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Now that it has been two weeks since returning from the Dominican Republic, and I think that I have largely made it through the process of re-entering my normal day-to-day life.  What I consider “normal” here is so different from how the residents of Esfuerzo live that it is hard to explain and hard to conceive how the process impacts a person unless one has been through it before.

During the trip, the team grew close and accomplished a great deal.  Nearly 350 patients received care, and we launched a new initiative to provide patients with a personal health record (“pasaporte de salud”–health passport) that we hope will enhance chronic disease management and facilitate follow up care while empowering patients to be active in their own care decisions.  The new government of Santo Domingo Norte has taken an interest in the project (for better or for worse–time will tell), and we hope this interest will translate into more consistent government services provided to the community.  The new team members formed necessary connections with the community’s residents and leaders (official and unofficial) that will enhance our work over the next few years.

I suspect each member of the team has their own reactions to the return: the happiness of returning to families and friends, the pang of loss that results when 18 people who spent every waking moment together for a week of hard work are suddenly separated, the unease as the amount and variety of everything we have is contrasted with the facts of life facing each resident in Paraiso, and the anticipation of the next time we will meet as individuals and as a team to reflect on what has been accomplished and the very large amount of work still to be done.

A few links to other people’s thoughts:

David Aday’s letter to the team, which sums up how much respect we all have for the team members, and demonstrates the group’s closeness, friendship, and dedication.

Jess Lucia has been actively posting her thoughts about the trip: her first impressions upon return, an attempt to answer the most common question, “What was it like?“, and a description of the communities of Paraiso.

Finally, a link to Jess’s photographs of the trip.  She has a keen eye for catching emotion and context, and her work gives an in-depth sense of what it is like to be working in the communities of Paraiso and Esfuerzo.

Thanks to all the team members and to all those who supported the work.  I look forward to our continued work together.


I apologize that I’m too tired to post a long update today.  So I’m going to go the easy way, and highlight a couple of recent blogs that have given their perspective on the project:

David Aday’s blog for the College of William and Mary, which looks at the research and community development side of the project.

Jess Lucia’s blog highlighting her thoughts, experiences (and photos) as a first-time trip participant.

Please read, comment, discuss and share!  We’d love to further the discussion of the work we’re doing.

Yesterday, the team arrived and gathered at the hotel–all arrived safely, and all the luggage made it through.  This morning, we received the rest of our medicines (which we purchased locally) and counted out the vitamins we brought and that we will dispense to nearly every patient we see.


This afternoon the team went to Paraiso, allowing the new members to familiarize themselves somewhat with the community.  The team also set up a “gran evento”: a big event, with face painting and games for the kids, music and dancing, and food and snacks for all.  Also: a community meeting to discuss the near-term plans for the project.


Last year, at a similar meeting, the community expressed an interest in a trash collection program, but this was not sustained (for various reasons).  At this year’s meeting, the community continues to express this interest and feels this will help improve the community’s health status.  The government representatives at the meeting expressed their commitment that they will work to ensure that a truck comes around regularly to pick up all collected trash.  Now, we can determine how best to assist the community in working out the best way to ensure the trash gets collected.


After dinner tonight, final clinical preparations will follow.  The first day of clinic is tomorrow.


(Remember to watch the DASV Twitter account for more updates.)

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