May, 2008 A note from Anita

Getting a Feel for Violence Resources Visiting local agencies was our first concrete step in developing a new health promotion program on domestic violence. 1. “Oficina Fiscalía de Violencia Intrafamiliar” (District Attorney’s Family Violence Office). They are on the legal frontlines for battered women. They have some ideas, but no official prevention program. They agreed to review the legal issues with us and look at the possibilities. 2. Secretaria del Estado de la Mujer (Secretary of State for Women). The staff greeted us warmly and told us that they give community presentations about abuse. When we asked to whom they had talked and inquired about the content of the presentations, they really could not tell us either one. Hmmm … an example of government patronage, say our Dominican colleagues. As we thanked them and left, they told us that the regional public hospital had a very active physical, psychological and sexual abuse program in its adolescent department. 3. Regional Public Health Hospital. We talked with Dra. Fulgencia, a friend and member of our church. She smiled as she listened to us and then said, “Well, if there were such a program it would be in my department. There’s no program.” She added, “Talk to the hospital director. Ask if we are supposed to have a program. See what he says and let me know.” After listening to us politely, the hospital director smiled and said, “We do have a domestic violence program – forensic pathology.” Oh great! After a man murders his partner, they’ll do the autopsy for the trial. Moving on … 4. Secretaria del Estado de Salud Pública y Asistencia Social (public health and social services). Public health has “norms” for reporting abuse and offers workshops on how to fill out the forms correctly. OK, next … 5. Tribunal de Niños y Adolescentes (Juvenile Court) considers the children’s welfare in the wake of domestic violence. They are overwhelmed with active cases and enthusiastic about prevention. “We’ll do anything we can to help you,” they promised. “Prevention is the key. By the time we find out, it’s too late.’ We have some hard work ahead of us, but at least we found a few allies today.

Keep praying, Anita

October 15, 2008 A note from Michael

I was recently in the States and a patient generated some strong feelings on the part of some Clinic personnel, some serious fears, and some reluctance to take care of him when he came for treatment. He did not have HIV/AIDS. The Clinic has an active HIV/AIDS treatment unit. Most everyone is now comfortable with that condition. He had leprosy. After a bit of an initial delay (and some quick reassurances to those concerned), the man with leprosy was folded back into the usual care system at the Clinic.

In some ways, our work has not moved all that far beyond how things were “in Biblical times.” Leprosy here still incites concern and may produce its share of prejudice and rejection. Tuberculosis (the 19th-century’s “White Plague”) also provokes similar reactions at times. The “stigma, discrimination, and rejection” associated with medical conditions have an historical reach stretching well beyond HIV/AIDS.

It is actually helpful for us from a spiritual standpoint to have so many Biblical elements within our daily circumstances here (leprosy, people going daily to the well for water, donkeys in the streets, …). It gives us a context for our faith and thinking about the Bible that we did not have while living in Cincinnati. Maybe not a better context, but at least a different one.

I got my mind back into the service before the end of it. One problem with my mind wandering is that I nearly always end-up with more to pray about: the stigma, discrimination, and rejection accompanying HIV/AIDS… and tuberculosis and leprosy. So, please …

Keep praying, Anita

September 14, 2008 A note from Anita

We closed the monthly health promoter meeting in prayer. However, during the “meeting after the meeting” the group considered where we might hold the next workshop for the promoters in that community. The Assembly of God chapel was engaged; the Roman Catholic chapel already had a meeting scheduled; the open-air community “terrazo” is too public and noisy (OK for a meeting, but not a workshop); and the Episcopal church would be occupied that day (and is also very small). However, the Church of God Pentecostal church would be available and would work well. Those promoters who had a connection to that chapel took responsibility for reserving it for the workshop.

One of the ways that the “community” supports its community health program is when the local churches offer their buildings for meetings and workshops. We have been told by the diocesan staff here that the community health program may be the most actively ecumenical ministry within the Diocese. We are constantly “borrowing” facilities from and sharing resources with various denominations.

All of our materials say that the Clinic is a health ministry of the Episcopal Church, Michael and I are missionaries, and the Clinic’s car has a large Episcopal diocesan shield plastered on each front door. However, the community health program approaches communities less as the Episcopal Church and more as the generic Church with a big “C.” We have promoters across the spectrum from Roman Catholics to Evangelicals, as well as non-believers. And how could it be otherwise in a community health program if it really reflects the local pluralistic community.

One of the common elements among the health promoters is that they all volunteer to serve their neighbors and community. Most of them feel some kind of “call” and recognize this as a ministry. I am delighted when I see the “Church” working in the “world” and providing the means for us to serve one another in very real ways. I am privileged to have been called into a spot where I can see that intersection so clearly and frequently.

Keep praying, Anita

August 19, 2008 A note from Anita

We spent last Saturday at a funeral – a head-on collision of two busses on Friday took the life of the father of a Dominican co-worker on the community health team (as well as about 40 other lives).

The custom here, without embalming, is that friends, family and acquaintances hang-out with the family all day and that the burial occurs that same day or the next depending upon the timing. For a poor family, as this was, everyone gathers at the house while the coffin sits in the front room. People gather in the house or yard (usually a tarp has been positioned to offer some shade). While some people drop-in to offer condolences and then leave, most people stay and then join the procession to the cemetery. During the hours of vigil, people console the family members, chat quietly (in this case about some of the gruesome details of the accident as seen on the news) or meditate silently.

As with many things here, schedules are more approximate than definite. Thus, the procession to the cemetery starts when it starts. Last Saturday, it was a bit looser than usual as four people in the vicinity had died in that accident and there was only one hearse available in that rural area.

The custom of taking time to “be with” is different than my usual North American (and personal) efficient, task-oriented, and “just do it” style. The “ministry of being” has been identified as perhaps one of the most important elements in cross-cultural mission work. Even so, after more than eight years here it still feels a bit foreign to me. On the other hand, I can’t imagine using my time last Saturday in any other way under the circumstances than spending it with our co-worker’s family.

Keep praying, Anita

July 17, 2008. A letter from Michael

Manuelito was the topic of one of these missives several months ago – a 9-month-old with HIV infection who had been unofficially “adopted” by a woman who tends to take-in needy children. Manuelito arrived at the Clinic in poor shape, but is now doing well. In fact, I was at his house (a dilapidated wooden clapboard and tin roof thing) on the day that he started walking. The delighted older children were enticing him to take wobbly steps on the uneven floor to retrieve toys and shiny objects.

However, the reason behind the visit was that the family may be losing that house (not uncommon in the USA these days, either). The community outreach worker from the HIV/AIDS treatment unit was checking on the status of the problem. This family is already living in cramped quarters - eight people sharing two beds. We can keep Manuelito healthy, but there is not much we can do about the housing problem. There are always limits to how much we can do.

The temptation to try to “fix everything” is certainly there for us. But that would be a losing battle. People commonly ask us how we can do this – confront the poverty on a daily basis, see the problems, constantly run into the limits of what can be done, and resign ourselves to the harsh realities.

Mother Theresa’s answer to that question was basically that she did all that she could for the person in front of her, and then moved onto the next. We have to be content with knowing our limits, and offering what we can up to those limits.

Another answer lies in our call to mission. After a long discernment period (involving people from our parish, the diocese and far beyond), it was determined that this was the life to which we were called – this is the life that the Lord has intended for us to live. And from that standpoint, the question becomes: How can we not do this?

So, we do what we can and pray for the wisdom to know where the limits lay.

Keep praying, Michael