Health Care Fair

Mission accomplished....first health care fair in a rural community has been completed.  

"And how did it go?" you ask.

Well, that is a marvelous question.

I have been working on this project with my three nursing students; Lauren, Renee and Lauren for the past four weeks.  We brain stormed about ideas, we read about how effectively to teach the uneducated, we cut and pasted posters, we copied advertising fliers, we bagged vitamins and medicines and they spent time with Vanesa (our dentist), Silvio (our physical therapist) and Fernando (our ob-gyn) to learn about key problems in the communities related to these specialties.

And, this week we welcomed two of my student's professors from Bethel to join us.  They wanted to observe the ladies in action and see my sites and the program I've put together for them.  It was exciting to share the hard work we've done, but this did add a certain element of pressure.

Naturally, the week before the fair was spent making final preparations.  We walked throughout the community of Sabaneta and advertised and spoke with many of the people who live there.  We went to colmados and asked if they could hang our flier on their walls.  And what normally would take half an hour to do took 5 hours!  Because people were pumped!  And so were we!  I just knew in my hearts of heart that this was going to be a phenomenal week of ministry with an awesome turn out!  And so did my partners in crime.

my clinic in Sabaneta

it's a community center of sorts also used for mass

my consultation area

a typical patient's house

Imagine our dismay when on day one we had one patient.  All day.  Three nursing students.  Two nursing professors (one of which is an NP).  A doctor.  A PA.  And hardly any patients.  Or anyone desiring to be patients.

My students were utterly defeated.  All their hard work.  Their desire to improve the living conditions of our patients.  To help them take care of themselves.  

And, even after spending a year and a half doing community development, I felt myself right there with them.

Welcome to community health in a developing country I found myself saying.  Where we care so much and our patients don't even know enough to care because they have so many other things to think about....like putting food on the table.  Or they don't think prevention matters bc they aren't educated enough to realize it does.  Welcome to working so hard for something that just doesn't seem to work.  Welcome to trial and error.  Welcome to an occupation (medical missions) that none of us have perfected as of yet.

And then, I thought of that one patient who was at our fair.  Who maybe will make changes that will enable her to live a longer healthier life.  Or help others.  Wasn't our presence there worth it for her?

Our first day was a heavy lesson in community development, but an incredibly valuable one.  Who's to say our efforts weren't worth it for one person?  After all, we can only change one heart at a time.

Don't worry.  The rest of our week was busy, and, what we in the Western world would consider successful.  But, when I look at this past week I am so thankful for Monday.  For my young nurses who aspire to be in missions one day to taste the challenges.  For their professors to also understand how difficult what we're trying to do can truly be.

The week ended well with my students teaching about blood pressure, dental hygiene, back care and nutrition.  They worked hard and I believe their professors are leaving more than a bit satisfied with their progress and my program.  I am more than a little proud!

So check out below for some more snapshots!

Day 2- Our Back Care Clinic!

Lauren checking BP

Lauren sitting with me while we see a Haitian patient

look how my patients are bending!? Awful for their backs!

Dr. Fernando translating for the students as they teach
about back care

Practicing strengthening exercises

Day 3- Our dental hygiene clinic!

Lauren teaching

Demonstrating proper brushing technique on Caroly!

Breaking off into smaller groups to further re-enforce
our teaching

He's got it!

Day 4- Nutrition!
Teaching in a rural clinic in Buena Vista!

We had a great turn out!

Renee teaching and Dr. Fernando translating about
carbohydrates!  A staple to the Dominican diet.

Lauren teaching in a smaller group.

Growing Pains

Sometimes as a Christian I feel as though I'm constantly going through a bit of growing pains.  Things that I should know, en grained in my heart and soul, just aren't always connected to my thinking.  And then when I have that moment of realization, I just feel so young in my faith.  And, recognize what's been there all along but that I just momentarily didn't lean into.

I'm tired, a lot.  I am very much living in the mission world and yet, ashamedly, still trying to live for me.  When I'm not in my communities serving, sometimes the last thing I want to do is answer that late night or early morning medical phone call or when putting laundry in the washer, speak with the lonely young Dominican who lives on the base.

This week, God has placed on my heart to read the gospel of Mark.  And so I have, for five days and I am only a few chapters in.  Because, I am just so in awe.  Jesus was surrounded by so many todo el tiempo.  His ministry did not end.  He gave.  And gave.  And gave.  He gave of himself and of his time.  He healed people, spiritually and physically.  He had so many people following him around that he had to stand in a boat to preach to them.  I cannot even fathom that!  The bible constantly talks about the compassion Christ had for the multitude.  God calls us to give until it hurts just as Christ did in all His humanity, and I just realized...am I truly doing that?

As Christians we need to be careful of the extreme, we need to be quasi-protective of our time or we could get burnt out.  We of course need to take time for ourselves, to rest and to spend time with our Father.  But, I realized all those people in my life who I could have the opportunity to minister to (like my awesome neighbor who takes such good care of his three single girls living next door and is not a Christian) that I just don't, because I'm too tired or some other insignificant excuse.

And I stand ashamed.  And stretched.  And with eyes wide open to all the opportunities to share the love of Christ that I haven't taken advantage of.

Last night, I set aside two hours and spent time with Isabel that young Dominican who lives on the base as her husband is the care taker.  And I listened.  And my head was tired of speaking in Spanish all day and all it wanted to do was hear English, but I continued to listen.  And I knew without a doubt I was where I needed to be.  As she shared with me something incredibly heavy on her heart that she had not shared with anyone but her husband I knew why God was showing me the compassion Christ had for the multitude.  Because, sometimes we have to be where we don't want to as Christians.  We have to place our selves on the back burner and listen and love and give.  Like He did, and continues to do.

And, so I ask that we all take time to reflect whether we are truly "giving of ourselves in all aspects until it hurts?"

Auyamas and Nursing Students

I sit here tonight by candle light typing in a house without electricity or water....going on day number two.  Ojala, this is only temporary.  We spoke with our neighbors who said the city usually only turns off the water for a couple days.  Electrical outages are a common part of life here (everyday we lose power for about 10-12 hours).  Deficits of both in mi casa are simply because we are on a grid with those who cannot pay.

And so, tonight, as I feel a little bit sticky and just want to wash my face and be connected to the world I can empathize with so many of my patients who only have running water from a hose within their neighborhood that isn't entirely clean and is only turned on twice a week.

But, my lack of household "necessities" are not what this post is about.

I wanted to share with you how we celebrated American traditions low key in the DR.  Those of us who have no change in season have been dying to share in the cooler North American temperatures, the falling leaves and the snow.  And so, we have done the best we can to bring fall to the DR.

This includes....Auyamas!  A cross between a pumpkin and a squash, auyamas are not found in the states but are a main staple in Dominican cuisine.  You can find this flavorful, orange veggie in our famous habichuelas (beans) or in soup.

Auyamas!

Carving!

Me!  We had a chilly night! Yay!

Baked auyama seeds!

As the Halloween season has ended and we prepare for Thanksgiving, do not worry we have plans to make a full turkey dinner and enjoy a "Friendsgiving" together.  Almost as good as being home with family.

I can't believe it is already mid-November and I find my mind wandering towards my upcoming time in the states.  But, I continue to be brought to the here and now as both myself and my nursing students are busily preparing for our health care fair next week in Sabaneta.

Two Bethel professors will be joining us as we spend four days in clinics and teaching about topics related to each of our SI medical sites...including Women's Health, Community Health, Physical Therapy and Dentistry.  I am so excited for my student's hard work to be put to use.  I will update my blog after the profs leave!  Please keep us in your prayers as we initiate our first preventative teaching sessions!

My nursing students in action

Bagging medicines for our women's health clinic

Dios te Bendiga!

Encouragement

"Therefore encourage one another and build each other up, just as in fact you are doing."

1 Thessalonians 5:11

E.N.C.O.U.R.A.G.E.M.E.N.T.

      .........Perhaps one of the most vital traits of a Christian in fellowship with other believers.........

And I am thankful to say, my community of Christians (both in the US and abroad) have showered me with this very gift.

I couldn't have been more wrong in my perception of this Fall when we ended our summer of teams.  I was convinced my days would be empty and life would be mundane without our sites filled with the energy our interns and students brought to the field.  I was sure my social life would be nonexistent and that time would creep slowly by as I waited for Christmas to arrive and a visit to the states.

My view was quickly proven wrong as I started mentoring a young Dominican girl, joined a bible study, began an intensive Spanish class and a Creole class all while preparing for our nursing preceptorship program and continuing to see patients in various communities and missionaries.

As my schedule didn't allow for much free time and dengue slowly began to creep upon us (milder this year than last) along with  daily tropical storms I realized I was sinking.  And then came my encouragement.

*Through my friend Meghan, an emergency medicine PA from Delaware, as we traveled across the DR to our dear friend's wedding

*Through my friend Priya, an internal medicine PA from DC, who came to serve for my birthday

*Through my friend Elissa, a Cardio Thoracic surgery PA from Pittsburgh, who came to work with me at my clinics

*Through a team of 5 nurses, a PA and a student who left on Saturday after showering both me and my patients with love and support of the seemingly enormous task of delivering good health care in less than ideal circumstances 

*And finally through my Mom and our close family friend Cindy Nasman who came to serve at our pre-school and special needs school last week 

This week as I am once again solo (for 4 days) I realize how encouraged I am.  I have finally had the time to reflect and evaluate my thoughts and have noticed a stark contrast from several months ago.  And I know without a doubt that that difference in my thinking is the encouragement I have received from each of these incredible people and those at home who continue to remember me.  Through words, hugs, laughter, medical supplies, fall goodies, candy, pumpkin coffee, etc!

I am so thankful that so many people see the vision and hope I have for the Haitians and Dominicans I serve; a vision I'm confident was given to me through our Father.  I am so grateful for the renewed energy serving with American health care providers has given me as they each believed in my goals and desires for each of my patients.  I am thankful that I am still tied to American medicine.  And I am beyond grateful to share my life with those I love so very much.

And so, as Friday begins a new six week preceptorship of three nursing students and my work in the community continues, I am encouraged.  And for that I give thanks.

a motorcycle burn, known as the "Dominican mark"
Moto accidents are the leading cause of death here, but
with gas at $7/gallon it is the cheapest form of transport

proudly showing off his burn

Last week I had 5 nurses, a PA and a student work with me
here I'm explaining how my clinics function

Felix, my 86 year old patient who continues to farm!

teaching how to take his medicine

one of my littlest of patients!

checking eyes

Fernando and our student seeing a patient who suffers
 from chronic allergies

Translating for a patient in Creole (not me!  Yvenor)

loving my patients!

a house visit to Julito

A trunk filled with medical supplies!

Unpacking donations at the public hospital

the public hospital

They were so happy!

Estoy una nyonya esta noche, pero ojala solamente un chin....

Oh facebook.  Instagram.  Twitter.  Google plus.  Linked in.  And insert any other type of social media here____.

How on most days, I love thee because you keep me connected with all the people, places and things I love so dearly in the world.

But, today.  When I am feeling a bit heavy hearted.  When my sacrifice to live in the Dominican Republic just. feels. heavy.

.......................today, I loathe social media.

I miss fall.  I miss the leaves.  I miss wearing sleeves on my arms.  Or drinking a pumpkin spice latte.  Or cuddling underneath blankets.  I miss apple picking.  Or celebrating Halloween and not being looked at as a hypocrite because in the Dominican culture it is truly a demonic holiday.  I miss my parents and having coffee with my mom.  Or calling a friend on my drive home from work.  I miss order and being surrounded by people who obey the laws because they are enforced.  I miss driving to DC to visit my friends for a weekend away.  I miss....you get the picture.

Yes, after 14 months of living in my mission field, I still get homesick.  And I admit to all of you, I am in the middle of a big pit.

My load feels weighty.  I find myself frustrated that this is where God wants me.  That as my friends are all getting together after work or celebrating weddings or babies, here I am.  Sweating in my room.  The electricity inconsistent after a big tropical storm and my water brown from said storm.

Rarely do I dwell.  Rarely do I let my emotions get the best of me.  But, occasionally, I miss my home country.  And sometimes that miss is just all consuming.

And then I feel guilty.  What He has asked me to do is nothing compared to the cross He bore.  Christ carried the weight of the world and all who lived and was going to live.  He suffered torture and betrayal and hate.  And all He asks of us in return is to love Him and care for His people to the ends of the Earth.

This morning as I found myself trapped in my thoughts of self-pity, sitting in my clinic in Buenos Aire, in walked widows and orphans, my patients.  The very people Christ asks us to care for.  And He gave me the opportunity to love and help them.  And that provided more joy than any of those "Earthly" things listed above that I so desperately miss, ever could.

Yet, even though he knows I'm where I need to be, Christ let me weep.  He let me miss those very good things that I miss so dearly.  And He walked with me.  And gave me shoulders and support tonight through other missionaries to share the load and who understand the lengths we all have to go to follow Christ's very greatest commandment.

So, don't feel pity for me.  I am where I need to be.  And don't stop posting pictures or telling me about that beautiful New York fall.  Just drink an extra latte, or take an extra breathe of fall air or cuddle further under those blankets even go hike Montauk, for me.  

But, remember where your fulfillment comes from.  As He walks with me, I sure can't forget it.

Another day in Saboneta....Another day reminded of joy

"For our heart shall rejoice in Him, because we have trusted in His holy name." 

Psalm 33:21

I should have known it was going to be a a joy filled day when I awoke to this little baby cow (vaca) outside my house......

 It started off as any other day with Yvenor (who runs our Haitian outreach site and speaks fluent Creole, French and English), Caroly (my assistant) and Dr. Fernando (my attending) packed my car as normal....I'm blessed to have a "pharmacy" on wheels with me at all times!  And we headed to Saboneta...our newest community to do some relationship building and house visits.

First stop was a colmado (a small roadside convenient mart) to talk with Dominicans about their ailments and life.  To listen to them.  To love them.  To share with them about my clinic that's held every week in their town.  Then, in normal Dominican fashion we were invited to an elderly woman's house for some morning "cafe."

And outside there were these two bright eyed, beautiful children of God playing.  Without much clothing, they were tickled to be playing in the dirt together climbing up a pole and on top of two broken plastic chairs.  Both kids had pretty impressive fungal infections of their scalp.  You can already see this little girl is suffering with alopecia (hair loss) from the disease.  And the little boy has multiple white lesions covering his head.  They both also have scabies.  Shortly after joining their game, I was introduced to their Mom who couldn't have been more then 20.

 I was so blessed to have the ability to communicate in Spanish with their mother.  I still continue to be amazed that after almost four years of doing missions in the DR I can love on my patients with my own words!  And not in English!  Anyways, I spent time talking to their Mom about the importance of treatment.  They both will lose all their hair if we don't start medications.  The tricky thing is this medicine costs half of a months salary for the full treatment (8 weeks) and compliance is low.  But, thanks to a recent donation I have money to buy the medication.  I am so excited to work with this precious family and teach this loving Mom how to better care for her little ones.

This is probably the most exciting part of my job.  As a community health leader I can visit my patients weekly and make sure they not only are taking their medicine but understand how to and the importance of compliance.  It is amazing to see how much confusion there is for patients in regards to the dosage of medicines.  But, if you've grown up un-educated, you just don't think the way we do.  I love trying to meet the challenge of helping my patients understand better!

 

These adorable children are Haitian and live in Saboneta.  They are unable to go to school because their birth certificates were lost in the Haitian earthquake.  Every Friday morning, Yvenor and I spend time teaching about God and health care prevention.  Today was just a play day and clearly they wanted to be models for the camera!  So fun!  Each of them have scabies and fungal infections as well bc they live in such crowded conditions and usually sleep on the floor.

This is a snapshot of a typical morning for me.  Why was it more joy filled than normal?  Because I took the time to remember that today is a gift from God.  That he orchestrated every encounter I had with my patients.  That He loves each of us the same.  That He has given me the means, through many of you, to help these people.  And that is incredible.

I wish I could say I start off every morning like today.  That my heart is always one hundred percent open and my smile is huge with every patient I see.  I wish I could say I always remember what a blessing every breathe we take is.  But, unfortunately, as so often happens in the states, my life at times becomes a bit routine.

But, then a day like today happens.  When I see Jesus in every smile.  When a woman calls me their "Doctora."  When God opens opportunities to teach people how to care for themselves.  And then I remember how fulfilled I am by the joy Christ has given me.  I pray that we can all remember to find His joy in all that we do....even in the mundane, "normalcy" of life.  And that as we are filled with that joy it shines through every pore in our bodies!

Dios te bendiga!