We have a new addition to the family. Baby Anali arrived on April 28th safe and healthy (gracias a dios) she weighs 7 pounds and has the most beautiful little face. She has a full head of black hair and I think she might have light eyes like Marina.  I was so honored that I was there to participate in the birth and to be a support for Marina. After only 48 hours in the hospital Marina was home and is doing very well.

It was very interesting to me to have the chance to observe the differences in care between here and the states. Ill share a couple of them with you. So...Marina and Edi are poor, but because of the reputation public hospitals have in this country, Marina chose to have all her prenatal appointments and her delivery in private facilities. Each prenatal visit cost her and Edi about 100 pesos ($4) and her delivery was about 10,000 pesos or $300 dolars. The prenatal visit I would say was pretty much the same as the states, but the delivery experience was very different. First of all the surgery itself the amount of materials sutures and sponges etc...used during the surgery was very minimal compared to the states. Lets just say there was a lot less precautions taken as well. The anestesiologist checked her blood pressure once at the beginning of the surgery and that was it. The doctor had no assisitant only the scrub nurse, in the states there are always 2 present. The recovery experience made me a little nervous. After the c section the doctor made sure she wasnt bleeding,checked her uterus once. In the states after a c section we take vital signs and check for bleeding every 15 min. Here they dropped her off in recovery, told her to lie flat and dont talk. No vital signs in recovery no one checking her to see if she was bleeding. I couldnt help but peek under her blanket every so often to make sure she wasnt bleeding... but she didnt, it was the best and fastest recovery Ive ever seen. If that is the private clinic experience is, Im very interested to see what the public hospital experience is.

All of the family was allowed in to see her immediately. They needed to be there because her family were her care givers. Yes there was a nurse to give medication but all of the care, washing her, emptying out her foley, helping her breastfeed, attending the baby was all done by her family.

On the same day, another women from my community had a c section right after Marina, Ledi (pronounced Lady) a young mom I think 19 years old was having her third c section that day. Her baby boy Eli, was obviously delivered a bit early... In the recovery room the baby was having difficulty breathing but his "nurses" (Marinas mom Mercedes and the grandmother Lucia) were right on top of it. "Hes complaining" "this baby is not right" they were saying and they ran out to bring the doctor and nurse to come.

Why I mentioned this baby is because one of the public health concerns I observe in the campos of Jarabacoa are the use or abuse of medications specifically antibiotics and injections. These people are so INJECTION happy, head ache...give me an injection, sore throat...inject me, black and blues...Injection. Im also witnessing many of the dangerous affects of these practices. Anyway, back to Eli, 48 hours later baby Eli comes home with mom. The doctor sends his 19 yr old illiterate mother home with Gentamycin (a potent antibiotic that can cause deafness ) injections. The next day the grandfather of the baby comes to find me to ask if I can come to the house and inject the baby. I get to the house and the parents have a prescription that they cant read, one needle that they were planning on using for all 6 injections and an 80mg vial of Gentamycin....Situations like this are common in my communities. You can imagine I havent only been very busy doing my Peace Corps work but also being the nurse for everyone which I love to do because it makes me feel good that Im able to be there for them.

One of the communities where Peace Corps is building an aqueduct called "Arollo Frio" I have been going up weekly to do health education with a group of women. Im focusing on child health and illness, but I said to the group of women. I have to talk about child health but what are some of the health priorities in this community what do you all want to talk about, all of them said "show us how to give injections!" So my last meeting with them on Wednesday I put together a class about the dangers of medications, and how to give a safe injection. Everyone always gets a big kick out of my drawings. Im not an artist by any means but thanks to David Werner (Where there is no artist), they get the picture.Also bringing banana bread helps to keep everyones attention. 

Im lucky because as I mentioned before I live in a house with a solar panel so we have electricity from time to time. My family also owns a small black and white television which is watched by  not only us but a group of about 20 other poeple from my community. Every night 7 pm everyone brings there chairs because we are all, myself included, addicts to the soap opera "La Mujer en el Espejo."  We havent had electricity in my house in weeks because the panel is damaged. The other night after doing the injection for baby Eli, I realize his grandmother Lucia has a television. I got a front row seat to the soap opera and a warm glass of hot chocolate for doing all the injections. I love how Dominicans are so animated and emotional, they cant help but yell out at the characters on the TV sing along to the music. Its 7 pm everyone is singing ..."Tengo la alma en pedazos, la vida en tus manos desde que te fuiste....." especially when its been a while that we havent seen it.

Interesting... one thing I realized about this culture, very different from that of American culture is the majority of people are not legally married. Here is one example of how cultural misunderstandings can create conflict. In Rhode Island there are a lot of Dominicans, in this culture women have children young, tie the tubes young. When I was working at Women and Infants, there were a lot of Domincan young girls having babies "out of wed lock" and I got the sense that there was a lot of negative attitudes on the part of Americans towards this because the assumption was "they dont get married because if they do they cant get their check from the government" I doubt very much in most cases that was the intention. Here is the reason why. OK.. so Dominicans in the campos believe when you have sex with someone your married. In the campos you hear everyday did you hear "fulana" (so and so) got married last night? What this means is, fulana didnt have a wedding ceremony and reception, it means she didnt come home to her parents one night and so her parents assume shes at her boyfriends house. From that night on they are offcially man and woman in the eyes of everyone in the community. A few days later when the smoke clears fulana comes homes to collect her things. From then on she is living in the house of her husband. Example, my friend Nana, her daughter is 22 married having her first baby in a few months. Nana expalined my daughter was never " legally married" because we didnt approve of her husband. Same thing with Inocensias 18 year old daughter Verenisi, she simply didnt come home one night...shes been married for a year now. In the case of Marina and Edi they have in their home photos of a wedding ceremony, Nana told me they are legally married because both families were very happy when Edi and Marina decided to marry. One of the interesting cultural differences.        

What else is happening? Well elections are coming up on the 16th. Everyone is telling me election time is very interesting because Dominicans get very excited around this time. I plan to lay low be safe and not go out of the community during that whole week because some people get a little too excited!  I did get the chance to go to one political rally it was a PLD rally (the party of president Fernandez). I went because I have been petitioning the current local politicians and candidates for a sign in the area of the road where Sarahs accident happened. 2 months after Sarah died there was another motorcycle accident in the exact same spot. This particular area of the road is extremely dangerous with barbed wire on both sides. Its a death trap so I have been busy trying to do something to prevent future accidents. I think the current Mayor is going to do something for the "Americana" We'll see. I'll let you know.

My parents will be here in 2 weeks I cant believe its already May, Im going to be 30 years old this month. Im glad Im going to be sharing it with my parents.(Please excuse all the errors and bad English Im out of practice.) Thats all the news for now I have to get back to work. Come vist me!  Love and miss everyone.