For all the visual learners out there, a photo montage of our life and work so far.  Click on each photo for descriptions.  Thanks again for following our blog!

Until next time,

Laura & Angi

The sugar cane fields have been in flames for the last several nights. The one thing that everyone agrees on is that it is not the routine, controlled cane burning that happens annually. Some say it’s a protest, as the legislature is currently evaluating its consitutional policies on determining Dominican nationality – the symbolism of burning the fields where thousands of Haitians toiled for generations makes the message pretty clear. Others say the protesters are targeting the government’s refusal to re-open the sugar refinery in Montellano, which would thereby alleviate some of the widespread unemployment. Still others say it’s just “gente mala” causing trouble. The police are theoretically trying to catch them.

It is both sobering and overwhelming to see the continued manifestation of hundreds of years of tension, violence, racism, and oppression between Dominicans and Haitians. Regardless of the actual intent in setting these fires, the image is a strong one – and but one example. The more subtle and everyday manifestations are perhaps even more crucial to note. Understanding health, and how to promote it in partnership with individuals, communities, and organizations, requires an understanding of this history, and the interpretations that people believe today. It’s an understanding I’m working to attain. I’ve really enjoyed talking with Wilson, who volunteers here with the DREAM Project, Fútbol Para La Vida (aka Grassroots Soccer), and does a million other things in the communities around Ascención. He grew up in Batey Libertad, close to Santiago, and has since been able to attend high school and college in the DR. He knows so much about the history and current political situation around Haitian-Dominican relations, so it’s been very interesting to hear his perspective.

Wilson and Angi walking down the highway toward Montellano.

The extent of needs here is striking. Be it food, money, medicine, shoes, soap, clothes, or any number of other important things, the requests from the people in Ascención are constant. I’ve found it very challenging to understand my limitations and establish boundaries – the parameters I’ve defined for myself in other service provider environments do not translate well to a context in which there is little, if any, infrastructural support for people living in poverty. The fact that living in the Mission House creates a distinct divide between us and the rest of the community adds another layer of complexity. The expectation of hand-outs from volunteers passing through the Mission House has been created over several years, and it is difficult to justify how I, in good conscience, can continue to feed into that culture. At the same time, the moral dilemma exists on the other side: how can I say no to someone asking me for food, who knows full well that I eat everyday and he does not, just because I can’t feed everyone forever? How can I justify saying no to a basic need that I have the capacity to meet at least in the present?

I keep reminding myself that one thing I can offer without limit is empathy. It’s not enough, but with a foundation built on respecting the dignity of everyone who comes to me with their needs, I hope that my work here will become something more.

Hunger and unemployment seem to be the two major issues in Ascención and elsewhere. Angi and I have been talking a lot about how to proactively respond to what we’re experiencing. It’s a daunting process to even begin thinking about. I feel that I’ve learned more in these last few weeks than I even realized there was to learn. It’s exciting, but has also been mentally and emotionally exhausting.

But I promise we’ve done more than ride on motos and talk about solving poverty this week.

We have continued to meet with health organizations (broadly defined) and community leaders, and it has been incredibly inspiring and motivating. One particularly wonderful partner: the village of Samán has an active community development organization, called ODHS (Organización Desarollo de Haitianos en Saman), led by a very charismatic man named Peralta. That’s right, no last name needed. Over the past several years, ODHS has implemented projects in construction, agriculture, medical service, education, and recreation. They partner with Dartmouth College to raise funds for major projects – currently, the community is voting on whether to begin an adult literacy program, a housing renovation program, or a multi-service clinic. The power of leaders to organize their communities, leverage partnerships, and improve quality of life cannot be overstated. It’s that same sense of working from within a community that is driving the community health worker program. Angi and I have been meeting with Dr. Batch several times each week to discuss the curriculum, recruitment, management and vision. We are aiming to begin the course on November 7th.

Meeting with Peralta in Samán.

There’s nothing like waking up to roosters crowing, crawling out of my mosquito net, lacing my Asics, running down the dirt road past the goats that graze at the side of the river and over the cement bridge past the hub of motoconcho drivers yelling, “?Adonde van?” and continuing through miles of sugar cane before coming back to the village to start the day. On our runs, we pass the cows, men on horses, and women carrying produce in large tubs on their heads. Sometimes, someone will join us, another will offer us a ride, and others will launch into a conversation while we huff and nod and keep pace as we run past them. Today, a cow tail quite literally smacked me in the face as I passed him. It’s been one of the American routines we’ve tried to keep up here. Running and applying sunscreen and bug spray have been two traditions that we haven’t quite given up yet. (By the way, Mosquito Bite Count: 27. Tan: fantastic.) We have been here eleven days.

On Monday mornings and Wednesday afternoons, Dr. Batch, a local Haitian doctor with whom we will be working to develop a community health worker team, sees patients in Villa Ascensión. Laura and I helped dispense pharmaceuticals and organize the crowd in the clinic beneath our bedrooms. Dr. Batch is doing his year of service, a requirement of all doctors who get their medical degree in the Dominican Republic. Although only doctors who have Dominican birth certificates have the opportunity to work for the public health department and actually get paid, Crossroads provides a stipend for Dr. Batch’s year of service to the villages in this area. The community health worker team will meet once a week during this coming year starting in November. Laura, Dr. Batch, the team, and I will work together to cover a curriculum on health education that will include lecture and discussion based learning, as well as a medical skills practicum at the public hospital in Puerto Plata. There will be one or two people from each of 16 batey-villages of our region on the team. We hope that after completion of the course, they will be well-equipped to continue spreading health information amongst their respective communities, addressing local needs, and working in partnership with HHI’s short-term medical teams. We are just at the start of this exciting prospect, and I cannot help but be hopeful.

Before beginning our actual community needs assessment and evaluation, we have taken these first several days to learn about all of the organizations working in health in this area. So far we have met with leaders from CEPROSH (both it’s Puerto Plata and Muñoz health clinics), the AIDS program at the public hospital in Puerto Plata, Esperanza (a microcredit organization that partners with some health organizations), the Centro Sanitario (public health department’s clinic in Puerto Plata), the Social Security clinic in Montellano, Dr. Lambert (a physician based in Cangrejo that serves the impoverished), and a meeting of young international and local leaders held on the porch outside a home in Caraballo. That night ended with dinner at Cristino’s, the president of the Town Council. Avocado, boiled yucca, and fried cheese in candlelight were a treat after a productive day.

One of the most important lessons these meetings have taught us is that there is already a large community of people working for the same cause: access to food, shelter, education, and health for the underserved. Everybody we have met with this vision is eager to work in ‘alianzas,’ or alliances, making each interaction formative and productive. We have also begun to understand the ex-patriot community down here, as there are many young people spending their year volunteering, researching, and learning just like us. It’s been amazing how fast word of mouth travels – we’ve met all of the Fulbright scholars, Peace Corps members, and jewelry co-op and education volunteers in our surrounding area.

This coming week, we will continue to meet with local leaders, but will also launch into informal community discussions in four of the surrounding villages around Villa Ascensión. Summer, one of the American volunteers in education living in Cabarete, suggested we spend the first month “sitting on people’s porches” without pen, paper, or computer just to listen, learn, and reflect. I’ve been surprised by how productive porches can be, and I look forward to many more this week.