October 2013 – Vocation and Our Newest Blessing

Dinner with our friends Pablo and Yudy

Dinner with our friends Pablo and Yudy

Greetings, family and friends!Hope this finds you well and with cooler fall weather.  We write amidst our most busy season in the DR yet! We have each picked up a physical therapy (PT) course at the local university, are in the process of renewing our residency paperwork, and are still recovering from moving to a different home!  Part of the process of moving has included re-learning when the blackouts are in the new neighborhood (3-4xs per week, ~4 hrs each), when the trash comes (~every two weeks randomly), and figuring out how to make the water department come to reconnect the water (it’s been 4 days- oh my!).  Please pray for ongoing adjustments. Overall, we are still thrilled with our new place. The noise– even more so than violence or any other factor- was something that really wore us down at our old house. We certainly gained a keen appreciation of noise as a potential major stressor for folks living in poor dense urban zones. We’re sure grateful for a new sense of well-being and energy in this quieter neighborhood!

The students Nick has been teaching on their clinical rotation.

The students Nick has been teaching on their clinical rotation.

Teaching PT in the DR has brought a clear sense of vocation and joy. We both teach a different group of 10 students during their lab and practical clinic classes at the nearby public hospital, “Cabral.” We are gaining a truer insiders’ perspective on the state of health care education, which allows us better wisdom for the ongoing curriculum revision work still in process. We have found that instead of focusing on the neurology and orthopedic patient topics that our classes are supposed to entail, we spend a lot of time catching up on other basics such as exercise prescription, and this must improve.

Facing the stark needs at Cabral hospital continues to bring to mind God’s mercy, and with this an urgent sense of the very real, individual impact that poverty has on our patients. Support systems that we take for granted in US hospitals may not be available here- certainly not for the poorest patient, but even hospital wide.  Beyond clinical service gaps, there are not standard bed-side food services, and hygiene or other “extra” items like air mattresses must be purchased and distributed by family members, if available. If you don’t have money for an orthopedic surgery, or if they just don’t have the surgical piece you need, your hospital stay may be prolonged for weeks.  Staff shortages are another piece of the puzzle. At Laurie’s old US hospital, there were 3-4 inpatient therapists for the 250 bed hospital. There is one inpatient therapist for Cabral’s 471 bed capacity, and she was just hired a few months ago after a gap of several years without this service.  With research showing better functional outcomes, lower hospital costs and faster discharges when patients have access to inpatient therapy, lack of sufficient PT services is one more challenge within this deeply complex hospital environment.

Hospital Cabral y Baez is the home of the Patronato Rehabilitation Center where our clinicals are held.

Hospital Cabral y Baez is the home of the Patronato Rehabilitation Center where our clinicals are held.

Just this morning, Nick and his students arrived to the terrible news that one of the pediatric therapists died of dengue, a mosquito borne illness. It was hard to get through the morning.  We are reminded that all socioeconomic classes of people are affected when larger prevention programs are not in place. Please pray with us for all countries suffering from mosquito borne illnesses.

Finally, we have some great news! We are pregnant! All is going smoothly and the first trimester is complete without too much fuss. The baby is due April 4th. That is just about the time we had hoped to be home visiting family in the US again, marking our 3rd year here. It will be a great gift to share this with them in person. Please give thanks to God with us!, as we continue to give thanks to God for you.

Peace and Joy to you,
Nick & Laurie
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