as free medicine and treatment. I never have to worry about the cost of a procedure, if I need it Peace Corps will pay. I probably have the best health care plan of my life right now. My neighbors are at the other end of the spectrum.

Preventive health care is essentially non-existant in my rural community. I do not know of anyone who goes to the doctor and dentist for yearly check-ups. There are no school nurses or yearly eye exams for students. It all costs too much. Aside from brushing ones teeth and eating a balanced diet not much else is done until someone gets sick (And many people do not brush their teeth and eat healthy).

When someone gets sick the first thing people do is wait to see if it gets worse. Have a toothache? Wait until you can't eat. It costs three times as much to get a filling as it does to get a tooth pulled (A cleaning can cost even more). Vision problems? Stand close to the chalkboard. I don't know of any kids of the 300+ I have worked with who wear glasses. When the Chikungunya virus was spreading around the country like crazy, no one went to see the doctor until the pain from their joints made it difficult for them to walk, and even then most of my neighbors didn't see a doctor. Again, seeing a doctor is expensive. Just going to and from town can be expensive for many Dominicans.

Probably in part because of the inaccessibility of doctors, most medicine can be bought without a doctor's prescription (including Prosaic and Viagra - the latter I have seen handed out to men at a bar in the capital). However, rural Dominicans often prefer local plant remedies. Tea made from the leaves of a cotton tree are said to be great for anemics. Alcohol is often also used as a substitute for pain medicine. It is not uncommon for teenage girls with menstrual cramps to take a couple swigs of Mama Juana, a rum-wine-plant root beverage.

When an illness or injury does become very serious Dominicans will go to the hospital, but the results are not always the best. As I mentioned a few weeks ago, sometimes the doctor needed will not be at the hospital and patients end up waiting hours to receive treatment. Once a patient has been admitted to the hospital they typically have to share a room with six to eight other individuals. There are no special wards for different types of injuries just one for men and another for women and children. There are better hospitals located in the capital - you know someone is really sick when they are sent to the capital.

Side note about babies: Due to the unavailability of doctors when it is time to give birth Dominicans with some money prefer to schedule caesarians instead of giving birth naturally, to ensure the doctor will be present for the entire birth. Also, many women go home with their babies the same day they are born, via motorcycles. There are not enough beds for women to stay more than one day, and there are no laws here saying you need a car-seat before you can leave the hospital. Would it even be possible to make one for a motorcycle?)

A lot of improvements are needed in the Dominican health care system. Thankfully, things are slowly headed in the right direction. All medical centers offer free HIV/AIDs testing, and many offer free birth control. This year many hospitals, including the two major hospitals on the Samaná peninsula, are being expanded and remodeled to provide more services and treat more patients. Also this year a national 9-1-1 system was launched. As its next step I would like to see the government begin to provide more health care services at schools. Ensuring kids know how to take care of their personal health from a young age will go a long way to ensuring healthy generations to come.

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Library Update: The library now has a cement floor! We plan to install the floor tiles and paint over the next two weeks. Tentative inauguration date for the end of November. - It is time to start planning the celebration party!

Now it's time to make it look pretty!

Library Update

Since I arrived in my community, nearly a year and a half ago, I have been continuously working with my neighbors to build a library. This Saturday we turned the lights on, and the finish line is in sight. By the end of the month we plan to install flooring on one half, paint, and hassle the mayor for the doors he promised us. Next month we plan to have a big celebration party - you all are welcome to stop by. Many readers have helped us get to this point through donations and moral support. Thank you all so much!

This past week the library committee received a donation of 80 books from the Mid-West Medical Mission. The medical team spent the week in the Samaná hospital and stopped by my community to get a better understanding of how their patients live. The majority of books are textbooks, which have already been put to use by students researching breast cancer - October is Breast Cancer Awareness Month in the D.R. too. Thanks again to the whole team for dedicating a week of their time to helping the people of Samaná. It was a pleasure to act as a translator for you all.

Below are some before and after pictures of the library progress so far - keep us in your thoughts as we move on to the final stretch. Remember to check out more updates on the library website: http://bibliotecadelcoyote.blogspot.com/

The Library and Community Center - Before

The Library and Community Center - Now

Library - Before

Library - Now

Computer Lab - Before

Computer Lab - Now

Things that Probably Didn't Happen to You this Week

My life here in the D.R. is never ordinary by American standards. This week, however, has been particularly eventful in its non-ordinariness. Here is a run down of what's been going on in my community over the past seven days:

Emely at home resting her leg

My host sister, Emely, was hit by a motorcycle as she was leaving school. Don't worry she is okay, except for the broken leg. Here is the full story: A 17 year-old was popping wheelies on the dirt road in front of the primary school, and surprise he lost control and hit Emely as she started her walk home. First they took Emely home, but soon they decided she needed to go to the hospital. By the time they arrived at 7p.m. the doctor who knows how to set bones and make casts was gone for the day. Luckily, they were able  to take her to a private doctor. The boy who hit Emely has agreed to pay for the cast, which cost $700 pesos or $16 dollars,  an amount my host mom had to borrow from her church because she didn't have the funds available at the time of the accident. Emely's family will still have to cover the costs to transport her to school since she will be in the cast for a month - she will be traveling via a motorcycle. Emely doesn't seem to phased by the ordeal. She is enjoying the lack of chores, getting a ride to school, and the piggy back rides from friends as she changes classes.

Putting the finishing touches on the ceiling

My project partners took all 150 gallons from my water tank to use for library construction. The water was mixed with cement to seal the ceiling of the library. Part of me is happy that one more step is done and the other half is annoyed that my water tank is empty. Remember, I don't have running water. All the water I get comes from the sky, so taking all the water from my tank is not a small problem. My project partners' excuse is that they thought it would rain, which to their credit it did look like it was going to rain. I just wish they would have asked first. I have had water taken from my tank without my permission before, so I keep an additional 70 gallons of water inside my house. I am hoping we get a good rainstorm before I run out of water. If that happens I will have to sit out by the side of the road with an empty trashcan and hope the water truck passes by. I am lucky that I can buy water; not everyone can, but I still don't like having to waste my day waiting for water.

Nana inside the water tank

The one benefit to my project partners emptying out my water tank is that it gave me the opportunity to clean my tank. Or more correctly, it gave my 9 year old neighbor, Nana, the opportunity to clean my tank. Over the past year my water tank had collected its share of mud and leaves at the bottom. The bottom is out of reach of my hands so Nana offered to go inside the tank and clean it out for me. My biggest contribution to the cleaning was to blast bachata music by Romeo Santos over my portable speakers. I heard neighbors across the street talking about the music and declaring that I am bien dominicana (very Dominican).

Neighbors at the beach - Nana is the one covered in sand

Wednesday was a school holiday, Día de Las Mercedes, so I went on a trip to the beach organized by my girls' youth group. We took a safari bus and the entire ride music was blasting (bachata, merengue, dembow, and salsa). When I returned home my ears were ringing.

Thursday I presented at a teacher's workshop in the northern area of the Samaná peninsula. In order to get to the rural school where I was presenting I got a motorcycle ride with a teacher trainer. The ride was over an hour and we primarily stayed along the coast line allowing me to enjoy some beautiful views. But I will say that riding a motorcycle isn't as glamorous as it seems. We nearly had to cancel the trip due to a rainstorm, and my hips were aching by the time we arrived at the school.

Lastly, a highlight of my week is that we installed windows and doors at the library! Whoo! It is starting to look like a real building! You can check out more pictures of the progress here.

Library Committee members showing off the new windows

Library Construction

This week a new sound has been added to the cacophony of motorcycles, bachata music, donkeys, and screaming neighbors that make up the background noise in my community. The noise is construction work (See the video to hear the noise I love to hear). Finally, construction of the library has begun in earnest. All this week from dawn to dusk the men of my community have been preparing the library for today, the day we pour the cement roof.

Things have gone pretty smoothly this week. Except last night when a truck delivering supplies hit a power line and left my community without electricity. Whoops. Luckily we only had to wait three hours for the power line to be repaired.

Construction is the D.R. is different in many ways from construction in the States. First, almost all of the men helping to build the library are volunteers whose construction experience has been gained by building their own homes. Also, different materials are used. Scaffolds and supports are made of wood, not steel. And instead of wood and shingles for roofs, Dominicans prefer cement.

Laying out rebar on top of the roof.

The cement roof, while rare in the U.S., is becoming the standard roof in the D.R. A zinc roof is cheaper and is still the most common type of roof in the D.R. However, it is prone to leaks and can be torn off a house during a hurricane. Therefore, as Dominican families become wealthier they are choosing to build their new homes out of cement from top to bottom. Until this week I had never seen a cement roof being built. I now understand why they are not common in the States.

Cement is heavy, so any building that is going to have a cement roof is going to need support columns. You also need to set up an elaborate system of wood and rebar to allow the cement to set and dry properly. Setting everything up to pour cement took  10 men four 12-hour days to complete. The word cement roof is also a little misleading. Mixed in with the cement is also sand, gravel, and lots of water. You then have to get the mixture to the roof. Today we have twenty men working on mixing and pouring the cement. We also are using a big cement mixer and lifter that a neighbor is letting us borrow.

Temporary Roof Supports

Despite the free equipment, labor, and other donated materials we have spent, just this week, $123,300 pesos or $3,082.50 dollars on the roof. But every penny is worth it to ensure the safe-keeping of the library's books and the longevity of the community center. Now that construction is underway my neighbors have already begun to talk about how they would like to build a second level where they can hold big meetings with the entire community. My neighbors never stop dreaming, and I love them for it.

The library now has a website: http://bibliotecadelcoyote.blogspot.com/
You can find more information about the library and see more pictures there

Other non-library things that happened this week:

I have a new club. We meet once a week to watch a novela (Spanish soap-opera) made by the Peace Corps with a cast of entirely Dominican youths. Each week the characters are faced with an important issue like teen pregnancy, AIDS, violence in the family etc. My students couldn't get enough of it!

When I returned from camp, I discovered that my cat had disappeared. I thought that he had either run off with another cat or he had been eaten by a Dominican. It is not unheard of for Dominicans to eat cats. Some people think their meat can cure diseases and others think it will make them stronger. Luckily, my cat did return but he was injured. He tore up his leg so bad that the veterinarian cursed, in English, when he saw it. In his first year of life my cat has already lost three of his nine lives (he has also been attacked by a chicken and he once ate poisoned food).

While cataloging books I realized that I took a picture with a statue of a character from a comic book we have in the library when I was in Argentina in 2010. I had no idea at the time who/what the statue was made in honor, hence my desire for a photo.

Me and Malfada in 2010

Sunday was Father's Day here in the D.R. and to celebrate we held a movie night. The film for the night was Sanky Panky, which is about Dominican men on the hunt for rich white gringas to seduce. It was a hilarious movie and I now want to watch the sequel.

On Thursday morning I was woken up by the screams of a pig being slaughtered...not the first time this has happened. At least there was also the sound of men building the library.

Mil Gracias

THANK-YOU ALL SO MUCH!

These kids all have brighter futures thanks to you!

You all made my day today. Today I found out that my Peace Corps grant has been fully funded thanks to you. As we say in the D.R., mil gracias, a thousand thank-yous. The $5,628.09 that you all donated will go towards finishing construction of the library. We may even be able to use some funding to buy more books for the library as last week we received a donation of construction materials from the Governor of Samaná. Everything seems to be lining up perfectly. If we are able to get enough volunteer laborers, we will be able to finish construction by the start of the new school year in September! We would not have been able to reach this milestone with out your help.

Onto other news:

Loading everything on the truck

Fates aligned last Monday. After dropping my sister off at the airport, I went shopping for furniture for the library with the president of my Library Committee. We were able to find chairs, fans, and tables all within our price range. But we then had to figure out how to get everything back to our community three hours away. After some calls we learned that some of our neighbors had finished selling their harvest of yams at the market and were headed back to our community with an empty flatbed. They kindly agreed to take all of our items back with them - what luck!

Learning about Menstruation

 I spent the rest of my week an eco-lodge with 70 Dominican teenage girls from around the country. The girls are all members of Peace Corps D.R. girl's empowerment program, Chicas Brillantes, Shining Girls.  The Chicas camp was a lot of fun. There were games which explored inequality, a panel of professional Dominican women from poor backgrounds, a condom demonstration party, Zumba, healthy snacks, presentations on healthy relationships, identity, internet safety, AIDs, hair, violence, and many more. The best part for me was during the closing ceremony several of the girls spoke about how their self-esteem grew while at camp.

I presented twice and both times the girls enjoyed themselves and learned a few things. My first talk was about professionalism. We had a mock interview during our presentation, and I was the bad interviewer. I dressed very inappropriately, wore garish make-up, used Domincan slang, and spoke on my cell-phone. I even wore a tubi, basically a hairnet, Dominican wear them to keep their hair straight while they run errands or work around the house. Then when it is time to go our for the night they take off the tubi to show off their salon perfected locks. The funny part was before the presentation some of the Chicas were complementing me on my outfit and a volunteer admitted that for a second she thought I was one of the Chicas.

Demonstrating Inappropriate Work Attire

 The second presentation I gave was on 1st aid. We taught the girls how to treat lacerations, burns, and animal bites, talked about Emergency Action Steps and the new 911 system (Bill Gates donated money to set it up). We also explained why mosquitoes are the true transmitters of Chikungunya. I think we had at least 60% of the girls convinced by the end of our discussion. Prior to our talk only one girl believed mosquitoes transmitted the virus. 

As we left camp one of my girls saw a mango tree and said, "Look at the mangoes Susi! I can't wait to go home and eat some! Thank you for bringing me, I had a great time." She then hugged me and started to cry. It was one of the funniest and sweetest things I have experienced during my time here. I would have started to cry too if it wasn't for the part about the mangoes. The idea of getting homesick at the sight of mangoes is something I had never considered until then. But I know when I leave I too will miss the mangoes.

You Can Help

“Oh my gosh, what you are doing is sooo great! How can I help?” For the past 15 months I have heard family and friends ask me how they can help, to which I have responded, “Eh, it’s kinda tricky to send things to the D.R., I’ll let you know if something changes.” Well, family and friends, the time has come to step-up to the plate. My community and I need your help!

The library will be on the right-hand side.

Since 2011, my community has been working towards building a community library. I arrived one year ago to help the library become a reality. Construction began last month, and we need your help to close our funding gap. My community has already fund raised $23,728.42 via donations of construction materials, books, labor, land, grants, and cold hard cash. We just need an additional $5,628.09, to help cover our remaining construction costs.

You can donate to our project by going to our project’s webpage on the Peace Corps website. Or you can look up my project on donate.peacecorps.gov. Search via my last name, Stine, or my project code, 14-517-025.

The leaky zinc roof will be replaced by a cement roof.

Many readers are probably thinking, “Why should I donate?” Here are some reasons why:

- The idea to build a library was developed by my community not by an outside group.

- The average family makes less than $125 dollars a month, and yet the community has fund raised 80% of the library costs, $23,728.42.

- None of the three local primary schools has a library. The closest children’s library is located in the capital, an expensive three-hour bus ride away. 

- Classrooms at all grade levels do not have enough textbooks for every student, if they have even have textbooks.

- The library will provide community members with access not only to books but also to computers. Of the 151 houses in my community, only 47% have a book in their home, and less than 10% have a computer.

After 7 months of cutting red tape, the bridge is functional.

- We spent seven months fighting, successfully, to get a permit to build an access bridge from the road to the site of the library. We will stop at nothing to make the library a reality.

- My community and I had to submit a lengthy grant application, which includes: essays, goals, monitoring and evaluation plans, a timeline, and a detailed budget. If you want any of the information we submitted please contact me at scstine@gmail.com.

-Check out our project’s webpage for even more reasons.

Now that you are convinced that my community’s library is a worthy cause, here is some information about the donation program, the Peace Corps Partnership Program:

Reading with a neighbor.

 - Every penny that you donate will directly fund my project. No part of your donation will be used to cover staff or overhead costs of running the Partnership Program, as the office is supported by congressionally appropriated funds to the Peace Corps.

 - All donations are tax deductible! Once the donation has been processed a thank you letter will be sent, which can be used as a tax receipt. The name on the tax receipt will reflect the account owner on the credit card or check.

 - You can donate offline. Although donating on-line is the fastest way for projects to get funded, you may also donate by mail or over the phone:

Community member repairing library walls.

Send a check to:
Peace Corps Headquarters
Office of Gifts and Grants Management
1111 20th Street, NW
Washington, DC 20526

Please make check payable to Peace Corps Partnership Program
Please also note the project number (14-517-025) in the memo section of the check.
(Please print and mail this donation form with your check, so Peace Corps can contact you with information regarding your donation, if necessary.)

-or-

Call the office and Peace Corps can take your credit card information over the phone at 855.855.1961 x2170.

Many, many thanks to all of you who donate funds. My community has a lot of dreams, especially for their children, and with your help we can begin making them a reality.

The Library Youth Committee meeting (in my house).