Odds & Ends

Ashley and I

Things are chuggin' along here in Montecristi. About a month ago the fall interns arrived, and it was a nice change of pace from the 3 or so weeks when there were less than 5 of us at Orphanage Outreach. These interns are here to teach English classes this fall at our English Institute, where I lived earlier this summer. They spent a couple of weeks renovating the English Institute, transforming it from the dusty shell of a learning environment that it was following its evacuation on July 26th, when the summer program ended, into a veritable rainbow coalition of English eye candy, with posters, figures, tables, etc covering the walls throughout the building. As children walked in for registration they were amazed at the makeover, and certainly seemed excited to begin learning English in such a user-friendly environment.

At the English Institute we offer three levels of English classes, with Level I being offered to 5th graders, and a couple of weeks ago we spent a few days going to the local schools to advertise our program. The local schools here in Montecristi opened at the beginning of September, but it usually takes about a week for attendance to reach normal levels. The Dominican Republic has some serious problems with its educational system. Some statistics: net enrollment at the secondary level is 35%; currently only 1 in 10 Dominicans graduate from high school; the average student receives 2.5 hours/day of instruction; at the secondary level, 50% of students are overage and up to 20% are three or more years behind. From the last few weeks of teaching in the schools, I have become acutely aware of these problems. Montecristi's public education is especially terrible for a number of reasons. MC is one of the poorest provinces in the DR, and there is not one public university in the municipality, thus 'brain drain' is a huge problem. Many kids see no reason to finish high school when they clearly can't afford moving to Santiago to go to college. The closest university is in Dajabon, a 45 minute bus ride, and I know a few Dominicans who are struggling to make it through college there while dealing with rising transportation costs. The ones who do manage to make it out of Montecristi to universities in other cities rarely return. As Father Toni, the town's Catholic priest, told me in a conversation about the state of his city, "Return to what? Say you leave for Santiago to pursue a degree in engineering. What work would you find in Montecristi?" Futher, most of the roads in Montecristi are unpaved, and schoolbuses do not exist, so any day that it rains here school is cancelled. The situation in the bateys surrounding Montecristi is even worse. Most villages have two or three classrooms for all levels of education, forcing teachers to cluster several grades of students into one classroom. In several bateys where I work there is no secondary school classes, so once you graduate from 6th grade you would have to take a 20 minute walk every day to the next village to continue your education. Most kids don't find that worth the trouble, and thus a large percentage of children start working in the fields at age 12 or 13. All these problems have led the World Bank to conclude that the Dominican Republic has one of the worst education systems in Latin America. Needless to say, English education in public schools is not taught by native English speakers, and public health education is a low priority for teachers. Thus Orphanage Outreach has the opportunity to make a huge difference in these two areas.

We ended up going to the schools the second week of September to advertise our English program to the 5th graders. I tagged along because I needed to ask the principals if they would be comfortable with my giving public health lessons this month. As I explained in a previous post, I have been designing a public health curriculum for the schools and bateys here in Montecristi, and my intention was to test all the lessons this fall in order to improve the lessons for this spring, when public health teams will come to teach the curriculum with me. The teachers were very receptive to the idea, and I organized times to come to different schools for my last month here in the Dominican Republic. Schools in Montecristi come in all shapes and sizes, from the large Catholic Colegio and Liceo hosting hundreds and high school students, to Ciudad de Luz, a small school started by a former OO volunteer. We entered the atrium/playground area of Ciudad de Luz to find tons of toddlers enjoying the extended recess times that contribute to the 2.5 hours/day of schooling that the students average here in the DR. The kids, all dressed in red polos and jeans, cheered that all too familiar greeting, "AMERICANOS!" and swarmed us with glee. At the end of the week we had recruited about 80 5th graders to enroll in our Level I classes, and I had a busy schedule planned for teaching health lessons in the schools.

Children at Ciudad de Luz, a local school that was founded by former OO volunteers. Cutest uniforms ever.

The next week I began teaching the curriculum that I had slowly compiled over the past 3 months in the DR. This work was made much easier with the help of Julie, a new program leader at OO who at one point was bound for medical school until she found a passion for teaching in New York. Julie helped me focus my lesson ideas into appropriate modules for the grades that we would be teaching. I now have modules on hygiene, dental health, infectious disease, anatomy, nutrition, and sexual health, with more in the works for drug and alcohol abuse and mental health. Those last few lessons are targeted towards high schoolers, while the rest are appropriate for 5th to 7th graders. The basic model for the lesson plans is to have about 20 minutes of lecture, with an assistant (Julie in my case) writing information on the board. The lectures usually include material to keep the kids engaged ("Who can tell me an example of an infectious disease?", etc.). At the end of the lecture, there is an activity/quiz to reinforce the lesson. The lessons usually take about 30 to 40 minutes to teach.

The first day of teaching we went to Rosa Smestre, a primary school, to teach a lesson on nutrition. I had bought a host of Dominican food items at the local grocery store, Lilo's, so that I could teach the kids how to read nutritional labels and what's necessary for a healthy diet. Julie and I walked into the principal's office to speak with La Jefa, and she quickly ushered us into one of three fifth grade classrooms that we were to teach that morning. I took a deep breath as I looked upon a classroom full of boisterous 5th graders. I was about to teach my first lesson, and I was a little bit nervous. Quite frankly, I'm not sure I would have been able to do it before I arrived here in June. It took me three months of working with the 40 children at the orphanage, along with the hundreds of kids that I had led at the various camps throughout the summer, to be confident enough, both in my Dominican Spanish and in my ability to command the respect of rowdy children, to teach a large group of Dominican children on my own. The children in this first class were especially crazy that day because their teacher had left once Julie and I entered the classroom. Without their Dominican teacher to scare them into submission, they knew they didn't have to listen to a word I was saying about the merits of vitamin C in fruits. Despite a few children who were clearly not going to pay attention no matter what we did, we managed to keep the kids interested by asking them easy questions about nutrition. Julie recommended that we start the classes by raising up two food products and asking which one is a good source of a particular nutrient. The kids like those kind of yes/no voting questions. Understandably children at that age are less inclined to bite on open-ended questions for fear of being embarassed in front of their class. The lesson seemed to be going well until about 15 minutes into the lecture when a few of the boys got out of their seats and decided they wanted to have a wrestling match at the side of the classroom. I tried yelling at them, but they kept fighting, and so I walked over to break up the fight. By the time I had stopped the match the whole classroom was out of their seats, walking around the room, and some walked out of the classroom into the hallway. I was losing control, and I started to panic. Luckily I was saved by the principal who noticed the disruption spilling out into the main hallway. She walked up to the classroom with a look of pure fury, screaming "Desgraciados! and when the children saw her they scrambled back into the classroom. It was a beautiful site, seeing those kids shriek in terror at the site of the all-powerful Jefa. The rest of the lesson continued without many problems. Some of the kids really enjoyed the activity we had planned in which they would record the nutritional information for food items that we handed out. The next two classes went much smoother, each time getting better as I became more comfortable with the lesson. We made a few changes to keep the kids interested in the lesson, but overall I was proud that my initial lesson plan came out quite well.

The next day I expected a similar experience in another middle school, John F. Kennedy (yeah, strange). We walked into the principal's office and told the principal that we were ready to teach lessons that morning in the classrooms. She told us to wait in her office, and she left. I assumed she would come back quickly to bring us to one of the 5th or 6th grade classrooms as the principal of Rosa Smestre had done. I began to wonder what was happening, though, when she was still gone 10 minutes later. How long does it take to let a teacher know we're coming into their class? We had already talked to her the day before about coming. Maybe she got distracted with something else, I thought. Another 10 minutes later she finally returned to her office and told us to follow her. Without thinking about it to much, I noticed that all the students were leaving their classrooms and seemed to be heading to the same room on one side of the building. Oddly enough we were also heading in that direction. We arrived at a salon where all the students were pouring in with their teachers. The principal motioned me to enter the room, and there I stood in front of an entire middle school. She nodded to me and Julie, giving a gesture that seemed to say, "Good luck, you're going to need it." About 250 students were gathered to hear us speak about infectious disease. I was expecting a classroom of 20.

"Uh, so is this your assembly? Or do you want me to give the lesson here?" I stupidly asked. She looked at me funny for a second, then said I would be giving the lesson here, that it will be better this way. I waited a few minutes, pacing and grinning in front of the classroom full of students with a finger to my mouth gesturing the "SHH!" sign. It became clear after a couple of minutes that I was not going to be able to calm down the kids by myself, so the principal swept in with a couple of other teachers and had the kids all sing a song and then she presented us to the group, giving a nice little summary of our organization, Orphanage Outreach. She passed it off to me, and I began in a shouting voice describing some basics of infectious disease. I had designed the lesson to be interactive, having kids answer questions, but I had to improvise a little bit because none of the children wanted to answer a question in front of 250 students. So I started off with some yes/no questions ("Hello guys, I am a student of medicine. Does anyone here wanted to be a doctor?" and a chorus of "SIIIIIIIIIIIIIIIIIIIII!" in response). After I explained the difference between a bacteria and a virus, and went over the basics of TB, rabies, dengue, malaria, the flu, and worms, Julie and I ended with a little patient-doctor skit, partially to test the kids knowledge of the material presented, and partially to give them a very superficial sense of the life of a doctor. Julie was my 'patient' in five different situations where she described the symptoms of the different diseases we covered. I'm glad she was a good sport about it, because I made her look like the most unhygienic person in the world- playing with stray dogs (rabies), playing in the mud and dirty water in the gutters in the city (worms), leaving large containers of untapped water sitting around her house (malaria/dengue, sespools for mosquitos). The kids thought it was pretty funny. We ended the day with "Heads, Shoulders, Knees and Toes" which the 4th, 5th, and 6th graders sang and the 7th and 8th graders decided they were too cool to learn. At the end of the lesson, I began to erase the board where Julie had written all the basic information for the IDs we talked about, until one of the teachers came up to me and stopped me because she wanted to copy the information. It will be exciting to collaborate with the teachers in the spring to make the lessons available for them to teach in their own classrooms, thus making the program sustainable.

One lesson that I did not expect to be teaching until Dr. Garcia said it would be a good idea and Coco gave approval was sexually transmitted diseases, which I taught to the 12th grade classes of the local high school. I sat down one Saturday with Dr. Garcia and designed the lesson plan to be appropriate for the age group I was working with, but I must admit I was pretty nervous when we showed up to the Liceo for the first day of teaching the lesson. 12th graders are certainly different from 5th and 6th graders. One glaring difference was that any word that I said with any accent at all they would quickly correct, thus making me insecure about my Spanish as I plowed my way through the lesson for the first time. They were also unafraid to interrupt me at any point to ask a question, which was actually a good thing because it kept me from slipping into a monotonous, preachy lecture on the dangers of STDs in sexually active adolescents. In one of the classrooms my 30 minute lesson quickly extended another 15 minutes as the kids continued to ask me questions about HIV. Many of their questions reflected some of the most common myths commonly about HIV and AIDS ("Don't people with HIV all have rashes on their arms?", etc.). I was surprised by how enjoyable the lesson was. I expected there to be lots of snickering and giggles when I talked about things like the thick discharge associated with gonorrea and the importance of checking your privates regularly if you are sexually active, but the kids actually remained very attentive and were interested in what I had to say. I think that by keeping a confident tone throughout the lessons, which improved as I had done the lesson a couple of times, the kids respected me as someone who knew what he was talking about. I think it probably also helped that I started out the lesson by saying that I was a student of medicine who works with Dr. Miguel Garcia, former director of the Montecristi Hospital. The kids who knew Dr. Garcia, which was most of the class, had a lot of respect for him. Knowing the right people can have a significant impact on the level of respect you get with people in MC. I realized that earlier in the summer when Coco and I stopped by the office of public health (SESPAS) one day to discuss our plans for designing a public health curriculum to be taught in the MC schools. The tone of the conversation with a public health official quickly changed from standoffish (What are these gringos doing here trying to get involved in public health, he was thinking) to warm and cordial when we mentioned the fact that Orphanage Outreach had a long standing relationship with Dr. Garcia. Anyways, by the end of several days of teaching the lesson, we had taught what must have been about 150 12th graders about the most common STDs in Monte Cristi. I'm excited to teach other lessons on sexual health in the spring. Dr. Garcia and I discussed lessons on family planning and reproductive health, but I never got the chance this fall to teach these lessons before I left for the states. I don't think we will have the pre-med volunteers teaching the lessons on sexual health, for a number of reasons. I am wary about the confidence and fluency they have with their Spanish, and I am not sure how they would react in a room full of Dominican 12th graders, who began asking questions about STDs and their prevalence in MC that I was able to answer because of conversations I had with Dr. Garcia but they might not feel equipped to answer. Finally many volunteers will likely just feel uncomfortable teaching that unit. However there are a couple other units I am designing this fall for older students that could be more reasonable for our volunteers to teach- lessons on alcoholism, drug abuse, and mental health. The experiences teaching health lessons in the schools have been extremely rewarding, and I'm excited to revise these lessons for the Spring program when pre-med volunteers from U.S. universities are coming down to teach my curriculum in the rest of the schools.

This past month I began driving the OO Daihatsu pickup truck, which is quite a piece of work. It kind of reminds me of the first car that I learned to drive a stick shift, a 1987 Isuzu Trooper. It even makes the same catlike streeching upon startup, as the belts in the engine beg for an end to their sad, decrepit existence. The Daihatsu also does not have the luxury of power steering, so I'm definitely getting buff as I drive it more often.

Kids singing my handwashing song. The lyrics (to the rhythm of "If you're happy and you know it clap your hands"): "Si tu estas feliz, lava las manos, CH CH CH (x2)

Si tu estas feliz, y no quieres un lombriz

si tu estas feliz, lava las manos"

("If you're happy, wash your hands

if you're happy, and you don't want worms

if you're happy, wash your hands" with the CH CH CH being a handwashing motion)

Here I'm teaching the infectious disease module, talking about the four different methods of transmitting IDs- fecal/oral, direct contact, blood, respiratory. module.
Hygiene lessonSoftly crying while walking back from school after our day got cut short by a MC rainstorm. When rain comes, schools are often ended early here.
"Una foto, Una foto por favor!" Some of the neighborhood kids.

Besides the health lessons in the schools, I also spent a couple of days one week writing a health puppet show for the kids at the orphanage. There were three 'acts' to the puppet show: dental health, hygiene, and nutrition. I'm expecting a Tony this year for my groundbreaking depiction of the young Dominican boy, Maliento (short for mal aliento, bad breath), as he struggled to brush his teeth regularly, contracted several infectious diseases due to poor hygiene, and was humiliated by his younger brother who beat him in sports because he ate a healthy diet. It was a study into the depths of the human condition that rivals Chekhov's greatest works. Seriously though, the kids really enjoyed the puppet show. I unfortunately could not see their faces as I was busy backstage directing the other puppeteers and being the voice of several (male and female) puppets. Let me tell that holding puppets for an hour, moving their mouths for each syllable you say, and making sure when you hold two puppets that you are manipulating the right puppet for the right voice is hard work. By the end of the show I was covered in sweat, my voice shot, especially due to an unexpectedly long exchange on nutrition with the audience. The fact that 20 kids had stayed until the end was a small miracle. We're still preparing our acceptance speech for that Tony.

The main characters

Christina, Julie and I going over my script in the dress rehearsal

A master of puppeteering

Maliento learns to brush his teeth to my Grammy awarding winning "El Cepillo de Dientes" song

Que mas? With the start of the English program in the month of September the fall interns also started a pre-school class for the younger girls who are not old enough for the MC kindergarten programs. The rule in MC is if a child is potty trained he/she can go to school. We've got quite a few kids, all girls, still in diapers, so the volunteers decided to spruce up the education center in the orphanage and turn it into a pre-school area for this fall. I've helped them out a few times with the activities, which include fun things like singing songs about the days of the week, teaching the girls the first letter in their names, and having colors and numbers of the day. Christine prepared the color red to be the color of the day one time, and made a little scavenger hunt all around the room with red items for the girls to find. They retrieved them with some assistance, and brought them over to our color station. We went through each item and asked them what color they were. For each object Jennifer would say, with confidence, "Amarillo", yellow, the color of the day the previous day. It was adorable.

Grandpa Hagan shares a story about a green dragon with his children.


Jennifer and Franchezca getting excited about the color of the day, Red, by wearing Santa Claus hats.

I never mentioned in previous posts that we survived hurricane season in Montecristi without any real problems, despite the fact that other areas of the DR were hit pretty hard, and Haiti was devastated by the storms. Montecristi is surrounded by mountains that tame most of the worst forces of the hurricanes, but we did get a few days with some impressive, dare I say torrential rainfall. For whatever reason most of these storms passed over us during the night, producing a nice cooling effect on the hot and stuffy Montecristi summer nights. What they also produced were large cacatas, or tarantulas. Tarantulas live in holes in the ground, and when it rains hard and their homes are flooded they head for our buildings to take cover. One ominous stormy night I was watching lightning flash in the sky outside my bedroom window, when one of the flashes illuminated a large dark moving creature. I flicked on my lights and was horrified by the sight of two large cacatas casually crawling across the wall in my room. After wetting my pants, I ran out of my room and asked one of the volunteers to kill the spiders for me. I have a visceral fear of spiders, and needless to say I was up all night cycling horrible images of tarantulas crawling all over my sleeping body and eating me alive. I shouldn't have had anything to be worried about, given that tarantulas are not aggressive and their bites are only slightly more serious than a mosquito bite. I wasn't going to let that information stop me from sleeping that night with the lights on in my room. Pathetic, I know.

An uninvited guest in my room

One more thing. In the weeks leading up to my departure, in the wake of hurricane season, an enormous outbreak of conjunctivitis (pink eye) hit the country. I first noticed it when we saw a lady at a colmado (candy shoo) with the infection while preparing ice for a cup of juice without using gloves. Hygiene habits like that certainly contributed to the fact that almost every kid in the orphanage had the disease the following week, but the disease doesn't require such egregious violations of sanitation to spread. It is very contagious, and it was comical to watch how kids one day picking on the first few kids to contract the disease would be moping around the orphanage the next day with a rag over their eye. Some of the kids were excited about the chance to catch the virus so they could miss a guaranteed 5 days of school, until they finally caught it and realized how miserable it is. I thought the disease was somewhat of a joke as well until, 3 days before my departure I finally came down with the symptoms, waking up with one eye crusted shut. It was a nice going away present for my time here.

Despite having conjunctivitis for my last few days in MC I managed to enjoy my final moments, and it was much harder than I expected to say goodbye the kids even knowing that I would be back a few months later. Vounteers generally do not tell the younger kids when they are leaving until the day that they leave to avoid lengthening the pain of the goodbye process, so I had only told a couple of the older boys that I would be leaving the next Saturday. The next day the entire orphanage knew I only had a night left in Montecristi. Pele, one of the girls who had grown attached to me when she first arrived but had been pretending to be in a fight with me in my last few weeks was almost on the verge of tears when she found out, saying, "Pero estamos contentos contigo! No te vayas!" (But we're happy with you, don't leave!).

I don't really have some amazing final reflection about my stay in the DR and how it has changed my life, although I am certain that it has an enormous impact on me. I think I am still figuring out what this experience has meant to me and I will continue to do that for a long time as I begin the readjustment to life in the States. I just can't wait to get back in January.

To be continued...