First Family Visit! & GoMad Ministries :) Feb 2014 - Month 32 in the D.R.

I was super excited this month (February 2014) to have my parents, my aunt Fern and Uncle Rich, my aunt Sue and my Uncle Marlin all come from the U.S. to visit me!  I was so excited to have them come to learn about and experience my life here!  Thanks guys for letting me drag you all over the North Coast!

Here's a little video and a couple of my favorite photos from their 7 days here on our little Island of Hispanola! :)

 

 

 

 

 

We visited GoMad Ministries and

learned more about the work of my friends from church -- Missionaries Chantz and Renee Cutts. Here we are in one of the rooms of their medical clinic.  They'll soon be starting an after-school tutoring program in this same building as well.  Chantz and Renee's ministry began (and continues) with and outreach to women involved in the prostitution and sex-trafficking ring in Sosua Dominican Republic -- where my church is located. They are empowering local churches to reach out to these women, and they offer a safe-house and help with job training for women who want to get out of the trapped life of prostitution here, where older, rich, white men mostly from the U.S., Canada, and Europe come. The foreign men are the primary source of income generated to keep the sex trafficking industry going strong here in Sosua.  Since Chantz and Renee are friends of mine from church, I took my family to visit them to learn about their lives in ministry here in the Dominican Republic.

  

Here's their website it you'd like to learn more about their ministry.

http://www.gomadministries.org/about-us/

 

 

 We got caught in the rain at the Fortaleza (Fortress)!   

 

 

                                     I got a hug from my friend Wilmeri in Pancho Mateo

  
                   We visited My Friend and Co-worker Willy and neighbors in Pancho Mateo,
                                     and my family got a lesson in hair extensions. :)

             We watched Estela's elementary school aged daughters Hoola Hooping in Negro Melo

                                     
                                     Everyone got hugged by EVERYONE in Pancho Mateo! :)

                                              
                                                          ... And in Negro Melo  too :).

 

We took a walk down by the River in Pancho Mateo and chomped on sugar cane in Negro Melo :)

 

                  It was a real joy to me to have my Parents and Aunts and Uncles here to visit! 

                       A true HIGHLIGHT of the 2 3/4 years that I have been here so far! :)

 

Pharmacies, Meds, and Medical Volunteers (January 2014 -- Month 31 in the D.R.)

 

This month we had another busy week of medical field clinics in 4 low income communities!  We welcomed 6 U.S. PA students and 4 U.S. MDs as they joined our team of community health workers and staff in the clinics.  In the photo above the Community Health Workers are running Intake and Medical Records, while the PA students help set up the triage area, at the beginning of the clinic day.

  We took the PA students and MDs out to check out the Latrines (out-houses) being built by HHI and families in the communities. Here's one that I am sitting on. It will soon have walls and a roof to give the family privacy. Latrines help improve sanitation conditions in communities where people sometimes just use the restroom in the great outdoors around the community which can contaminate their living situation and lead to illnesses in the communities.

Nurse Jenny and Interpreter Pierre (above) proved that sometimes the best medicine for kids is a hug, a nap, and some giggle time. Go Jenny and Pierre! Thanks for the help!

PA student Jen teaches a 1 year old future doctor how her stethoscope works.

 PA students and Community Health Workers check vitals on community members waiting in line to see the doctors in the little church in the mountain community of Negro Melo.Thanks to my friend Jacalyn, there in the corner, for that happy "thumbs up!" :)

Now Here's a Separate Adventure:

Before the week of Field Clinics my colleague Marineli and I got the chance to travel to the big city of Santiago to meet with representatives of medication distribution/pharmaceutical companies, and to visit the lab where one of the pharmaceutical companies that supplies meds to our patients makes and packages those meds.  Since medications made and distributed in the D.R. are not always made correctly (there is inconsistency in how well they work depending on which company made them because they don't all have the right amounts of the correct medication components actually in the pills. It's a problem the Dominican Government is actively trying to combat, which is good, because many doctors and patients here feel that the meds they sometimes take and prescribe are not effective because the manufacturers lied about the components in the meds.)  So it was great to be able to visit the sanitary lab at Iberofarmicos where many o fthe meds we purchase for our patients are made.   Above, Marineli and I suited up in scrubs, lab coats, and sanitary slippers for our tour.

 Here's me (white coat) with our tour guide -- the physician in charge of the labs.

Here are the women packaging the thousands of packets of meds into boxes -- by hand.  A boring job that I suspect is very hard on the hands.  But they did it very carefully and professionally. God bless then for doing this 6-8 hours per day each week, each month, all year.

Here's another shot of the quiet, industrious med-packaging room.

 

Here I am in the lab where they make sure the pills all contain the proper ingredients.

And here is one of many rooms where lab techs in scrubs and gloves check the meds for quality, then move them on to the next step of the packaging process.

It was all very interesting, and the staff at the Iberofarmacos company (photos above) were very proud of the measures they take to provide quality control in their pharmaceutical manufacturing labs.  Marineli and I enjoyed our very informative, scrubbed up adventure, and can now share with local health workers in our region what we observed at the Iberofarmacos lab.

Happy Holidays from the Dominican Republic! (Month 30 in the D.R.)

Dear Friends and Family,

Happy Holidays from the Dominican Republic!

I put my Christmas letter in video form this year.  Click the square at the bottom right of the 

video box if you want to make it full-screen.

I'd love to hear about your 2013 as well! It's hard to receive mail here, but please email me your news at Christmas (or any other time of the year) at jkbiti@gmail.com  :)

May your Christmas be filled with Love, Hope, and Peace.

Isaiah 9:6

For to us a child is born, to us a son is given, and the government will be on his shoulders. And he will be called Wonderful Counselor, Mighty God, Everlasting Father, Prince of Peace.

Driving Across the River, A Kitten of our Own, and a Trip to the States -- Month 29 in the D.R.

After a great 2.5 week visit home to Raleigh, NC where I was glad to catch up on the lives of my friends from Raleigh Mennonite Church (a few pictured below), SCBWI and the Goalies (a few pictured above,) my old job friends from CAS, my family, and others, I have now returned to the Dominican Republic.  After almost another year in the D.R. without a visit home, it was wonderful to see you all, to smell the rain, enjoy the beginning of the fall leaves changing, and wear SWEATSHIRTS & SOCKS - something we rarely do in the D.R. Thanks to every one of you for your continued friendship and continued support in so many ways for my work and life here in Hispaniola! I would feel much farther from home than I actually am if it wasn't for all of yoU keeping in touch!

Upon returning to the D.R. I've been delighted to be greeted by my housemate Julienne, Missionary neighbors Sadrac and Leeann, Co-workers, and this little guy below. He's the one cat we have left from our litter of 5 mommy-less kittens that Julienne and I and our friend Elisabeth from Germany bottle-fed for 5 weeks in July after their mother died.  The others have all been parceled out to good homes in our town -- one even went to live at the local veterinarian's office (how lucky for him!)  We decided to keep little "Sol" ("Sun" in English -- pictured below) and are enjoying his fuzziness, antics and purring.

 

Here are a few more photos of life back in the D.R. again!

Above -  I'm sitting in Community Health Worker Coordinator Carlito's front yard where we're planning this past week's Community Health Worker Continuing Education class and discussing patients in need of doctor's appointments. 

Below - Carlito and his wife Claudia (also a Community Health Worker) are discussing patient's needs in their community of Pancho Mateo.

 

Their grandson, little Emmanuel, was born at the regional hospital last Christmas and he'll be a year old soon.  I think that's probably the best name ever chosen for a Christmas baby.  

"God with Us"

He's a great reminder of the 1st Emmanuel celebrated at Christmas after his birth many years ago -- a reminder of what's important as we head toward the Holiday season 2013!

Today I took a new staff member up the sugar cane road
to visit our 4 partner communities .

 

To get to our farthest out community, Arroyo de Leche, we had to drive across the river.  Luckily the water was very low today otherwise we wouldn't have attempted it. We would have gone up the steeper but dryer road on the other side of the mountain on motorcycles, as we usually do, to get there a different way. :)  But no worries. The river was very low today!

On our journey today we visited with 4 of HHI's Community Health Workers in 3 communities, including Dorka (in the purple shirt,) and her teenaged daughter Kaeila. We found them walking down the dirt road in their rural community, Severet, holding a bunch of notebooks.  They were on their way to a place across town where they have started a free afterschool tutoring program for 50 children from their community.  Dorka, the local pastor's wife, is a Community Health Worker with HHI, a full time high school math teacher, and she and her daughters started the tutoring program on the side (as volunteers) to help the kids in their village do better in school.  I really must say that all of my co-workers truly inspire me with their sense of volunteerism, and the way they put aside the fact that they may have worked or volunteered all day already, and have kids of their own to cook for at home, and despite all of the things that they're already doing, and the fact that they're tired, they put others ahead of themselves and volunteer their time to better their communities!  It's really very inspiring!

Here's a photo looking down from Dorka's rural community of Severet, looking away toward large Mount Isabel which towers over far away Puerto Plata city, the seat of Provincial government in our region.  To the left of the Mountain you can see the line of darker blue just below the sky -- the Atlantic Ocean. 

Truly - despite the hard work that we all do here, there are also many advantages to living in the Campo in the Dominican Republic -- not the least of which is the fabulous view!

Huge Thanks for your continued daily prayers for our work and lives here in the Dominican Republic! The notes, Skype-calls, and PRAYERS are always so very much appreciated!

Making Chocolate from a Tree - July 2013, Month 25 in the D.R.

While joining Community Health Worker Mercedes on rounds conducting home visits to our HHI patients with Hypertension, Diabetes and Asthma 45 minutes up the mountain in Arroyo de Leche earlier this summer I finally got the chance to fulfill a special non-work-related goal of mine for my time in the D.R.  I got to learn where chocolate REALLY comes from, and how to make it -- from Tree to Chocolate syrup!

This is a Cacao Fruit.  It's where Coco comes from to Make Chocolate.

Community Health Workers Mercedes and Carlito, and Mercedes' youngest daughter Marielis took me and two medical students into the woods near one of her patient's homes to find the ripe Cacao Fruit growing on the nearby trees. 

Here Marielis holds an open Cacao Fruit.  If you eat it fresh, there are small purple sweet sections you suck on.  The purple is covered by a layer of white skin, similar to the white skin inside the rind of an orange.  Here we are sucking the sweetness out of the Cacao. :)

(As a side note, yes, there are blonde Dominicans.  Marielis, the little blond girl, is Dominican through and through!)

Here Marielis shows off a Cacao fruit she expertly plucked off a nearby tree, while medical student Brad, in his "doctor scrubs" looks around for more.

I took a Cacao fruit home, to learn to make Chocolate.  It was yellow when they first plucked it, but because of a busy work week, it waited in my hot kitchen for almost a week before I could start the chocolate process, and it turned rather brown. Luckily the fruit inside was still good!

This is what the fruit looks like when you first take it out of the shell.  See the purple below? Those are the Cacao seeds! Yucky if you chew them! They have a sweet outer coating which is what you suck off if you wish to eat the fruit raw. :)

 
To make chocolate you separate the seeds.  They're a bit slimy, and a beautiful shade of purple inside.

Separate them into individual seeds...

 

Now they're ready to be dried so you can make Cocoa!  

So, onto the cookie sheet they go, and up onto the roof in the hot Dominican sun for a week or more.   Mine were drying for almost 2.5 weeks. That's partly because it kept raining and I kept having to bring them back into the house for a day or two to avoid the rain. :)

 *Note to self -- don't try to dry Cacao fruit on the roof during a rainy month! :)

In the end I didn't quite make it to the Chocolate stage. :(  I got to the "fruit is dry (see fruit in bowl) and smells like chocolate and is ready to be pounded into dust and turned into a liquid chocolate syrup" stage. Alas, I had to hurry into another busy work week and didn't have time to make the syrup before the hard, dry chocolate scented fruit seeds began to rot.  

*Note to self -- only try to make chocolate when you're own vacation for a week or have the time to really commit to the several week long project! : )

But still,  I am excited to now have first-hand knowledge of how chocolate is made and to be able to say I helped pick Cacao fruit off a tree and baked chocolate seeds on a cookie sheet on my roof!
Mmmmmm. The smell of baking chocolate!

Note the picture of the Cacao Fruit on the candy bar wrapper from Europe (via Ecuador) below!

So when I'm in Arroyo de Leche again I'll have to get another Cacao fruit 

and finish the whole process through to the eating stage next time!

 Here we all go - Me, two Community Health Workers, two Medical Students. and one  6 year old Marieli, crossing the river, off to visit patients in their colorful wooden homes 

in Arroyo de Leche.

Two Years in the D.R. -- Looking back and Ahead -- Month 24 in the D.R. (June 2013)

             Here's a photo of me in Pancho Mateo, one of the communities where I work.

Well, I initially signed up for one year of working at Health Horizons International (http://hhidr.org/), as the Clinical Programs Director, in Montellano, Dominican Republic, in June 2011.   I always assumed that that one year might turn into two years, and of course it did.

Now, as of June 11th, 2013, I've celebrated 2 full years of living in the D.R, and now I'm signing on for another (3rd) year.  

So this month I'm just going to share a few of my favorite photos and memories from the work and life I've experienced here over the past two years.

Still one of my favorite photos of the last 24 months, this picture above  shows 100 kids from Pancho Mateo (including one of my favorite groups of siblings standing in front -- my little friends Francia on the right, and her brother baby Alexandre being held by another sister on the left.)  This was during the kids camp that I and the Raleigh Mennonite Church teen girls, and the teen girls from a church in Pancho Mateo organized in Summer 2012. I love this photo because it shows one of the Dominican teen girls (Nina) taking a leadership role and sharing structure and God's love with the children of a local Hatian family -- her neighbors.  It is God's love that breaks the barriers of racial conflict in so many places, and it is love and structure and older mentors like these teens from the community who can help all these 100 kids grow up to be wonderful women and men who can be leaders in their communities for the future! (I love the RMC teen ladies working hard in the background loving-on the children as well!  I was so impressed with all the teen leaders from both countries! It was a hot, exhausting, and great week!)

I took this photo during one of my first weeks on the D.R. and it is still definitely one of my favorites.  It shows the road we take on motorcycle to get to Arroyo de Leche -- our farthest away community up the mountain -- to check on patients there.  The Dominican countryside is a beautiful place -- especially along this, the sugar cane road, flanked by acres of tall green sugar cane on either side.  But it is a difficult road, sometimes impassible, and sometimes I've had to walk up in rain and mud when trying to go up on moto was just not safe.  So this road reminds me of our journey in life. It can be difficult, sometimes next to impossible, almost impassable.  But there is beauty all around us on the journey -- if we look.

I love this photo of 6 of the 19 Community Health Workers who I supervise and who I have helped train, and who continually share their love, friendship, and knowledge with me.  I will always be proud to know them!  I'm so impressed with how they spend their time, energy, and resources without hesitation to help others in need in their communities, and I hope to grow to be more and more like them.

This photo shows a note that was stuck to the side of the fridge in the house we borrowed from missionary-from-Canada Rachel Stickley when I first arrived in the D.R.   I was glad to see this important reminder as I sat in the dark in the evenings those first few weeks here, with no electricity, (the generator broke while I was there,) being eaten by mosquitos, (I was still learning to use my mosquito net!) and trying to flush the toilet with just a bucket of water, and cook on a gas stove that I was sure was about to blow up in that borrowed house. : )

In this photo I'm visiting the river with my friend, Community Health Worker Dania, to learn about the dangers of unclean water in the river around the time of our cholera outbreak in fall 2011.

Here we are going door to door with co-workers, friends, and neighborhood children delivering cholera-prevention information and hand-soap called "Harmony" that same month, Fall 2011.

Here missionary women from the surrounding area gathered at my and my housemate Julienne's house in December 2012 for a Christmas party. We made ornaments and sharing stories.  We hope to do it again in December 2013!  It was great to have everyone over!

Here I and one of the medical students, Kate, are accompanying "Awesome Community Health Worker," Estela and her youngest daughter on home-visits to her patients in Negro Melo, on a rainy day when the roads had flooded. :)  That rain never stops US! :)

And...

I'll end with a video that is old -- it was actually made before I came to HHI -- but it shows a little bit of what we do here and some of the experiences that I've had the opportunity to be a part of here. (I'm now responsible for the field clinics, and for doing the work that "nicole" did -- working with the communities, patients, and community health workers. So this video definitely shows a lot of what I do).  Note: The address for donations in the video is wrong, so please disregard that and go to the link above for the HHI website if you want to learn more about where I work or feel like making a donation).:

Here's the Video: HHI Field Clinics Video

Thanks so much to all of you for the prayers, visits, and support over the past two years! And thanks for the continued support and prayers as I move forward into the 3rd year here in the Dominican Republic!