Semana 3/4

3 02 2011

Well, my plan has failed me in a sense. (Of course) I had a plan to write my blog posts every two weeks. But I have realized that with the timing of things it will probably be best to write when something new and exciting happens (which is basically everyday, by the way) so after this post I will follow my sister’s example and write on experiences rather than on a timeline.

About two weeks ago now, I met with a professor that I had this summer who works in the Ciencias de Salud department at PUCMM. She is essentially the go-to woman in public health and helps to coordinate Juan XXIII, which is the public health system of hospitals, clinics, and community educators that was established between the university and various government organizations. She is (obviously) a wonderful resource for my project. After the initial shock of seeing the “rubia” again, and I explained to her what I was doing back in the country, she was actually jumping with excitement. In her rapid fire Spanish she explained that I could absolutely continue to work in la Zona Sur in order to be around lots of medical professionals and public health workers and have access to community members. She also explained that she would put me in contact with all of the administrative people that have information about the policy specifics. I can’t tell you how excited I was that she was excited. I have found that here, all you need is a smile, the ability to communicate, and evident interest and you can usually find what you need. At the conclusion of the meeting she told me to get a letter from my director explaining that I had permission from Yale and PUCMM to investigate seguro social and conduct interviews and that she would then help me set up a schedule for working in la Zona Sur and starting to make contacts with medical professionals and health administrators.

My classes are going extremely well. I really enjoy each and every one! In Caribbean History we are learning about the indigenous populations that existed in the Caribbean before the Europeans began the conquest. We have learned where the people originally came from, the theories about how they traveled to the islands, and how they established their towns. We also had to write an exposition about the definition of the Caribbean after reading an article that explored the various components that make up “la mezcla” (mix) that is the Caribbean. It’s an interesting area of the world to study because it can be defined many different ways geographically, culturally, and economically. Because of the way in which it was discovered and colonized by various powers, it developed into an area with a variety of cultural influences. There are four main languages spoken, a variety of religions are practiced and African and European influence can be found in the food and music. My Spanish class has a sociolinguistic focus so we are focusing on how Dominicans speak Spanish. It is so engaging because each class we review words that we’ve heard in the streets or read on signs that are specific to the Dominican Republic, or sometimes Latin America. It’s really good practice for my vocabulary and I blend in more and more with the Dominicans! We just spent some time working with “piropos” which translates into compliments. Piropos are the comments that men (and boys, they start young) yell out to women in the streets. I’m the victim of piropos everyday, multiple times a day, simply because I am white, American and a natural blonde. Usually I get things like “rubia, mami, venpaca” or “Americana tu eres tan bella”. Sometimes, they get really creative. “Si tu caminas como concinas, guardame un chin de con con”, or “tu crees en amor de primera vista o debo pasar otra vez”. I encourage you to try and translate those, but the beauty of them is that there are references to things you will only know if you are Dominican or have spent a lot of time here. Piropos, in a sense, are metaphors and part of the culture, like an art form. The piropos definitely represent the machismo that exists here. Occasionally, they are genuine. There is an older security guard who works in my neighborhood and every morning he greets me with “buen día rubia bella te Dios te bendiga”. My direct enrollment class, History and Anthropology of Medicine is divided into two parts. Right now we are learning the meaning of all of the roots of medical terminology. It is extremely practical information (after all, I am in class with soon to be doctors). It’s been a bit of a challenge because sometimes I don’t know the concept in English much less in Spanish! But, it’s a wonderful experience and I am just going to be a step ahead when I finally get to medical school. I have to say, it’s frustrating being in a class with Dominicans who are my age and in two or three more years will be graduating with their medical degree already! I look around and think, wow, while I am just starting medical school they will be writing prescriptions. But at the same time, they tell me they wish they could have gone to the states for medical school. After all, they say, if you have a medical degree from the United States you can practice anywhere you want. (I hope they are right!). My class on the socioeconomic and political status of the Dominican Republic was slow at first but is definitely catching my interest. We started by learning about Trujillo who was the dictator here for 31 years from 1930-1961. His dictatorship was oppressive and he is blamed for many of the problems that the country faces today. We have also been learning about the structure of the Dominican government, which is technically a democracy, and also (and more interesting) the political culture here. More to come on this political culture a little later in this post.

We had a long 4 day weekend, so of course, we went to the beach! Not just a beach on the northern shore, however, a beach called Barvaro which is part of Punta Cana on the southern shore. It was beautiful, like nothing I had ever seen. It was just as beautiful as Bermuda but different. The sand was perfectly white and very fine, the waters of the Caribbean ocean were at least 5 different shades of blue/green, and the palm trees added that postcard touch. We had perfect weather and lots of time to enjoy the sun. I had organized the trip with a friend and a total of fifteen of us went! It was fun, but needless to say, I don’t think I can organize another large group event anytime soon. I sort of felt like I was the mother and every 30 seconds someone needed something or someone didn’t agree with the plan or lo que sea. Mom, I have an inkling of how you must have felt at all of those birthday parties that we had when we were younger! But, the beach was beautiful and a 6 hour trip from Santiago, so gracias a Dios we had four days to enjoy it!

Barvaro- White Sands

The girls!

When I returned from Barvaro I got right to work because I agreed to write an article for the Yale Journal of Public Health. The coming issue is all about food and how food influences health. This past summer I had focused some of my time on studying diabetes here in the Dominican Republic when the email about the upcoming issue, I thought it would be really interesting to include an article from abroad, having a global perspective is always interesting. I proposed to write an article, here was the lead: Diabetes affects more than 220 million people worldwide. When the pancreas does not produce enough insulin or the body cannot effectively use the insulin that it produces, raised blood sugar can lead to seriously damaging effects. Type II diabetes is preventable and Type I can be managed so that people at risk of or living with diabetes can live to the normal life expectancy with minimal consequences. Yet, people still die from this chronic disease and 80% of the deaths occur in low and middle-income countries. What are the barriers preventing people from receiving care? How does the food industry influence the food choices that people make, especially those who live below the poverty line? Does education about prevention and management enhance understanding enough to manage diabetes?

I interviewed one of my friends who is a doctor to get some basic facts down and he told me about El Centro Diabético that exists here in Santiago. So obviously, I went to check it out. The thing that I love about this country is that people are always willing to talk to you and help you. (Maybe it’s because I’m blonde and I can communicate well, but regardless it’s a big perk!). I conducted some interviews and learned a lot about the impact of diabetes here and how the public health system has been constructed to care for diabetic patients. I don’t want to give it all away, you will have to read the article when it’s published (it’s about 3,000 words) 😉 I absolutely loved the experience, though, and it was a wonderful “warm-up” for the interviews to come with my research on the insurance policy.

Speaking of that research, it is going extremely well! I have an outline and I have already completed part one. The general plan is to research the following: 1) the history of health insurance, 2) current systems of health insurance in certain countries, 3) case studies on Caribbean nations, 4) health insurance here in the Dominican Republic. I decided that in order to really understand the health insurance policy here, I needed to understand policies that other countries have in place. I started working on part 2 first because I want to make sure that I have plenty of time to delve into my case study on the DR so the history of health insurance section may wait until the end as I am compiling all of my research. So far I have information on the current insurance systems in the US, Canada, India, China, Spain, Colombia, Cuba, and the Dominican Republic. I chose these countries as a sampling from each area of the world. I am going to start writing my first chapter for my final thesis as well as draft slides for my presentation. My advisor suggested that I write as I go so that everything is fresh and I can invest fully in each part. (Not to mention that one of the professors would like me to publish in an article here and in Latin America at the end of the semester so I need to write as I go, and in Spanish!). After I finish writing this chapter, I will continue with more detailed research into the history of insurance in the Caribbean specifically and the logistics of each system in order to place the system that exists in the DR into context. I can’t put into words how much I am enjoying learning all of this- and I think it’s going to help me immensely for my Masters! (That was the plan 😉 )

My week concluded with a David Guetta concert and a Sancocho competition. Let me explain. David Guetta is possibly my favorite artist. He is more or less a DJ/producer. He came to Santo Domingo, so obviously, I bought a ticket. I went on a tour, which meant that transportation to and from the capital was provided; I got a tshirt, food, and drinks. We left Santiago at 7pm and didn’t arrive back to Santiago until 7am the next day! The concert itself was incredible, and I even snuck my camera in!! Usually they don’t let you in with a professional camera, but I found a way, and I have some amazing photos.

At the Guetta concert!

The next day (after sleeping for the majority of it) I went with my family to the Centro Español to a Sancocho competition. The Centro is more or less a country club and they have various events that you can sign up to participate in. Sancocho is a traditional Dominican food that is like a stew made with various types of meat, potatoes, plantains, yucca, and corn. It’s absolutely delicious. The idea was that each family/group made their own Sancocho and then they were judged and the top 4 won prizes. We made the sancocho over fires in large pots, the pictures describe it best. There was also a live merengue band! I love merengue. And apparently I dance pretty well. People kept checking to make sure I was American! They also had other typical music and I got to dance some salsa as well. That is probably one of the things that I had missed the most, the dancing. It’s a joyous thing, everyone participates, it’s fun and light-hearted, and it’s not that obnoxious (Toad’s style) American dancing. New goal: go to more discotecas with traditional music to keep practicing my skills!

Competencia de Sancocho

With Laura ("Tia") at el Centro

Sancocho- yum!

In more recent news there was a riot/strike (una huelga) yesterday (Feb 2). According to, the largest English Dominican news source, “Public transport drivers serving several “concho” routes disrupted traffic along 27 de Febrero, Estrella Sadhala and Juan Pablo Duarte avenues yesterday in protest at the new routes approved by the city council. The drivers, members of the Fetranreno union blocked the roads in the morning and part of the afternoon. According to Hoy, one person was injured and several windows were broken, and city officials complained of the fact that while the demonstrators blocked the access to the municipal office, the Police did not do anything. According to reports, at least six people were injured in other protests. El Caribe said that at least one person was injured in Monte de Jagua, and another two between Moca and San Victor in protests that extended throughout the Cibao region over the higher fuel prices and the cost of living.” What’s very interesting about this is that just two months ago there was a huge movement here called “4% para educación”. The people encouraged the government to allocate 4% more funds to the public education system here. The government did not grant any more money for education but did raise gas prices, food prices, and the cost of public transportation. Here are some interesting statistics: in 2008 a barrel of petroleum cost between $140 and $145. Gas in the DR cost 140 pesos (about $4). Today a barrel of petroleum costs $90 and gas in the DR costs 180 pesos ($5). Why is it that petroleum costs less but gas in the DR costs 40% more? The answer: taxes. Who imposes these taxes?: the government. People are frustrated because there are less jobs and yet the cost of living is climbing. We learned in our class that there is an attitude of “paternalismo” when it comes to the government. Dominicans view the government as a father that is supposed to provide and provide unconditionally. There is an obvious flaw in this way of thinking, a democracy required involvement from the people, and otherwise all of the resources end up in the hands of very few. But, candidates use this attitude to campaign. The next presidential elections will take place in 2012 and there are already posters up for candidates. One of the candidates uses the slogan “Llegó Papá” (Dad has arrived). It will be interesting to keep following this because if something like this were to happen in the states, the government would respond immediately. But has the government made any announcement here? Not that I have seen- it’s as if they turn a blind eye.

Look for the next post soon- I promise to keep them coming more frequently! Enjoy the pictures!




One response

4 02 2011

Que han enriquecido mi vida tanto, gracias. Ir con la gracia! (_0_)

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