We're Back!!

I am so pumped.

If I had known 2 years ago all the avenues God would open within our Community Health Site, I just would not have believed it.

Fernando and I have spent this week preparing for this year.  And as I have previously shared, it will be an eventful one.  Especially this next month!

Next week, we welcome Helena Duran (our previous intern and volunteer) and April Ether (a previous student) to our site.  That means our medical site literally doubles.  Fernando keeps insisting we are going to be more like a medical gang than anything else.  Watch out communities.  Ha.

Helena and I, during her
volunteer year

Helena just graduated from Boston University with a degree in Public Health!  She will spend 9 months as a long term volunteer with us.  Finally we will have someone who can focus on identifying and preventing community health problems!  We can't wait to see how God uses her fluency in Spanish, strong faith, love of Dominicans and education to impact our communities.

April when she came on an outreach
as a student in March 2012

April is a nurse from Michigan who will spend two months with us as a volunteer and then move to Jarabacoa as staff full time in January 2016!  We cannot wait to have a nurse with us that can increase patient relationships, do house visits, teaching sessions and preventative care.  We know God will use her passion for the Lord and His people to further His kingdom.

As we increase in size, it only seems natural that we should also increase our clinics.  And so, shortly I will leave for a meeting with a pastor in a new community, La Hoya.  And, next week we will have another meeting with a pastor in Majaguita (yes, the 276 steps down the side of a mountain community).

TWO NEW COMMUNITIES!!!

So please, join with me in prayer.  Prayers for Helena and April as Jarabacoa becomes their temporary home and they are trying to use the skills God has given them to help others.  Prayers for La Hoya and Majaguita.  That we may serve them well and develop deep relationships as we have been so blessed to do in other communities.

2015....here we come!!

Praying with patients in Mata Gorda

Dar Gracias

On Friday December 19th I once again found myself in Union station, DC watching commuters pass by.  I was waiting for my 12:00 train to Philly where my Dad would pick me up and we would head on to NY.

I had just spent that past week on "vacation."  I left Jarabacoa Friday December 12th and since then had been traveling all over the greater DC area....spending the weekend with PA school friends, then heading up to Delaware for a couple days with my old roommate and finally staying with a dear high school friend in Silver Springs.

And gosh what a sweet time that was.  I haven't spent endless hours with these friends since I moved two and a half years ago.  It was incredibly therapeutic to just sit with them, laugh until tears rolled down our cheeks and share in their jobs, engagements, relationships and lives.  I am so proud of their medical and professional accomplishments.

And as I sat and shared life with them, a huge part of me longed to work beside them as a colleague.  To practice American medicine.  To have weekend barbecues. To see my family often.  To own a house.  Plan a wedding.  Be expecting a baby.  To travel.

Almost three years ago, in missionary training school, they said from now on we would always have a divided heart.  We would have two homes.  A foot here and a foot there.

And for a long time I couldn't relate to that, I didn't feel like I fit in either place.  A year after I left NY it didn't feel familiar.....yet neither did the Dominican.

Now, I can go back and forth fairly easily without major culture shock but complete love and appreciation of both places...the good and the bad.

So in my divided, dichotomous state with love for community health internationally but also American medicine; living cross-culturally but also comfortably in the states; living an adventurous life but wanting to settle; following Christ over seas but also wanting to spread the gospel in the states...where am I left?

During my time at home I have found a new love for our country.  For the professional opportunities, a future family,  the seasons (ok so I've always loved autumn), the American people; but mostly sharing the love of Christ stateside.

Lets be clear...No, it is not time to leave the DR.  

I know I still have much to do.  But how cool to know that God is growing love in my heart for my own culture.  Which can only mean someday he will call me home....

But until then... he has given me awesome opportunities to combine the DR and NY as my Dominican family came to Queens for Christmas this year!  And so on Monday I found myself a tour guide of the subway, Rockefeller Center, Times Square, the Marriot Marquis and Bryant Park.  How surreal not 5 years later after living there to be sharing "my city," in Spanish with people who mean so much to me.  I was so grateful for that gift.

And as I look to 2015, I am still excited to be living in the Dominican...there is SO much more to come in Jarabacoa!!

~Fernando and I have been asked to help a Dominican Physician open a new community health site in Santiago (the city!) with SI.  

~We are looking to open a new clinic in a rural community called Mahaguita...only 276 steps down a mountain side.  

~We will also welcome a new Dominican Assistant to help us (that will make 3!) who like Caroly and Shaki is in medical/dental school.  

~And we have 2 American nurses (Katie and April) and a public health worker (Helena, my previous intern!) coming on staff with us full time.  

Plus...we will continue to welcome students, interns and volunteers to walk beside us as we venture out into our communities and serve both Haitians and Dominicans.

So thank you.  For being interested in my work.  For supporting me.  For praying for me.  But mostly, for caring about the future of my patients and friends in the DR.

I wish you only the absolute merriest and happiest of Christmas and new years.

Love,

Rachel

We've been shut down!

.........ok I'm being just a tad bit dramatic....BUT

This awesome new rural clinic in Limonal has

Replaced our clinic site in Mata Gorda.

AND!!!!  I couldn't be happier!!!

As I head out to my communities I often find myself thinking about what my long term hope would be for my six clinics that are so near and dear to my heart.

Well, in Mata Gorda that hope has turned into a reality.  

Allow me to explain.  Throughout the DR you can find sporadic government funded rural clinics called Poli Clinicas.  They are staffed by residents and attending physicians.  Kind of the governments way of taking care of the poor.  They serve as primary care centers, vaccination hubs and urgent care sites.  They are free to all (even my Haitians!) and also offer medicine.  Many times they are short on medicine due to inadequate funding but for the most part they function quite well.  

Patients in Angosto, Corocito, Mata de Platano, Sabaneta, Buenos Aire or Mata Gorda have never been blessed by one of these medical centers....until now!!

So join me with excitement!  Mata Gorda now has a clinic open to them 24/7 to help provide regular and emergent medical care....run by Dominicans!!!

When Fernando and I decided that this was the solution to this community's health needs we also had to think of the ministry aspect.  I can confidently say that many of the spiritual needs of Mata Gorda are being met by a new social work site started by an SI missionary Yohana and a new church plant by her husband Andres.

I don't think there is anything more beautiful from a community development/missionary stand point than seeing a government trying to meet the needs of the poorest of its people and churches being planted and grown....times they are a changin.  And man would I like to see that happen in all my communities.

But, until then....Fernando, Caroly, Shaki, our students and I will keep seeing patients, sharing the gospel and now looking for a new community to fill in our schedule.

Stay tuned... 

I didn't know they were hungry...

Where do we draw the line between "When Helping Hurts" and Christ's mandate to give all to the poor?

I find myself pondering this question a lot these past few days.  The new shift in missions is towards accountability, to being met halfway by the people we are serving and icks-naying free hand outs.  

For the most part.

I agree with this ideology.  We (people in general) have unintentionally ruined relationships by giving of our own volition creating a hazardous dependency in which once we (the provider) have been removed from a situation the receiver fails to stand on their own two feet.

The new mission model has created a beautiful partnership.  And, as someone who uses this model daily, it works.  My patients have dignity and our relationships have freedom without the weight of dependence.

But.  Then I was confronted with a new situation.

Last week, I went to visit a patient whom I see weekly.  We always arrive at her house in the afternoons, after meal time.  I knew her family was poor.  I knew 6 of them lived in one small room.  I knew her husband hasn't had work for 5 months.  But, I guess I didn't understand how that translated into their day to day living.

This family is hungry. 

They are not eating daily.  And when I ask, they already feel like I've done so much for them, and so they lie.  

This brought to fore front my previous question.  In the New Testament Christ makes it obvious that we are to give to the poor.  Most notably in Luke 12:33 

"Sell your possessions and give to the poor."

But how much?  I could feasibly drop off food every week and help them with gas and electricity....they are used to living on such a low standard of living I'm sure they could survive on $100/month.  And I could probably cut back on my own lifestyle and afford to help them, but would that be healthy?  Probably not on either side.  But they are hungry and are more than just faces to me, they are friends.  And so of course I want to help.  

But how much giving is too much?  Not enough?  Where do we as Christians find that healthy, Christ-mandated balance?

In this circumstance, Fernando and I have begun looking and praying for a job for the husband.  Of course in many circumstances in an impoverished country work is the key to many financial hardships.  But what if that doesn't happen?  In the DR, unemployment rates are high.  Especially for Haitians.  Will dropping off a bag of rice and beans every week damage our friendship?  Or do I let my friends go hungry?

Please join me in praying for this ethical dilemma.  I trust "what would Jesus do" to help guide me....so help me find....what would He do?

Dr. Fernando reviewing anatomy with our medical assistant
Caroly in our clinic in Angosto

Bienvenidos, little one!

I have the most incredible job.

We're still waiting to find out her name!

I wasn't really looking forward to this weekend.  I had no plans except church on Sunday.  Which makes for the fourth weekend in a row without a concrete activity.  Since returning to the DR I have found I crave this chill time...but this weekend I was finally ready to resume my faster pace of living.

And so, I wasn't disappointed when I received a call at 6:30 am from Dr. Fernando at the local clinic that my dear sister/patient/friend Rosne was in labor and therefore we would be performing her c-section unexpectedly early.

So that is how I spent my mañana...

Praying with my dear Rosne as she was prepped for her ceserea.  I held her hand in the OR as the anesthesiologist gave her an epidural.  I cringed as I saw that her blood pressure was high (160/110) despite my more than weekly visits to her house and provision of Methyldopa.  I thanked the Lord that we decided to have her deliver at the private clinic where she would get good care as opposed to the public hospital where my dear friend would be treated as a number and her high blood pressure not as closely monitored.  I heard the cry of her newborn daughter as she was brought into this world.  I watched the expert hands of Fernando perform a tubal ligation and suture her abdomen closed.

And this afternoon...I rejoiced with Rosne as she finally had her baby girl.  And I now have a sweet Haitian god daughter.

Me and my goddaughter :)

So from the bottom of my heart, and Rosne's (she made me to promise to share with you), thank you. For your prayers.  Your concern. And your love.

Caroly (my assistant), Rosne and her baby!

Imperfection?

I passed.  In so many ways I feel as light as a butterfly.  I don't need to worry about medical tests or boards for 10 years.

But through my studying and preparations I saw how ugly my heart can be.  As PAs we have more than one opportunity to take our boards...I think it may be something like five times.  But, due to my incredibly public life, taking my exam didn't just slip under the radar like other PAs.  No I had to apply for a leave from my international job, fly home, study and take the test.  Without any board preparation.

And yet, my greatest concern wasn't that I pass for myself or my patients, but that I wouldn't have to admit to seemingly the entire world that I failed.  My supporters who believe in my skills and my patients who are receptors of my knowledge.

I also realized how much of my identity is in grades and doing well in things.  Ugly.  I was so confronted with this reality that I was almost positive that I would fail so that I needed to admit to the world imperfection.

But then, that is not the God we serve.  We serve a God who honors His call on our lives.  And provides us with the resources needed to do that.  For me, my license.

And so, I thank Him.  For carrying me when I was tired.  For helping information to permeate into my brain and then allowing me to retrieve it when needed.  And for continuing to shape my flaws.  My ugliness.  And any part of my identity that fails to be focused on Him alone.

Once again....I am always learning....

buh bye 20s

I do not want to turn 30.  I am kicking and screaming each day that is leading to September 8.  And yet despite my search for the fountain of youth the days keep coming.

Why am I so resistant?

Anyone who knows me knows how much I usually love birthdays.  Each year growing up, my poor mom had the difficult task of trying to live up to my unrealistic birthday expectations.  I have always thought life deserved to be celebrated, and greatly.

When I moved to the DR at age 27 I thought of how I would be turning 30 during my time abroad and what that would look like.

As I have been incredibly challenged this summer, I have found my thoughts drifting negatively to 30 and to what I am lacking.  Instead of thanking The Lord for the incredible gifts and opportunities I have been given; I have focused on exhaustion, heat & humidity and missing the comforts found in America.

I am ashamed that in my trials; struggles have been whispered into my ears and taken root in my thoughts.  Lies of inadequacy, of the sacrifices of following Christ, of no longer fitting into my home culture, of if I would ever fit into America again, of what good am I really doing in the DR.

My thoughts have focused on the abundance of engagements, weddings and pregnancies that continue to bless my dear friends and yet I continue to serve The Lord solo.

I don't share this for a pity party.  I share this as a reality of the struggles of being tired and on the mission field.

This past month as I have been cramming for my boards, I have had more time alone than in years.  And that is when 30 has even more become this horrifying age of what society tells me I should have but so clearly lack.

I don't have a high paying job.  I don't own a house.  I don't have a husband.  I don't have children.

As my laments became stronger and stronger this month, I had the opportunity to go away for a weekend.  To celebrate my roommate as she moves back to the states.  To be in air conditioning away from the heat.  To eat a variety of vegetarian foods (I was even becoming sick of rice and beans....the tragedy!!!).  To sleep.

And to spend time alone with The Lord.  When am I going to learn that is always what is needed? Always (see missionaries are far from having anything figured out).

When I was living in NYC 5 years ago; I had money, I dated a lot and had a prestigious job.  I was living our societal ideation of success.

But I lacked purpose.  Fulfillment.  Meaning.

I lacked Christ.

During my time alone with Jesus at the beach, he lead me to 2 Corinthians 16-18 which reads:

"Therefore we do not lose heart.  Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all.  So we fix our eyes not on what is seen, but on what is unseen.  For what is seen is temporary, but what is unseen is eternal."

As I pondered these verses, I reflected...

I may not have societal successes but...

I have CHRIST!!! In a post-modern world I have a relationship with the creator of the university and He has chosen me to follow HIM!

I have an adventurous life in the DR.  I have an incredible Christian community who sharpens and grows my faith on the regular.  I have countless friends all over the world.  I have the privilege of paving the way in medical missions, teaching nursing students, tackling the tropical disease Chikungunya and sharing the love of Christ.  I am living my passion.  All the time.

So, Rachel, what is 30?  What does it matter the earthly things we are lacking when we as Christians are looking toward our eternity.

I still struggle with turning 30.  I know age may always be difficult as the future continues to close in.

But, I am so grateful to be reminded of the choice to be thankful.  Just like we daily choose to follow Christ, I can also daily choose to look at the incredible path that has been paved for me.  That hopefully glorifies God and forever impacts those I work with.

My life is so full.

What is a number anyways?