oh, God

March has been busy, hence this is my first blog entry this month. I began the community portion of my research last week by journeying to Sabana Perdida, a marginalized collection of sprawling neighborhoods just north of the Ozama River (which is joined by the Isabela River and eventually dives south to meet the ocean). It is just east of Villa Mella, the area where I used to work with SOMOS. It was under the suggestion of one of the NGO staff members I interviewed that I began with a clinic in Sabana Perdida, which is one of the sites for the NGO’s TB program. The clinic serves a population of just over 14,000 people and offers tuberculosis, HIV/AIDS, emergency, and general health services. It’s a small, cramped compound with a large, outdoor waiting area, but it boasts laboratory and x-ray services, and a passionate and committed staff.

My first task has been to observe the daily operation of the TB program, which is housed in a tiny, well-ventilated office in the clinic. From around 8am to noon every day, 10-30 TB patients and “sintomáticos respiratorios” (those experiencing suspicious respiratory symptoms that warrant a TB test) filter in and out of the office for treatment or testing. Some of the patients receive nutritional supplements, and all medicine, provisions, and services are provided free of charge.

I’ve been getting up before 7am (so weird!) in order to make it to the clinic by 8, which is sometimes a tricky prospect based on traffic and when the guagua (beat-up bus) decides to leave in the morning. For several hours I hang out in the TB office, engaging staff members and patients in informal conversations and taking notes on everything I see and hear. My plan is to build up rapport with the patients (who are obligated to show up 2-4 times per week to receive their treatment) in order to ultimately conduct qualitative interviews with them. I will extract data from these conversations and disaggregate it according to gender. My hope is that the information gleaned will help TB programs and their implementation at all levels – from the formation of policy by donor agencies to the local health workers in target communities.

Recently, I’ve also been dealing with the challenges of religion and personal health in this country. It just so happens that the nurse who runs the TB program in Sabana Perdida is a zealous Christian. She begins clinic days by reading from the Bible and making us say a prayer. As a non-Christian (I consider myself spiritual but not religious, and if I had to pick a religion to convert to right now, it would be Islam. I am nowhere near Christian.), this makes me uncomfortable.

The Dominican Republic is an historically Catholic country, but the Catholic church here is more a social and political institution than a religion. No policy gets passed without the approval of the DR’s archbishop, a notoriously conservative man who has been known to attribute child exploitation in the sex work industry to “the way young people dress,” and who has been an instrumental proponent of the recent (and highly controversial) changes to the constitution, which include the banning of abortion under any circumstances, including cases of rape, incest, or danger to the mother’s life.

But the Dominicans who talk about Jesus on a daily (no, minute-ly) basis are primarily Protestant. There has been a notable explosion of evangelical Christianity in recent years. On one hand, I find that taxi drivers who listen to Jesus songs are less likely to hit on me and/or attempt to overcharge me, so I don’t mind it per se. But when someone randomly starts proselytizing (my taxista the other night asked out of the blue if I was aware how much Jesus loves me), it makes me uncomfortable. Thus I sometimes find it difficult to spend so much time with the TB nurse in Sabana Perdida (and the main TB community health care worker, who is almost as zealously religious). I am all for faith, and if subscribing to an organized religion is the best way for people to experience faith and meaning in life, then more power to them. But when I asked the nurse if she took prophylaxis to protect herself from contracting TB from her patients, and she responded, “Prophylaxis? No, but there is a medicine called Jesus Christ,” I almost threw up a little bit. Multiple times I have been randomly approached by strangers on the street hoping to preach to me or hand out written materials about Jesus. Others' religion doesn't make me uncomfortable; but when I'm drawn into it against my will, it does (at the bus station today, this guy could not understand why I didn't want one of his pamphlets about Jesus). My four-year-old roommate has begun to make signs of the cross and announce “may God bless us” at random times as a result of the indoctrination he receives at his nursery school.

As for personal health, take a guagua ride across Santo Domingo and you’ll see what I mean. You can’t go anywhere in this city without breathing fumes constantly. It almost makes my throat hurt. Produce here is treated with pesticides not legal in the United States (and back home I purchase only organic food), and the meat and dairy industries are even more environmentally harmful and hormone-heavy than that of the U.S. This makes me sad, because I cannot go running without feeling like I have probably developed cancerous lung lesions, and it’s sometimes difficult to feel good about what I am eating, even though I cook almost all my food from scratch. Since I’m here for only three and a half more months, I know that the overall effect of these factors will probably be negligible in the long run. But it’s just gross.

On the other hand, the lovely gym located two blocks from my apartment recently moved to a new location; while it’s slightly farther away, it’s still within a ten-minute walk. The new place is a large space on the sixth floor of a building. The view is incredible and luckily most of the fumes don’t reach that high. In addition, Crudo, the small café/store a few doors down from my apartment, was started by a local doctor who shares some of my concerns. He owns an organic farm right outside the city, and everything served at Crudo is organic. I can also find imported, organic green tea, pistachios, and other products. Apparently there’s going to be a yoga retreat to his farm for semana santa (Easter week). So I have a few health havens.

This weekend I’m taking a break in Santiago, the Dominican Republic’s second-largest city, and the coming week is our Regional Enhancement Seminar for Fulbrighters in the Caribbean. This means that on Tuesday I’m off to Trinidad and Tobago! It’s going to be weird to be in a Caribbean country where no one speaks Spanish or (Haitian) Kreyòl (which I’m still trying to learn!).