If there’s one English term that doesn’t translate to Dominican Spanish, it’s “personal space.” The DR is a country where packing three adults and a chicken on a motorcycle becomes a quotidian activity, where your neighbor’s music becomes the soundtrack to your evening, where your skin touches strangers’ skin, your voice mingles with other voices, and even your sweat is subsumed by the collective sweat of the crowd. It is a country of gossip, a nation of open doors, and an island of close quarters. Arriving from the States, it is an assault on the senses, a maddening crowd.

However, over the past few weeks I’ve taken notice of exactly what this seeming cacophony consists of – the shouted salutations, the clattering of Dominos, the inquiries about neighbors, the rhythm of merengue – and I’ve come to realize that the sum of these parts isn’t the chaos I once imagined, but rather a sense of community I’ve never felt before.  Time and time again, I’ve been impressed by how virtually everything here belongs not to individuals or even to families, but to the community as a whole. Just this week, Meg and I trekked up to visit Mercedes, our community health worker in Arroyo de Leche, to find a huge lunch awaiting us. We not only ate with Mercedes’ family, but also with a host of friends and neighbors’ children that were there for the meal.  We saw that while people here do not necessarily have much, what they have is shared.

I’ve also realized that this sense of community is exactly what gives Meg and I hope for HHI.  We’ve seen our community health workers commit their time and effort to help those in need. Currently, they are working to give appointment cards for our September medical service trip to those who are sick, and long after our doctors go home, they will be working to ensure that those same individuals are taking their medicines correctly. Some are doing this work while raising large families, others in addition to working at free clinics, and still others while teaching at local schools. They are of the community and for the community. After these first weeks as IPDs, Meg and I are filled with gratitude for those that are putting the community in community health and making what was once a maddening crowd feel like home.

Saludos,

Nicole

High fever, insufferable headache, pain in the eyes, intense muscle and joint pain, vomiting… the Dominican Republic is on high alert because of the illness these symptoms point to: dengue fever.  Dengue is a viral infection transmitted by the Aedes aegypti mosquito, which lays its eggs in stagnant, clean water, usually in and around homes.  There are several classes of dengue, and in people who have been infected once before, the illness can progress into a life-threatening hemorrhagic form.  Characterized by a distinctive rash, bleeding into the abdominal and chest cavities, and bleeding from the eyes and pores of the skin, this form of dengue is almost always fatal.  There is currently no vaccine and no cure.

More than 8,400 cases of dengue have been reported in the Dominican Republic over the last several months, and 27 individuals have died — an epidemic level not seen in over a decade.  So far, the illness seems to be concentrated in the Santo Domingo and Santiago regions.  The Ministry of Public Health has launched a nationwide campaign to slow the spread of illness and prevent new cases.  The campaign includes educating individuals about dengue prevention, conducting home visits to eliminate receptacles that could hold standing water, and fumigation in certain high-risk areas.

Here in the Puerto Plata region, dengue has not hit epidemic levels — yet.  The regional Ministry of Public Health is proactively working to mobilize volunteers to participate in its prevention campaign.  With the oh-so-catchy slogan “Sin criaderos, no hay mosquitos.  Sin mosquitos, no hay dengue” (“Without breeding places, there are no mosquitos.  Without mosquitos, there is no dengue”), the Ministry hopes to avoid an epidemic.

HHI is collaborating with the Ministry  to do our part in this nationwide public health priority.  Dr. Elisa, an epidemiologist from the MSP, and Laura, a nurse and TB specialist, came to Montellano to do a special training for our  cooperadores de salud on Saturday.  They discussed dengue prevention, symptoms, and treatment, as well as the active steps our cooperadores could take to educate their communities and eliminate breeding places in their neighbors’ homes.  We then made plans for each cooperador to conduct a workshop in their community.  The room was buzzing with creative ideas and energy, so now it’s a matter of carrying them out.  Listos?