September 7th, 2013
Author: Clemence Sullivan, UIC Med-Peds Resident
I am sitting out on the outdoor porch in Guaymate with Oscar, the younger brother of Alejandro whose house we are currently staying in, and he is playing his favorite music for me. He plays for me some Dembow (the Dominican version of regeatteon), salsa, merengue, bachata and then now the song, “stand by me.” He tells me he has learned the words but wonders what “stand by me” means in English. I try to explain literally and then figuratively and then paraphrase as I seem not to be able to fully communicate its implication – “it’s an expression of support…”
This has been a day of reflection for us. We arrived yesterday afternoon and then got ready for the CAB meeting by identifying appropriate objectives and questions. While there, I was the designated the note keeper. Initially each person was taking their turn to add their thoughts about the focus group meetings, but as the meeting continued and the energy of all those present rose, more and more people interjected comments and the pace quickened – I could hardly keep up trying to translate the shortened Dominican words and understand all the expressions!
It was only when we sat down this morning and dissected the discussion together that I started to put it all together. The youth group and several members of the community (mainly community leaders whom had been identified by Rosa, our peace corps volunteer) had made a list of potential focus groups in the community including different Batey divisions as well as different sub-groups of people in Guaymate. They were able to gather people for the focus groups and discuss our project and learn about their health concerns. One of the CAB members summarized it perfectly to the focus group she was working with, ” this is going to be a slow, slow process,” but reminded them that we were committed to making a change to improve health. After reviewing the results and health concerns, we started coming up with ideas for interventions. We shared our individual thoughts and ideas. The ability to bounce back impressions and conclusions and future questions allowed an overall process and potential plan to develop. What impressed me about the CAB meeting the night before was the energy that the youth had in the meeting – how they took pride in the project and were diligent about going from door-to-door to recruit members. This energy inspired me and gave me hope. From afar such a daunting project may seem unrealistic but it is happening step-by-step, with the support and collaboration of all of its members and maybe in a way more importantly the energy and motivation that each member gives to one-another….a further more extensive definition of “stand by me.”
In the afternoon, we were able to spend time with William and his mother. William is a doctor who is working at the Clinica de Familia. He talked to us about his experience in medical school and his experiences working. He also took us on a tour of the city and showed us the different buildings including the police station, the municipal building, the new high school being built, the houses of the employees of the workers from Central Romana and the hospital. He was able to give us an idea of the medications provided at the hospital as well as the prices – usually 1-2 pesos for one pill of nifedipine or amlodipine and easily accessible insulin and metformin. This information helped us in our process of identifying and working on a more concrete plan for intervention – another small but again significant step to the entire puzzle.
The song “stand by me” has finished and Oscar plays the next song, Gangastan – what? They know this song as well in the Dominican Republic? Oscar’s friend who is sitting next to him starts singing to the song and we sit there all swaying our head to the rhythm…it may not have the same significance as the song “Stand by me…” but us bobbing our heads along to this well-known song and enjoying the nice breeze after hours of rain on this calm afternoon may be yet another definition of being a community or “stand by me…”