Week 2&3

4 04 2010

7:00am the alarm went off, class at 8:00am. There is a group of 6 or us who live in the same neighborhood and we are now pros at taking the concho to and from the university. First class was Spanish. I am enjoying the focus on medical terminology and there are no set themes or topics as far as grammar but we just talk about things as they come up throughout the course of the class. Next was Medical Sociology which I really enjoy. We learned about the main differences between public health and clinical care. After the two morning classes, we go home for lunch and a nice siesta (nap!). We return to the university at 3pm for a 3-hour long class called Topics in Community Medicine. A lot of similar topics are presented in Sociological Medicine and this class, but the reinforcement doesn’t hurt considering it’s all in Spanish. This afternoon class also includes a practicum aspect: that includes the week we will spend in the clinic and weekly hospital/clinic visits and volunteer time. On Monday, we had a lecture defining public health and differentiating between prevention and treatment. After class, two other friends and I headed to the gym that we have joined for the month. It is now a routine to go everyday after class and I am really enjoying the steady exercise schedule! We also decided to eat in the plaza where the gym is, I got a meal with vegetables- I was so excited! Vegetables are very hard to come by here, and these were even good vegetables. When I returned home from the plaza, my host Mom and I had a very interesting chat about the government in the DR. They just had elections for various representatives and she was explaining to me the dynamics of the process. It’s quite complicated (as all governmental processes seem to be) but basically there are 3 main political parties in the DR and two of them combined forces and essentially swept all of the positions. So all of the power is concentrated into the hands of a few people. And to win the votes, they literally paid the voters. They targeted poorer communities (by the way, over 40% of the population here lives in poverty) and gave them money and food in exchange for a vote. My host Mom fears for the future of this country because she says that they are moving further and further away from a democracy. Sounds familiar.

On Tuesday we started our Film Studies class, which is part of our Intensive Spanish Language course. I am really excited about this class! I have never taken anything like a film studies class before and we are watching films that are made in Spanish speaking countries and immerse us further into the language and culture. We will start watching movies next week. Medical Sociology was next- the lecture was on poverty in the DR. The situation here is very sad and just viewing the statistics were nothing compared to what I would see later in the week. After lunch we got assigned our clinics for the week that we will spend in Salcedo. I am going to work with another girl from Yale and I can’t wait! I think it’s going to be a really wonderful learning experience as well as a way to give back to such a needy country. On Tuesday night a few friends came over to use the internet at my house, we really had a nice time. I have a great group of friends here and my host parents are so inviting and always willing to have others in the house. I also played with my little brothers quite a bit, they are starting to get really comfortable with me and I think it’s because I can already communicate so much more effectively. My host Mom said that she has noticed a huge improvement

Wednesday morning we took a field trip to el Centro León, a cultural center that was built in 2003 by a man with the last name of León. We got a tour through a few of the exhibits in the museum. It was very nice and the exhibits were clear, interesting, and informative. The Caribbean culture is truly a mix of many different cultures. Influences from Europe, African, and the indigenous people make of the unique foods, music, and traditions. Spaniards who brought Africans for laborers and slaves lived among the indigenous inhabitants and thus created the Dominican identity of today: una mezcla (a mixture). Wednesday afternoons are free every week so a few friends and I decided to take a trip to “la Sirena” which is the DR equivalent of a Wal-Mart. We spent about an hour just enjoying the air conditioning and familiarity with some American products. I got my brothers some toys, my host father some Pop Tarts (which he has eaten everyday for breakfast since) and my host mother some Nutella (which she LOVED). We bought ingredients and headed home to bake some brownies from scratch for our host families. The process of baking was a bit of a challenge: 1) problem: the ovens here do not have thermometers or temperature controls, you light a flame under a grate so how were we going to “preheat to 350 degrees”; solution: just light the flame 10 minutes before putting the brownies in to bake and check throughout the baking process to see if they were finished. 2) problem: we didn’t have any measuring cups; solution: tea cups for the “cup” measure and the eye-ball method for teaspoon measurements. 3) problem: usually you use a microwave to melt butter, we had a microwave but the power happened to be out; solution: heat the butter over the stove. So by the end of the afternoon we had successfully baked three batches of brownies, and they were quite delicious. We used cocoa that was grown here and I think that really made them. My host family had never had brownies before! They really really really liked them. I also had a talk with my family about the week that I will spend in the clinic. When one of my brothers heard that I would be gone for a week he said “wait, you’re not going to be here for a week?” and I replied that I would be gone for the week but return for a few more weeks in Santiago. After I replied he started crying and said “I don’t want you to leave!” They have become accustomed to sitting on my lap at my computer before bed and watching Michael Jackson music videos on my computer- they love Michael Jackson because they think his dance moves are really entertaining.

Thursday morning was another field trip, this time to hospitals. We visited three public hospitals, two “level three”, meaning the most intensive and specific care, and one “level one”, meaning general primary care. The first hospital we visited was called Hospital Regional Universitario “Jose Maria Cabral y Baez”. Everyone I had spoken to prior to going on these visits had told me that the public hospitals here were horrible, but I still wasn’t expecting what I saw. Jose Maria was a very large complex and housed every specialty. As soon as you walk in, you are hit with a heat wave and people trying to get by. There were people everywhere. An administrator gave a quick introduction to the hospital and then we proceeded on a tour. As soon as we got into the care areas I was immediately struck with sadness. There were lines stretching longer than you can imagine and people waiting everywhere. The floor was just cement that was dirtied with everything imaginable. We proceeded to tour every floor and it took me a while to even convince myself that what I was seeing was not just a dream. All of the treatment rooms were communal, there were people with IVs everywhere (in the hallways included), there were some beds in the hallways because there wasn’t enough room in the rooms, there was trash spread throughout the hallways, there were needles and gloves in the trashcans in the hallways exposed as well as on the floor, I didn’t notice a single computer, and there were very few medical professionals. And because nothing was air conditioned, it was hot, very hot. Another thing that I noticed was that there were at least two family members with every patient. Even though the people may not have resources, it seems as though they always have the support and love of family. There was no sense of order, no one seemed to have authority, and just the amount of people in every part of the hospital added to this sense of inefficiency. For those of us that are accustomed to Hopkins, this was literally unreal. The next hospital that we visited was called Hospital Infantil Regional Universitario “Dr. Arturo Grullón”. This was also a public third level hospital but specifically for children. This hospital was a bit more orderly and clean than Jose Maria but the sanitation was still totally unacceptable by American standards. Again, the rooms were communal and there were at least two family members with each child. The hospital also offered resources for new mothers, like training about healthy development and feeding patterns and had a playroom for the children. In addition, we toured a new oncology unit that just opened 3 months ago. This unit was extremely clean, nicely decorated, and the technology was impressive. In order to be a pediatrician in the DR you have to do an additional 3-4 years of training after graduating from university. After the children’s hospital, we went to a smaller level one clinic. It was one level and about 6 rooms and a pharmacy. It was simple with the bare minimum resources and only 2 doctors and one nurse. I imagine this is much like what the rural clinics will look like. They see patients first, try to take care of the problem, and if they can’t they refer them to another doctor at a larger facility (like Jose Maria).

After that incredibly eye-opening morning, we had Medical Sociology in the afternoon. We discussed the migration into the cities and Zonas Francas (“free zones). The dynamics of the economy really effect healthcare and health literacy. Gym after classes then a few of us went to a dance concert, ballet! It was amazing, some of the best dancing I have seen in a very long time. It was given by a contemporary ballet academy; the choreography was phenomenal and the dancers had incredible technique. It was quite a nice treat! And after, some of the Dominican support students from PUCMM came to pick us up and about 11 of us went out to sushi, yum. It was a lot of fun, a great ending to a very long day.

The Bateys

Friday we visited Bateys. Bateys are small very poor neighborhoods of Haitian immigrant workers. The first Batey we visited was called Batey Chichigwa. It was a community of about 100 people living in the countryside in extreme poverty. It is best to capture the community with pictures, so I have posted a few below. Everyone was wearing clothing that had been mixed and matched together, shoes that were ripping (crocs seemed to be the shoe of choice, the cheapest with the most protection), and no one looked like they had bathed in a few days. There was a small community “building” that acted as the church and a place where a community outreach group went to teach reading and writing. People spoke both Spanish and Creol. They explained to us that their biggest problems were access to drinking water and education. They get one tank of water twice a week for the whole community and there is no school near-by. There are lots about 50 children living in this Batey with no access to education. The men go off during the day to work in the fields and the women stay home to care for the children, cook, and wash clothing. There are members of the community who have been living there for over 40 years. It was incredibly heart-wrenching. After a tour through the shacks, we got to play with the children for a bit. They all loved our cameras- and learned how to use them very quickly. I think they were just so happy to have some attention for a few hours. They also really like Americans because it is an American man who provides their water. Surprisingly, a few of the members of the community have cell phones that they use if there is a medical emergency. There are no clear cut families on the Batey, it is a community in the sense that everyone helps to raise all of the children and everyone works together to accomplish everyday tasks.

Then we visited another community that is called an “arraño” because both Dominicans and Haitians live together. This community had a few more resources like a school, electricity, and some “developed” store fronts but the clothing worn was pieced together and there was trash throughout the streets. There was again a community building but this one had a TV in it and all of the men were jammed in watching a World Cup game…I guess all men are the same! After a quick tour we went to play baseball, soccer, and color with the children. This community was much larger so there must have been at least 150 children there. As we were coloring I noticed that everyone was very content and happy to share. No one fussed about needing a certain color or picture, they worked as a unit even just to color. The field where we went to play baseball was scattered with trash, unlike anything I had ever seen before.

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I wasn’t quite sure how to react to this experience. At lunch, I almost felt guilty being hungry. I am excited to get to work at the rural clinic and be able to give back. I think the part that was the most saddening was the lack of education for the children. The more I learn about poverty and it’s vicious cycle, the more clear it is that education is the key to rising out of and eventually eliminating poverty. With education comes access to information and with access to information comes knowledge about health care and job opportunities. Maybe one day I will be able to return here and build a school.

Saturday was the first day that I had free to just explore Santiago! I went with a few of my classmates to a market basically in the heart of the city on a street called “Calle del Sol”. It’s essentially like a mini version of Chinatown in NY. There are street vendors (the popular thing to sell here is Blackberry cases and sandals), various clothing stores, and a cultural market that sells traditional Dominican jewelry and nick nacks. We spent at least three hours wandering around the market talking, bargaining, and buying. When I got home I forced myself to pound out some homework and then headed back out with a friend and her little host sisters for MORE shopping at the mall. Then we went to sushi (yum!) and of course had the obligatory “Bon”. Bon is frozen yogurt that they mix fresh with any fruits that you chose! (My personal favorite so far is strawberries, cherries, and dates). It was a day full of shopping!

Sunday came around and it was time to hit the gym. We got up early to get to the gym and then head to a cafe to get our homework finished. Our classes have really started picking up so now most of my free time is spent doing homework. We learned quickly that Dominicans are extremely friendly and prefer to talk then to do homework. There were lots of students at this cafe (free wifi) and the only way that any focusing occurred was if you put in your headphones and looked busy, otherwise, you were a target for conversation. After lots of essay writing and presentation making, dinner was a nice break and sleep was a welcome visitor.

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8 responses

12 06 2010
Dad

You are in my thoughts and prayers more than you know. I feel as if I am there with you as I read and re-read your writings. Misty and Sardiny say ” meow.”

All my love. Dad

12 06 2010
Mommy

God bless you as you go forward. I am so touched by your thoughtfulness and proud of your willingness to be open to all that you are experiencing. You are giving us all a gift with your writings. Remember to take care of yourself and rest whenever you can!

Sending you tons of love and a big hug! (_0_)

14 06 2010
Aunt Lisa

Hi Darling,

I am just overwhelmed reading your experriences. My God! You have so much goodness and giving in your being and you will be blessed. Take care, stay safe and I will pray for all those poor souls. Can’t wait for the next episode. I’m printing them all out for Uncle John to read.

We love you,
Aunt Lisa

14 06 2010
mimi

Gabriella,

We will figure this blog comment out yet.

14 06 2010
mimi

Hi Sweetheart: Maybe the 8th time will be the charm. I really want to leave comments so I hope this works for future weeks.

Love you, MIMIxxxooo

17 06 2010
Dad

One last comment before you go wireless for a week. Be well and continue to soak in the language and the culture. We will have much to discuss later this summer.

Love – Dad

17 06 2010
KEHS

Hi Gabby,

It sounds like you are having an amazing experience already. All of us at Carver Center are really enjoying following your journey.

From all of us to you – our best!

19 06 2010
B

School’s out here. Wish we could teleport the old Carver (or the new one) to you for your “school”. The picture of you and the children is priceless.
B

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