Thursday, July 24, 2014

Jarabacoa: Voy a reír, voy a bailar (Thursday Week 7)

"Voy a reír, voy a bailar, vivir mi vida, lalalala"
"I'm going to laugh, I'm going to dance, live my life, lalalala"
--from the song by Marc Anthony, one of the "theme songs" of our trip

Three friends post 14 km of rafting!
Last weekend was my last full weekend in the DR, and I was feeling pretty conflicted because there were so many things that I wanted to do and not enough time to do them all. On Friday I went whitewater rafting in Jarabacoa with two friends. The trip was 14 km long and took about two hours. There were three other girls in our group who are living in Jarabacoa and studying Spanish post-college, and we were all in one raft with two guides. The main guide's name was Clemens, and he's German but has lived in the DR for more than 20 years. He was awesome--very funny but very capable at the same time (a good thing because I fell out once! I was totally fine though.)

One of the highlights was a set of rapids named Mike Tyson, which involved going over a 8-10 foot high waterfall. Afterwards, we stopped by the side of the river for a swim and a snack, and we took turns jumping off a 15 foot tall rock into the water. I only went once, but I'm glad I did it because I never did make it to the 27 Charcos, where the main attraction in jumping off the rocks into the pools beneath the waterfalls. After the rafting, we went back to the ranch, ate lunch and wandered around a little bit. The ranch is very focused on ecotourism, and they had a short trail that went over a creek and to some ponds. I enjoyed getting to try out some more nature photography of all the beautiful plants and flowers.

I spent Saturday relaxing doing homework and hanging out with my host family. All of my host mom's adult children and their spouses come over for lunch on the weekends, and I didn't want to miss one of my last chances to hang out with the whole family at once. On Saturday night I also went to a fair by the monument park. There were a lot of typical fair things, like music and food (including cotton candy), but also a lot of food and household good companies selling bulk groceries at a discount. It would have been great if I was back in the states, but alas I can't be bringing home Costo-size packages in my luggage.
Hiking selfie!
Waterfall we saw during the El Mogote hike

On Sunday, I returned to Jarabacoa with two different friends to hike up one of the mountains. The trail was called El Mogote and climbed 3,000 vertical feet over 4 miles. That's pretty steep, and on top of that the trail was really narrow and overgrown in some spots. I really enjoyed the challenge and spending time with my friends, and we were rewarded with several spectacular views. We took a wrong turn and didn't actually reach the summit, but it was still a really fun day (and now I have a reason to go back and make it to the top!)

I also had a really nice time on Monday night, when my host brother Carlos taught me to play table tennis. He plays competitively and he started telling me about the sport when he came over to watch some YouTube videos of old matches and instructors demonstrating different skills. We went to the student center on the university campus, where they have four tables set up for open gym. All four tables were occupied with people playing, and they were so intense! We started with the basic shots and worked up to playing real games. I lost every time, but I liked the sport a lot--it's all about precise control and mental focus. Afterwards we talked for awhile about our countries and families and the process of language learning--he's taking English classes at night, so every time we see each other he asks me a few questions about English, and I ask him a few questions about Spanish. He's a 36 year old married lawyer, but he's one of the people I'm closest to here and I'm really going to miss him when I leave.

My host mom, Josefina, and I at the going away party
Last night we had our goodbye party, which was very bittersweet. Almost everyone who worked with us or helped us during the program was invited, and there were probably about 150 people, including students, host families, program staff, university staff, professors, promotoras, estudiantes de apoyo, and even the guagua drivers. I was pleased that five people from my host family came--I thought it would be just my host mom and maybe my host sister. It was nice to introduce everyone from all the different parts of our experiences--I met my friends' host families, they met mine, our families met our promotoras and our professors, etc. There were thank you speeches and and photo slideshow, followed by dinner. The slideshow made me very nostalgic, but after dinner there was plenty of dancing and it was great just to relax and have fun. Dancing is another thing that I'm going to miss a lot when I leave--there's nothing like bachata and merengue in the US. Fortunately, they burned us all a CD with plenty of Dominican music, including the song that's the title of this post--one of my favorites!

Tuesday, July 22, 2014

Barrio Lindo: Si me pegas, no me quieres (Tuesday Week 7)

"If you hit me, you don't love me"

The days are flying by faster and faster as the end draws closer.

On our first day back in class after returning from Salcedo, we went to Juan XXIII, a secondary level health center, to start our urban community outreach projects. We were divided into groups of two or three and assigned a neighborhood and a promotora or community health promoter to work with. I was extremely happy with my group, and Esperanza, our promotora. As we were trying to decide on a topic, Esperanza asked us what our interests were. I said chronic diseases, and my two partners said women's health and children's health. We all looked at each other for a minute, since our responses were all so different, and then Esperanza suggested domestic violence as a topic. We all agreed it was perfect--it's a complex chronic issue that impacts women and families, and it's a significant problem in the community.

Barrio Lindo
After choosing a topic, we left Juan XXIII and went out to visit our barrio. We are working in Barrio Lindo, which is a poorer neighborhood, but not terrible by Dominican standards. Like the rural town of El Coco, the community is very close-knit. Everyone calls out greetings as we walk around and the promotoras know almost everyone by name. It's a much different feel from the upper-class neighborhoods where we live, where all of the houses have high wall and gates and the streets are almost deserted during the day.

For our project, we decided to conduct interviews in the community about the prevalence of and attitudes toward domestic violence, and then incorporate our findings into a charla to be given at the local community center. We wrote up a list of seven questions, then headed out into the community to do the interviews. We recruited the help of two other promotoras (Dolores and Yanesli) so that we could split up into three groups and get more interviews done. This was good for efficiency, but also made me a little nervous since I couldn't rely on my more outspoken group members to do the talking. I was with Esperanza, and she was very encouraging and let me do the interviews mostly on my own. She gave me help when I needed it, but only when I needed it. The experience definitely pushed me outside my comfort zone and the responses were really fascinating.

My group member Bellanira doing an interview
Twenty-nine out of 38 people agreed that domestic violence was common in the community. Nationally, 24% of all Dominican women between the ages of 15 and 49 experienced physical aggression from a romantic partner or family member. The people we interviewed cited all sorts of things as causes of violence, including jealousy, alcohol and drugs, lack of love, respect and communication. Multiple people also brought up lack of employment, because the lack of money puts stress on the relationship and because partners lack constructive ways to occupy the time so they end up arguing.

I found this answer especially interesting because, from an American perspective, I've noticed that Dominicans of all ages spend lots of time hanging out and just passing the time, even on weekdays during working hours. Part of the reason for this is a lack of jobs, especially full-time formal jobs, but a lot of it just is the Caribbean culture. It's a little less obvious among upper/middle class Dominicans, who tend to work 9 to 5, but I think the gulf between my American need to accomplish things and the Dominican "Cógelo suave" (Take it easy) attitude would be difficult to bridge, even if I were to live here for a long time. Anyway, because I know my impatience with all of the "hanging out" is a cultural difference, I wasn't expecting to hear people acknowledge it as a cause of violence, but they did. Of course, acknowledging a problem and figuring out how to solve it are two different things entirely, but everything has to start somewhere.

The interviews also revealed some things about gender relations in the community, where  machismo has a very strong influence. There are efforts to change that, but progress is slow, especially among lower class people. Some people said disobedience on the women's part causes of violence, and many people emphasized that violence was the "not only the man's fault" or "the women's fault too." Although it's true that both parties can contribute to a conflict, it sounded like the community might tend to blame a victim instead of supporting her. A lot of people knew of resources for victims of domestic violence, but many people also brought up fear of retaliation from the abuser if the victim tried to get help. It's a serious fear--unfortunately there are reports of women being murdered on almost a weekly basis.
Giving the charla!
On Monday, we presented our findings in a charla in the local community center. We invited all of the people that we interviewed to the charla, but very few of them came. We were starting to get worried when some of the neighborhood kids wandered in. The promotoras convinced them to stay and listen, and suddenly the room was full with about 30 kids from ages 4 to 15, plus a handful of adults mixed in. We had to change the tone of our presentation a little, since we had prepared for an adult audience, but we were able to improvise and got a lot of audience participation. I was surprised by how successful it was and how much fun I had doing it, and I'm excited to present our project in my Community Medicine class on Thursday.

Our charla was well-attended!
Overall, our project in Barrio Lindo has been one of my favorite parts of the program, because I get to see public health theory turn into practice. In my global health classes at Pitt we talked about the importance of "community health workers" and "knowledge, attitudes and practices surveys" but I had no idea what the terms really meant in practice. Now I know, and I'm even more convinced of how effective promotoras can be and how vital they are to public health. Each primary health care center in the DR is supposed to have two paid promotoras, but unfortunately many centers don't have the funds--Barrio Lindo is one of the lucky ones (Yanelsi, the third promotora, is a volunteer). It's very inspiring to see how well Esperanza and Dolores know the community and how much they care about improving it, and I'm grateful that they so graciously and generously took the time to work with us. Even though our project was pretty small and insignificant, it's nice to know that Dolores and Esperanza do this kind of work every day and over time it has a big impact on the community.

Saturday, July 19, 2014

Santo Domingo: Cuatro siglos de historia y leyenda (Sunday Week 7)

"Four centuries of history and legend"

Last weekend we took a trip to Santo Domingo, the capital of the DR. Everyone in the program came, including the staff and two of the Dominican estudiantes de apoyo--about 45 people in total. Santo Domingo is on the Southern coast, about 3 hours from Santiago.

We checked into the hotel at about 6:30 on Friday evening and got ready to head out to dinner. The restaurant was only about a 5 minute walk from the hotel, but as soon as we left it started pouring and we were drenched by the time we got there. I wouldn't have called it fun, but there was something unforgettable about running down the middle of the street, clutching my camera to my chest so it wouldn't get soaked and trying not to slip on the wet cobblestones. The restaurant was inside an old warehouse from the colonial era, and it was beautifully decorated and the food was delicious. In general, the food was one of my favorite parts of the trip, because everything was arranged and paid for by the program, and they took us some really nice places.

First hospital in the Americas
On Saturday morning we got up and took a walking tour of the colonial part of the city. We saw the house of Christopher Columbus' son Diego, who governed the city for a while, and the ruins of the first monastery (which later became the first psychiatric hospital) and first actual hospital in the Americas. We also saw the first cathedral in the Americas, Fortaleza Ozama, and the National Pantheon, where many of the country's historical figures are buried. A flame is always kept burning in the center, and an honor guard in dress uniform keeps watch over it.

Exploring the Ciudad Colonial
We had free time to get lunch on our own and explore in the afternoon. We ate lunch outside on the edge of a big square. I had a typical dominican plate of rice, beans and chicken, and we got to watch a guy making hats out of palm fronds and listen to street musicians while we ate. After lunch, we headed to the Chocolate Museum that was right across the street. It was more like a glorified gift shop than a museum, but they had free samples and didn't charge admission so no complaints here. After that we went shopping on El Conde, a pedestrian-only street in the center of the Ciudad Colonial. I successfully used some bargaining skills to get a deal on a bracelet and earrings made out of larimal, a turquoise blue mineral that's naturally found here. The fact that I saved a hundred pesos was just a bonus--the actual haggling was the fun part.

Next we went to El Museo de la Resistencia, which tells about the rise and fall of the Trujillo dictatorship that lasted from 1930 to 1961. The museum is a little overwhelming--there's big blocks of text on every wall, and it's all in Spanish--even if it were in English I couldn't possibly have read it all in one visit--but it was worth it to learn about some modern history in addition to the colonial era. Trujillo actually renamed Santo Domingo Ciudad Trujillo while he was president. They changed it back as soon as they got rid of him, but if you look you can still find some manhole covers that say Ciudad Trujillo on the streets.

All dressed up for dinner in a cave!
Photo Ryan Bowen Photography

On Saturday night we had a formal dinner, so we went back to the hotel early to get ready. It was nice to see everyone dressed up, and we spent a while taking pictures outside of the hotel before going to the restaurant. The restaurant, El Mesón de la Cava, was super cool--it's in an underground cave that's lit up beautifully with lanterns. Outside, they have terraces and lush gardens lit up with colored lights. The food was delicious, especially the creme brûlée and chocolate mousse that we had for dessert. Dessert isn't a huge thing in the DR, so I enjoyed being able to indulge my sweet tooth.

Los Tres Ojos: some of Jurassic Park was filmed here
On Sunday morning, we headed to Los Tres Ojos, a national park about 15 minutes outside the city. The ojos are natural cave lagoons, and there's actually four of them, not three. One of them was explored by Jacques Cousteau in the mid 1900s, and connects to an underground river that extends all the way to the ocean. The water is really aqua blue and there are all sorts of vines and ferms--parts of the Jurassic Park movies were actually filmed there. After the Ojos, we ate lunch a cute little Italian restaurant, then headed back to Santiago in time to watch the World Cup final. If I had one more weekend here, I would love to return to Santo Domingo--there are plenty of things that I didn't get a chance to see, including the Museum of the Royal Houses and the botanical gardens. Even though it was a short weekend, it was a great way to see more of the country and spend time with my American and Dominican friends

Monday, July 14, 2014

El Coco: Tierra verde y cielo azul (Part 2, Monday Week 6)

"Green earth and blue sky"

Only two weeks to go now, and I still have to finish writing about my visit to the rural clinics.

Getting ready to give our vaccine charla
Wednesday marked the middle of the week, and I the morning we gave a charla, or educational talk, about vaccines in the waiting room of the clinic. The vaccine program is actually one of the stronger elements of the Dominican health system. The vaccine schedule is quite similar to the one in the US, and all of the vaccines are free for everybody. They recently made available vaccines against rotovirus, a major cause of infant deaths from diarrhea, and pneumococcus. These vaccines are fairly expensive, but people who work in the health system are proud that the government is now able to provide them. During our charla, we ran through the different vaccines and the different ages when they are given. We also talked about the importance of the vaccination card, which serves as the child's official government ID and permits them to enter school.

On Thursday, we went out and filled out more fichas (family information cards). The process was the same as on Tuesday, but we visited some Haitian families in addition to Dominican ones. In general there is a lot of animosity between Dominicans and Haitians, and many Dominicans are especially upset that many Haitians are here illegally and using services like healthcare that the Dominican government provides. During our visits, the Haitians were clearly more suspicious of the clinic staff, and the clinic staff was much less patient with them when they didn't understand questions or were missing documents. Even more concerning, some of the clinic staff implied that the families wouldn't be allowed to visit the clinic until the forms were filled out, which I'm fairly certain is not an official policy (in any case, it was never mentioned when Dominicans were missing their documents). It's small interactions like these that, when added together, create the huge social, economic, and health inequalities between Dominicans and Haitians.

Enjoying our last afternoon at Sylvia's house--right before we met Stefhani
In general we were only busy in the clinics until lunchtime, so we had a lot of free time in the afternoons, when the clinic is open but most of the patients have already come and gone. We did a lot of reading, writing and sleeping, and one afternoon the nurses taught us to play dominoes. In the evenings we cooked and ate dinner at the clinic and then visited with Sylvia, our host for the week, or other families in the community. We went to the home of one of the nurses twice--her name is Altagracia and she's been a nurse for 24 years. She is very opinionated and a little loca, but I found her entertaining to listen to. She told us about herself and her family, other American students who visited the clinic and stories about people she knew. She was also a great source of information for our vaccine charla and for a class assignment on alternative medicine. On our last night in El Coco, we visited a young woman named Stefhani and her two month old baby Justin. We really hit it off and had been talking for more than an hour when we realized that Stefhani was only 16 and married with a baby--I had been thinking she was about 21.

Painting of Las Hermanas Mirabal
On Friday morning we packed up and headed back to Salcedo to meet up with the other groups and head back to Santiago. On the way, we stopped at the Museum of the Hermanas Mirabal. The Mirabal sisters were three women who were part of the resistance to the Trujillo dictatorship, which lasted from 1930 to 1961. They were assassinated while returning from visited their husbands in prison, and the national outrage from the event helped bring about the fall of the dictatorship and turned them into national heroes. Their family home is now a beautiful museum, and I enjoyed getting to learn a little more about that part of Dominican history.

The tropical flowers and plants are gorgeous.
Overall, I learned so much during my clinic experience. The region and the people are absolutely beautiful. The land is very green and the mountains in the distance create postcard-worthy views wherever you look. The houses are very colorful and the people are friendly, generous and content in a way that I've never experienced in the US. However, if I had to do it over again, there are a few things I would do differently. I feel like I let my shyness and struggles with understanding/being understood hold me back in many situations. I think it sometimes prevented me from learning things I was genuinely interested in and building better relationships with the people I met, particularly the doctors in the clinic. However, realizing this gave me the motivation to take advantage of the short amount of time I have left in the DR. Even though it's been more than a week since I got back, I'm still looking for situations to push myself outside my comfort zone and reach that place where I'm truly thinking in Spanish as I'm conversing. At this point I wish I was staying for longer, but I am beyond grateful for every opportunity I've had and I am savoring each day I have left.

Wednesday, July 9, 2014

El Coco: Tierra verde y cielo azul (Part 1, Wednesday Week 5)

"Green earth and blue sky"

Last week marked the halfway point of my trip. It was completely different from any other week so far, because we spent it living in different rural clinics throughout the province of Las Hermanas Mirabal, which is about an hour and a half west of Santiago.

CIEE students (Asia, top row far left, Jessica, bottom row far left,
Denise, bottom row middle and me) and El Coco clinic staff
We were divided into small groups of two to four people. The three other girls in my group and I were assigned to the clinic in El Coco. The town has about 900 families and is very close knit. There were yuca, corn and plantain fields, but the fields are small so at most it's a 2 or 3 minute walk to a neighbor's house.

Scarlet and I!
Many of the other groups lived in their clinics, but our clinic didn't have space for that. We slept at the house of the mother of a woman who works at the clinic, but we ate, showered and kept our stuff in the clinic and just bought a backpack to the house every night. This arrangement was a little strange, but I'm very glad that we got to stay with a local family. Sylvia, our host mom for the week, was incredibly kind and generous. She treated us like her children and got teared up when we had to leave. Sylvia is taking care of her four year old granddaughter, Scarlet, and we also got to know her very well during the week. She loves to draw and play school. She "taught" us the Spanish vowels and numbers, and we taught her to write "perro" "gato" and "ratón."

We arrived at the clinic on Friday afternoon, but because the clinic isn't open on weekends, we didn't get to start working until Monday. We spent most of Saturday getting our bearings, trying out the kitchen in the clinic and playing with some of the local kids. On Sunday we went to a talent show in a nearby town, and then we went to Mass in the evening. The service was simple but very joyful. The towns are so small that one priest travels between many different churches--the service in El Coco was his fifth of the day, and the congregation spent about five minutes simply thanking him for coming to celebrate Mass for them.

On Monday morning, we started our clinic experience by organizing the medicine shipment that had arrived on Friday. Because it's a public health system, the medicines are all generic and arrive together--very different than the US! We recorded the arrival of each medication by hand (the clinic has one computer, but nearly all of the record-keeping is done the old fashioned way). It was worrying to see that the clinic had run out of many medications before the shipment's arrival, and even more concerning to realize that some medications hadn't been in stock for over a year. We also helped the doctor calculate her needs for the next month's shipment, even though she doesn't always get the quantities she orders. Trying to do basic arithmetic in Spanish was more challenging than I expected!

Making home visits to fill out fichas
On Tuesday, we conducted home visits with the doctors and other clinic staff to fill out fichas familiares. The fichas contain basic demographic information and health histories of everyone in the household, and also summarizes the living conditions of the family (type of walls, roof, floor, bathroom, water storage etc.) Most of this was already complete, but they are trying to computerize the records, so we had to go back to fill in missing information before they send the records off to be computerized. Most people were surprisingly fine with a large group of people showing up and asking to see their IDs and insurance cards and to know how many bedrooms they have and how they dispose of their trash. Every house, no matter how humble, has a stack of plastic lawn chairs for visitors, and at every house the wife/mother wouldn't be content until we were all seated. It was really nice getting to explore the community and talk to people in their home environments. There was a large variety of living situations but Dominicans in general seem to be content with and grateful for what they have.

We also got to observe the consultas or office visits or hang out in the waiting room whenever we weren't busy. The office visits were generally short, and most of them were for Chikungunya. Chikungunya is a viral illness transmitted by mosquitos that arrived in the DR in March or so. It spreads really quickly and is all over the news and pop culture (See the music video!) It's not fun to have, but the good news is it's not life threatening. The main symptoms are fever, headache, pain in joints, particularly wrists, knees and feet, and a rash. The main treatment is Tylenol, which is by far the most commonly prescribed medicine at the clinic. Unfortunately, a lot of people, (including some doctors!) believe that it's an airborne virus because they don't think it's possible that mosquitos are spreading it this quickly. This is particularly bad because the only prevention strategies involve avoiding mosquito bites (using repellent and mosquito nets, and eliminating standing water where mosquitos can breed), so if people don't believe the mosquitos are responsible the disease will continue to spread.

Chickungunya music video

There's so much more to write and I've already written a short novel, so I'll save the rest for another post!

Saturday, July 5, 2014

Centro León: Luz, Sabor, Vida (Saturday Week 4)

"Light, taste, life"

Before I start writing about this week, there are still a handful of things from the week before that I need to catch up on.

Last Tuesday (June 23), we spent the afternoon visiting private health centers in Santiago. The first hospital we visited was Unión Medica, a private clinic only a few minutes from the university. The atmosphere was completely different from that of the public hospitals. We were greeted by about seven PR/administration type people, who took us on a tour of the clinic in small groups. Unión Medica is quite large--it would be called a hospital in the US, but here it's called a clinic because it's private. They have inpatient floors, outpatient offices, multiple emergency rooms, two MRI machines (including an open one for bariatric/claustrophobic patients), advanced lab tests, and a rehab department. Unlike in the public system, they focus on providing technically advanced and specialized care for complex cases, and they place much less emphasis on primary care and prevention. They seemed to have many more nurses and support staff than the public hospital, and they also had a computerized medical records system. After the tour, they showed us a video about the hospital, the director of the clinic held a small Q&A, and served us snacks (again, totally different than the public hospitals). Although I'd like to have more information to compare quality of the medical care, not just the material resources, the visits emphasized the tremendous influence that socioeconomic status has on healthcare in the DR.

After visiting Unión Medica, we visited Hogar Crea, which is a private rehab clinic for men who have problems with drugs or alcohol. One of the men who is currently going through recovery gave us a presentation on the organization and its philosophy. It sounded like an admirable and successful program. Their approach seems similar to AA: different steps of recovery, acknowledging the influence of a higher power, self-examination, long-term dedication to staying clean, etc. Unfortunately, I missed a lot because I had a hard time understanding the presenter. Although my Spanish is getting a lot better, I still have a long way to go before I can fully comprehend street Dominican Spanish!

Luz, Sabor, Vida, Color, Mezcla: words that describe the identity of the DR
Last Wednesday, we visited El Centro León, a museum of Dominican art, history and culture. The entire visit was guided, and (unfortunately) we weren't allowed to take any pictures inside. The whole museum was very modern and sophisticated, and because there weren't a lot of guests on a weekday morning we could really take our time in the exhibits. The first exhibit was an anthropological look at the different societies that have lived on the island and formed the Dominican identity. Teh exhibit opened with a photo montage of words and images that describe the DR, including luz, sabor, vida, color, and mezcla (Light, taste, life, color, mixture). They had a really awesome exhibit on the manglares or mangrove forests, an ecosystem that's unique to the Dominican Republic and the home of the first society on the island, the recolectores. I was especially interested in learning about the manglares because we got to see some during our beach trip at the end of the first week. The exhibit had brown metal pipes from floor to ceiling in the form of the roots of the mangrove trees, and fishing line criscrossed the room between the pipes a few feet above our heads, giving the illusion that we were standing under the water. Cases on the walls showed the types of fish and other animals that live under the water, and there were leaves projected on the ceiling to mimic the tree canopy. My description doesn't do it justice, so just trust me when I say it was really cool.

The manglares from our trip to La Ensenada during Week 1
The next part of the exhibit covered the colonial era. Columbus landed on the northern coast of the island on Dec. 5, 1492, and by about 1535 the native Taínos were virtually wiped out. Hundreds of thousands of slaves were also brought to the island to work on sugar plantations. Ever since Columbus' arrival, a great deal of racial mixing has occurred so that most Dominicans today are of mixed race. However, for a variety of reasons, Dominicans tend to emphasize their Spanish and indigenous roots and downplay their African heritage. This was evident even in the museum, where the colonial Spanish artifacts were displayed in brightly lit glass cases, while the African pieces were literally hidden behind a wooden wall with little slots that you peeked through to see the items. When we were discussing this with our program director, he told us about a Dominican saying that reflects their attitude about race: "In the DR, everyone has a little black behind their ears," meaning that everyone is at least a little black, but they don't want to admit it. Even though this is a public health program, I'm glad that I've gotten to talk about and think about the concept of race a little bit more while I'm here. It's such an interesting topic, and it's so central to the history of this country. Of course, it's central to the history of the US too, but discussions of race in the US are so fraught with strong emotions and fear of causing offense. Here, I feel like the program has encouraged us to combine historical facts and cultural observations with our personal experiences, allowing us make measured comparisons between the US and the DR and reflect more objectively on our own opinions and ideas.

Painting by Yoryi Morel
The last part of our visit to Centro León was the art gallery on the second floor. The art was arranged in roughly chronological order, from the colonial era to modern times. The styles and types of artwork were incredibly diverse, including paintings, drawings, sculptures, photographs, graphic design and installations. Although having a guided tour was really educational, I wished I could have had more time to just look at the artwork instead of just listening to what the guide was saying. Some of my favorite works were by Yoryi Morel, a painter who focused on depicting rural Dominican life. One cool feature of the art gallery was that they had accommodations for blind visitors, with a textured line on the floor for them to follow, audio descriptions, and miniature 3D reproductions of 2D paintings for them to touch and "see" what the painting looks like. Overall, it was an awesome visit and it was way more fun than going to class!

Tuesday, June 24, 2014

S'mores, surfing, Santiago (Tuesday Week 3)

Last week there was an international fair at PUCCM, and our CIEE program had a booth. We taught people how to make s'mores, and we even had some little catering burners to roast the marshmallows! (Big shout out here to Dorvelie, the CIEE intern who organized it all!) The host moms' organization also had a table and they made a ton of delicious food, and we got to visit tables for Haiti, Spain, Peru, Korea and Germany, among others. Finally, some of the kids in my program performed a dance with flags from all different countries (I missed the rehearsal so I was the photographer). It was a blast!

The s'mores were a hit!
I also had a blast this weekend, since we took a trip to Cabarete, a beach town about two hours from Santiago. We got there by taking a Caribe Tours bus, which is a nicer and cheaper version of Megabus. We bought our tickets the morning of the trip for 160 pesos (about 4 dollars) and they have their own bus stations, so you don't have to stand on the sidewalk. Our hotel was only a 10 minute walk from the beach, and it was one of the most beautiful places I've ever stayed. I shared a room with two other girls. We had a balcony, a shared kitchen and a tree whose trunk went up through the floor of our hallway and out through the roof!

Tree growing through the floor in the hallway!
Cabarete is significantly more touristy and developed than La Ensenada, the first beach we visited. After two weeks in Santiago, it was very weird to see signs in English (and German and Russian) and prices listed in US dollars. There were plenty of restaurants and bars along the beach, and there was a beach volleyball court! I was really excited when I saw it, so a friend and I worked up the nerves to ask if we could join in. We were the only Americans playing with a large group of Dominicans who were taking turns playing 6 v. 6. The players were athletic so it was a good game, but it was pretty casual. Then a few hours later a few Dominican guys came to play doubles, and they clearly knew their way around a volleyball court. They were much, much better than me and I was pretty tired, but they were very nice and let me play in their warm-up game. The whole afternoon was awesome and playing volleyball on the beach was one of my favorite moments in the DR so far.

(Side note: It felt weird typing out "Americans" in that last paragraph, because Dominicans, and Latin Americans in general, feel that the word "americano/a" describes the entire continent and should not be used to describe things only pertaining to the US--to say that, you should use the word "estadounidense." Unfortunately, there's no easy way to make that distinction in English. I should also point out that multiple Dominicans have described me as "americana" but they get to do that since they live here, but it would be seen as arrogant for me to do it because I'm from the US.)

The view from our balcony! Paradise!
Besides hanging out on the beach, the other awesome part of the weekend was taking a surfing lesson! Cabarete is known for watersports, especially kite surfing, windsurfing and surfing. The waves were really rough but our instructors were great and I was able to stand up on the board a handful of times! After the surfing I was pretty exhausted, so some of the others and I decided to skip going to the 27 waterfalls on Saturday. I hope I make it back there at some point, but it felt really good to get back to Santiago. Being in a tourist town, people assume that you're a tourist who knows no Spanish, and they see you mainly as a potential customer. Of course, we are foreigners and we were there to relax and have a good time (and spend money) so I really can't blame them.

In short, I'm glad that I went to Cabarete because it made me appreciate the fragile, but growing sense of belonging I have in Santiago. I know my way around the neighborhood and I feel comfortable walking back and forth to school on my own and greeting people in the streets. Between my looks and my accent I'm still obviously a foreigner, but I feel like people tend to perceive me more as an exchange student and less like a tourist. This makes it a lot easier to let down my guard and ask more questions and go new places and try new things, and then those experiences help me feel even more comfortable and ready to try something else. One of my goals for the rest of this week is to keep pushing my boundaries by talking to more Dominicans on campus and going out to explore more of the city.

CIEE dancers at the International Fair

Sunday, June 22, 2014

"The idea is that you are better today than you were yesterday" (Sunday Week 2)

Classes officially started last Wednesday, but we're still spending more time out of class than in it. We don't have classes on Wednesday afternoons or Fridays, and this Thursday was a Dominican holiday, so we had a four day weekend. We have three classes: Spanish (which includes a separate film component), Medical Sociology, and Community Medicine. Spanish is definitely challenging, but my professor is very nice and engaging. She mixes grammatical lessons with practical tips and information, like idiomatic expressions and how the Dominican accent works. We still haven't seen any films in the film component, but I like the professor a lot and I'm looking forward to having that class on Tuesday.

"The idea is that you are better today than you were yesterday"
The Medical Sociology class and the Community Medicine classes are pretty similar, so sometimes it's hard to keep them straight. They take place in the same classroom, are taught by young female professors, they include a lot of group work and they sometimes cover the same topics on the same day. We've covered the organization of the Dominican health system in both classes, and now we're going over the Millennium Development Goals in Sociology. In Community Medicine, we're talking about the transmission, prevention and treatment of diseases endemic to the DR, including Dengue, Chikungunya, Malaria, Leptospirosis and Salmonella.

We also got to visit three hospitals in the Dominican public health system on Tuesday. The first hospital, Hospital Regional Universitario de José María Cabral y Báez, was built in 1978 and is undergoing a much-needed renovation. The wing that had been completed looked like a different world compared to the un-renovated part. The Dominican health system is leveled, and the this hospital is part of the third level, which is the most specialized. They have almost all of the specialties that you would see in the US, including things like laproscopic surgery and a NICU, and plenty of doctors and medical students, but a huge lack of material resources. They were pretty proud of their one modern X-ray machine and two computers for viewing the images. They don't have an MRI machine yet, but they are getting one as part of the renovation. It seemed like the hospital was slightly, but not hugely overcrowded, but the biggest thing I noticed was that US hospitals have so much more stuff. The hospital rooms have four beds and a bathroom and maybe an IV pole or two--no TV, no monitors, no chairs, no cabinets, no tables, no boxes of tissues, no hand sanitizer, no trash cans, no boxes of gloves and gowns. I'm sure the lack of stuff also carries over to things we didn't see as visitors--lab tests, operating supplies, etc. It makes me wonder how much of the "stuff"in US hospitals is necessary to practice good medicine, and how much of it is spending whole lot of money for little (or no) benefit. The other crazy thing is that this hospital covers the population of 14 provinces--there are only 2 or 3 similar third level public hospitals in the whole country. The government is investing a lot of money in upgrading this hospital, which is very good, but they also need new hospitals altogether, so that people don't have to travel two hours or more to get to this one when they need it.

Regional University Hospital (The wing on the left is being renovated)

We also visited the third level children's hospital and a second level regular hospital. The children's hospital seemed to have more resources than the adult hospital and was a lot less crowded. We saw an oncology unit and a burn unit, and there were a lot of murals and a fish tank and toys for the kids. We didn't spend much time at the third hospital (we were running late) but we listened to an administrator talk about the services they offered as a second level hospital. The system is supposed to work through references--when you have a problem, you go to the primary health center first, and they decide whether you can be treated there or should be referred upwards. However, in reality, people decide on their own to go to the hospitals, because they think they'll be treated better there, even if they have a routine problem. Our professor said that one of the biggest challenges is convincing people to use the system the way that it is designed, so that it can work the way it's supposed to.

Children's Hospital

The hospital visits fit nicely into a larger pattern that I've noticed over the past two weeks: Dominicans are very focused on and committed to improving their country. There are a lot of problems here, but there are also so many projects happening to address them. In the 15 days I've been here, I've read about or heard about a national effort to regulate the prepaid cell phone industry, the opening of the national 911 emergency system, a new naturalization/registration process for Haitians living illegally in the DR, an increase in funding for education to 4% of the GDP, plans to increase the country's use of clean energy, and a campaign to eliminate illiteracy. There are also lots of billboards and announcements (many featuring baseball players or other celebrities) encouraging people to obey speed limits, wear helmets on motorcycles, speak out against domestic violence, etc. I saw a phrase painted on the street that captures this attitude perfectly: "¡La idea es que hoy seas mejor de lo que eras ayer!"which means "The idea is that you are better today than you were yesterday"

Monday, June 16, 2014

La Vida Dominicana (Monday Week 2)

Last Thursday we had a cena comparativa, where all of the host families in one neighborhood cooked one dish of the meal, and our group of students went from one house to the other, meeting each others' host families and seeing their hoses. It was a really fun way to get to know each other better and try different kinds of Dominican food! We started with a salad with a delicious passionfruit dressing, then a vegatable soup. For our main dish we had pasta with bacon, and then mangos and an almond cake for dessert. Finally we had coffee, tea and juice at my family's house.

In general the food here is a lot fresher than in the US, and there are fewer grains and starches. I've only eaten bread a few times, although rice is pretty common. (Red beans, called habichuelas, and rice is probably the most typical Dominican dish--I love it!). I've tried a lot of plantain dishes too, including mangú, which is mashed green plantains, frequently with onions and/or cheese. Fruit is also a huge part of the Dominican diet, especially fruit juices. We have a mango tree in our backyard and I have mango with breakfast every morning. Sometimes all the sugar can be a little much for me (and this coming from a girl with a massive sweet tooth!) so I try to drink water whenever I can. I've also had a lot of chicken and fish cooked with really delicious spices. 

The culture is also rather more relaxed than in the US. One of the first phrases our resident director Ryan, taught us was Cojelo suave, which roughly translated means "Take it easy."Most people take a long lunch break in the middle of the day--we have a three hour break between classes from noon to 3 where we go home, eat lunch and rest a little bit. You also see people, especially older men, hanging out outside and socializing at all hours of the day. However, Dominicans, especially upper-class Dominicans, tend to care about how they look a lot more than in the US. At the university, pretty much all of the students look nice, and for special occasions people really go all out. I attended my host sister's graduation from PUCMM on Saturday, and it was a beautiful ceremony, but I also really enjoyed the opportunity to people-watch. For women, heels, lipstick, and jewelry are all more common and more showy than in the US, and men's clothing is just more fashionable in general. Overall, I like taking the effort to look nice, although I've been passing on the heels, since even in flats I'm taller than most Dominicans who are wearing heels!

I also have to correct some of the info about my host family that I posted earlier. While adjusting to the language barrier and just general settling in, it took me a few days to realize that the family profiles that were sent to us introducing our host families were four or five years old, so a lot of things have changed since they were written. Anaida, my host mom, has a husband, Miguel and three children, Carlos, Carolina and Melissa. Miguel was living and working in New York, but he had a stroke a few years ago and came home. He walks with a limp and has some speech problems, but he seems like a pretty happy guy and spends his time doing work around the house. Carlos is married with a three-year-old son, Carlos Angel. He lives nearby and comes over a lot, and Anaida and Melissa frequently watch Carlos Angel. He's particularly friendly and easy to talk to, and he's taking English classes so he likes to ask me questions about grammar and punctuation. I also love playing with Carlos Angel--he was very shy the first few days I was here, but now he talks to me and likes to climb all over me. Carolina is also married and lives in Santiago, although further away than Carlos. I met her and her husband for the first time on Saturday. Melissa is the youngest. She's 23 and just graduated from PUCMM on Saturday with a degree in dentistry. She is living at home for now but wants to go study in Brazil in the fall.

We started classes on Wednesday and went to the beach on Friday (we don't have classes on Fridays). The beach was called La Ensenada, and it's about 2 hours from Santiago. The water is super blue and shallow, and there's barely any waves. We spent most of the morning in the water, and then had lunch, which was fish, salad, rice and beans, sweet potatoes (batatas) and tostones (fried circles of yellow plantains). In the afternoon, we took a 25-minute boat ride to a tiny sand little island in the middle of the ocean. The boat ride was fast, exhilarating, and very wet, and I would do it again in a heartbeat. We went snorkeling at the island (my first time). The reef and the fish were a little less colorful than I was picturing, but there were all sorts of different fish to see if you looked closely. I also saw an eel that was more than three feet long!

The beach! It's a small beach and it was was early on a Friday morning so it was basically empty.


Sand island--I wish I could have taken pictures of the snorkeling

Little restaurants and stores on the beachfront road--I love the bright colors.

Tuesday, June 10, 2014

Orientation (Tuesday Week 1)

Studying abroad continues to do funny things to my sense of time. It feels like it's been more than a week since I wrote the last post, but it's only been 72 hours. On Sunday morning we went to Jarabacoa for an orientation, which is a town south of the city at the base of the mountains. We drove for about half an hour in a guagua (a large van that seats about twelve people comfortably and fifteen or sixteen if you squish. We always have to squish--a good way to get to know people better!) and arrived at Casa Club, which had a large open pavilion, a snack bar, a regular bar, a pool, a basketball court and pool tables.

We spent the morning listening to the program directors talk to us in a small room with very cold air conditioning. It was cooler in Jarabacoa than in the city, but it was still very warm outside and we felt like we were defrosting each time we had a break. Then we had lunch, which was delicious--rice chicken and salad. Lunch was nice because we got to spend a lot of time talking and getting to know each other, especially the students that we hadn't met yet. After lunch the estudiantes de apoyo (support students) from PUCMM talked to us about university life. This part of the day was in Spanish after a morning of English, which was an adjustment. After the presentations ended, we had free time to hang out with each other and the estudiantes de apoyo. It was getting cloudy and a little colder, so I didn't swim, but I played some basketball with some other students and some Dominican kids. The game we played was sort of like a team version of Horse, and the kids clearly had fun teaching us the game and bossing us around.

When we got back to Santiago, we went out to a restaurant/bar called Puerto del Sol to celebrate someone's birthday. The place was large and casual but quite nice. No one went crazy since we had to be at the university at 8:15 to take Spanish placement tests the next morning, but we had a good time.
The Spanish placement test was very similar to what I've taken at Pitt, and I guess I did well since I'm in the advanced class. I'm slightly nervous about this since there are 8 or 9 heritage speakers in my program who are very good at Spanish and I'm a little worried about being compared with them, but overall I'm glad that my Spanish was good enough for them to place me there.

I think I'm ready for the classes to start, although we know surprisingly little about them. They are going to be taught entirely in Spanish by professors from PUCCM, but there aren't going to be any Dominican students in our class. I haven't seen a detailed syllabus yet, and I have no idea how much homework there will be, but I guess we will find out soon! Overall I enjoyed orientation, but I'm getting very tired of being in such a large and cumbersome group all the time. Everything starts late and takes forever because there are so many of us, and I feel like we're always very loud and conspicuous and a little obnoxious. Sometimes it seems like things could be better organized, but the program this year is almost twice the size of the one last year, so I can see that that they might not be used to working with such a large group.

This afternoon we actually did get to go out and see the city by ourselves in smaller groups. We did a scavenger hunt through the city, and it really helped me become more comfortable using my Spanish in real-life situations and getting around the city. Dominicans are super friendly and we had no problem getting directions and other information from people on the street. In addition to walking, we traveled using conchos, which are cars that follow a fixed route and pick up and drop off passengers at any point along the route. They're very safe during the day and they're super cheap--twenty pesos per person (about 50 cents). The catch is that they will hold as many as six passengers, two in the front seat and four across the back, which is more than a little uncomfortable!

Besides all of the CIEE activities, life with my familia anfitriona (host family) is a entirely different but equally important part of my experience. I'll save that for another post since I have a lot to say on that subject, but in general everything is going very, very well. I really like talking about life with our host families with the other students when we walk back and forth to the university each day, because we can compare our experiences and tease out the general patterns of Dominican life from all of our individual experiences with each family.

I've been really bad about taking pictures over the last couple days, but I'm going to upload some that other people took (and that they promised to send to me) as soon as I get them!

Saturday, June 7, 2014

Arriving! (Saturday Week 1)

Twelve hours ago I was sitting at the gate waiting to board the plane...but it feels like ages ago. My flight left from Newark at 9 am, and I was very lucky to have about twelve other students from the program on the same flight. We started getting to know each other at the gate, and we got louder and more conspicuous as more and more people showed up. The flight was pretty short--about three hours and forty minutes. When we arrived, the first thing I noticed was the heat. 82 degrees here feels a lot warmer than 82 degrees in Pittsburgh, because there's more humidity and less AC. Also, we were able to go through customs and immigration as a group, which was wasn't hard but it was still nice to be with a group.

Once we had our baggage, we got in a big van and went straight to PUCMM (the university) to meet our host families. As the van was parking and we were gathering up our things, all of my nerves and anticipation peaked, and I could tell that the other students felt it too. To add to the stress, I was one of the last people to find my host mother, but eventually she found me and we went into an open air pavilion (out of the sun!) where we could sit down and get to know each other. They served us some snacks and we watched a few short videos introducing us to PCUMM and the DR. It took me a little while to warm up to speaking Spanish and get over my nerves, but eventually my Spanish started flowing well enough to hold a conversation.

The reception was pretty short, and afterwards we all split up to go to the homes of our host families and start settling in. My host mother's name is Anaida, and she has two daughters who live with her, Carolina, who is 24 and Melissa who is 18. Anaida's husband Miguel Angel usually lives in the US, but he is home now so I got to meet him too. Anaida also has a son, Carlos, who is married and lives with his wife and three-year-old son in an apartment around the corner from Anaida's house. Carlos and his son drove us home fromt he reception and he was very kind and helped break the ice by describing some of the city sights as we passed them.

I spent the rest of the afternoon chatting with Anaida and eating the food that she kept offering me. I had the most delicious mango from the tree in their backyard, so I'm looking forward to eating more of those in the mornings before class! My Spanish speaking is going way better than I could have hoped--I was able to keep up conversation with Anaida for most of the afternoon. Of course there were plenty of times where I trailed off in the middle of a sentences because my vocabulary failed me or where I had a deer-in-the-headlights look on my face because I lost the thread of the conversation. Overall though, I can make myself understood and I know I'm going to improve rapidly with so much practice.

Tomorrow we have a full day of orientation at a hotel/conference center/vacation club (not exactly sure which description is most appropriate) that supposedly has some beautiful waterfalls and a pool to swim in. The pool is our reward for sitting through three hours of presentations about diarrhea, Dengue fever, cultural adaptation and other fun topics. I'm excited to talk to everyone that I met on the plane to hear about their evenings with their host families. I'm also excited to meet the 20-ish other participants in the program whom I haven't met yet. (There were different host-family receptions for the people whose flights arrived at different times). I'm also excited to see more of the country and the city and start getting a feel for what everyday life is like here.

Side note: The house where I'm staying has wifi so it seems like Internet access won't be a problem. Feel free to email and send Facebook messages! Also, if you'd like to get a postcard, send me your address and I'll mail you one!

Our descent into Santiago. The city is right at the base of the mountains so it's really beautiful.

Flying directly over the city

On the ground!

Saturday, May 24, 2014


Today marks exactly two weeks until I leave for the Dominican Republic! I am participating in CIEE's Community Public Health program, which runs from June 7 to July 26. I'll be taking three classes (Medical Sociology, Community Health and Medical Spanish) at the Pontificia Universidad Católica Madre y Maestra in Sanitago. During the online orientation that I had on Friday, I learned that the university is known as PUCMM (pronounced pu-ca-mai-ma) which makes me smile every time I say it!

Santiago is the second largest city in the DR, and it's about an hour and a half from the coast in the northern part of the country. I'll be staying with a host family within walking distance of the university, which is probably one of the things that I'm most excited about. I won't get to know anything about my host family until shortly before I arrive, but I get to write them a letter in Spanish introducing myself. I'm working on it now, but I'm taking my time to make sure I say exactly what I want to say, and I don't make any silly grammatical errors.

Attending the online orientation made the trip and the program seem so much closer and so much more real. The program director gave a short presentation about the country, the city and the program and then we were able to ask him questions via chat. He also gave a short primer on some of the differences between Dominican and American culture that we'll go over more closely during orientation. For example, although the Dominican climate is similar to Pittsburgh's during the summer, people rarely wear shorts outside their homes. Also, carrying a backpack to class is apparently uncommon and will make us stick out. I was planning on bringing my backpack, so now I have to decide if I should accept the consequences of standing out or try to bring a purse large enough to carry my school things. 

Lots of people had good questions to ask during the online orientation. Most of them were practical sorts of questions about what to expect and what to pack, but it was nice to know that we all have similar questions and that everyone wants to be as prepared as possible. I've been trying to brush up on my Spanish by reading a book in Spanish (Outliers by Malcolm Gladwell) and listening to some free Spanish audiobooks that I found on the Internet. I'm not sure how much it's helping my Spanish skills, but at least it's (mostly) keeping me from worrying about being totally underprepared. 

To be honest, I probably am underprepared, and I probably will struggle to communicate for the first few days. I've never traveled to a Spanish-speaking country before, and I've only been studying Spanish for two years (I took Latin instead of Spanish in high school). Also, Dominican Spanish speakers (and Caribbean Spanish speakers in general) speak much faster than Spanish speakers from other parts of the world. However,  I know that once I get there and I'm immersed in Spanish, I'll learn really quickly, and I'll learn much more than I could in an American classroom. After all, that's a big part of why I'm studying abroad!