What's New With the Dominican Republic Project?

April 2008

Warm greetings from our town of El Cercado. We are overjoyed to have
received $4,000 from your congregation for our Community Health Promoters
Program. Your donation has helped us to accomplish many miracles:
training another 30 volunteers as community health promoters

monthly orientations on health topics
the start of a Senior Citizen Center which will provide food,
medical care, recreation and hygiene for 50 seniors
a health and sanitation project in 7 communities
a small business for a group of local women
home visits, orientations for preventive health care clinics, bringing specialized physicians
advocacy

The health promoters, thanks to your support and their commitment, are the foundation for all of these projects, and provide
the momentum to keep the projects growing. Thank you from the bottom of our hearts. Please come and visit and see for
yourselves. Peace, Joanne Peterson

February 2007

A Note from Joanne Peterson

Members of Incarnate Word: We give thanks to Incarnate Word for supporting the Health Promoters Project these last two years in El Cercado. The health promoters will be graduating in April. Dr. Gina Montero has agreed to train new health promoters in new villages. Those already trained will continue in specialized training courses from time to time. We are so pleased! Approximately 55 health
promoters in 30 villages will finish the course and get an identification card, a certificate and a first aid kit with blood pressure cuff and stethoscope. They will continue to weigh malnourished children, monitor diseases and illnesses, give instruction to promote good health and good hygiene, vaccinate adults and children, give injections, do blood pressure checks, provide first aid in their community, and
notify patients in their village who need surgery when volunteer doctors from the States come and sponsor surgery clinics. Right now we have more than 60 patients who need surgery for prostate, hernias, thyroid conditions, hysterectomies, skin cysts, bone surgery, cataracts, tubal ligations and more. Four weeks of clinics have been scheduled in January-March.

Without the economic support and prayers that Incarnate Word has provided, none of this would be happening. So you deserve a big pat on the back and hugs for your interest and dedication, and ongoing support for this project that saves lives! One more part of the health promoters project: In ten villages we just installed medicine chests or small pharmacies selling over 100 types of over-the-counter
medicines at low, low prices. The people who run these small pharmacies are health promoters who have been trained in selling medicines. We hope to be installing 15 more during 2007. They will also sell water purification filters and mosquito nets. Thank you from all of us in
El Cercado!!

Joanne Peterson

June 2006

Incarnate Word Lutheran Church, Rochester, NY, has been providing some support for the ministry of Joanne Peterson in the Dominican Republic (DR) for a number of years. My wife, Monika, and I believed that the congregation would benefit from a first hand report of the ministry, especially the Health Promoters Program. Beginning with $5000 a year in Hondo Valle, until it became funded by other sources, and now $4000 a year in E1 Cercado, a Dominican woman doctor has been paid to train 80 community volunteers in preventive health and each of them has trained 10 families!

We spent a week visiting in the parish of E1 Cercado near the border of Haiti in March, 2006, and are pleased to be able to say that we can scarcely think of a better use to which that money might be put. The following is an account of the many programs that have evolved from the Christian Base Community, or “Communidad de Basa" process Joanne introduced there. Small groups reflect on their problems (health, education, clean water, food production, etc.). They discuss the social and economic implications of those problems and then what the Bible says about the issues. That leads to "ownership" and real empowerment of the people. Other members of our group, Ted Pullano and Alison Clarke from Calvary St. Andrews Parish with whom we have collaborated, and Linda Lazore, had the opportunity to be part of one of these weekly meetings.

We expected to be put to work. Instead, most of the week we rode around with Joanne in her large five‑passenger pickup—often with several other riders in the truck's bed‑‑trying to get a grasp of the range and variety of the enterprises in which the people are involved. Much of the time Joanne left us breathless in amazement at the work and accomplishments.

At each stop, people involved—health promoters, members of farmers' and women's associations—explained their projects with pride. Bartolo, community member organizing and teaching soil conservation and organic planting techniques, spoke some, but often the farmers spoke enthusiastically about what they were doing.

El Cercado, a parish made up of many communities totaling some 28,000 inhabitants in the impoverished west central part of the DR, shares a watershed over the border with Haiti. Although Joanne is Lutheran, she works through the local Roman Catholic Parish. The salary of the priest, an American named John Cervini, is paid by the Catholic diocese in Long Island. He is nominally her supervisor, but it's doubtful that he can keep track of all she does, much less supervise her! In the 23 years she has been in the DR, she's seldom stayed in a parish longer than 5‑7 years, not wanting to build dependency.

A Florida‑based agency, Food for the Poor, has a major housing project in the area. Joanne works ceaselessly with the local director, Arturo, with the mandate that the houses go first to the "poorest of the poor." The houses are mass‑produced 400 sq. ft. very spartan houses. They are donated to the families, who are responsible for finishing the interiors. Some 300 such homes had been build and given at the time of our visit, with 300‑400 more planned.

A list of projects going on at the same time includes: training health care workers, promoting safe water supplies, promoting reforestation through soil conservation and teaching organic production practices, road building, building and managing a school, adult literacy, a senior center, a day care center, clinics, pharmacies, nutrition and prevention of domestic violence ...all incorporated in the planning when the various Christian Base Communities send representatives to meet regularly together.

Joanne's involvement varies greatly from activity to activity. In fact, one of the characteristics of her mode of operation is its pragmatic quality. She does whatever she believes is necessary to deal with a problem, but as a fine community organizer, she mobilizes others to do the bulk of the work. She seems to know and be known by everyone. As she drives around the area, her truck is stopped every few hundred feet by Dominicans who are involved in one or another of the projects and have questions or reports. As a result, she never gets anywhere on time.

However, the Dominicans know this and when we arrived two to three hours late up in the mountains, traveling across rocky "roads" and streams, 50 children, with their parents, came out of the houses and woods to be weighed for signs of malnutrition as part of the Health Promoters Program.

Some examples may illustrate the way she works. One of them concerned a project to bring drinking water to a community of 15,000 without a central water supply. She traveled with community representatives to Santo Domingo, the country's capital, to persuade government officials to lay a 10 kilometer pipeline from a nearby stream. They laid the pipeline, but they did not run it high enough to tap into potable water. Only muddy water came through. She went back to the capital and convinced them to return and reappraise the situation. They sent two engineers who decided that she was right, but they could not lay the pipeline further as there was no road for the equipment. Joanne went house to house and people contributed what they could to pay for the additional diesel fuel for the bulldozer and had a road built. Now the community is getting proper drinking water.

A second example concerns road safety. Dominican drivers have no respect for yellow lines on highways. They pass anywhere. If another vehicle is approaching from the other direction, it is expected to get off the shoulder of the road. However, on one stretch of road near E1 Cercado, the highway crews had allowed brush to grow on the shoulders, so vehicles had nowhere to go when an illegal passer approached. As a result, that stretch of road had 46 traffic fatalities in a short period of time. Joanne hired a bulldozer and cleared the shoulders of brush.

A third example is the building of a quality public school. Troubled by the number of children from poor families not attending school, the priest and Joanne enlisted the assistance of the Jesuits, acquired a piece of land on the edge of E1 Cercado and the school will be built with the construction expertise of Arturo, the director of the housing project. The Jesuits will administer the school, but the government will provide the teachers, some of whom will be teachers the community has found to have special talents. Everyone agrees that the principal would not be a government employee, because all such posts are filled with political appointees with no requirement for professional qualifications.

The local hospital, which we visited, is an example of the result of patronage appointments. The unsanitary conditions are appalling! For this reason Joanne has worked with the communities to develop and build private, cooperative clinics and pharmacies.

Reforestation is a major problem. Because of abusive logging practices and "slash and burn" agriculture, much of the country near El Cercado has been deforested with serious soil erosion as a result. The government has a large tree nursery nearby, but that effort is now being a major CommunityAgricultural Nursery supplemented by project.

Fifty‑six Farmers and Women's Associations have decided to be a part of this project which will teach organic production of citrus, avocado, coffee and cacao trees with at least 3 associations working on each of the projected 10 nurseries, to grow a minimum of 400,000 trees. This project will not only teach soil conservation and organic production, but eventual marketing of the products as organic and fair traded, rather than the environmentally harmful methods they have used growing various beans. They will begin growing the beans needed for their families in a more sustainable way while the fruits of the trees will bring more profit. Simultaneously the trees will be planted on the hillsides against the terrible deforestation. Four of the nurseries have been started so far. With the technical assistance by trained community farmers, all the materials, seeds and worm farms for fertilizer, each nursery will cost less that $6000.

International Partners in Mission (IPM), the organization that has been funding Joanne's small living expenses through individual donations all the years Joanne has been in the DR (Project 503), has now set up another project category for donations to be given toward Community Agricultural Nurseries (Project 732) If you wish to contribute to both, please make your check payable to International Partners in Mission and identify the amount you wish to give for each project. With many, many thanks from Joanne and all her colleagues!

International Partners in Mission
3091 Mayfield Road, Suite 320
Cleveland Heights, OH 44118-1214

This newsletter is a project o The Lutheran Church of the Incarnate Word, 597 East Avenue, Rochester, NY 14607, as part of its outreach ministry.

June 2005

Joanne Peterson reports that in the short time she has been in the parish of El Cercado, 80 people have volunteered to be trained as health promoters by Dra. Gina Montero. Perhaps the most exciting event is that some trained health promoters from Hondo Valle are coming to El Cercado to help train the new volunteers how to give vaccinations! That kind of cooperation is wonderful, and may serve as a model for future cooperation in the newest project in El Cercado!

El Cercado parish has 45 agricultural associations whose goal is building and organizing 10 community nurseries that will be owned and voluntarily maintained by the farmers, with farmers working one day a week on a rotating basis. They expect to change from beans, guandules, and onions as cash crops to fruit trees, coffee, and cocoa as a main source of family subsistence. The switch from beans to trees will change the slash and burn methods and promote reforestation, soil conservation methods, and protection of the watershed area of rivers and streams. Joanne reports that they hope to grow 300,000 thousand tree plants twice a year. Thinking realistically, instead of 600,000 trees, plan on 500,000! Hopefully, the people in Hondo Valle will also be involved in this project.

People from El Cercado and Hondo Valle, and from Calvary‑St. Andrews Presbyterian Church and some from Incarnate Word are working to obtain grants of $45,000 to cover the cost of establishing trees over three years which will produce crops for export, including gourmet, organic coffee which meets Equal Exchange standards. And cocoa, too! If God so wills, that can provide a steady liveable income for the growers each year.

Pastor Wennerstrom will be sending a grant proposal to ELCA World Hunger and Lutheran World Relieve for a share of $45,000. He recently read of a similar program which Lutheran World Relief has worked with in Haiti, not far from El Cercado, and he received encouragement to do so from the author of that article. God willing, we will not request money from Incarnate Word for the coffee growers project. We are, however, still supporting the Health Promoters Project, now in El Cercado, and in the amount of $4000 a year. (Fund‑raisers include Equal Exchange Coffee, cocoa, and chocolate bars.) Please pray for Joanne, the people planning and working on these projects, the funding agencies which we will approach for grants.

The project in Hondo Valle, Dominican Republic, directed by Dra. Xiomara Aquino, is such a success the people in another area, El Cercado, are going to do it, too! Dra. Aquino will remain in Hondo Valle, supported by funds found from other sources.

So, our contributions will support work in El Cercado. Dra. Gina Montero capably heads the new program. She is assisted by a part‑time staff person, Micenis, who will work with her, and also help re‑establish many small pharmacies with "over‑the‑counter" medicines. Joanne Peterson says, “We just had our second workshop (to train health promoters) and 65 people came from 35 villages! I'm still hoping for 80 workers when we have our next workshop. Then we will close the registration. Everyone is pleased, including Dra. Montero.”

In the workshop, they identified several themes for the next two years of work. Each volunteer will be responsible for 20 homes in their village. They began with vaccinations for pregnant women and children. They take a census: how many children under 5? how many pregnant women?

As Joanne wrote this on her laptop, the lights were going off! Joanne says they may have 3‑4 hours of electricity a day.

The health promoters project has saved lives in Hondo Valle. The people know that. The DR Health Dept. knows that: they ttarained volunteers to administer vaccine when an outbreak of polio was confirmed in another area of the country. Because the project is such a success in Hondo Valle, the people in El Cercado want it too; so much they already have 65 volunteers!

Spring 2005

Incarnate Word has raised $5000 per year for this project during the last 5 years or so. The money paid the salary of a physician who sees patients but also trained 65 health promoters who were responsible for teaching a certain number of families in a specific geographic area. Areas of health education included prevention through proper nutrition, good hygiene, water filters, mosquito netting, use of natural medicines etc.

Joanne Peterson is the layperson who works in the setting of a Christian-base community to achieve her goals. Work to improve the community also included education, promotion of human rights, agriculture and community organization. Joanne has moved to a different town now and is trying to work the same way in this new community. Our current commitment is $4000/year.

We know where every dollar goes, it pays Dr. Aquino to train the volunteer health promoters to bring life-saving measures to their villages, and now almost no children die of malnutrition or diseases because of impure water or other preventable causes. Dr. Aquino will now focus training for the pre and post natal care and furthering prevention of malnutrition and childhood diseases.

Joanne Peterson has moved from Hondo Valle, but the health project there will continue. Joanne writes, “We had been in Hondo Valle for seven and half years. The role of a community organizer is to organize and train leaders . . and then let go. It was time. I moved forty minutes down the road to Al Cercado, twice the size of Hondo Valle but with similar problems. I hope to organize more Christian Base Communities, which may decide, in turn, to organize projects involving health promoters, legal rights promoters, and to work with local existing farmers’ associations. I am already selling water filters and will soon be installing medicine chests (small pharmacies for over-the-counter medications) in rural communities.” And Joanne writes, “A big thank you, Incarnate Word!”

Artemio

Tucked in the mountains of Hondo Valle, along the border of Haiti, is the community of Palo Blanco. It is inaccessible to motor vehicles. There is no running water and no electricity. But the forty families who live there have a small botica (pharmacy) run by Artemio, a health promoter.

Artemio is a volunteer, who has had four years of training in health. He sells common over-the-counter drugs like aspirin, cold and asthma relievers, skin products, antacids, and vitamins at a discount. Often, Artemio opens up his botica in the middle of the night, when a child becomes ill. Without Artemio's work, the people of Palo Blanco would have to walk two hours in order to reach a clinic to purchase Artemio dispensing medications in the botica even the simplest medications.

Gloria

During past years in Palo Blanco, fever, vomiting or diarrhea were often fatal. Mostly caused by contaminated water that contains parasites and bacteria, rapid dehydration resulted. The dehydration would kill a child within 24 hours.

Gloria's contribution to her community is the operation of a rehydration center. She has rehydration salts on hand, and teaches the mothers how to combine the salts with filtered, boiled water. The fluid must then be given in small amounts every ten to fifteen minutes.

Gloria has also spent much of her time teaching her community about the need to drink only filtered, pure water. She has promoted good nutrition and basic health care. This has reduced the activity in her rehydration center. Fewer people have needed to make use of the rehydration center. In fact, in the past three years, there has been only one death recorded due to dehydration. Gloria can devote her time now to working on other aspects of community health. Combined with Artemio's botica, Gloria's health promotion continues to make a measurable difference in the lives and the quality of life
of Palo Blanco's families.

Sensa and Luzmarinda

Proud graduates of the Health Promoter's Project, Sena and Luzmarinda have been a team for the past four years. They work together in the part of Hondo Valle known as Sahonada. This community has been one of the “tough” ones. Most of the children under the age of five were malnourished. The only water for drinking and bathing was the contaminated river water in another community. Women carried the water home in buckets perched on their heads. There were no latrines. Illness and death from the squalid conditions was an expectation of life in Sahonada.

Sahonada is now a different place from what it was four years ago. Sena and Luzmarinda are happy to display the new latrines in the village. Each home has its own latrine in the back yard. They point to the aquaduct, built by the men in the village, to bring fresh water into town. A nonprofit organization supplied the materials, while the villagers supplied the labor. But the most dramatic change is in the appearance of the children.

The “baby weighing” project began with an idea to determine the degree of malnutrition by weighing babies systematically and comparing the weights with normal age and weight charts. After weighing, the babies were categorized into three degrees of malnourishment. Then the mothers were offered milk, whole wheat and oatmeal, and vitamins at low cost to supplement their babies' diets. Before long, every one of the babies had gained from 4 1/2 to 6 pounds in a month to six weeks. Coupled with the improved hygiene and purer water, the baby-weighing nutrition project has raised the level of health in Hondo Valle.

Sensa and Luzmarinda promote health in other ways. Like Antonio, they also keep a botica stocked with common drugs and vitamins. They are also available when Dr. Xiomara comes to give consultations with patients. Ideally, the doctor would consult with about ten patients during her visit. But the lines begin forming early in the morning of the doctor's expected arrival. Sensa and Luzmarina assist by dispensing medicines, taking blood pressure, and giving injections. They also help to organize the procedure of vaccinations. They update immunization charts, and encourage mothers to have their children vaccinated at the appropriate times.

Health Promoters Make the Difference

Only four of the 80 health promoters have been the focus of this newsletter. Working with their colleagues, all of the health promoters have made a difference in the lives of Hondo Valle's 800 families. Here is a summary of the accomplishments:

13 boticas (pharmacies) are now operating throughout the area.
500 water filters are now being used by families to ensure better quality drinking water.
800 mosquito nets are in homes, helping to prevent malaria and other diseases.
Aqueducts are bringing fresh water to 12 communities. Six more are in the process of construction.
Massive quantities of milk, cereal, and vitamins have been distributed to families with small children.
Rehydration centers have been established in several communities.
600 latrines have been constructed.
Vaccination programs are flourishing in every community.

All of these accomplishments add up to making a world of difference in Hondo Valle.

About the Dominican Republic Health Care Project

The Dominican Republic project was designed by Dr. Aquino, Joanne Peterson, and their colleagues and put into action by 80 volunteers.

Each volunteer trained by Dr. Aquino is responsible for visiting ten families in his/her village twice a month, bringing health education information, and monitoring the health of their assigned families. They offer low-cost water filters which are so important to provide a pure supply of water; they offer mosquito netting; they refer families to the dental clinic or eye clinic which have been developed and are maintained by the people.

But sometimes children get sick and become dehydrated with diarrhea and vomiting, which can be fatal. The Health Promoters monitor those children and facilitate their treatment in Re-hydration houses when necessary. Health Promoters also recommend low-cost medicines which are available in most village medicine chests.

Joanne recently toured the villages to evaluate the project. In two of the poorest villages the Promoters were not depleting their supplies of medications. Joanne expected the Promoters to say that crop damage has made money tight and the people can’t afford the medicines even at a very low cost. Instead they said, “Well, everyone is healthy these days!” That is evidence the project works; lives are being saved!

But not everyone is healthy. Children often are malnourished. With doctor’s training, the promoters checked 550 children for body weight, and according to growth charts 74% were found to be malnourished. But that can be solved. Health Promoters are now charged with the responsibility of improving the nutrition of young children. Each Health Promoter receives the development and vaccination charts of the children in their assigned families. Each month the children are weighed. The Health Promoters train families on nutrition and how to prepare healthy meals. They provide those all important water filters at low cost, egg laying hens and protein products like milk, and seeds for home gardens. Kids are going to get healthier; lives will be saved!

A spin-off of the Health Promoters project will be the training of 30 “Legal Promoters.” Three thousand people in the villages have no birth certificates and, therefore, no rights of citizenship. That can be corrected. The volunteers will be trained in an eight month course about land rights, women and children’s rights, how the justice system works, and how to get a birth certificate. Lives will be improved!

Five nurseries now provide resources for farmers to grow coffee, cacao, avocados, mangos and oranges. Eventually we hope to put a dent in the deforestation problem, as well as provide food items for export.

Making a Difference

The Lutheran Church of the Incarnate Word and Calvary St. Andrews Presbyterian Church in Rochester, NY, have raised funds to sustain the Health Promoter's Project and have been sending equipment to launch the low-cost medical laboratory. Joanne's is facilitating these projects and more.
Please consider a donation to support this project. $2000 per year helps to make this important work happen. Contributions should be sent to International Partners in Mission. The address is: International Partners in Mission Project #503 Dominican Republic 2475 Lee Blvd., Apt. 2A Cleveland Heights, OH 44118-1214

This newsletter is a project of The Lutheran Church of the Incarnate Word, 597 East Avenue, Rochester, NY 14607, as part of its outreach ministry.

Dominican Republic Health Care News