Tuesday, November 25, 2014

social media.

my maternity leave came and went in a glance - i head back to work tomorrow.

i was mainly in my house, taking care of my family and haven't really had anything very interesting to share on the blog. i hope that will change once i am back en la calle (in the streets) every day with fun things to see.

despite not having blog worthy content, i am pretty active on the instagram under @girlinthedr, or just click on the little camera box there.


Instagram

you can find me there, and under the hashtags #adayinmydominicanlife and #islandliving. If you're interested in pictures from Futuro Lleno de Esperanza, you can find those under the hashtag #futurollenodeesperanza.


Thursday, October 30, 2014

dude, where's the driver?

I have been a terrible photographer lately - I used to travel with a smart phone in hand to snap pictures of the random things I'd see around town. I've caught overloaded motorcycles, car accidents and funny clothes worth of "what not to wear." I've gotten plenty of funny house-moving trucks, overloaded with furniture and often with someone sitting in a lazy chair on the top.

Of course, whenever I don't have my camera ready, I see the best things - once, there was a truck transporting corn-grains (not on the cob) and the trap door open, emptying the corn onto the highway. There were people with bags, buckets, cans all collecting their free corn.

Sometimes, though, things are so common place that I don't even think to take a picture to share with you, readers. I'm sorry. I've been here so long that I just forget that somethings are novel to the rest of the world.

Last week, I was sick. My fever, at one point, hit 103.9 and I knew I needed to go to the doctor's office. I couldn't go by myself - for two reasons: 1) I had to take the baby since he doesn't drink from a bottle yet, and I didn't know how long I'd be gone and 2) I was kind of delirious. The fever had me loopy and I didn't want to do anything ridiculous in the street. So, my dear, sweet friend Andrea offered to come with me. Added bonus? She's just about to graduate from medical school. If anyone can handle my hypochondria, it's her.

After me dawdling around and trying to avoid the doctor, we finally got out of the house and into a public car. We thought it would be smooth sailing since it was 10 am, but in front of the free zone, the traffic stopped. It was like a parking lot - which is not normal at any hour. We notice a large group of people in front of the police headquarters - police and civilians alike, in some sort of altercation.

Finally, the traffic started to crawl past.

We're not sure if the jam was caused by the rubber-necking to see conflict with the police or if it was caused by this public car.

Abandoned by it's driver, completely filled with paying customers. IN THE MIDDLE OF THE ROAD.

It's the little things, folks. I thought i was hallucinating, but no. This car was chauffer-less.

Wednesday, October 29, 2014

Baby-brain eating witches.

Right now, Adiel is outside with his two uncles and a cousin. Amely is running in and out, and Samil went to the corner store, colmado,  to buy some yucca for dinner. I'm trying to get some work done (obviously. That's why I'm writing a blog post).

It's dusk. So, that's dangerous, and I shouldn't even allow the baby to be outside. In fact, the cousin was concerned when she picked up the baby and said she was going outside.

"Eh, this is okay, right? He's not going to get sick, right? I can take him with me, right?"

It's very important not to take your children outside after dark - and I've come to realize that the witching hour is the worst. The northern wind blowing from the sea can really do a number on the baby's digestive system - everything from the pujo to the green poop. And, since we're such bad parents and have neither put  azavaches -charms- nor bracelets to protect our kids from such things, I have to be really careful about green poop.

You may remember our community witch, Luisa. I hadn't seen her in awhile, but the other day I took the baby to school with me. I had a bunch of things to do (like hand out Student of the Month certificates and eat candy), and the students were bugging to meet Adiel.

Luisa showed up.

She looked at the baby carefully, but never asked to carry him. "Oh, he's so big, God bless him." "Oh, he's so handsome, God bless him." "Oh, look at that hair, God bless him." I think she could tell I was getting frustrated with her accolades for things that we really have no control over, so she decided to explain to me. "If I don't say God bless him, you will think I'm jealous and trying to give him the mal de ojo - evil eye. And I know what people say about me around here."

She finally reached out her hand to touch the baby. She grabbed his ankle, and then his wrist and wanted to know why he had no protection. I thought she meant socks. Silly me. She meant protection from curses - protection from the people who do not follow every compliment with "God bless him," because they are, obviously, trying to give the baby mal de ojo. "You need to get this baby santiguado right away, he has no protection! You need to go to someone who knows about this and have the prayers said over him!"

Luisa then asked me if we had "thrown water" on the baby - a home baptism of sorts, an added layer of protection. We haven't. And we didn't "throw water" on our other babies either, so I think we're okay. But, Luisa is sure we need to do something because we haven't done anything. Do we know the danger we're putting our children in by not protecting them from brain-eating witches? Surely I didn't know, you know as a foreigner, the absolute terror of having the local witch swoop down and suck the brains right out of my baby's head during the night.

There are a lot of things to worry about with a baby. Is he clean? Is he healthy? Is he sleeping too much? Not enough? What's that lump on his head? Is it too hot to go out? Is it too cold to go out? Is the crazy northern wind going to give my baby the bad poops?

I'm not sure that Luisa got the irony of her, the renowned community witch who tap-dances on roof tops, giving me advice to protect the baby from... well, from the community witch. But I like her, she's an eccentric old woman who seems to want to protect people around her. God bless her heart.

Thursday, October 16, 2014

Diez.

April, 2005.
In the Episcopal Church, children are confirmed somewhere between the ages of seven and ten - or, at least, when I was confirmed, that's what it was. You spend weeks learning about the faith with other similarly aged children, learning the Lord's Prayer and the Nicene Creed and what happens during mass and why. If you're really lucky, Mary Wood will teach you about everything on the altar and the different vestments. (But, let's be honest, if you're really lucky at all you get a Mary Wood, "Mean," in your life at all). And you get a Mrs. Knapp to teach you the rest. That is luck.

At the end, you get to wear a pretty dress - mine was pink, if I recall correctly - and the bishop comes to your church. You say all of the things you've learned and the bishop smacks you. Or at least that's how the story goes. Our bishop had a pretty strong reputation for smacking. I'm pretty sure that he didn't smack us.

When I arrived to the Dominican Republic ten years and one day ago, I was living in an apartment on the third floor of a church. Like, I had to walk through the sanctuary to get in if I forgot the side key, and even with the side key, I was walking right by the altar to get in. There was nothing, nothing, in my confirmation classes that could prepare me for living and working in the Dominican Republic under the auspices of the church. I had prepared the best I could, but to be completely sincere, the whole experience was a smack in the face. **

I don't mean that to be negative. At least at confirmation we were expecting a slap.
I had no idea what a ride I was in for.

Ten years and one day ago, I arrived to Santiago, eyes wide and wonderous. I had a plan. I had a job. I was here temporarily. Ten months and out. Maybe, just maybe, I'd give it two years. There was a lot of work to be done after all.

Ten months turned into ten years, and here we are.

There have been ups and downs. It's been happy and heartbreakingly lonely. I've been self-employed and have worked for the "most prestigious" university on the island. We've celebrated all of the virgin-protector-saints of the island and American Thanksgiving. We've gained friends and lost friends. I learned how to frieve from afar, and how to mourn up close. I've learned to trust in friends and family and who my friends and family truly are.

One marriage. Three kids. Two dogs and what seems like a million chickens later, I am still here.
Three apartments and one house, two cars (and only one terrible accident), ten years has been, overall, good.

The good has outweighed the bad. The happiness has outweighed the sorrow.
But I've learned that without the bad, there is no appreciation for the good and without the sorrow, happiness is hollow.

I don't know where the next ten years will land me, but I'm thankful for the past ten and hope to learn and grow just as much in the future.

Cheers! Salud! To life! To the island!

--------------------------------------------------------------------------------------
** my dear, dear friend, Father Rafael de la Cruz has since been interred in the sanctuary of that church. It's been a few short weeks since his death and I miss him and his presence in my life. Still, I'm not sure how I'd feel living in that apartment with someone buried in the church.

***** a few pictures from my first year in Santiago - top: me and two kids (I think the girl is Rosy) during one of the camps that happened; middle: Noemi and Ruth and their dear parents Jose and Maria threw me a little birthday celebration. It is, to date, one of the best I ever had; last; a mission group from St. Peter's Church in Florida, The three little girls are the children of the priest who were my little lights of joy. Of that group,

Wednesday, October 15, 2014

Typhoid Mary

As an American - raised in a country where certain illnesses have been eradicated and medication has done a great job at squelching others - there are some words that make my skin crawl. Scabies. Ringworm. Scurvvy.  Some words scare me. Tuberculosis. Leprosy. Cholera. Typhoid.

I never in my life imagined that the creepy-crawlies affected people in real life. Scurvy? That's for pirates. Leprosy? Biblical. Tuberculosis? Doesn't happen anymore.

There is no "prick-test" for TB in the DR. I guess it is assumed that most people have been exposed at some point to TB, so the standard is a chest x-ray. There are still tuberculosis wards in public hospitals.

In my ten years here, I have witnessed - but luckily have not been infected with - outbreaks of both measles and mumps. The entire country was re-vaccinated for rubella (german measles) and for tetanus in the past three years.

I had scabies once. And a really crazy rash on my stomach - one which local folk-belief says is a worm that spreads only around your waist. If it makes it all the way, you'll die. So, in order to prevent your (imminent) death, you draw a circle around each outbreak and separate each outbreak by drawing a cross in between each circle. And pray. A lot. Because you could die.

Speaking of prayer, we prayed through the cholera epidemic. The dengue fever outbreaks and the chikungunya.

These diseases are not extinct. We have not eradicated them.
Sometimes, though, I forget that. It's been awhile since some medical term popped up in the news that made me, a developed-world native, freak. This week though, Samil has had a fever. It wasn't terribly high, but it wouldn't go away - not with cold water showers, acetometaphen or ibuprofen. So, he was taken to the ER to get blood tests done and a shot to bring down his fever.

The doctor has diagnosed him with typhoid fever. La fiebre tifoide.
I laughed when they sprung out that word. Surely typhoid does not exist anymore. It has been wiped out with vaccines and medications and such. None of our family thought it was funny. Apparently typhoid is serious, especially if not treated with strong antibiotics.
Antibiotics were prescribed and Samil's fever went down. I'm actually pretty confident that he did not have typhoid, but when I think about it, it's better safe than sorry. His fever was consistent, and there was some alteration in his blood test to indicate infection. He's better now, but many children are not. People still die from typhoid. Still. I laughed because, for me, it is non-existant. I mean, who has hear of a case of typhoid?

But. Who had heard of active cases of cholera so close to home until cholera hit Haiti and we were cast into the times of love in the times of cholera.

Even after ten years (today!), it's easy to forget that the rules of childhood health and wellness are different here. It is so comfortable to pretend that we all have the same access to health care and medications to cure these things.

Luckily, and thankfully, Samil is fine. He's playing a baseball game on the computer with his uncle and happy as a clam that he didn't have to go to school these past three days!

Tuesday, October 7, 2014

on socks and hats. (part 1)

This one is for you, Fiona!

Today, I was in the grocery store. Adiel and I had just enjoyed a nice lunch with our friend Deborah - who Amely calls, "my french teacher, mommy" - and I needed to replenish our pantry.
our house is filled with newborns lately - chicks and ducks!
lucky animals don't have any rules to follow!

This particular grocery store is more like a super Wal*Mart: food downstairs, everything else upstairs.  I had the baby in my mei-tei carrier, snuggled up like a bug and sleeping. Snoring, even. We went upstairs to get some felt-tip pens and foam balls (random, I know) and look at Christmas. (Never mind that it is 800 degrees in the Dominican Republic and that I wake up either shivering from the night time dip in temperature to 793 degrees or bathed in sweat from the night time rise in temperature. )

We took the elevator downstairs, I grabbed one of the carts with an infant seat and stuck the baby in there. Of course he woke up - and was as happy as a goose. As I picked out some red peppers, I sense someone staring. I've got a cute baby, so it happens. Even still, I try to avoid contact because this is what happens:

Random shopper woman (RSW): "You know what's wrong with him? He's cold!"
I look at the baby, who is obviously not unhappy nor uncomfortable. I ignore the woman.
RSW: "Hey! Did you hear me? Cover him up, he's cold."
Me: "I don't think he's cold, I think he's okay."
I usually try to be nice at first, especially if the person is older. (Unless you catch me off guard, then you get a sharp-tongued response. EVERY.SINGLE.TIME)
RSW: "Newborns can't regulate their temperature. He's cold."
I walk away. Pick up some tomatoes. I thought she had also gone to another aisle, but she back-tracked to tell me, again, that my baby was cold and should be wearing a hat and socks.

Did you hear that? A hat and socks in this heat! That's not even mentioning the heavy fleece blankets I got as gifts when he was born because we didn't have one. We didn't have one because we live in the Caribbean! (Disclaimer: we do have two lovely fleece blankets. They are in the bottom of a storage bin waiting for the six days in December that it might get chilly enough to use them, or the visit to a resort or other thoroughly air conditioned place)
brand new baby. complete with hat and
blanket. (to be fair, the air conditioning was
fierce in the hospital).

I am now cleared to wash my hair and take showers, which , at first glance, seems like the worst of the post-partum is over. Unfortunately, just because I'm clear, obviously doesn't mean that baby is in the clear. Instead of getting yelled at about my body, I'm getting snarky commentary and unsolicited advice from random strangers on the street.

My friend Kelsey thought I was exaggerating, until we were walking into a (different) super market the other day. I had the baby in his carrier and this woman walks up behind us, makes no eye contact and says "Oh my, poor little guy is HOT!" Adiel was, in this instance, sleeping. He may have been hot, but was not uncomfortably so - or any more uncomfortable than any other person walking around in the Caribbean sun! She caught me off guard, and so I kind of yelled at her. Oops.

The idea that there is always something wrong bothers me. Baby in the super market is cooing and staring at the lights, no signs of distress at all, but he must be cold. Baby is sleeping in his carrier, but he must be hot. It is a commonly held belief that newborns cannot regulate their temperature at all and therefore must be wrapped in a blanket, hat (and socks!) at all times. In fact, when I left the hospital, we were chided by the nurses into putting a hat on the baby's head (along with his long sleeved, footy sleeper). By the time we got home, he had a fever and he had to go right back to the hospital to make sure he was okay. (He's been living in onesies ever since).

As I mentioned, I carry (and have carried the other two) baby in a mei-tei carrier. I have a structured carrier for when he's bigger, and I was known to carry Amely on my back with a modified bed sheet. You would think that I was killing my child. A carrier will make a child bow-legged with scoliosis and attachment issues.

But! A stroller is no better because a baby's head will flop around and the hot sun will burn his eyes. You should, after all, keep a baby in the house at all times. Except, maybe, in the case of emergencies. If baby's head does flop because of irresponsible stroller usage, numerous people on the street - including children - will try to persuade you to "fix" the head. It's hard, because if a baby is comfortable, chances are his head will go right back to the same position.

Most of this is just nerve-grating - especially because this isn't my first baby, and while I will take all of the help I can get, I'm not really up for unsolicited craziness. Some of the other beliefs for newborns are:

- Babies can't go outside at night because the sereno or night air will make them sick. Mostly the sereno sickness is green poop and pujo - baby constipation. (Just tonight, Amalio put a blanket (a blanket!) over the baby to carry him outside at night so the neighbors wouldn't criticize him for being outside with a baby, at night. Then he wanted to know why the baby smelled like baby-sweat.
oh, (almost) naked baby. in a cloth diaper
(but that's another post for another day!)

- If you hang the baby clothes on the line at the wrong time of day (or during the wrong type of wind) it will cause some sort of problem when the baby wears the clothes.

- If a baby has hiccups:
   1) put a piece of red thread on baby's forehead and wish the hiccups to his padrino (god-father)
   2) give the baby water (because milk, apparently, doesn't work for hiccups).

- You also give a baby water to quench his thirst. And there are special "teas" for different baby ailments. The only one that I know is a double-oregano tea for diarrhea (and I know that it works wonders on adults, but is probably not too great for a baby).

- Baby cannot sleep in bed with parents because the body heat will kill the baby. (This one is interesting for me because I've never really heard of a case of SIDS here and overheating is thought to be maybe one of many causes for SIDS.)

- While I haven't really heard of a confirmed SIDS death, I have heard of witches eating baby brains in the night. When the witch eats the brain, baby dies and the doctors just don't know why.

I'm going to leave it at that for now.

Saturday, October 4, 2014

"El Desarreglo"

When my doctor came to my hospital room to give me my last check-up before I went home, he removed the dressing from my incision, asked me about my milk supply and told me, "Go home and wash your hair. You have my permission to wash your hair. You're a sweaty mess."

The nurse looked at me with a "don't you dare" care-bear stare and I felt like I was stuck in the middle of a really contentious cultural battle. Whose advice do I take? The doctor who I trust and respect? Or the nurse, who I don't know and haven't ever met before?

I had taken a shower the day before - IV bag hanging from a hook in the shower especially designed for that, in a room that, as far as I know, has always been a maternity room. The nurse told me that I needed to take a shower, so I did. It was fast and cold and I didn't wash my head, but I had immersed myself in water. I would have done it even if she didn't tell me to; I was dirty and sweaty and gross.

I wasn't, however, surprised when a friend arrived minutes after my shower and freaked out.

FREAKED. OUT.

I was surely going to get an infection, and if I got sick it would be the kind of sick that doctors don't know anything about** and OMG what was I thinking. And on top of it all, I was in the room with air conditioning and it was cold! I just took a cold shower in a cold room and seriously.

You see, the rules of newborns do not only apply to the newborn. There are more rules, even, that apply to the mom. Generally speaking, nobody can leave the house or lift a finger for six weeks post-partum. The only thing that can be lifted is your baby, and even that is iffy.

The rules are not exclusive to Dominicans - there are similar rules in most of Latin America and even Asia. (My Korean friends were also shocked that there was air conditioning in my hospital room, as cold air is thought to be terrible for a new mom, and in Korea women are not even allowed to have visitors in the hospital for five days.) A new mom is supposed to be very careful - guardar el riesgo - for about 40 days. Anything that is done outside of the rules, can cause a desarreglo and then you're in for it.

Being careful includes not being cold. You might see a Dominican mama in a sweat suit and wool cap in August. August in the Dominican Republic. It includes not showering for several days after birth, and even when showering is acceptable, washing the head is not. Hair washing cannot happen for six weeks. One cannot go outside at night, or even open windows or use a fan because the sereno, or night air, will cause complications. A new mother cannot lift anything, wash anything or participate in regular household duties (except of course when it is convenient or beneficial to the other members of the family - the rules only apply sometimes)

I am just about out of the risky stage and will be expected to get back to my normal life (with a new baby!) in a few days (though, the doc has already given me the all-clear). I still have a year of baby advice and rules to "follow," but I'm really trying to take it all lightly and not get too upset by los entremetidos - the people who want to tell me what to do all the time!

--------------------------------------------------------------------------------------------
**While (many) Dominicans tend to trust medical professionals more blindly than (many) North Americans do, there is a underlying system of belief in the supernatural that often negates a doctor's authority. The most common problems are caused by mal de ojo - a curse of sorts - and a doctor's knowledge is not apt for mal de ojo. You must go to a bruja or someone who does ensalmes (praying over the body, in the name of "saints" and spirits) to be cured of mal de ojo. Some of the more mentioned problems caused by curses are empaches (which cause digestive issues) and fertility issues. 

Friday, September 26, 2014

Budgets. (an opportunity to help!)

I love my job. It is stressful and crazy and sometimes irritating, but in the end, I konow that I'm doing something worthwhile. The best part has been that I'm not really responsible for "maintaining" our projects - I can't fundraise a dime to save my life - and I have a really hard time with the missionary culture of personal fundraising, so my salary helps me live within my means and not go overboard. (But that is probably a conversation we should have over coffee and not a monologue I should have on my blog).

Futuro Lleno de Esperanza has grown so much - three years ago we started with 23 kids. We now have 100, plus programs going on to enrich education in the whole community. The building of a new public school have us re-structuring to meet the needs of our people, but it's clear that FLE is really a benefit to our little piece of the world.

Whenever I think that we aren't doing a good job, or we aren't doing enough, I get reminded that even the little things make an impact.

Because of our growth, we are a little short on the budget for this calendar year. It's a seemingly irrelevant amount of money, but $900 we're short is needed to cover a ton of expenses.


Nine hundred dollars could check off any of the following list items in our budget:
1 month of teacher salaries
3 months of medical insurance for the entire staff
3 months of paid maternity leave for pre-school teacher and her substitute 
6 months of specialty classes (karate, art)
50 school day lunches
69 days of nutritional snack
So, as much as I hate fundraising, and I've said it here before that I hate using the blog to ask for help (I just hate asking for help, period).  We are  running an indiegogo campaign to try to raise the last few bucks that we need, and I'm asking you, blog readers and friends of the Dominican Republic, to consider donating a few (or many) dollars to help us continue offering quality, innovative education to a community in need. Your money will be put to good use, and every last cent that we receive (there are fees for the indiegogo campaign) will go directly to Colegio Futuro Lleno de Esperanza's school programs in Cienfuegos, Santiago! 

Thursday, September 25, 2014

This is the way we wash our clothes.

Santiago is experiencing a severe drought. It hasn't rained enough in months, and now we are feeling the effects of it here in the city. There is a lot to say about poor service management at the reservoir and wasteful habits of citizens, but it is too late really to fix those problems - we're in crisis mode now and the only thing that can really help is to get enough rain to start refilling the reservoir (in collaboration, of course, with water conservation education and a better water-distribution plan).

We started to feel the effects of the drought in May when the water supply for school was altered and we began to receive water two days a week instead of four. We felt it at the house in July when our 2,500 gallon cistern, a cistern that had only been less than half full when we moved in and when it was being cleaned, started to slowly empty. With as many people in and out of the house as we had this summer, it was drastic. We had to take measures to conserve the little bit of water we had left - we turned off the pump, took bucket showers and let the beautiful, lush green grass die a sad and thirsty death.

When the kids and I arrived home from vacation in the States, the cistern was still empty and there wasn't much hope that it would be full anytime soon. There was enough water every morning to refill what we had used the day before, but washing clothes in my wonderful automatic washing machine was just too much. We had to start washing Dominican-style.
(disclaimer: I was still washing sheets and towels in the automatic washer until it shorted out on me a few weeks ago, they're a pain to wash basically by hand. The automatic washer is not fixed, but still on limited use) 
The Dominican washer is a double barrel - one for washing, and one for spin-drying. The washing side gets filled with water, a little detergent and is set to "agitate" for 0-15 minutes. Theoretically after this step, you would wring (yes, hand-wring) the clothes and throw them in the spinner.

Our spinner is broken.
Of course it is.

So, we hand-wring a little harder and throw the clothes into a bucket of fabric softener water, hand wring again and then throw them into the clean water bucket for a last "rinse". After the clean water "rinse," the clothes get wrung out as best we can, and then hung on the line. On a good, sunny day, the clothes take an hour or two to dry - IF they went through the spinner. Hand-wringing is not nearly as effective and it feels like clothes are on the line for day. 
To be very honest, I hate (detest, abhor) washing clothes this way. It is a lot of work, especially when I have a *real* washing machine sitting silently next to me while I wring out underwear. But, I've come to the decision that it is important to teach the kids by example the importance of saving water - and hard work. Samil and Amely have always helped with the laundry process (in age-appropriate ways), but now that they are more involved, I see they (read: Amely) have really cut down on the costume-changes through out the day. 
Adiel started using cloth diapers this week, and washing diapers is a hassle even with an automatic washer. Knowing our water and washing situation, I researched and found a "hand-wash" tutorial for cloth that includes stomping the (pre-rinsed, not poopy) diapers in a washing bin. It seems kind of silly, but it's some exercise I've been able to add into my day and (for now) is kind of a fun way to break up the monotony of staying at home.





Tuesday, September 23, 2014

Feeding bellies.

For the first three years of Samil's life, I was a work-at-home-mama. It was nice. I liked it well enough, but when we moved, I was kind of glad that I'd have to go back to work outside of the home.

I make a mean home-made pizza - dough, sauce, the works.
I don't really like to cook.

I could keep my house spotless clean, craft up some beautiful decorations for each month and homeschool my kids like a boss. But the kitchen? Not so much.

I didn't know how to cook when I got married - blame it on my American-ness. I had a few specialty dishes up my sleeve for dinner parties, and a few things that I could pass off as edible - if I had a box mix of spices and a jar of pre-made spaghetti sauce. I couldn't make rice. And my grandmom had to buy me one of those egg stones that tell you when an egg is hard boiled.

It was bad.

We're also really good at making fruit juices.
Not the green kind.
All of those pre-made spices and condiments are imported and expensive. If I was going to cook, I'd have to learn how to cook without the box. Which meant, realistically, I was going to have to learn to cook Dominican dishes - one, because the ingredients were most available and two, because someone was going to have to teach me. And (most) Dominicans only know how to cook Dominican food.

It was great fun in the beginning - I had a few lady friends who came over and showed me how to make the staples (it took me about 80 times to get the rice right): rice, beans and boiled meat. Once I had the basics, I took on some of the more complicated dishes. It was wonderful. We had delicious food on the table for lunch every single day. It was filling and mostly healthy.

I'm also pretty good at this
kind of cooking. This was a
birthday present a few years
ago. YUM!
The thing is, Dominican food is delicious, but it's not very varied. The daily meal gets mixed up: white rice with beans or a one-pot-rice & beans dish and chicken, beef or pork - but it all uses very similar seasonings. So, cooking and eating the same thing every day got old fast, especially because I don't really like to cook anyway. I always tried to mix it up, but when you are not a cook, it's hard.

When I did go back to work outside of the house, I had to hire someone to watch the kids and help out in the house. It was amazing - I no longer had to cook, because this person took care of it. Every day!

Except I've now been working for four years and let me tell you, rice and beans gets boring. Really boring. And because I don't want to eat rice and beans every day, I got into a habit of eatinhg something - anything - as I ran out the door to work.

I've also been known to whip up some baked goods.
Jae will hate me for posting this picture :)
Now I'm home and finally getting back into the swing of things and guess what? We're not eating rice and beans every day. I cook two or three days a week and someone else cooks the rest - and it is glorious. The problem?

I only really know how to cook four or five things that aren't rice and beans.

This blog post was/is just a really long, drawn out way to get your sympathy and have you send me easy recipes to try out.


Got one for me?

Tuesday, September 16, 2014

How to feed your newborn.

Isn't this the most precious little face ever?

We didn't plan to have three kids. In fact, we were pretty done with two - I mean, it's been five years since we had a baby and we finally have two school-aged kids who are pretty independent.

We are thrilled for this new life, though, and he is pretty cute, so I guess we'll keep him. I mean, seriously, how cute is he?

Being pregnant had it's craziness, but having a newborn is just confusing as far as cultural norms go. I never know where I stand, and when I think that I'm doing things right, I get told that no, sorry, that's not the way to do it. I've mostly learned to turn off my ears when people start to give advice - not because I don't respect their opinions, but because in the end, we are the parents and we need to make the decisions that are right for us.

Amely's first day home.
And therein lies the rub. I am pretty well-saturated in information about what I believe. (Wow, that sounds pompous. It's not meant to be). I read a lot before making a decision. My husband is a crap-shoot. Sometimes he believes what the old-women say, and sometimes he gets on the internet and searches. So, one day he can be completely ¨Haha, so and so tried to get rid of hiccups by putting a thread on the forehead. Does that work?" And the next day, he'll be "OMG baby has hiccups, why didn't you put the thread on his forehead, that totally works. My grandmom told me."

I did get lucky in some respects - most Dominicans don't understand that exclusive breastfeeding is a real option for feeding a baby, but my in-laws are supporters of EBF mostly because it's all they've known. Their mom gave birth in a house with no electricity or running water and had no option but to breastfeed. The neighbor ladies divvied up the first 30 days of a baby's life and picked up the cloth diapers to wash in the river every day. No, I'm not joking.
Baby Samil

My two big kids were exclusively breastfed for one year and eighteen months (respectively). So far,
Adiel only knows the boob juice (well, except for the formula they forced on him in the clinic, but that's a story for another day).

The day I got home from the hospital, I started being force-fed malta with oatmeal, bacalao soup and chocolate de agua. I say force-fed, but the only really gross thing is the malta - it's got all the hops that beer has, but none of the delicious-ness of actual beer and none of the alcohol. Amalio put oatmeal in it which made it more drinkable, but still not enjoyable. Cod fish soup and hot chocolate made with water (not milk) are good. Not my favorite foods, but not terrible either. Milk production is serious business, and the food that is meant to help it along are all a mom is supposed to eat for the first few days.

I actually deal with the breastfeeding side-eye much better than I ever dealt with pregnancy advice (and MUCH MUCH better than I deal with other newborn advice), but it can get tiring. I imagine that the reason a lot of women don't even try to breastfeed here is because every five minutes someone is in your face with a new reason why breastmilk is terrible and how you're messing it up somehow.

My favorites:
+ You cannot eat or drink two hours before breastfeeding. The fat will leak into the breastmilk and cause baby to have green poop.
+ You can definitely NOT eat or drink WHILE breastfeeding because baby will probably die. (Or just get some crumbs on his head, but no big deal, right?)
+ You CAN drink alcohol while breastfeeding because beer helps production! Rum makes baby strong!
+ Baby cannot drink milk while laying down.
+ Baby cannot drink milk while sitting.
+ Baby can only be breastfed in traditional cuddle position.
+ If you are sad, angry, stressed, etc... your breastmilk will turn salty or sour and baby will not drink it.
+ If you are happy, breastmilk tastes delicious.
+ If you want to wean baby from breast, you need to express a cup of milk and throw it on the sidewalk so people can walk on it.
+ If you breastfeed at night, your baby will never.ever.sleep. (which might be true because Amely is still a terrible sleeper. Not Samil though. I guess it's a crap shoot).
+ Breastfed babies are bad sleepers in general.
+ Breastfeeding overheats babies. So, if it's hot outside when they are born, it is better to bottle feed to avoid death by overheating.
+ Only poor women breastfeed.
+ Women don't produce enough milk to exclusively breastfeed anymore because they work outside of the house. (I've also heard that women have more c-sections nowadays because they spend so much time sitting down).

A friend of ours came over today to visit. He claims he didn't know the baby was born yet, but we'll forgive him because at least he came. A friend of mine was over as well, and as we sat on the porch, he leaned over - all confidentially - and whisper-asked me if it was true that we don't buy milk. Like it was a big secret. I told him no, and his jaw dropped. "Women still do that? Well you all can keep having kids because they don't cost you anything!"
I found this image on google. It's a snap-shot
from a YouTube video of a baby
playing with his milk cans from his first year.

The idea that "milking" a baby has to be expensive is rampant here. A lot of newborn feeding decisions get made based on social-appearances more than anything. It is a status symbol to be able to feed your baby can after can of expensive formula. And pediatricians don't help as Nestle, one of the worst formula-pushers in the market, has most of the medical professionals in their pocket.

I've seen pictures taken at first birthday parties with the child and every single can of formula he drank in his first year. A pyramid of milk cans. And that's great, but where do you store all of those cans for a year?? It's also great if you can afford suffi
cient milk for your child, but the fact is that milk is expensive and most people don't make enough money to properly feed their child with formula. Add that to a contaminated water supply and it can get tricky.

So, I stick to my guns and do what I have to do. Adiel has already gained enough weight to feel heavy in my arms and grow longer. I drink my tea while he suckles (I kind of hate that word), and eat toast that drops crumbs on his precious little head and all of the neighbors stare and whisper. But, I figure, they're going to stare and whisper anyway, so I might as well give them something to talk about.



Sunday, September 14, 2014

PRegnant in the DR

My doctor encouraged me to exercise during pregnancy - walking as he referred to it, because you know, chubbies don¨t actually exercise. It was the first thing, besides him talking me off the ledge of ¨my blood pressure will kill me¨ (completely unreasonable fear, I have LOW blood pressure), that endeared me to him and made me go back to a second pre natal care appointment instead of finding a different doctor.

See, pregnancy is complicated in the DR. There is a list - much longer than the one I published here - of things that can and cannot be done for nine months. Exercise of any kind is usually on the list of cannots.

translation: Dominican man, eventhough your belly looks like
this, remember that this parking spot is for pregnant women! 
It takes a long time to really figure out how to manage the cultural taboos. In fact, usually by the time one figures it out, there is a newborn in the picture.

Alas, not all things are bad for pregnant women in the Dominican Republic. There are many lovely things that happen here that are so ingrained in the culture that I didnt even realize how much I appreciated them until I returned to the states this summer and those things were non-existent.

In any parking lot, there are spots reserved for pregnant women - spots that are different from the handicapped spots. Well, to be fair, some are shared sports, but mostly there are spots just for preggos. And it is serious. I have been yelled at for parking in the spot during a rain storm by the security guard. Those spots are sacred. Pregnant women should not have to walk a mile to do their shopping.

Pregnant women also never have to wait in line. And if said pregnant woman tries to wait in line, at least three people will point out that she should not be waiting in line. Basically, if you have a baby in your belly, you can cut in any line you want. This is especially helpful in Wendys at lunch time and the bank on pay day.

When I was dating Amalio, we went to the movies. I had no idea about this no-line-waiting policy as it does not really exist in the USA. We were waiting to see a really popular Dominican movie - which means the line went around the block - and a pregnant woman was in front of us in the line, with her baby-daddy. The usher came to pull her out of line and let her into the theater, but wanted to leave the baby-daddy behind. The uproar was insane. The no-line-waiting applies to everyone in the pregnant womans  party and everyone knows it.

There is no lifting involved in pregnancy. Strangers on the street will offer to help you carry a piece of paper if you are pregnant. While this can be pretty annoying, it is really helpful on grocery shopping day or any day there is a lot of stuff to be moved. I have spent the last seven months soaking up the help with every thing from my purse to groceries.

Our neighbors have brought us so much food it is a wonder that I didnt gain 60 pounds during pregnancy. Any time they cooked something special, we got a plate. Any time someone thought I was looking particularly tired, a plate. And forget about it if I even mentioned a craving. Some of our ¨boys¨ went all over Santiago looking for a specific type of fried something or other when I mentioned I was craving it. And my brother in law spent more time walking to the intersection in the midday sun to buy me cold coconut water and pineapple. We are still getting a ton of food dropped off and Im not really sure when this falls off, but Im enjoying it while it lasts.

The Dominican Republic labor law protects pregnant women as well with a three month paid maternity leave AND a maternity stipend for one year for employed women.

I was completely shocked when we got back to the States this summer and I was expected to wait in line like there was nothing special about me. I had to park at the back of the parking lot on numerous occasions and no strangers offered to help me with anything. And I was very very pregnant. (My mom recently got her knee replaced. So, when we went to Walmart (I know, I know, dont judge me), she got a motorized cart and believe me, I stole that and drove around like people of Walmart because my feet and back and head hurt from being SO pregnant.)

So, while the rules are strict and kind of bizarre, Id say pregnant women are, in general, treated with the respect they deserve - I mean come on, we are carrying around the generation in our bellies!

Thursday, September 11, 2014

Old wive's tales (or what not to do during pregnancy).

Photo courtesy of Rebecca Rousculp
I just had a baby. I just had my third child - all of whom were gestated and birthed in the Dominican Republic. You might think that I'd be used to everything that pregnancy entails. I'm not.

I worried about my blood pressure. Okay, I obsessed about my blood pressure. Some of that was physiological - I am overweight, a little over-stressed and (was) pregnant; but, mostly, I worried that there would be one comment, one sly little remark about how I was doing it all wrong that would throw me into a pre-eclamptic fit and I'd have to be rushed to the emergency room.

My doctor is amazing, though, and he assured me that my blood pressure was fine, that no, I was not diabetic and no, I was not going to be rushed to the ER because of someone's snark. (If you're in Santiago, I highly recommend Dr. Enrique Herrera for all of your gynecological needs. He's kind of dry and more than a bit weird, but he's dedicated and knowledgeable and just a good doctor. He also speaks enough English to consult, but not enough to fall into the "well, he's a good doctor because he speaks English category. He has an office in HOMS and one in Corominas). 

Pregnancy is a funny thing here in the DR. It is a rite of passage - a woman who does not want children is viewed as strange, and woman who cannot have children is pitied. It is an illness - pregnant women are supposed to adhere to a list of rules and regulations to guarantee a healthy baby that are archaic and often cruel. It is also empowering.

I did not know that I was pregnant until I was pretty far along - 12 weeks - and because of that, I was able to avoid some of the taboos. It was also because of that that some of my female friends were angry with me - they thought that I had purposely kept the information to myself for my first trimester to keep them out of the happiness loop. See, babies are a blessing and from day one of a missed period, people share their good news. The fact that I hadn't shared meant I was being stingy with the good stuff.

I was a *little* insane at the end of my pregnancy. I convinced
my brother to DRIVE with me and the kids from Chicago to
Philadelphia. That's 14 hours, folks. At seven.point.five
months pregnant. Here is a picture of me, the belly and
my amazing brother at the Bean. I broke *all* of the rules
on that trip - we must have walked one million miles.
I did, in fact, hold off a few weeks to tell people that I was pregnant because I was in shock. I also really wanted to go to the beach without the commentary. Like I said, there is a list of rules and regulations for pregnant women, and going to the beach is off-limits. The waves and the water and movement of the ocean will apparently cause miscarriage almost all of the time. All of those crazy gringoes at the beach on their baby moons are in for a terrible shock when they return to their homes.

Some of these rules and regulations are based on actual good advice, but they've been so that there is no real meaning left to them. Eating plantains is on the list of no-nos which is strange since plantains are a staple in the Dominican diet; however, plantains can cause constipation which is not something that you want to exacerbate during pregnancy. The rule makes sense, but when someone is yelling at you to stop eating plantains because OMG YOU'RE GOING TO HURT THE FETUS is just obnoxious and makes me want to eat more plantains.

I also teach (have taught?) pre-natal education classes - and while I really love doing that, sometimes I get so frustrated that I think my head might explode. There are DOCTORS telling (healthy, pregnant) women to refrain from normal, everyday activity because... well, I don't really know why.
I also went to the beach at about six months pregnant. I even
went in the water. No pictures of me in a bathing suit, but
these two cuties can make up for that.

Here is a (non-exhaustive) list of some of things I was told during my pregnancy.
*I'm marking with a star the things that are also old wive's tales that I've heard from North Americans as well. 
** A double star for things are based in fact

- You cannot swim in the ocean because the movement of the ocean can cause miscarriage.
- You cannot squat down (aplastarse in good Dominican-spanish) because the baby might fall out.
- You also should not bend over.
- You cannot exercise (aerobics or lifting) because it can harm baby


- You must not go out on "chilly" nights
- You must not carry anything over 2 pounds. **
- Foods to avoid: bananas and guanabana (soursop), will give (in-utero) baby "mucous" in lungs; plantains (cause constipation); fruits in general (will give mom  gestational diabetes); soda (will cause kidney problems** but coffee is okay)
- You need to give a pregnant woman all of her cravings or baby will be born with birthmark resembling said craving *
- Baby bellies are shaped differently depending on the sex of the baby *

It is interesting to note that in the United States, one of the beliefs for inducing labor is to go for a bumpy car ride. Here, it is not abnormal to see pregnant women on the backs of motorbikes until the very end of pregnancy (and motorbike rides are almost always bumpy!).

There are many, many benefits to being pregnant in the Dominican Republic (another post), but it's not for the faint of heart or the fast-tongued. It took me three pregnancies to learn to ignore snide comments on the street - and now, with a newborn I have to listen to a whole different stream of consciousness-baby-raising-advice.

What old wive's tales have you heard for pregnancy?

Tuesday, September 9, 2014

welcome.

It's been awhile since I last blogged.

This time I have a great excuse.

Presenting to you, blog readers,

ADIEL.
Our new son. Born 25 August 2014 at 8:35am.
Weighing in at a whopping 9 pounds and measuring 23 inches long.


There are plenty of pregnancy and newborn anecdotes to share. But we'll get to that soon. I am recuperating from a c-section and getting into a routine with two kids and a baby! I do have three months of maternity leave to enjoy this.

Thursday, July 10, 2014

break-bone fever, bent-back fever and malaria, oh-my!

When I first came to the DR ten years ago, I was given a course in tropical diseases - it was a general "going-overseas" course, so a lot of the diseases we learned about didn't even really apply to my part of the world, and really, THANK YOU WORLD. Some of those things - worms that bore through the heels of your feet and end up in your blood stream, scorpions that sting, snakes that bite - are enough to give the most seasoned outdoorsmen nightmares.

The Dominican Republic doesn't even have a malaria problem (though occasionally you'll hear of malaria in Haiti). As far as mosquito-borne illnesses go, malaria was the scariest for me. Afterall, I had recently read The Poisonwood Bible.

I have since learned that malaria is not nearly the most painful or even the most widespread of mosquito-borne illnesses. 

Dengue Fever - often referred to as break-bone fever - is common in the DR. It is transmitted by a special, of course, type of mosquito and everyone once in awhile the country's emergency rooms fill up with infected humans. It is marked by high fevers, diarrhea and vomitting and an intense pain in the joints and bones. There is no treatment, and is often deadly - especially for small children and the elderly. 

Doesn't sound terrible, right? Some fevers, dehydration, and in the end you (probably) live? Perfect.
Except you can't take pain killers stronger than tylenol, and the only other relief is simple re-hydration by IV. And the pain can last for days and days. 

Dengue hasn't reared it's ugly head recently - at least not in epidemic status.
No, in fact, I haven't heard one story of dengue for months, but mostly that's because a new disease arrived in town about two months ago.

Chikungunya Fever.
Lovingly referred to in Africa as bent-back fever because the pain is so strong it forces your back to hunch over. Bent-over. 

Same mosquito, different disease. Pleasant.
Not as deadly, apparently, as dengue fever, but far more uncomfortable - high fever, vomitting and diarrhea, intense pain in the joints and bones and, for added drama, a bright red rash that covers the body. 

We're not really sure if it's run through our house yet, but I'm going to bet on no. We all got some intense fevers, and I was pretty uncomfortable - but no rash, no intense bone pain. Amely, we think, had strep throat and so I'm sure that's also probably what Samil had. I probably just had pregnancy-whiny-ness. Katherine, Amalio's cousin, was down for the count for three days, but also didn't have the bone-pain. Amalio, of course, was left unscathed.

The gross-ness did make it's way through school - our attendance dove into the ground in June. I had parents in the office, waiting in line to tell me that their kid was sick. And our cook, our has-never-missed-a-day cook was out for three days because she literally could not put her feet on the ground to get out of bed. 

Earlier this week, a friend called to tell me that her two month old son had the chikungunya and could I recommend an ER? (Hi, Janet!) I recommended the ER I always use. I told her that I don't really buy into any of the pediatricians there, but we've always had a decent experience (with the exception of Amely's chicken-pox visit) with the doctors in this particular one - and as an added benefit, it's just busy enough to inspire confidence but not so busy to frustrate. 

I have never waited in this particular ER. ever.
I swung by on my way home from work, to check on her and the baby because medical care can be overwhelming here. I imagined she was on a bed, getting checked or waiting to get checked. She was standing in the triage area, with a thermometer under baby's arm because there was no where else to go. There were at least 25 people waiting in line - even pregnant women were waiting in line (unheard of for preggos to wait in ANY line in this country) because there were just so many people.

She was sent home with the indication to hydrate and continue acetometophen treatment. There's not really much else to do. 

I'm hoping to avoid being a statistic this time around - it's predicted the 85% of the island will be infected, and that it will be a worldwide epidemic, not limited to tropical regions. It's worse for newborns and the elderly. If you're traveling to the Caribbean, make sure to bring mosquito repellant and apply liberally to avoid bites. The specific "breed" of mosquito is more likely to bite during the day (instead of at dawn and dusk like "normal" mosquitos) and looks different than the mosquitos that most non-tropic-natives are used to (a little bigger, front legs are higher than hind legs, and are striped like a tiger). DO NOT take any pain medication except acetometophen (I don't know how to spell that), because Advil and others can make it worse. And, if you do get sick, hydrate, hydrate, hydrate!

Tuesday, July 8, 2014

never a dull moment.

On Sunday, I took the kids to the beach with our friends, The Rousculps.

The nearest beach is only about an hour from our house, and I'm very sad to tell you that we do not visit there often enough. It is a beautiful, Caribbean beach with waters as azul as the sky, and as warm as ocean water should be. The beach sand is white and soft. And.

And we can go there in January. Or March. Or really whenever.
But we don't.
Because we apparently do not know how to take advantage of what we've got.

Nevertheless, on Sunday, we went.

The water was beautiful, the sun was out. And, of course...

thank god it's not a baby! just a dead puffer-fish!
Josh wrestled with a barracuda. At first, he thought one of the kids had rammed into his leg, but when that "kid" bit into his trunks and tried to steal them, he put his hand down and felt a long, sleek fish that was pretty big.

Rebecca and I made friends with a sweet little girl, no older than 18 months who just wanted to eat our cookies.

And then! a dead puffer fish appeared in the water, and it was like a scene out of Dominican Baywatch -- you know, the slow motion of the entire beach running toward the lifeguards pulling a drowner out of the water onto the beach -- the entire population of the beach ran toward the brave swimmers carrying a dead fish out of the ocean, including a woman who dramatically dropped to her knees and praised God when she realized that it wasn't a drowned-child.

Overall, it was a great day. Just enough drama to keep it interesting and just enough energy to knock the kids out on the way home! (well, just the boys - Zora and Amely were all about their fantasy land).

-------------------------------------------------------------------------------------
On the way home, we pulled over to a road-side fruit stand and Josh got 5 avocadoes and a bucket of mangoes for less than three dollars. And that bucket of mangoes has SIXTEEN mangoes in it.


Friday, July 4, 2014

on reading.

Volunteer Anne Pelsser read to students
three times a week for an entire semester.
We miss you Anne (and Pierre!)
I've said - quite frequently and to anyone who would listen - that most of the problems that we've dealt with in starting and running a school are not the problems that I foresaw. I expected irresponsibility with payments, lack of concern from parents and maybe some teacher truancy and attendance issues. There are some inherent problems due to the demographic that the school serves, but overall, I guess I expected some semblance of teacher preparation and training - after all, all but one of our teachers (the 3-year old class teacher) are trained, professional educators.

I've known that there is a deeply entrenched literacy poverty in the Dominican Republic - even among the upper class - that affects how our children think and learn. There are no public libraries and most schools - again, even in the fancy private school - are lacking books. Sure, there are text books, but there is a deficiency in any other type of text: few story books, few non-fiction books, few encyclopedias.

What comes with this lack of actual physical reading resources is a lack of understanding of the real, profound importance of teaching kids not just to sound out words, but how to actually read - to comprehend, to question, to analyze the words that are on the page. But, how does one even go about switching something so ingrained culturally?

Samil was in first grade this year. He fought learning to read - he dug his heels in and absolutely refused to practice. Homework was a dreaded task - for everyone involved. The "reading" that was happening was phonetic, and from what I could decipher consisted in sounding out long lists of words.

No sentences. No pictures to describe sentences. No stories.
Lists and lists of words.

As far as technical reading goes, the method works. The student learns basic phonetic combinations of consonants and vowels (ma, me, mi, mo, mu), and then combines those sounds into simple words, building upon the previous sounds learned.

What happens when the student has to not only decode words, but decipher meaning in sentences? Or read a story and figure out the meaning?
Learning the phonetic sounds using scoops of ice-cream!

It's tragic.

One of the first teachers who worked at school - teaching three year olds - told me that she didn't have time to read stories to her students. That she needed to be focusing on far more important skills, like making sure everyone was sitting at the right table. Another told me that, after reading one story book, she just didn't have time for something the students aren't interested in. She taught four year olds.

Loving reading is an acquired skill. Loving stories is, too.
Unfortunately, there just hasn't been an emphasis on reading as a means to better educational quality. It is so hard to incorporate simple reading into the curriculum because neither the parents nor the teachers understand the importance. Sadly, I don't think this is a Dominican Republic problem. I think we're taking the joy out of reading for most kids - be it for lack of exposure, or for forcing test-based-reading, or for just not providing quality texts.
---------------------------------------------------------------------------------------------------
There are some awesome organizations on the island that are working hard to enhance the culture of reading for our kids. Check them out:

Amely loves reading story books!
FUNDEBIBO - is an organization that works to train librarians and other "resource-arians" and to promote literacy in the Dominican Republic. Based in Santo Domingo.

Lleva un libro en la maleta - is a grassroots movement to motivate people to bring a book, many books and/or school supplies with them in their suitcase when they visit the island and then donate them to schools that need them.

Fundacion Mahatma Gandhi  - is located in Las Terrenas - a beautiful beach town on the Samana peninsula and offers library services with more than 7000 books to the community.

Biblioteca Comunitaria Dr. William House is, of course, my favorite literacy program on the island. Located in San Francisco de Macoris, the library offers programs ranging from story time to English classes to art hour.

Thursday, July 3, 2014

Emergency (part 3)

Last March I had a health scare. It started with just a little shortness of breath, tightness in the chest and, overnight, escalated to not being able to breathe. I got  up in the morning and even got in the concho with Jewel to go to school. Half-way there, I knew I wasn't going to make it. Could we please just go to the emergency room of that terrible public hospital by school? Surely, being located next to a burning landfill they'll have the resources necessary to deal with a respiratory issue. We got out of the car, walked down to the hill to the ER entrance and asked our way in. It looked promising, until we got to the intake "desk" and they asked if I had a mask. No, I don't have a mask. I'm dying here and you are asking me about a mask? I didn't even know what in the world a mask had to do with anything - I don't suffer from breathing problems. The intake woman told us we needed a mask; they don't have any, we'd need to buy one from the pharmacy.
you may or may not get emergency care
from this very experienced doctor

The problem? It was only 7:30 and the pharmacy doesn't open until 8. Meanwhile, I couldn't breathe and I was scared. Instead of playing the game - mostly because we had no idea what the rules were - we walked back to the avenue, paid a concho to take us to a private clinic in the city and hoped for the best. I got nebulized twice that day and even after a few minutes on the machine I felt like a new person. I didn't pay more $40USD for the treatment and emergency care, but $40USD is a week's salary for most people.

Luckily for us, we've not had any real emergencies - Amely's ear bleeding, my one-time breathing issue, a few night-time/weekend fevers, some stitches - and the emergencies we've had have not been very serious.

Emergency medical care is laughable in public centers, but it is not any better in the private clinics. There is no "emergenc-ology" - most of the docs working in ERs are the doctors who just don't cut it anywhere else. From what I understand, the "emergencies" that are generally presented are so routine that it is not necessary to have specialty doctors waiting around. The occasional car accident or burn victims call in the on-call doctors.

Emergency care is generally cheap - especially because, with insurance, it covers all of the medications that they give you, plus the bed-fee and doctor honorarium. We paid just $16USD when Amely had the chicken-pox - which included a salmonella test, blood and urine tests and an IV of saline solution plus anti-vomit and fever-reducing medicine (don't even get me started on all of that). A friend of ours spilled a pot of boiling water on her lap and the bill for all of the services she received was $60USD, for what she reports was pretty decent medical care.

A visit to the local, public hospital to get stitches
for one of our students.

I visit that tragic public hospital far more frequently than I would like to admit, but considering the lack of resources, the doctors and nurses in the ER are polite, receptive and good at what they do. I've taken numerous students for stitches and the service is quick and as painless as stitches can be. And it has never cost us one cent. (In fact, the antibiotics, triple-antibiotic cream and tylenol that we have to purchase in these situations costs less than $3USD). Now that I know most of the emergency care nurses and intake personnel, we get nice service (and a lot of our students have reaped the benefit of a good relationship with these people).

Obviously, I don't have any serious emergency experience here (and for that I'm thankful), but basic emergency care isn't terrible - and I guess it really depends what you call an emergency. Make sure to steer clear of the public centers unless you know the people who work there, but remember that just because a place is swanky or costs more, doesn't mean you'll be getting better care.

Sunday, June 29, 2014

school's out for summer!

This school year was filled with growing pains - we now have a 100% different staff than when we started imparting informal classes three school years ago, we have new resources and a completely new national curriculum to comply with. It's a lot of figuring things out and dealing with problems, and I'm really sad that I wasn't able to spend nearly as much time with the kids as I would have liked.

But! Because of my limited interaction with all of the students, I was able to form and stregthen relationships with a few that I might not otherwise have had a ton of time for. In fact, I looked forward to one kid in particular who has been with us since day one. His dad is a single father, and until very recently, if I wanted to see him, I'd have to go to his house and wait until he'd grace me with his presence.

Child-rearing is still, and not just here in the DR, very gendered - moms have their role and dads have theirs. Unfortunately, the dad role has been one of discipline and violence. Disciplining a child means spanking and beatings. Add in poverty of mind and body (and wallet!) and it is a recipe for disaster. Throw in a kid who you have been saddled with, on your own in a world where men just don't do the single-dad thing.

I met this dad before I even entered formally at school - he had come, on the last day of June to pay off the entire year of tuition. He just hadn't thought to send the money, but wanted to make sure his son "wouldn't be bothering him at home next year." I took his payment, and tried to stress the importance of paying on time, hoping that we might see more consistency in the future. 

Forget it. Last school year, I saw dad twice at school. He came in December and he came in June. His new "wife" had been checking up on the child, and we had seen definite changes in his personality - he was more open, loving and willing to receive affection. This woman was doing great things for him at home. But, she admitted, it wasn't a nice environment for anyone and she didn't know how long she'd be sticking around. 

This fall, we hit a wall with the student. He was nervous - visually shaken more than once, and his mental walls went up. We were scared to talk to the dad for fear of his punishments to the kid. Step-mom had, in fact, moved along in her life and left this boy alone with his dad. 

We talked and played and sometimes, our shy little man would  stop by my office to give me a hug before he left for home, and things got better. In March, step-mom was back in the picture and shortly after, dad was visiting me in the office to pay and just to "check-in." In May, he came and asked me for a copy of the birth certificate so he could get his son vaccinated. Three days later he brought me a copy of his new vaccination card!

No matter how much our student had changed, his mental walls and probably  a learning disability really held him back academically this year, and he'll be repeating second grade. And even with all of the change that I've seen in the dad...

I was so scared to tell his dad..

The abusiveness of old scared me. I would be much better off in my life if I hadn't heard of the "techniques" to punish this child for not being able to read or write or for wearing the wrong socks to school. I know that dad has changed - we've seen it in the kid's character as well - but failing second grade is a big, big deal.

The step-mom came to collect the report card, and I told her that I really need dad to come in so we could talk. I explained - in my best principal tone of voice - that it was best for the boy, that it will allow him to build his "base" and do better in higher grades. I told her that even if he couldn't come in, I would go there - but no matter, we needed to talk. 

Imagine my joy when dad showed up just half an hour later - leaving his little shop with an assistant - to tell me  that, yes, he understands and it is okay to leave him behind. Also, he will be attending review-weeks at school to get a little more "of that base you told my wife about." It was only more that he brought me a candy bar and told me how much he appreciates everything that the teachers have done for him and his son this year.

I had to close my door for a few minutes when he left. It's not really professional to cry in front of the parents -even if they are tears of happy.

It's hard. But slowly, step by step, we're seeing the lives of these kids change. We're growing. There are growing pains, but it seems to be working. 

Saturday, June 28, 2014

Finding a Doctor (part 2)

We began our search for a pediatrician shortly after Amely bled from her ear and the insurance coverage we had sent us on a wild-goose chase. It was difficult because most of our Dominican-friend base works in education, and therefore was either covered (and content) with the teacher's insurance program or had also just left the system and were in the same situation as us. I also have ex-pat friends, but the criteria "speaks English" is not important for me - there are few English speaking pediatricians in Santiago, and just because the Americans use them, doesn't mean that they are quality.

English not being a requirement, I have a list a million miles long of what I need in a pediatrician. I am a bit ... demanding, and, because of Amely's ear problems, we wanted someone who could deal with that and not ship us out to an ENT every time there was an issue.

to be fair, this happened on vacation in the
states. but, it's clear - amely needs a doctor.
and i'm a terrible blogger because i have no
picture evidence at all of any of our
doctor-adventures.
There are a number of private clinics in Santiago - the good, the bad and the ugly. The system is different than in the states - you don't go to a doctor's office. You go to a clinic, where the doctors have private consult areas, there is in-patient treatment, diagnostics areas (imaging, labs, etc...) all in one building.

After I chose the clinics that I could deal with, I started looking for suggestions. Oh, the suggestions came. I have a list 2 pages long of the the best and brightest and most dedicated doctors in the area.

And that's when I found out that it's not really the doctor's that are the problem.

Attempt #1. Highly recommended, Christ-loving, young(ish), female pediatrician in a favored clinic. Arrived at 8:30am, not really sure what this doctor's hours are. (very few doctors work on appointment schedules - it's first come, first served). The secretary is chatting away with the security guard. I stand at the desk for about five minutes before she even acknowledges our presence. She then tells me that the doctor arrives at 9am, on-the-dot, every day. At 10am, on-the-dot we were still waiting. When the doctor arrived, the secretary pushed two other patients up on the list. Amely threw up on the floor.
I actually really liked the doctor. Enough so that I was willing to try again last week. Bad idea. When I entered the waiting area, she was on her cell phone, talking to a friend and didn't acknowledge our presence at all until I scooped Amely up and carried her out... and even then it was to tell me that pregnant women shouldn't carry heavy things. No questions as to whether I had been waiting to see her doctor or not.

Attempt #2. Samil had a pretty persistent fever and was throwing up, so I grabbed my list and headed out to try a new doctor. I know that this inconsistency in their treatment is not helpful - but my kids are pretty healthy, so until we find a fit, I'm not that worried about it. The doctor from my list wasn't available in the morning, so I asked the secretary to put me on the list for the doctor who typically arrived the earliest. Unfortunately, that's how it works. No appointments. Just a list. And sometimes the doctors show up on time and sometimes they don't. This day, she didn't. I almost left - again because of secretarial crap. The doctor usually arrives at 9. By 10:30, she still wasn't in. When someone asked the secretary, she responded that "she's on her way, she had an emergency" and then stage whispered to her co-worker that the doctor was getting her nails done. So professional of the secretary to announce that. When she finally did arrive, and we were ushered into the office, I was told to turn my phone off. Weird. She was an older woman. I don't tend to like female doctors, but I really did like this doctor. She sent us for some tests to make sure there was no parasite, and when we returned in the afternoon she wrote a prescription for a BRAT diet and some pain relief. No unnecessary antibiotic (because it was a virus) and no crazy long list of meds. The secretary even called a few days later to make sure Samil was okay. (**this is probably the pediatrician we'll stick with)

Attempt #3. Not really an attempt to look for a pediatrician, but it fits - Amely got sick at school, threw up once and then threw up in the afternoon. She was fine, really, but her dad is reactionary and took her to the ER (which is a whole other post in and of itself). They took blood and pee samples and everything basically came back normal, except a very small amount of bacteria that the doctor called salmonella (eventhough on the lab result paper it just had some generic title). Even the ER doctor agreed that there was nothing wrong with her, if she wasn't still throwing up and wasn't dehydrated, she just needed to rest. HA! Until he called the pediatrician on call for permission to release her. The pediatrician insisted on coming in, and writing a prescription for anti-vomitting medicine (she threw up twice in the whole day), re-hydration whatevers (she just had an entire bag of saline), and some heartburn medicine (because she was obviously having so much reflux). I just kind of shook my head. Amalio got the medicine and the next day Amely was covered in chicken pox.

half-attempt (not really a pediatrician). Amely has a distended stomach. But only sometimes. So, after much complaining of snakes in her tummy, I researched out a pediatric-gasteroenterologist. She did a battery of lab tests - parasites and amoebas, blood disorders and pee testing, anemia - normal stuff in these parts. What I liked was that she prescribed on two papers - one, all of the tests that our insurance covers and on another the 2 tests it doesn't (a certain amoeba and a stomach bacteria). She was great, and had a gentle hand. I don't even want to tell you how much I loved her because it makes me sad that she doesn't do normal pediatric stuff. Also, nothing wrong with AMely's belly.

Attempt #4. And probably the final, disappointing craziness. There is a crazy illness going around town, and both of the kids got it in the past week. High fever, sore throat, sluggishness, and, apparently, mommy my shoulder hurts and mommy my eyeball hurts. It was Friday afternoon, of course, so I quick found a substitute for the uni and headed to the clinic. For some reason, I tried to go back to doctora number 1, but was reminded quickly of her secretary - and headed to the ER to take Amely's temperature - if she had a high enough fever, they'd run an IV of fluids and give her medicine right there. She didn't have a temperature (of course, not), so I asked for the doctor who arrives earliest for the afternoon shift. It was a male doctor, with 40 years of experience and not an ounce of bedside manner. I think he might have said hello and then proceeded to check out Amely. No questions about what might be wrong with her. She had no temperature, normal everything - except her throat was inflamed. He starts writing on his pad, checking a million boxes for lab tests ranging from her thyroid glands to parasite tests to blood typing and a sickle-cell analysis. "Um, sir? y todo eso?" Is there a reason that you're prescribing all that. Oh, it's just standard procedure. For a throat infection. Her blood type is A+ and she doesn't have sickle cell. To which he responded: "I can't trust your word on that, I need to see these recent lab results in order to know if it is true."
With that, I asked for the prescription of medicine he had written and went on our way. She was better the next day. (and then Samil got the bug). Considering that the doctor just assumed he'd be our new ped, but asked me zero questions, I wasn't too impressed.

I think we've found one (attempt #3) that I can deal with - and she takes our insurance. It only took two years - we'll see what happens.

-----------------------------------------------------------------------------------------
Life on the island isn't always sunshine and rainbows - we live in a developing nation. I have received numerous emails from people asking for advice. There are forums and facebook groups and other blogs. Life here is a great, but there are some realities that are very, very different and take some time. The medical thing (and education) have been my two biggest roadblocks and that's why I'm writing about it - not because I'm a Negative Nelly trying to make you feel bad for me and my family or to convince people not to come here. I have a few more posts about medical care - like how cheap medical imaging and dentistry are - that are fairly positive.