March 2018: Transitions


We arrived back home in the Dominican Republic in January, after several weeks of continuing education, time with family and transitional planning in the US over Christmas. The space away from the DR sharpened our sense of gratefulness for our time here, and helped us hone in on what we want both personally and in ministry for our remaining months. We also saw Daniel’s Spanish fluency drop sharply, and realized just how hard we will have to work to keep up our Spanish upon returning!

Please continue to pray that our final ministry opportunities would be both impactful and allow a positive sense of closure to our time. We’ve chosen to work with Creighton University for the month of April, where Nick will supervise U.S. students completing their last clinical rotations in Santiago. Nick and I first met through this program. Out of our experiences with Creighton in the DR, God called us into a longer term commitment in Santiago, so wrapping up our ministry engagements with them feels particularly fitting. Nick has also taught several semesters of Dominican students at the clinic he will serve in (Las Colinas), so will have a final opportunity to follow up with clinical recommendations he has modeled there previously. His lived experiences should help bridge culture and language gaps and support both parties to more deeply engage and reap the benefits of the month-long exchange. It will also give Nick the opportunity to experience the transition to U.S. clinic culture in his students, which is a gift.

ff7b8c7d-cf73-4104-8f9a-8354a88d3c9dWe’ve planned some relatively straightforward (here’s hoping) work items to fit into our final 2 months here. Last week Nick coordinated and distributed a room of rehabilitation supplies from Creighton, which looked like dozens of walkers, standing tables for children and a wide range of other supplies making their way to 13 welcoming organizations and clinics (top pic). Satisfied nuns from one of the only nursing and hospice care facilities in the area marveled over free adult diapers, compression stockings, a bedside commode and oxygen tank carriers. In the context of health ministry work, we are especially sad to be leaving the country. The relationships we have slowly built only make the work easier and better over time, and it seems a shame to stop now! We are trusting that God will keep us in these friendships for some continued exchanges even after our move.

Transitions ahead
Nick has slowly begun looking for work in California, and we appreciate your prayers for a good fit. We got confirmation that there is space for us at Providence Mission Homes, a missionary transitional apartment complex only blocks from Laurie’s parents in Pasadena. We are grateful to be a part of this similarly transitioning community for about a year as we get our footing.  Anticipating a full April of ministry activity ahead of our May move, we started posting our car and just about all of our household items for sale this week. Eek! Pray for wisdom to manage saying goodbye to stuff in the healthiest way possible for Mateo (18mos, and not likely to remember much) and Daniel, who turns 4 in April. The game has begun to whittle down to 7 last suitcases.

We continue to be vigilant, mourn, pray and find small ways to act with you from afar in the variety of challenges that you in the States are experiencing.  While we have somehow unfortunately gotten used to the variety of large guns readily on display on DR streets, I am certainly not used to the reality of mass shootings in the US, for example. May God help us to not get used to these things once we move back.  We are glad for the perspectives that some life away from the States has brought, and glad also to be able to partner again in loving others with you in our still internationally influential United States. What you do and how you love matters to your neighbor and to us abroad! Keep up the good work.

Peace, Joy, and the active and ever-present love of God to you this week,
Nick, Laurie, Daniel & Mateo

Posted in News

December 2017 Appeal: Celebrating the DR & Looking Ahead to the US

Dear friends & partners,

It is with full, grateful hearts that we write what will be our last appeal and summative ministry report from the Dominican Republic!

You read that correctly. We arrived in May, 2011, and will move back to the US in May 2018. God has sustained us through you. Your prayers, friendship and funds have paid our rent, clothed our kids, and allowed us to teach and heal. You supplied the 1997 Toyota Corolla that jostles us out to varied ministries. You buy the daily food that energizes us and the neighbors that come to our door. You showed it is possible for individuals to come together to propel a couple, then a family, into international service for 7 years. Great work. Thank you.

If you’ve always wanted to partner in this work but haven’t yet, take a moment now to contribute! Donate and pray that our last 6 months would be effective and meaningful. We need your partnership to finish this ministry well!

Looking backfb3b6309-cd7f-4f3c-8394-18d288e7e206
The long term view. Let’s remember a bit of what God has done through you. Your understanding of the value of development work allowed us to start ministry listening, with a year-long research project that recorded hours of Dominican therapist voices to provide a collective, local wisdom and direction for where God would have us collaborate. This research informed both medical missionaries and physical therapists, and stimulated conversation on standards for cross-cultural health care at conferences and talks. Listening led to a teaching invitation at the local university, where we’ve both intermittently taught and contributed on committees since 2012.

God’s timing allowed us to collaborate on curriculum changes in the physical therapy (PT) program, student research projects, PT professional association development, continuing education and clinical mentoring, all with a long-term focus on improving health care in the Dominican Republic.

Laurie preparing curriculum

Short term pieces. Your compassion for basic human needs allowed us to improvise with other ministry opportunities too. Laurie taught weekly at our church’s child sponsorship program for 2.5 years. Nick partnered with his running group for Christmas gifts for kids in the program, which has developed into a sustained relationship between Dominicans from different sides of the tracks. You’ve been tithing and giving special offerings all of this time at our particular little church in Santiago, supporting its variety of community projects, from church building repairs, paying for cancer treatments and providing food and spiritual direction to families in the neighborhood. We hope to use some of this 2017 year end support to supply children’s books for a small church lending library, as there is no functioning library in our town of 500,000+, and few if any books available in members’ homes.

You also continue to nourish the truly improvised ministry of an informal food pantry that seems necessary out of our home. Since “David” and “Simon” started coming by daily for a year or two, we currently have two more boys visiting, and a young family collecting a bag of food several times a week. Thank you for loving and encouraging your brothers and sisters here in Santiago. We hope this news encourages you, as you have encouraged us.


Help us finish these 7 years at full capacity.
To complete this work through May 2018, we need an additional $7,000
above our faithful monthly supporters. Will you join us one last time?

Transitions: Pray with us 
Ministry. Pray that Nick finishes his last semester of teaching well, and for wisdom as we wrap up full time ministry as a whole. Pray that some students would find healthy ways to remain in the DR, reducing health care shortages. Pray for guidance as we facilitate final supports for the new physical therapy curriculum, and for ongoing growth in rehabilitation in the DR. Give thanks! Margarita Olivo (our PT department head, below) had a successful November educational exchange trip to Creighton University. Thank you for sponsoring the trip! Pray that God’s love would be seen as people are healed, and that our local church would grow in wisdom and love. Pray that we would choose our final ministry tasks wisely, and transition healthily into new, meaningful life and work in the US.


Relationships & Family. Pray for energy as we organize last visits with friends near and far. Pray for ease of packing, and that giving and selling our stuff would be simple. Pray for Daniel especially, who at 4 will transition from the only home he’s known here in the DR.  Pray that Nick would find the right fit in a physical therapy clinic near our family, and that we would make a smooth financial transition. More news on our US plans another time.

As God has loved us, so we each may lean into our particular forms of loving God and our neighbor in the world. Thank you for supporting us vocationally. This work and your collaboration has been a source of great joy to us, and stretched us immensely both personally and professionally.  We will continue to support our Dominican colleagues with partnership from a distance.
You’ll hear from us just a few more times in 2018, before signing off from our DR home in May. God’s great love and peace to you this Christmas, as always. Love & Thanks,
Nick, Laurie, Daniel & Mateo
Posted in News

November Update

Dear friends,
We hope you are well this November! Both our ministry and our children are hustling as this year races to the ribbon. The rhythms of toddler growth and ministry can sometimes pace each other, with moments of quiet, salient pause, followed by rapid bursts of fatiguing activity and change.

After some cautionary days off during the hurricane season, Nick’s class sprang into action to make up lost hours. Plowing through midterms, he spent some difficult discernment time with a student repeatedly at the bottom of his class, speaking frankly about his career direction. The other students ask great questions, and demonstrate good potential for contributing quality health care in the future. Courses from the new curriculum we’ve collaborated on over the years are beginning to roll out. Students have given positive feedback about one new course, learning manual therapy for the first time from a Dominican therapist who did additional training in Colombia. Her hiring was a success that will lend to higher quality and sustainability in the new curriculum. Pray for ongoing quality education at PUCMM!

Students 1a-001

Nick with his physical therapy students from the orthopedic clinical rotation he teaches

Excitingly, with some extra grit from determined Dominican and US partners to recover from a glitch in the funding plan, our PT department head Elsa Margarita will fly to Creighton University (NE) next week for an educational exchange. Another hefty, first time addition to the new PT curriculum is cardiopulmonary physical therapy, which assists folks in recovering from events like myocardial infarctions, cardiac surgery, or living with childhood illnesses like cystic fibrosis. Margarita’s agenda will include observation at a hospital, in the cardiopulmonary PT classroom, and curriculum discussions with faculty. Seeing is believing, and we pray that this knowledge will invigorate her for the incredible challenge of facilitating and implementing cardiac rehabilitation here in Santiago over the next few years.

Finally, after another undesirable pause in meeting, the Dominican PT professional association is revived and chomping once again at needed health advocacy and policy issues. Nick is tasked with translating for and facilitating membership with the World Confederation of Physical Therapy. Some ministry goals take time. It has now been 5 years since we represented the DR at a WCPT meeting in Panama, and perhaps next year membership will occur, towards raising rehabilitation standards here through deeper international collaboration. Pictured is Margarita addressing the group at a recent meeting.


Margarita contributing to a discussion organized by the newly-formed PT professional organization, ADOFD. This month, she also will participate in a faculty exchange at Creighton University to further develop the new cardiopulmonary physical therapy course.

Laurie’s parents visited during some surges in unexpected work demands, helping us all to thrive. We overtook the backyard, beach, kiddie and hotel pools with gusto. The grandparents came with ideas fresh from a year apart, keeping us all entertained and a bit cleaner at home. Mateo is handing out fun new expressions and pauses during play to press his face into ours to share some love. Daniel seems to have settled more into his big brother skin, and sharing/taking turns comes easier. Thank you God! Daniel’s Spanish continues to expand. He loves chattering with neighbors from the front porch. Nick turned 36 in October! We are fortunate enough to get to visit the US around Christmas this year, and fulfill some professional education requirements while we’re at it! As usual, see your email version of this letter for related personal family photos.

Please stay tuned for a notable December newsletter, with news of some major changes in the direction of our lives, as well as our annual ministry appeal.  Thanks for all of your own updates, prayers, and care!

Posted in News

October Update

Dear friends,

Hurricanes- wow. Our family is relieved to report that we are well and remarkably physically un-ruffled here in Santiago after Hurricanes Irma & Maria passed by. Having just witnessed the devastation in photo and story from Harvey and early accounts of Irma on the more eastern Caribbean islands, the uncertainty of the closeness of the storm paths to our city created a significant sense of stress in the several days leading especially up to Irma. Our own history of water entering our home from more minor rains did not help, along with a real concern about the overall level of emergency preparedness of our DR home.

Irma initiated us, and by Maria, we felt more prepared emotionally and practically. When radar predicted that Irma’s eye would pass near our closest beaches an hour away, the final 48 hours before her visit brought an endless list of small preparatory tasks. Food, drinking water, candles, matches, chlorine, tarps, tubs of water in the bathtubs, and cleaning the ever present trash on our streets from the gutters on our block. Then sand bags (below pic) at both doors, gas for the car and for cooking. God provided throughout, including with 6 bags of avocados from our tree for our church to distribute, equally relieving us of what our North American minds predicted would be green bullets pummeling our windows.09-07-2017_09-050
We urgently questioned each cashier, neighbor and pastor on their level of preparedness for the storm. While everyone was in agreement that people in low lying homes with zinc roofs should leave, only the wealthiest/most educated of our acquaintances seemed to purchase anything extra. Nick became frustrated encouraging people to prep, for the number of shrugs and laughs he received for his concern. The individual lack of preparation felt alarming, though we were thankful that the city was clearing brush and released water from the dam nearby.

On the other hand, we gathered some new clues about resilience in numerous hilarious memes that passed through our Dominican chat feeds throughout both storms. Check out this video of a popular song intoning “Maria, se fue,” if you are up for a good laugh. This humor combined with other forms of top-notch preparation could have been a decent model for how to cope with disaster.
Thankfully, the DR was spared the brunt of both storms. Both brought moderate wind and rain at our house, and power loss for about a day (Pic- play courtesy of the sunlight, with sand bag decor). Because the DR actually schedules power outages weekly already given poor infrastructure, this was an extra pain but not a new stressor to acquaint ourselves with. Maria brought more rain, and even broke a retaining wall on our block, pushing a foot of water continuously through our neighbor’s house into the already flooded street. Maria collapsed several bridges in our city, and certainly, the expected unequally heavy burden on those living in the low lying areas where no one willingly chooses to dwell did occur, and assistance is needed. Several Nazarene families in other cities sadly lost their homes. As a whole however, our island is overwhelmingly grateful and well compared to our Caribbean neighbors.

Our church leaders still cannot make contact with several churches in Puerto Rico, and your prayers and support for the region are requested. Certainly being an island significantly complicates aide. Pray for ease of legal and physical access so that neighboring countries like ours can easily help, and for the lifting of communication, gas and infrastructure barriers that are keeping for example some of our pastors from visiting their own churches and from reaching one another to coordinate and receive aide that is/could be arriving at the ports. Here is one very damaged Nazarene church (Cataño), and we’re glad to report that our denomination has gotten food, water and some supplies through as well as funds this week. Pray for wisdom and kindness for those coordinating services at all levels, and for the hospitals.
Cataño PR church
Please also pray for some friends in our own neighborhood who were vulnerable even before the storms. David actually showed up at our house in the middle of Maria, swathed in plastic, seeking food for his partner and 1 year old. We were reminded once again of how wealthy we are, that we could easily still hand over a candle and matches, a tarp, food and diapers from our supplies, even as we were supposed to be hoarding for the emergency. Thank you for your partnership that allows us this level of general stability!! Both this family and another migrant worker, Jean-Claude, have become more frequent solicitors of food as they simply cannot find enough gardening work to meet basic needs.

Teaching. Finally, on to non-crisis news. Nick started teaching an orthopedic physical therapy class 3 weeks ago, with a great group of 8 students. They have some very packed days of learning ahead, having lost 10 hours of class with the hurricanes. Yesterday one of their patient’s broke down while reporting the loss of her house in the storm. More news and pictures from teaching next time.

We are grateful. We are able to continue to be active agents in our own family’s wellness and in the health of those around us. What a gift! Mateo turned 1 in August, and wants to precariously scale couches, etc like his brother. We’re so glad that Laurie’s parents will visit in October! We also find ourselves praying, stewing and mourning regularly over international news of hateful speech and threats of war that feel thick and enveloping in a way our own US generation may not have experienced previously. Let us be firm in prayer and find ever new and additional ways to act in love collectively, dear ones!! Sending our love and care today.
Peace to you!

Posted in News

August 2017 – Mentorship and Mangoes


August Greetings-

Mangoes as big as Mateo’s head are swelling on one of our backyard trees. On another, avocados dangle low like pairs of jade earrings from a well-seasoned ear. We are in an amazing fruit season here in Santiago, and Nick can even glean a few passion fruit, cherries and avocados from his trail runs. Our fruit glut is tempered by the cowering effect of the heat, which pushes us into careful file behind other pedestrians walking gingerly along thin, street light shadows while out and about. The water runs warm at our kitchen sink lately, where we don’t typically have hot water. Summer is here.

After much study, Nick, Denise and Pamela were able to deliver a continuing education course for therapists in the region. This was the culminating event of his mentoring time at their clinic. Nick was satisfied to experience the hoped for higher level of dedication to learning the material that occurred even in the week before the event, when the eustress of presenting for peers clicked into gear and heavy practice and good questions emerged during prep time. We thank God for these opportunities!



Fall ministry came into focus after an extended meeting with the physical therapy department chair at PUCMM University. Amid hashing out visions of international university partnerships, advocacy and continuing education efforts emerged the news that she will pursue a doctorate in physical therapy from the U.S. next year. We pray this exciting dream will come to fruition, as it will be the first Dominican therapist with this level of education not only at our university, but as far as we know in the DR. Nick was also scheduled to teach his usual orthopedic clinical rotation for the fall with 8-9 students, and has started preparations.

Family Life
07-16-2017_14-46_0839_1-e1502205287962.jpgAt 11 months, Mateo walks while flashing a 6-toothed grin! We’re grateful to have rediscovered a river about 15 minutes from home that is now perfect for our current explorers, and nice and shady to boot. We scrambled through our first 5k as a family last month.  Daniel has nicknamed Mateo, “Matato.” and Daniel is called “Baba” for now. Lastly, some of our missionary friends returned from an extended spell away, and we’re grateful to return to a weekly preschool which also provides encouraging friendships.

Thanks be to God for continued health and direction in this Dominican life.Thanks for your continued support and your own news! Love & Peace to you,

Nick, Laurie, Daniel & Mateo

Posted in Dominican Republic, Med Send, Nazarene, News, Physical Therapist, Physical Therapy, Republica Dominicana, Santiago

June 2017 – Clinic mentorship and success with potty-training

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Happy June! We hope this note finds you thriving despite the heat in your various homes across the US. Mateo sleeps in the one air conditioned room of our house, so we are beginning to get creative with fans, mid-day … Continue reading


March 2017 – Developments in the Clinic & Family

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This March finds us in a new clinic partnership, where Nick is keen on supporting recent advances in physical therapy education as they roll into patient care practices in the clinic. Thank you for your prayers for a clinical partnership ripe for … Continue reading


December 2016 – Possessional Burdens and Evolving Ministry

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Dear friends and partners, In our Catholic Worker circles from the Midwestern US, a true and delightful story popularly surfaced. It is hope for this Advent season, and a good antidote to the pulls of consumerism. It goes something like this. One … Continue reading

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November 2016 – U.S. stay and immigration update

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Dear friends and partners, Finding our DR Footing Again The humidity punched back as we left the air-conditioned airport, arriving home to the Dominican Republic a few weeks ago. Power outages, mosquito nets, old car troubles, and motorcycles with rear … Continue reading

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Christmas 2015

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  Merry Christmas from the Kietzman-Greers! We write with a mix of sad and glad tidings this Christmas! We’ve had a lot of fun these last few weeks with a university Christmas party, a wedding, and presents and dinner at … Continue reading


2015 Annual Report & Appeal

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Dear U.S. partners, “Ernesto” is a teacher being treated by Nick and his students. He had shoulder surgery after years of chronic shoulder pain and no access to therapy. After surgery, he was unfortunately not referred to rehab for 5 … Continue reading

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October 2015 – Update: Compassion

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Greetings to you this fall! This week we found a real pumpkin at the store (!), so are feeling a bit of U.S. culture in what is otherwise a holiday-sparse Halloween and Thanksgiving season in the DR. We hope this finds you well, thanks-giving and … Continue reading

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July 2015 – Immigration Reform & 4 years in the DR

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2015 July Update  Greetings! Every week, Nick runs past a group of early morning worshipers singing hymns in Creole at an open air church. There were about 30 faithful congregants, that is, until this month when the group dwindled to about 10. Last week, a … Continue reading


April 2015 – Developments in Education & Our Neighborhood

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Happy Easter season! Christ is risen indeed. We thought of you much during this season, missing some of the familiar faith and cultural practices from home. While the gains we made in taking Sabbath rest during Lent were all but … Continue reading

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February 2015- Immigration & Privilege

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A word from Thomas Merton: “There is a pervasive form of contemporary violence…activism and overwork. The rush and pressure of modern life are a form, perhaps the most common form, of its innate violence. To allow oneself to be carried … Continue reading


2014 Annual Report & Appeal

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Thank You for another year of partnership. Let’s take the long view and revisit some highlights of what we’ve been up to together in the last 3.5 years in the DR in Health, Faith and Community Partnerships. Health: Physical therapy … Continue reading

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November 2014 – Lights On!

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¡Llegó la luz!   This phrase can be heard shouted several times a day by children and shopkeepers alike in the dense, poorer neighborhoods of Santiago. “The lights have arrived!” has indeed proven a significant blessing for our household this month. After 5 … Continue reading

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August 2014: Inequality & Development: A Snapshot

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Dear Friends, A new Subway restaurant and some very bad (30hr/wk) power outages have forced us to reflect yet again on inequality and development in our DR context. The necessity of Gospel actions of mercy & justice easily comes to mind. We’ve seen many small signs of the DR’s … Continue reading


June 2014 – Returning home with Daniel

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Greetings from the Dominican Republic! We’ve made it back home to Santiago and are settling into life here. Immigration After Daniel was born, obtaining immigration paperwork became our avid hobby, and your prayers for a speedy completion of his residency … Continue reading

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March 2014

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Dear partners and friends, Greetings from California! We have arrived and are settling in for our son’s arrival in < 2 weeks! We are quite well and enjoying anew some of the everyday pleasures of the urban US, including: 1. comparably excellent health … Continue reading

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