Summer is Here!

DoRe Interns 2014

We are officially a month into teams....I have welcomed 7 students into the community health site on a one week and then a two week outreach.

One of the biggest blessings of the summer are the 12 interns who work within each of our sites.  My roommate Chelsie and I have the opportunity to lead the intern bible study on spiritual disciplines and get to know them on a more intimate level. 

Kacie Johnson (front row, fourth from the left) is my medical intern!  She is a fourth year nursing student who has spent the last three summers serving at the Christian camp Hume Lake in California.  She has a passion for students and children with disabilities.  After serving together for several weeks, I know we're in for an awesome summer of ministry together!

Please keep us in your prayers as we continue to welcome groups, take care of patients and prepare for an "eye" outreach in July complete with an ophthalmologist!

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Please also keep "Miguel" in your prayers.  We had a valuable meeting with a psychiatrist and infectious disease doctor last week in La Vega.  We're hoping "Miguel" will make his next visit on his own.  A huge answer to prayers came when "Miguel" was able to find a job.  Jim and I will continue to work with him on a weekly basis and set life goals.  Next step- finding housing. 

My biggest prayer for "Miguel" as he starts treatment is that he will remain compliant.  He is currently feeling great and asymptomatic, this will probably change as he continues with treatment as we don't have accessibility to the better tolerated HIV meds found in the states.  But, I continue to believe in miracles and that "Miguel's" heart changed for Christ will allow him to prevail.

I hope all of you stateside are enjoying warmer weather. :)

"Miguel"

Is this really mi vida????  I found myself thinking today as I pulled up to an abandoned, halfway built concrete house with a fellow missionary (Jim) at 7am and we headed down the mountain with my newest Haitian patient to an HIV specialist.

"Miguel" is homeless, has a past history of drug abuse and theft.  He has been in and out of prison multiple times and has been known to deceive and con those closest to him.  And, he's 19.  Only.

Being Haitian alone places "Miguel" at risk; but a known law offender does not help his cause.  Despite being placed in difficult situations with "Miguel" over the past year Jim has not given up on his life and has continued to encourage, love, mentor and guide him.

And finally, after a traumatic jail experience in February, "Miguel" opened his heart to the Lord.

He left prison a changed man.  

If only his exterior matched his new heart as there are many people in Jarabacoa (including fellow church members and police men) that need to be proven otherwise.

So why would a PA be thrown into the mix?

When "Miguel" was discharged from prison he found out that he is HIV positive.  And when he found this out...so did everyone around him.  Leaving "Miguel" without a job, a home or friends.  On top of this, his Mom died of heart disease in Haiti leaving him an orphan.

All this after he accepted Christ as his savior.

Welcome to our challenge of walking with a new believer and helping him to see the blessings of God amidst the repercussions he is suffering, as he walks through depression and suicidal ideation and attempts.

I have spent the last month meeting with Jim and "Miguel" on a regular basis and in the mean time trying my best to find him help.  Free HIV treatment exists in this country but how do I find information when I live in a remote mountain community without resources and things are just not organized and well advertised?

As I was pondering this question last week at my clinic in Corocito in walks a patient with well controlled HIV. Thank you Lord.  I cautiously breeched patient confidentiality (which doesn't exist) and found her incredibly willing to help "Miguel", including going with him to La Vega if needed.

Meanwhile time is ticking and "Miguel" is wandering the streets without food, family or even soap to bathe.  It would be so easy for him to slip into old ways to get money...stealing or robbing.  Yet he has restrained.  He is changed.

We made our first journey to the free public hospital in La Vega at the bottom of the mountain Tuesday afternoon and were disappointed to find that the HIV clinic is only open in the morning.  But thats ok, I think Jim and I both prepared ourselves for "un proceso."

Today we made the journey again.  And amidst the confusion and lack of organization, God provided an angel in the form of a happy Dominican woman with tinted red hair who has worked at the hospital for twenty years and took mercy on her two rubios and an Americano (if you can figure out which each of us is, I'd be greatly obliged!).

With Rosa's help we were given all the papers needed, taken to 4 different offices, quickly saw a referring doctor and were given an appointment with a specialist and for blood work next Friday.  All this before 10 am.  Gracias a Dios.

Jim and I found ourselves sitting with "Miguel" after returning to Jarabacoa in my office thanking the Lord.  For direction.  For help.  For an appointment.  For hope.  But mostly for "Miguel's" continued growth.

We than made an accountability plan.  If we are going to help "Miguel" with his medications and transportation he needs to meet us half way.  And so, today "Miguel's" life plan began.  We need to see church attendance.  Better hygiene.  Efforts to find a job.  It's time to live for a real life filled with a future and not just walking the line between life and death.

So join me.  Let's pray for "Miguel."  Pray that he won't stray from the Lord in his vulnerable state but continue to see the life he can have with Christ.  Pray that we can control his HIV.  That he can find a job and a house and his friends will no longer see him as a leper.  I want to see the change in him that I have had the opportunity to see in so many others; physically and spiritually.

I believe in a God who can work miracles.  Do you?

On Monday I received the call that Milagros was finally home from the hospital in Santo Domingo...2 weeks post-surgery.  The next day Mary Ellen (missionary in charge of hospitality at the base and Milagros's supervisor) and I loaded into my car and headed to her house.

I was surprised by how close Milagros lives; only a short drive up a dirt road behind the base....but it truly felt like a different world far more similar to the remote communities I visit in the mountains (like Angosto or Mata De Platano).

I am around poverty all the time.  My favorite patients live in scrap wood houses with cockroaches, lizards and rats scurrying in and out.  So, I was shocked at my internal reaction to her living conditions.

Milagros lives in a tiny house the size of an American living room partitioned into three spaces for a kitchen and two bedrooms.  The walls are made of moldy wood and plywood, the floors are hardened dirt and most of the time she has no electricity or running water.  A small outhouse is positioned behind her casa.

When Mary Ellen and I stepped out from my car; no bigger smile could have been seen. It was a little crooked with a large suture line at the posterior aspect of Milagros's cheek and tears flowing from her eyes as her tear ducts were affected by the surgery.  But nonetheless her cheeks were symmetrical...at last!!!  And that smile was so full of joy.  Her surgery was a success! Praise Jesus!

We sat with her in broken plastic chairs outside of her house amidst plantain trees and listened to her experience.  Milagros has been a very challenging patient since the beginning but The Lord has filled my heart with such overwhelming love for her.

Milagros stayed with her half brother in the capital.  He is quite poor and everyday looks for enough work to live.  Because of his quest for survival, Milagros was alone the day of surgery, while in the overcrowded hospital and while taking a taxi back to his house several days later.  Not one person visited her.

And now, here she is in her own small, hot house recuperating yet again alone.  She is not married, her two children work and the rest of her family are unsupportive.  How very different her experience looks than when most of us have surgery in a comfortable hospital with attentive nurses, supportive family and friends who cook and clean and transport us and then a comfortable house and bed to recuperate in.

Milagros fought for her surgery and she won.  She is doing great and she was able to get enough governmental assistance to afford her surgery.  But, the injustices of poverty in her situation are so overwhelming to me.  Does she not deserve the same as me?  Or you?  What is the difference in who we are? Our birth place? 

I am so thankful for all of your prayers for Milagros.  May you continue to pray for her healing and her next surgery as she also requires a full hysterectomy due to uterine fibroids that we're hoping will take place in August.

While I'm grateful for this small success, as I continue to be surrounded by innumerable injustices my quest for good health care, community development and that everyone may know the love and hope of Christ continues.  And don't you worry, I will be regularly visiting Milagros.

Pureza Retiro

This week I was blessed to have the opportunity to serve in a different capacity than normal.  Jess and Chelsie (leaders of Students International's women's sports site), Raul Canela (leader of our men's sport's site), Heidy (leader of our Los Higos social work site) and Jerry Cabot (youth pastor at my church) combined forces to put together a 3 day purity retreat for 60 Dominican Youth.  And so from Monday-Wednesday of this week, our base was filled with the laughter, joy and tears of youth from our communities.

Don't get me wrong, I love when we have American teens scampering around our grounds....but there was something so special about having the base filled with Dominicans.

The retreat focused on teaching the importance and value of marriage and glorifying the Lord with our minds, hearts and bodies.  The leaders got down and dirty as they tackled difficult questions and many of the youth had to confront broken images of family as marriage is not widely valued with many Dominicans.

Games were played, seminars were taught, testimonies were shared and  lastly the weekend terminated with a marriage ceremony in which we went through a mock wedding and the youth had the opportunity to "casate conmigo" or make intimate declarations of purity in front of their leaders, community and the Lord.

It was so much fun to be running behind the scenes and filling in the gaps and encouraging each participant as they took charge of such an important area of their lives that is so often overlooked in all societies.

Each girl was given a rose

The chapel at the base was all ready for a wedding!

The students signed a declaration with
various commitments

to be married with Christ :)

Raul prepping the guys for the importance of this decision

The girls all dressed up walking down the aisle

Each guy gave a girl a rose and escorted her to her seat

Waiting to walk down the aisle.  Yup that's Caroly my assistant
in the white!  She was a leader on the retreat.

Wedding Cupcakes!

60!

Heidy, Jess and Chelsie praying with each girl that
committed herself

The purity retreat was a great way to start Holy Week.  It was an amazing time to reflect the importance of giving up all of ourselves to the one who gave it all for us.

I hope and pray you have a wonderful Easter weekend and are reminded of the huge sacrifice made for all.  

Update: Milagros had her surgery (parotid gland tumor removal) in Santo Domingo yesterday.  I haven't heard how it went, but please continue to join me in praying for a safe and healthy recovery.

Patient Up Dates and Prayer Requests

I am so grateful for the prayers you send my way as I care for each and every patient.  Below is an update and further requests for four very special people that are near and dear to my heart.

Julian Hock

Julian is doing wonderfully.  He is a vibrant four year old with lots of energy, smiles and hugs.  If you remember, his mom Catalina was my Spanish teacher and is now on staff with Students International running our social work site in Los Higos.  Julian had a fractured left tibia which caused him an extreme medial deviation of that leg.  I am so excited to say that his deformity is almost completely healed after a rod was placed by missionary doctors in Santo Domingo in August 2012...only one month after my arrival to the DR!  He has a follow-up appointment in July at which point the orthopedist will determine when the rod needs to be taken out.  Please continue to pray for his healing.

Roseny

Roseny is my dear Haitian friend.  I met her over a year ago at the Haitian church I occasionally attend.  She speaks fairly decent Spanish and moved to Jarabacoa 12 years ago from Haiti to look for a better life.  She is a devout Christian and is continuously offering what little she has to her neighbors.  She volunteers her time on Wednesdays with me to translate for Haitians that do not speak Spanish, what an incredible blessing she is for me.  Roseny has 3 adorable sons and recently discovered she is yet again pregnant.  This is worrisome as she had pre-ecclampsia with her last child and has had uncontrolled Hypertension since.  She has seen a cardiologist and we are keeping a close watch on her...but she still has 7 months until her due date.  Please keep my friend close to your prayers and heart!

Milagros

We continue to pray for a miracle with Milagros as her surgery date is quickly approaching.  She continues to miss a lot of work and struggle with compliance, but we pray her diabetes and blood pressure will be controlled enough for her parotidectomy scheduled on April 14th.  Please continue to pray for her understanding and healing!

Juana

Juana's family has become my Dominican family.  She is standing next to her husband in the pink.  She has graciously opened her home to me and my students for multiple dinners.  Last year she was diagnosed with Stage 3 fatty liver disease...the stage before transplant.  This past week she has suffered a flare and was hospitalized.  We only have one gastroenterologist who comes to town once a week...I will be attending her meeting with him today.  Please pray that we are able to control the pain, bloating and fluid production that she is suffering and that she isn't progressing.


Thank you for being a part of my work in the Dominican.  Please let me know how I may better pray for each of you!

jOy!!

Today was an incredible day...not only did Rend Collective (my favorite Christian band) release their third album....

BUT

I met with Milagros and her meeting with the maxo-facial surgeon last week couldn't have gone better.  She brought her blood pressure and blood sugar records from our meetings and he APPROVED her for surgery!!

I attribute her new-found initiative and understanding to your prayers.  So thank you thank you for remembering her!!  If you could continue lifting her up; surgery is scheduled for April 14th.  :)

Milagros and I; you can see the 30mm Parotid gland
tumor on her left cheek

Also, pray for Milagros's continued depression.  I was ecstatic by the surgeon's approval, she however remains skeptical after so many failed surgical attempts previously; understandably so.  I will of course keep you updated!

Milagros, Keep Praying!

"Let them give thanks to the Lord for His unfailing love, and His wonderful deeds for mankind."

Psalm 107:15

Thursday as I was loading my car and getting ready to head out to Mata Gorda, I ran into Milagros.  She's back from the capitol, at last!

I must say, my initial reaction was frustration.  Here was this woman who only two months ago was crying out for help, desperately alone and needing her Christian family to surround her; yet when we did it appeared she didn't listen.  Milagros did what she felt best, regardless of the advice of those who know better.  Even when we firmly told her that it would be a waste of time and money to travel to Santo Domingo before her Hypertension and Diabetes were controlled, she went.

And then, in my frustration I started thinking and remembering the missionary training I endured two years ago at MTI and the chapter on "openness" I just finished reading from the book Cross-Cultural Servanthood and a conversation Sissy (the director's wife) and I recently had.  

I am serving in a pleasing culture.  A culture who at times will place themselves in a compromising position to honor relationships and to prevent hurt feelings.

Yes, Milagros took my advice.  And Betsy (the PT).  But, she also is taking the advice of her endocrinologist, cardiologist, gynecologist and facial-maxillary surgeon.  The last thing culturally she would want to do is let any of us down or un-fulfill her commitments.

Taking the advice of a multi-disciplinary team to an American sounds like an intelligent decision.  But, in a place where there is no correspondence between these providers (no progress notes, dictations, phone calls between specialists let alone electronic medical records) this can prove disorderly and detrimental to a patient.  Clearly, conversations need to be had to come together and decide a logical course of action for a case as complicated as Milagros.

And so, with all this in mind we decided to meet on Friday morning.  To say I went into that meeting a bit apprehensive is an understatement.  Milagros had gone to the capital to try and have two surgeries with completely uncontrolled blood pressure and blood sugar, no doctor in their right minds would operate.  She spent what little money she had and once again she missed work.  And, I had only spent three weeks with her which in my experience is not long enough to control her co-morbidities.

Imagine my surprise when I reviewed her medicine and I realized she was taking everything as I had prescribed.  When I asked about her symptoms (headaches, dizziness, pain) she said she felt the best she has in years.  And, when I checked her blood pressure....it was 130/80.  Completely suitable for surgery.

WOW!  Against all odds, Milagros is getting better.

Milagros was doing and listening and learning.  

And for that I thank you and our Lord and Saviour.  Because, trust me when I say this is a miracle.  A feat I was thinking impossible.

So, thank you for lifting her up in prayers and loving her from afar.  And don't stop!

Please, continue to pray for our relationship to grow, with trust and confidence.  That I may continue to be open to any cultural differences.  Pray for tomorrow when I check a fasting glucose and re-check her blood pressure that I can give her surgical clearance.  

And, most importantly, please pray that despite lack of communication between providers, that Milagros's appointment with her facial-maxillary surgeon on Wednesday will be fruitful.  I continue to hope for Milagros's life to be a miracle.  Join me in this petition.