The word batey is a Haitian Creole word that is translated into English as battle, struggle or fight (Batey in English, (n.d.). Haitians immigrate to the Dominican Republic with the hope of improving their standard of living. However, Jonas Pierre, a Haitian immigrant and cane cutter in Latey Los Pelao stated it this way: “Life here should be better than in Haiti,” he says, “but the work isn’t good. They don’t treat us well in this country. Sometimes you go a week without enough to eat” (Bracken, A. 2015).
Haitians and the people of the Dominican Republic have a long history of contentious relationships, commonly referred to as antihaitianismo. It is most evident in the treatment towards Haitian sugar cane workers in the Dominican Republic (Lemione, M. 1985). “Today, Haitian laborers reside in overcrowded “bateys” (the Spanish translation of the word is “residential communities for workers”), lack of access to healthcare, and continue to be denied basic rights under the law” (Jung, Y. 2006, May 9).
In an effort to share the gospel, implement an improved and sustainable health system, decrease the suffering of the Haitian immigrants working in the bateys, and decrease the prevalence of antihaitianismo, a partnership between Hands in Service and Ministerio Casa de Restauracion the La Romana, Dominican Republic has developed a five year, multifaceted plan. Hands in Service, will train medical and non medical volunteers to participate in short term medical teams to meet immediate needs of the residents of the bateys, and help Dr. Gerald Montas Inirio as needed to develop long term training for willing volunteers in the Dominican Churches and in the bateys so that a sustainable system for health improvement can be implemented.
Isidro Mejia is the Pastor of Ministerio Casa de Restauracion in Barrio George in La Romana and he has been our primary contact in the Dominican Republic. When asked if he would be interested in a five year plan to build a sustainable health plan for the people of the nearby sugar cane bateys Pastor Isidro responded: “I love to have teams from the United States come and help us help the people in the bateys” (Isidro Mejia, personal communication 2016). A five year plan has been drafted and the Hands in Service Board of Directors, Pastor Isidro and Dr. Gerald have agreed to move forward.
Haitians and the people of the Dominican Republic have a long history of contentious relationships, commonly referred to as antihaitianismo. It is most evident in the treatment towards Haitian sugar cane workers in the Dominican Republic (Lemione, M. 1985). “Today, Haitian laborers reside in overcrowded “bateys” (the Spanish translation of the word is “residential communities for workers”), lack of access to healthcare, and continue to be denied basic rights under the law” (Jung, Y. 2006, May 9).
In an effort to share the gospel, implement an improved and sustainable health system, decrease the suffering of the Haitian immigrants working in the bateys, and decrease the prevalence of antihaitianismo, a partnership between Hands in Service and Ministerio Casa de Restauracion the La Romana, Dominican Republic has developed a five year, multifaceted plan. Hands in Service, will train medical and non medical volunteers to participate in short term medical teams to meet immediate needs of the residents of the bateys, and help Dr. Gerald Montas Inirio as needed to develop long term training for willing volunteers in the Dominican Churches and in the bateys so that a sustainable system for health improvement can be implemented.
Isidro Mejia is the Pastor of Ministerio Casa de Restauracion in Barrio George in La Romana and he has been our primary contact in the Dominican Republic. When asked if he would be interested in a five year plan to build a sustainable health plan for the people of the nearby sugar cane bateys Pastor Isidro responded: “I love to have teams from the United States come and help us help the people in the bateys” (Isidro Mejia, personal communication 2016). A five year plan has been drafted and the Hands in Service Board of Directors, Pastor Isidro and Dr. Gerald have agreed to move forward.
The five year plan was named “Nourishing Body and Soul” and it is comprised five sustainable goals in the bateys focusing on:
1. Developing spiritual leadership: Pastor Isidro will direct this effort. He has a Ministry training center on the premises of his compound and he is well equipped to train spiritual leaders.
2. Developing sustainable clean water projects: Pastor Isidro is building a water purification system to help supply water to the bateys. Hands in Service is supplying, small, personal water filtration systems to individual families and churches in the mean time.
3. Identifying and overcoming the obstacles to food shortages in order to combat malnutrition and parasite infestation. We will work with international aid organizations to address this issue in the short term. Over the longer term we will bring in farming and food storage experts to teach soil management, small plot cultivation techniques to grow family or community vegetable gardens. We plan to solicit help from industry experts to initiate a poultry program and educate the batey workers on how to raise chickens for eggs and meat.
4. Teaching willing volunteers in Pastor Isidro’s coalition of churches how to operate mobile medical clinics: There are many willing and able Christian volunteers in the Dominican Republic who would love to be a part of these clinics.
5. Developing the role of a Health Advocate and educator in each the of bateys: Dr. Gerald will identify candidates for this role and provide training. Hands in Service will offer help in the form of printed materials.
In 2017 we focused on team building, identifying committed interpreters and team members. We built the record keeping and education systems required to make the mobile clinics run smoothly. We had our first trial run with mobile clinics in La Romana in October of 2017. Since then, Pastor Isidro has identified bateys to target over the next two years, and five to target during the last two years. We have agreed to focus on the most underserved batey populations in La Romana. At the end of five years, Ministerio Casa de Restauracion will independently operate the program.
One of the first steps in the process has been educating American volunteers to operate the mobile clinics. With this perspective in mind, Hands in Service requires all American team members to attend three team meetings where cultural, logistical and medical education is provided. The teams are usually comprised of non medical volunteers and nurses; Dr. Robert Handy of Doylestown is our Medical Advisor. The clinics are set up into stations where each patient is given personal attention from the volunteers. Non Spanish speaking volunteers have an interpreter. Non medical volunteers can participate in evangelism programs or basic clinical functions such as measuring height and weight, using electronic equipment to measure vital signs, helping in the pharmacy or distributing gifts to the patients. Nurses are able to perform triage at the vital sign station, distribute de-worming medicines and vitamins, perform quality assurance in the pharmacy or assess patients.
If nurses on the team would like to perform physical assessments, they receive a Hands in Service Clinic Manual that has been compiled over the past ten years that describes the symptoms of the most commonly encountered diseases. Since the clinics are not equipped with lab or imaging capabilities, diagnosis is based on symptoms and physical assessment. Nurses that will be doing assessments review the manual together and discuss questions. In the Dominican Republic nurses in this station work side by side with Dr. Gerald Inirio and another Dominican physician. American nurses refer any patients with complex problems or puzzling symptoms to Dr. Gerald or the other Dominican physician. The doctors and nurses in this area work in very close proximity to one another, so that collaboration is simple and frequent.
In order to be able to measure outcomes, each patient that comes through the clinics is registered and receives a clinical data sheet. The data sheets are transported back to the US where a volunteer, Sandy West RN, loads the information into an Excel spreadsheet. This data will be used to analyze successes and failures in the clinics. For example, because we weigh and measure each patient, we can calculate their BMI or, for children, graph their percentile on the appropriate growth chart. This will help us to see if our combined efforts of de-worming, supplying vitamin supplements, improving water quality and increasing food security are helping to improve the nutritional status in each batey.
“Appropriately collected nutrition indicators are not only important for assessing corporate progress towards meeting strategic priorities (RBM), they are also critical to effective programming - for monitoring trends in nutritional status and effecting project design changes that may be needed to ensure measurable impact” (A Manual: Measuring and Interpreting Malnutrition and Mortality 2005, p 12).
In order for the Nourishing Body and Soul initiative to be sustainable, the Dominican volunteers from the churches must learn how to maintain the programs by the end of the five year initiative. Funding is the biggest barrier in accomplishing this objective. If travel expenses are removed from the equation, the cost of running the clinics has been around $6500 to $7000 per clinic week where around seven hundred patients are treated; Hands in Service has committed to one clinic week every six months. Most American volunteers either pay these costs directly, or they perform fundraising campaigns. Although the Dominicans are generally more financially secure than the Haitians, this is still a very large financial burden for the Dominican church members. The Board of Directors of Hands in Service has discussed fundraising to help offset the costs for the Dominicans, but this single obstacle challenges the entire outcome of the Nourishing Body and Soul project. Further solution seeking discussions with Pastor Isidro and and Hands in Service will need to take place in order to develop a plan to overcome this obstacle.
The Nourishing Body and Soul Project in the Dominican Republic gives American volunteers an opportunity to actively serve side by side with Pastor Isidro, Dr. Gerald and many of our Dominican Christian brothers and sisters. Together we can share the gospel, alleviate physical suffering and serve Christ by serving those in need.
1. Developing spiritual leadership: Pastor Isidro will direct this effort. He has a Ministry training center on the premises of his compound and he is well equipped to train spiritual leaders.
2. Developing sustainable clean water projects: Pastor Isidro is building a water purification system to help supply water to the bateys. Hands in Service is supplying, small, personal water filtration systems to individual families and churches in the mean time.
3. Identifying and overcoming the obstacles to food shortages in order to combat malnutrition and parasite infestation. We will work with international aid organizations to address this issue in the short term. Over the longer term we will bring in farming and food storage experts to teach soil management, small plot cultivation techniques to grow family or community vegetable gardens. We plan to solicit help from industry experts to initiate a poultry program and educate the batey workers on how to raise chickens for eggs and meat.
4. Teaching willing volunteers in Pastor Isidro’s coalition of churches how to operate mobile medical clinics: There are many willing and able Christian volunteers in the Dominican Republic who would love to be a part of these clinics.
5. Developing the role of a Health Advocate and educator in each the of bateys: Dr. Gerald will identify candidates for this role and provide training. Hands in Service will offer help in the form of printed materials.
In 2017 we focused on team building, identifying committed interpreters and team members. We built the record keeping and education systems required to make the mobile clinics run smoothly. We had our first trial run with mobile clinics in La Romana in October of 2017. Since then, Pastor Isidro has identified bateys to target over the next two years, and five to target during the last two years. We have agreed to focus on the most underserved batey populations in La Romana. At the end of five years, Ministerio Casa de Restauracion will independently operate the program.
One of the first steps in the process has been educating American volunteers to operate the mobile clinics. With this perspective in mind, Hands in Service requires all American team members to attend three team meetings where cultural, logistical and medical education is provided. The teams are usually comprised of non medical volunteers and nurses; Dr. Robert Handy of Doylestown is our Medical Advisor. The clinics are set up into stations where each patient is given personal attention from the volunteers. Non Spanish speaking volunteers have an interpreter. Non medical volunteers can participate in evangelism programs or basic clinical functions such as measuring height and weight, using electronic equipment to measure vital signs, helping in the pharmacy or distributing gifts to the patients. Nurses are able to perform triage at the vital sign station, distribute de-worming medicines and vitamins, perform quality assurance in the pharmacy or assess patients.
If nurses on the team would like to perform physical assessments, they receive a Hands in Service Clinic Manual that has been compiled over the past ten years that describes the symptoms of the most commonly encountered diseases. Since the clinics are not equipped with lab or imaging capabilities, diagnosis is based on symptoms and physical assessment. Nurses that will be doing assessments review the manual together and discuss questions. In the Dominican Republic nurses in this station work side by side with Dr. Gerald Inirio and another Dominican physician. American nurses refer any patients with complex problems or puzzling symptoms to Dr. Gerald or the other Dominican physician. The doctors and nurses in this area work in very close proximity to one another, so that collaboration is simple and frequent.
In order to be able to measure outcomes, each patient that comes through the clinics is registered and receives a clinical data sheet. The data sheets are transported back to the US where a volunteer, Sandy West RN, loads the information into an Excel spreadsheet. This data will be used to analyze successes and failures in the clinics. For example, because we weigh and measure each patient, we can calculate their BMI or, for children, graph their percentile on the appropriate growth chart. This will help us to see if our combined efforts of de-worming, supplying vitamin supplements, improving water quality and increasing food security are helping to improve the nutritional status in each batey.
“Appropriately collected nutrition indicators are not only important for assessing corporate progress towards meeting strategic priorities (RBM), they are also critical to effective programming - for monitoring trends in nutritional status and effecting project design changes that may be needed to ensure measurable impact” (A Manual: Measuring and Interpreting Malnutrition and Mortality 2005, p 12).
In order for the Nourishing Body and Soul initiative to be sustainable, the Dominican volunteers from the churches must learn how to maintain the programs by the end of the five year initiative. Funding is the biggest barrier in accomplishing this objective. If travel expenses are removed from the equation, the cost of running the clinics has been around $6500 to $7000 per clinic week where around seven hundred patients are treated; Hands in Service has committed to one clinic week every six months. Most American volunteers either pay these costs directly, or they perform fundraising campaigns. Although the Dominicans are generally more financially secure than the Haitians, this is still a very large financial burden for the Dominican church members. The Board of Directors of Hands in Service has discussed fundraising to help offset the costs for the Dominicans, but this single obstacle challenges the entire outcome of the Nourishing Body and Soul project. Further solution seeking discussions with Pastor Isidro and and Hands in Service will need to take place in order to develop a plan to overcome this obstacle.
The Nourishing Body and Soul Project in the Dominican Republic gives American volunteers an opportunity to actively serve side by side with Pastor Isidro, Dr. Gerald and many of our Dominican Christian brothers and sisters. Together we can share the gospel, alleviate physical suffering and serve Christ by serving those in need.
References
A Manual: Measuring and Interpreting Malnutrition and Mortality [Pdf]. (2005, July). Center
for Disease Control and the World Food Program. http://www.unhcr.org/45f6abc92.pdf
Batey in English. (n.d.). Retrieved April 20, 2018, from https://glosbe.com/ht/en/batey
Direct translation from Haitian Creole to English
Bracken, A. (2015). Blood, sweat and sugar: Trade deal fails Haitian workers on DR plantations.
Retrieved April 20, 2018, from http://america.aljazeera.com/multimedia/2015/7/blood-sweat-and-sugar-trade-deal-fails-haitian-workers-in-dr.html
Jung, Y. (2006, May 9). HEALTH AS A RIGHT: Haitian Immigrants in the Dominican Republic
[Pdf]. New Brunswick, NJ: Rutgers University. http://sph.rutgers.edu/service/dr_outreach/health_rights.pdf
Lemione, M. Bitter Sugar: Modern Slavery in the Caribbean. Banner Press: Chicago. 1985.
A Manual: Measuring and Interpreting Malnutrition and Mortality [Pdf]. (2005, July). Center
for Disease Control and the World Food Program. http://www.unhcr.org/45f6abc92.pdf
Batey in English. (n.d.). Retrieved April 20, 2018, from https://glosbe.com/ht/en/batey
Direct translation from Haitian Creole to English
Bracken, A. (2015). Blood, sweat and sugar: Trade deal fails Haitian workers on DR plantations.
Retrieved April 20, 2018, from http://america.aljazeera.com/multimedia/2015/7/blood-sweat-and-sugar-trade-deal-fails-haitian-workers-in-dr.html
Jung, Y. (2006, May 9). HEALTH AS A RIGHT: Haitian Immigrants in the Dominican Republic
[Pdf]. New Brunswick, NJ: Rutgers University. http://sph.rutgers.edu/service/dr_outreach/health_rights.pdf
Lemione, M. Bitter Sugar: Modern Slavery in the Caribbean. Banner Press: Chicago. 1985.
Dr. Gerald Montas Inirio
