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!

Todavia, Estoy aqui!!

I know....I've been MIA.  And if you've noticed-then thank you for thinking about me and my ministry!  This may have been the biggest lapse I've had since joining the blog-o-sphere about 2 and a half years ago....losiento!!  Todavia, estoy aqui!  Sorry!  Still I am here!

We finished with teams on August 4th and then took the following week to recoup.  Man, I had no idea how truly exhausted I was!  Staff work hours with teams here are much longer as we have responsibilities at the base outside of our normal site hours....and for me that includes being the base doc (or PA!).  I see everything from minor wounds, bug bites, GI illnesses and parasites to more serious stuff....I even had a student this summer who needed an emergent appendectomy!  Things get a bit crazy when you have teams of 70 people staying in a foreign country!

During our week off, I started reading a fabulous book titled "Where There Is No Doctor."  It was so nice to finally read a book that talks a bit about what I'm trying to do!  Too bad it was written in the 70's....c'mon all you missionary doctors!  Start publishing your words of wisdom!  I was able to learn many new ideas for my clinics and the best way to reach patients.  It has been a joy to put these new ideas in to practice....such as medical slips explaining dosages for those who cannot read!

As a staff, we also enjoyed a two night retreat at the beach.  It was so nice to catch some R&R and be reminded that yes I do live on an island (we went to Puerta Plata for anyone who's curious)!

The "singles" on our staff
Chelsie (my housemate), me, Silvio (Physical Therapist),
Eric (microfinance), Jess (Women's Sports)

Upon returning, my PA school roommate came to visit and volunteer with me for a few days.  It was amazing to share with her my clinics and daily life!  We also were able to drive to Punta Cana (took us 7 1/2 hrs due to unpaved roads and no street signs....and its ony 110 miles away) to attend a close friend, Sharon's, destination wedding!  This truly was an answer to prayers to be a part of her day as her now husband is in seminary in Korea...who knows when we will get to share time together again!

Sharon and I at her wedding in Punta Cana

Me, Sharon and Meghan

Once Meghan left, I began planning.  I started meeting regularly with a mentor (who speaks only Spanish!).  And God continued to convict my vision of what a medical missionary looks like.  And so, I prayed, and planned and met with community leaders and took several weeks off from clinics.

And during that time I was blessed to receive two huge shipments of medical supplies!  Thank you Dick and Jane Godfrey and my Aunt's Lutheran church in Georgia!  My pharmacy is now stocked!

This week is my first week back in sites....all six of them!  And so far, it has been extremely encouraging.  I've spent the mornings holding clinic in my communities and doing house visits in the afternoon.  I always find home visits the most rewarding as I get to learn who my patients are and where they come from.  I also always get coffee and a bunch of fresh fruits and veggies from most visits.  :)  Yes, I will accept food as payment....hello barter system.

And looking forward- in addition to the above, I have started Creole classes once a week with the hopes of being able to communicate with my Haitian patients a bit better.  On Monday I will begin an intensive 5 week advanced Spanish class...with hopes of developing fluency one day.  I have also joined a bible study and will begin mentoring a teenage Dominican (in Spanish!) as she goes through a discipleship program run by my roommate Chelsie.  And I have two more supporters/PAs/friends coming to serve with me this month!  Not to mention preparing to begin preceptorship of nursing students from Bethel College in Indiana beginning in October.

So, perhaps now you understand a bit of my absence.  It's not for lack of God opening doors...it's actual life getting in the way.  I'm busy!  But, oh how I have longed for this day.  And, it is good.  :)

I promise I will bring you along in my thoughts and life better now that teams have left!  Enjoy those autumn leaves for me!  I'm already nostalgic thinking of crunching them with my boots!

Xo

End of Summer 2013

"Yet our walk only begins where God's grace has laid the foundation."  

Oswald Chambers

Today ends 11 straight weeks of summer teams.  It has been an incredible season with over 350 students and adults serving within our sites.  We have been abundantly blessed by the gifts participants have brought and the encouragement they have given each of us long term missionaries.  Check out a video of one of our outreaches HERE This was our July 1st-July 13th outreach....when my church served with our ministry!  I am incredibly proud of our various ministry and community development sites and how they integrate short term and long term missions.

Our Incredible Summer Interns
Benjamin, Jesse, Morgan, Aubrey, Erin
Tyler, Zac, Rachel, Rebecca, Amy

With the closing of the summer also means our interns and volunteers are returning to the states.  I am so encouraged that each of them will be heading back to their own mission fields all over the US.  On Thursday I have to say goodbye to Helena who has been volunteering with me since early May.  It's hard to imagine proceeding with my site without her by my side as she truly has been an invaluable asset, but I know God has great plans for her as she returns to Boston University and a future career in medicine.

Me and Helena

The next week finds our staff laying low, re-energizing and then heading to the beach for a two day staff retreat.  We are not expecting teams again until October.  I am looking forward to spending the next two months changing my site to meet the needs of both Dominicans and Haitians in the communities.  This past week we had a three day clinic in a new community called Saboneta where we saw over 100 patients.  I am so excited to get to know my patients better and hopefully feed more into their lives.  I now have a presence in 6 campos (small, poor, rural neighborhoods)!

I hope and pray everyone is doing well as August has begun and autumn/school is beginning to come closer into sight.  May God continue to bless all of you as you persevere in each of your mission fields!

Check out SI's August Newsletter as they highlight the DR!
Students International August Newsletter