12/19/2010
Feliz Navidad! I just got back from the holiday party for Peace Corps volunteers and staff in the capital. Romeo, our director, had the party as he does every year on the top floor of his apartment complex in downtown Santo Domingo overlooking the city. It was a very beautiful spot for the holiday gathering. To start off the night we read together “The night before Christmas,” but in Spanglish. It started with “It was the night before Christmas and all through the casa…” mixing up Spanish and English phrases to complete the poem, a nice was to share some Christmas spirit.
Many volunteers are going home for the holidays and its hard not to be a little jealous. Christmas in the campo is not exactly what it is back home. What it sounds like is that the main celebration is the night before Christmas, la noche buena. We will be having a dinner together, probably killing either a pig or goat beforehand and then enjoying some cervezas and rum together. Gifts are not exchanged and Christmas lights and Christmas trees are hard to come by.
So like the title of this blog states, I am 80 interviews into my diagnostic study of the community Casa Colorada. I will probably be doing about 20 more to complete all the houses in the area. The minimum amount of interviews is 80 but it has been a personal goal to interview every house in my community so that I have officially shaken everyone’s hand and they all know who I am and why I am here.
Through out this first 80, the interview format that I was originally using has changed a bit. A handful of the original questions that I was really excited about have turned out not to make cultural sense to the people here, so I have had to stop asking them. One of the best examples of this is the question “Me puede explicar un ejemplo de una comida saludable?” Can you give me an example of a healthy food? To myself, and the grand majority of people I know, health and food choice is inter-related and important. Here however, in rural Dominican Republic, health and choosing food do not have similar definitions or a connection. From what I have gathered, people eat what they can, what is available, what is growing in their backyard. Food choice as we know it is not a reality here.
After I asked this question, each family would look at me with a confused face. To help, I would ask further, “What is a food that gives you energy? A food that is good for yourself and your family? A food that makes your body strong?” …. STILL more blank expressions. The woman assisting me with the interviews would then translate this question to “What food do you like the most?” To me this was not at all a translation for an example of a healthy food but I just smiled and listened for the answer. I will get back to you with the actual statistic but my estimation is that 90% said arroz, habitúelas, y carne, also known as la bandera (the national flag in English, which is what they call their usual meal consisting of rice beans and meat). After about 20 interviews like this I had to give up on this question.
I remember in training when I was struggling with Spanish, I would sit and talk to children and ask them simple questions. What is your favorite color? How many siblings do you have? What is your favorite food? With the later the answer was always a matter-of-fact response: “arroz, habitúelas, y carne.” Other options and the ability to choose are foreign. One of my jobs is going to be teaching nutrition classes and trying my best to show the people of my community the connection between food and health and to slowly try and improve their diet. From what I have seen so far though this part is may be more complicated than I originally thought it would be.
Saturday, December 25, 2010
Friday, December 10, 2010
Cholera on Hispaniola
For the past month, the Dominican Republic and Peace Corps have been busy confronting the recent cholera outbreak. Cholera is a bacterial infection of the small intestine spread through water and food contaminated with feces that carries the bacteria Vibrio Choleri.
The main symptom is severe diarrhea that is the color of rice water. Additionally, cholera is often not accompanied with pain or fever, which sets cholera apart from other types of diarrheal illnesses. If left untreated it can kill a person in 24-48 hours though dehydration however, as Peace Corps has explained, if treated with rehydration fluids early (a mixture of salt, sugar, and purified water), the bacteria will pass through the body and no medicine or other treatment is needed.
Cholera was first confirmed in Haiti on October 21, marking the first time in the last century that Vibrio Choleri has been found on the island (CDC). What I have read is that the bacteria was brought to Haiti through post-earthquake aid that Haiti received from Nepal. Vibrio Choleri can survive on food 5 days and up to 10 days in colder temperatures too, so it indeed seems possible that foreign aid could have carried it here. Quite an unexpected consequence of receiving help…
In other countries cholera is endemic and has become a somewhat normalized illness that people have learned to live around. The reason why is it such a big deal now is because cholera is new on Hispaniola and the population has no knowledge what so ever on how to prevent and treat the illness. Additionally, there are neither solid waste treatment plants nor proper plumbing for the majority of both Haiti and the DR. Because of this the DR and the Peace Corps are working hard to makes sure the population can recognize the illness and know how to prevent and treat it through hourly radio announcements, television announcements, and charlas (informative talks) in the clinics, hospitals and schools throughout the country.
Since Peace Corps issued volunteer consolidation in the beginning of November in order to inform all the volunteers at once about the illness and how to educate our communities, I have seen the death toll in Haiti jump from 200 to 2,000 and the number of reported cases jump from 1,000 to 91,000 (CDC). Further reported by the CDC earlier this week is that the case-fatality ratio is 2.3%, meaning that in the 91,000 cases, 2.3% of these people have died. This seems like a relatively low percentage but between November 27 and December 3, there were 41 deaths per day on average (CDC).
In the Dominican Republic the government has been slow to announce the cholera cases, no doubt due to the threat this would have to the tourism industry, the number one source of income for the country. Just to give you an idea, the news announced the first case of cholera in the DR in a region in the East of the country (probably 2 hours away from me) on November 16th. However, the host brother of a fellow Peace Corps volunteer in the central region of the country had already been diagnosed with cholera. It took the public radio and TV a few weeks to announce the cholera cases in her region. What we do have publicly announced as of Tuesday is that there are 22 cases in the DR (Dominican Today). None have been in my community or anywhere in the providence of Hato Mayor, where I am living. Gracias a dios!
Very complete and most current update on cholera in Haiti done by the CDC:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5948a4.htm?s_cid=mm5948a4_w
Most recent article regarding DR cholera from Dominican Today, a good DR news source in English:
http://www.dominicantoday.com/dr/local/2010/12/7/37889/Public-Health-reports-Cholera-cases-now-22-but-under-control
The main symptom is severe diarrhea that is the color of rice water. Additionally, cholera is often not accompanied with pain or fever, which sets cholera apart from other types of diarrheal illnesses. If left untreated it can kill a person in 24-48 hours though dehydration however, as Peace Corps has explained, if treated with rehydration fluids early (a mixture of salt, sugar, and purified water), the bacteria will pass through the body and no medicine or other treatment is needed.
Cholera was first confirmed in Haiti on October 21, marking the first time in the last century that Vibrio Choleri has been found on the island (CDC). What I have read is that the bacteria was brought to Haiti through post-earthquake aid that Haiti received from Nepal. Vibrio Choleri can survive on food 5 days and up to 10 days in colder temperatures too, so it indeed seems possible that foreign aid could have carried it here. Quite an unexpected consequence of receiving help…
In other countries cholera is endemic and has become a somewhat normalized illness that people have learned to live around. The reason why is it such a big deal now is because cholera is new on Hispaniola and the population has no knowledge what so ever on how to prevent and treat the illness. Additionally, there are neither solid waste treatment plants nor proper plumbing for the majority of both Haiti and the DR. Because of this the DR and the Peace Corps are working hard to makes sure the population can recognize the illness and know how to prevent and treat it through hourly radio announcements, television announcements, and charlas (informative talks) in the clinics, hospitals and schools throughout the country.
Since Peace Corps issued volunteer consolidation in the beginning of November in order to inform all the volunteers at once about the illness and how to educate our communities, I have seen the death toll in Haiti jump from 200 to 2,000 and the number of reported cases jump from 1,000 to 91,000 (CDC). Further reported by the CDC earlier this week is that the case-fatality ratio is 2.3%, meaning that in the 91,000 cases, 2.3% of these people have died. This seems like a relatively low percentage but between November 27 and December 3, there were 41 deaths per day on average (CDC).
In the Dominican Republic the government has been slow to announce the cholera cases, no doubt due to the threat this would have to the tourism industry, the number one source of income for the country. Just to give you an idea, the news announced the first case of cholera in the DR in a region in the East of the country (probably 2 hours away from me) on November 16th. However, the host brother of a fellow Peace Corps volunteer in the central region of the country had already been diagnosed with cholera. It took the public radio and TV a few weeks to announce the cholera cases in her region. What we do have publicly announced as of Tuesday is that there are 22 cases in the DR (Dominican Today). None have been in my community or anywhere in the providence of Hato Mayor, where I am living. Gracias a dios!
Very complete and most current update on cholera in Haiti done by the CDC:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5948a4.htm?s_cid=mm5948a4_w
Most recent article regarding DR cholera from Dominican Today, a good DR news source in English:
http://www.dominicantoday.com/dr/local/2010/12/7/37889/Public-Health-reports-Cholera-cases-now-22-but-under-control
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