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“Mas bocas que comida”

“Mas bocas que comida”
Author: Sae-Rom Chae, Resident Physician

Date: 2/23/14

 This afternoon we headed to the bateyes (translation: shantytown settlements; provided to sugar cane workers by Central Romana), we were all eager to see face-to-face, at last, the communities that we had learned so much about during our months of preparation.  Our guide, Eduardo, was born in the bateyes and had offered to be our guide.  He had impressed us during our previous orientation with 180 Grados with his strong leadership and palpable dedication and I was sure he would be an insightful guide. 
We climbed into his diesel pickup truck and wove through the rippling fields of green sugar cane under a breathtaking backdrop of clear blue skies and rolling hills.  In between questions we asked of Johnny, a co-leader in 180 Grados, who also grew up in the bateyes, I imagined what it must be like to chop sugar cane with a machete all day long on a day like this with the brutal sun beating down.  At least we had the breeze to cool us from speeding through in a car.  The fields seemed endless; chopping by hand in this kind of heat for the pittance that’s paid to them seemed like a cruel kind of slavery.  Their reality became even harder to stomach when we walked through their homes and heard their stories.
The drive from Guaymate to Tocones (a batey) – sugarcane as far as the eye can see
A latrine in Tocones.  Shared between 3 homes.

Our first stop was Tocones, a batey that was built only two years ago after Central Roman decided to relocate/replace Milagrosa, the batey where Eduardo had grown up.  We could see the restrained indignance in his eyes as he told us how the company bulldozed their homes to the ground.  Upon arrival, we met the leader of the batey who was sitting in a small circle of elderly men under a tree, watching a pair intensely play checkers.  His eyes were gentle and kind like many of the other “dulce” faces we have seen.This batey has a population of about 800 people, 100 homes with about 8 people per household, making it one of the larger bateyes.  It is 6 miles away from Guaymate and more than 15 from La Romana, where they would need to go for all but the most basic health care.  Transportation to La Romana costs about 300 pesos roundtrip, almost 3 days’ wages, which explains why most have never seen a doctor.  The water and sanitation system seemed surprisingly well-established; a latrine exists for every 3 homes and there are 3 chlorinated water pumps for the batey that seemed well-used judging from the line of residents holding jerry cans.  Bright-eyed, playful children in rags were everywhere, running down the street chasing old tires with a stick, screaming in laughter at us when we spoke in Spanish or attempted Kreyol, and tailing us at a safe distance gnawing on sticks of sugar cane.

Eduardo explained to us some of the batey “rules.”  Since the housing was provided for workers by the “impresa,” a family member had to be working for the company and other sources of income were strictly prohibited.  This would theoretically keep them dependent on their low wages for survival.  Though minors are officially not allowed to work in the fields, it is suspected that some minors do in order to make money to support their families.  Additionally, only primary school (up to 5th grade) was available in the batey.   Further training is available in Guaymate or in other towns, though the barriers of transportation or documentation limit how often this is accessed.  Truly, the prospect of breaking the cycle of poverty seemed impossible.

Eduardo shows our group the local primary school.  Most children in the bateyes go to school up to 5th grade.  After that, it becomes very challenging for children to continue in school.

Eduardo made it a point to introduce us to the most vulnerable in town.  There was the gentleman who didn’t have use of his left arm and leg, presumably due to a stroke; an HIV-positive woman who had lost her husband some years ago to AIDS; the blind who Eduardo stated were made that way from “sweat running down into their eyes” while working in the fields; and the elderly, unable to collect their pensions, now dependent on the already stressed community for sustenance.  

The health promoter we met in Santa Rosa, another batey, was, unfortunately, a sore disappointment, especially given the initial impression we had of her as the only available trained health worker.  Contrary to what we had been told, she hadn’t had any training, she received no compensation, and she had very few supplies; it sounded like she had only had multivitamins, acetaminophen, and ibuprofen in her arsenal.  It was no wonder that as she said, these “pastillas” didn’t seem to do anything for the diarrhea she tried to treat with them.  She had no family planning methods to offer though she stated that previously, they did have injections, condoms, and pills available.  We couldn’t get a sense of how and where babies were delivered in the batey despite our questioning; we concluded that perhaps she was ashamed to tell us.  The only functional, reliable healthcare to be had in these bateyes seemed to be only for those with HIV, who were transported and treated by La Clinica de Familia in La Romana.  It was one bright spot in a sea of overwhelming challenges.

As we chewed on stalks of sugar cane on our drive back to Guaymate, we were sober.  I was especially thinking of the children.  Citizenship/documentation, healthcare, education, human and economic capital—all the basics needed to escape poverty seemed out of reach.  They were part of a complex geopolitical history that was out of our control.  But we knew that like our COPE intervention, change was possible with the energy and commitment of a patient few.  And we had met the talented youth of Guaymate—they were the people to make it happen.   

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