Kristymedicalletter2003

October, 2002

Dear Teams,

It is hard to believe that a full season of teams has gone by and we are getting ready for a new year! Wowtime really does fly! This last year we had some great experiences and I've made more friends than I thought possible. Each of you had an impact on my life this year, in one way or another, even if we didn't spend a lot of time together. So many people shared their concerns with me and their questions about the direction of the ministry here in La Romana. One of the most common requests was that I send out a general letter to all of the teams before they arrive and give an overview of the ministry, our expectations of each of you and some of the rules that we feel are important in maintaining the integrity of the ministry here. So, if you're ready for a great year, let's get started!

Rules

Let's get the hard stuff over with first. This is the part that there is always a lot of confusion about so I will hopefully clear a lot of things up.

Clothing

This has been an issue since the work here began. I will give you what I believe is appropriate attire and I will explain why I believe we must adhere to this. For women there will always be more rules and although it is not fair, it is the way it is. Women are expected to be modest in their attire because they are representatives of the church. This means no short-shorts, no spaghetti strap tops, no shirts that expose your bra, no stomachs showing, no lower backs bared, and no skirts that are very short. In your free-time at the dormitory you are welcome to wear what you wish but if you are on the work site, in the medical clinic or in church, please hold to these expectations. If you go walking around, please be aware that people still see you as a representation of the church and what you wear, in this culture, reflects back on the church. On the construction site, I know it is hot and tank tops can be worn but I still recommend that you wear short sleeves and roll them up so there is no question about whether the tank top is too revealing or not. For the medical teams, I ask that women wear short sleeves (rolled up if needed) and either scrub pants or skirts/dresses when we are at the clinics. Again, not fair, but it is showing respect. In church, skirts and short sleeve shirts or a dress with short sleeves is appropriate. For men, please leave shirts on when you are working on the construction site. If you look at most of the Dominicans and Haitians that we are working with you will notice that they do not take their shirts off. Shorts or jeans/work pants are appropriate for the worksite. Shorts are NOT appropriate for church so please plan to bring a pair of pants to wear to the church services that you may attend. For everyone, please remove or cover any body piercing of the tongue, nose, belly button or eyebrow when you are on the work site, medical clinic or in church. Ear piercing is becoming more accepted in this culture for Christians, so that is fine, but any other part of the body is not seen as a Christian behavior. This is no reflection on you as a person but, again, we are doing this out of respect for the culture in which we are serving. Smoking and drinking alcoholic beverages is absolutely prohibited on dormitory, hospital or church grounds. Take this opportunity to quit smoking if you are a smoker or if you would like to have a drink please go to a local restaurant. We have had some problems with this in the past and several embarrassing situations have been brought before the church. Drinking and smoking is not seen as a Christian behavior although I know many Christians have a glass of wine or a beer with a special meal. Drinking alcohol tends to be limited to special occasions.

Finally, I would like to give each of you a tentative schedule of the times for the clinics and work teams. I ask that you try to fit your devotional times or meetings around this schedule. This will allow for us to leave more regularly in the mornings.

8-8:30am Load bus with medications/ construction supplies

8:30-9am Leave dormitory

12noon Lunch (at batey or construction site)

4-4:30pm return to dormitory for showers before dinner

This time can be changed if a beach trip is planned

or if more time is needed for a special project

I also ask that medical teams sort their meds during the evening hours so that the medications are ready to be loaded in the morning. This means keeping the medications at the dormitory and not at the hospital. It is very difficult to run in and out of the hospital to prepare the boxes of medicines every day. If you run out of something and we need to stop by the hospital in the morning, that is o.k., but I do not want to make it a regular trip daily. Also, this allows your team to assess medication needs with more time. Trying to rush all of this in the morning usually means we forget something.

O.k., I think that's it! Enough rules and let's get to the work!

Construction Projects

All construction questions and projects need to go through Moises Sifren. I spoke to him this morning and he gave me some guidelines for the teams:

1. Money for construction should be sent 2-3 weeks ahead of your visit so that materials can be purchased.

2. The amount of money to be sent depends on the project and the number of people in your group. The larger the group, the more money needs to be sent to keep everyone busy for the entire time. A suggested amount of $10,000 has been a standard of Pastor Phanord in the past. This does not mean that if you don't have $10,000 that you can't come so please speak to Moises and discuss the potential projects.

3. Some of the projects for this year include maintaining the first floor with new government standards, working on the second floor plumbing, electrical, painting and flooring needs, connecting the pillars on the third floor, building 2-3 churches in the bateyes, working on the retreat center and building fences in the bateyes.

Many of the teams may have funds left over following a construction projects and ask what will be done with the funds. There are several possibilities. First, the money can be used to continue the construction work when other teams are here. Second, the money can be used to cover the costs of patients who don't pay their bills. Third, the money can be used for special projects like malnutrition, social services or education that are involved in my work. Fourth, the money can be used for scholarships of students. To give a scholarship, contact Andrea at Maranatha Church. Finally, the money can be used at the discretion of Moises for the greatest need of the hospital.

To contact Moises, you can email at samaritano@codetel.net.do.

To contact Andrea, you can email at ibmhmaranatha@codetel.net.do.

Medical Clinics

I'm expecting great things from all of you this year! Many of you asked how you can prepare for the clinic ahead of time or what special projects you can do in your churches to help raise the necessary medicines. Here are some ideas:

1. Drives can be held, starting now, to raise some of the following things for the clinic: ibuprofen, acetaminophen, vitamins, toothpaste, toothbrushes, Ziploc sandwich baggies, antacids and cough/cold medicine.

2. Spanish or Creole Bibles may be collected to give out at the clinic. Sometimes it is cheaper and easier to bring just the New Testament or Psalms/Proverbs.

3. If clothing is brought, I suggest putting a few things in bags so that a prepared bag can be given out instead of having to sort through the clothes during the clinic. This removes the temptation of patients to go through the clothing or keep coming back to exchange. The small bags (like using a Wal-mart bag) can be divided into three categories, babies, children and adults.

4. Our hospital donation pharmacy is very empty! We need just about everything so don't count on us having a certain medicine down here when you come. We had several groups with little or no meds this year as well as distributing more medications to the batey promoters for first line health care.

5. Pre-printed labels are a great suggestion that one of the groups had for the pharmacy. That way we don't have to spend time labeling the baggies. If you use the pre-printed labels, please find a way to show the expiration date on the medications as we often have to throw out medicines that are pre-bagged and labeled but have no expiration showing. Here are some examples of labels that can be used with English translation following:

For general medication label:

Toma _____ pastilla ______ veces al día por _____ días

(take __ pills __ times a day for __ days)

For vitamins or other once daily meds:

Toma una pastilla cada mañana

(take one pill each morning)

For pain medications:

Para dolor o fiebre: Toma _____ pastilla ______ veces al día cuando tienes dolor o fiebre.

(For pain or fever: take __ pill __ times a day when you have pain or fever)

Many teams have a "pill party" at their church just before leaving on their trip. This allows many members of your church or community who are unable to come on the trip to still participate in your mission work. It is important that when you are bagging medicines that you do not touch the pills with your hands as the moisture can damage the pills. Also, no one really wants someone else's hands on their medicines even if the hands are washed. Please use gloves, pill counters or other methods to avoid touching the pills.

Here is a list of the medications that we generally need with every medical group. If you want more specific information, please contact me by email.

Ibuprofen (infant, kids, adult) Tylenol (infant, kids, adult) Antacids

Vitamins (infant, kids, adult) Cough syrup/meds Antibiotics

Antibiotic cream Anti-fungal cream/oral Selsun Blue

Steroid cream Birth Control Condoms

Anti-hypertensives Sulfur cream (see recipe) Eye/Ear drop

Anti-Scabies Ointment

(Sulfur Cream)

1 part sulfur in 20 parts Vaseline = 5% sulfur ointment

(may also be used for cradle cap)

Piperazine Dosing(worm medicine)

(500mg/5cc Syrup)

For Roundworms (Ascaris):

Adults 7 teaspoons (35cc) per day for 2 days

8-12yrs 5 teaspoons (25cc) per day for 2 days

3-7 yrs 3 teaspoons (15cc) per day for 2 days

1-3 yrs 2 teaspoons (10cc) per day for 2 days

under 1 yr 1 teaspoon (5cc) per day for 2 days

I hope this information will help your groups prepare for the upcoming year of missions work. We are definitely looking forward to seeing each of you and working with you again. I am excited about how many new groups have expressed interest in coming here and encourage each of you to continue spreading the word and inviting new people on this trip. Please feel free to contact me by email at: kristynurse23@hotmail.com if you have any questions. I will try to get back to you as soon as possible but sometimes have electricity problems and can't use my computer!

Love in Christ,

Kristy Engel, RN



	October, 2002 Dear Teams, It is hard to believe that a full season of teams has gone by and we are getting ready for a new year! Wowtime really does fly! This last year we had some great experiences and I've made more friends than I thought possible. Each of you had an impact on my life this year, in one way or another, even if we didn't spend a lot of time together. So many people shared their concerns with me and their questions about the direction of the ministry here in La Romana. One of the most common requests was that I send out a general letter to all of the teams before they arrive and give an overview of the ministry, our expectations of each of you and some of the rules that we feel are important in maintaining the integrity of the ministry here. So, if you're ready for a great year, let's get started! Rules Let's get the hard stuff over with first. This is the part that there is always a lot of confusion about so I will hopefully clear a lot of things up. Clothing This has been an issue since the work here began. I will give you what I believe is appropriate attire and I will explain why I believe we must adhere to this. For women there will always be more rules and although it is not fair, it is the way it is. Women are expected to be modest in their attire because they are representatives of the church. This means no short-shorts, no spaghetti strap tops, no shirts that expose your bra, no stomachs showing, no lower backs bared, and no skirts that are very short. In your free-time at the dormitory you are welcome to wear what you wish but if you are on the work site, in the medical clinic or in church, please hold to these expectations. If you go walking around, please be aware that people still see you as a representation of the church and what you wear, in this culture, reflects back on the church. On the construction site, I know it is hot and tank tops can be worn but I still recommend that you wear short sleeves and roll them up so there is no question about whether the tank top is too revealing or not. For the medical teams, I ask that women wear short sleeves (rolled up if needed) and either scrub pants or skirts/dresses when we are at the clinics. Again, not fair, but it is showing respect. In church, skirts and short sleeve shirts or a dress with short sleeves is appropriate. For men, please leave shirts on when you are working on the construction site. If you look at most of the Dominicans and Haitians that we are working with you will notice that they do not take their shirts off. Shorts or jeans/work pants are appropriate for the worksite. Shorts are NOT appropriate for church so please plan to bring a pair of pants to wear to the church services that you may attend. For everyone, please remove or cover any body piercing of the tongue, nose, belly button or eyebrow when you are on the work site, medical clinic or in church. Ear piercing is becoming more accepted in this culture for Christians, so that is fine, but any other part of the body is not seen as a Christian behavior. This is no reflection on you as a person but, again, we are doing this out of respect for the culture in which we are serving. Smoking and drinking alcoholic beverages is absolutely prohibited on dormitory, hospital or church grounds. Take this opportunity to quit smoking if you are a smoker or if you would like to have a drink please go to a local restaurant. We have had some problems with this in the past and several embarrassing situations have been brought before the church. Drinking and smoking is not seen as a Christian behavior although I know many Christians have a glass of wine or a beer with a special meal. Drinking alcohol tends to be limited to special occasions. Finally, I would like to give each of you a tentative schedule of the times for the clinics and work teams. I ask that you try to fit your devotional times or meetings around this schedule. This will allow for us to leave more regularly in the mornings. 8-8:30am Load bus with medications/ construction supplies 8:30-9am Leave dormitory 12noon Lunch (at batey or construction site) 4-4:30pm return to dormitory for showers before dinner This time can be changed if a beach trip is planned or if more time is needed for a special project I also ask that medical teams sort their meds during the evening hours so that the medications are ready to be loaded in the morning. This means keeping the medications at the dormitory and not at the hospital. It is very difficult to run in and out of the hospital to prepare the boxes of medicines every day. If you run out of something and we need to stop by the hospital in the morning, that is o.k., but I do not want to make it a regular trip daily. Also, this allows your team to assess medication needs with more time. Trying to rush all of this in the morning usually means we forget something. O.k., I think that's it! Enough rules and let's get to the work! Construction Projects All construction questions and projects need to go through Moises Sifren. I spoke to him this morning and he gave me some guidelines for the teams: 1. Money for construction should be sent 2-3 weeks ahead of your visit so that materials can be purchased. 2. The amount of money to be sent depends on the project and the number of people in your group. The larger the group, the more money needs to be sent to keep everyone busy for the entire time. A suggested amount of $10,000 has been a standard of Pastor Phanord in the past. This does not mean that if you don't have $10,000 that you can't come so please speak to Moises and discuss the potential projects. 3. Some of the projects for this year include maintaining the first floor with new government standards, working on the second floor plumbing, electrical, painting and flooring needs, connecting the pillars on the third floor, building 2-3 churches in the bateyes, working on the retreat center and building fences in the bateyes. Many of the teams may have funds left over following a construction projects and ask what will be done with the funds. There are several possibilities. First, the money can be used to continue the construction work when other teams are here. Second, the money can be used to cover the costs of patients who don't pay their bills. Third, the money can be used for special projects like malnutrition, social services or education that are involved in my work. Fourth, the money can be used for scholarships of students. To give a scholarship, contact Andrea at Maranatha Church. Finally, the money can be used at the discretion of Moises for the greatest need of the hospital. To contact Moises, you can email at samaritano@codetel.net.do. To contact Andrea, you can email at ibmhmaranatha@codetel.net.do. Medical Clinics I'm expecting great things from all of you this year! Many of you asked how you can prepare for the clinic ahead of time or what special projects you can do in your churches to help raise the necessary medicines. Here are some ideas: 1. Drives can be held, starting now, to raise some of the following things for the clinic: ibuprofen, acetaminophen, vitamins, toothpaste, toothbrushes, Ziploc sandwich baggies, antacids and cough/cold medicine. 2. Spanish or Creole Bibles may be collected to give out at the clinic. Sometimes it is cheaper and easier to bring just the New Testament or Psalms/Proverbs. 3. If clothing is brought, I suggest putting a few things in bags so that a prepared bag can be given out instead of having to sort through the clothes during the clinic. This removes the temptation of patients to go through the clothing or keep coming back to exchange. The small bags (like using a Wal-mart bag) can be divided into three categories, babies, children and adults. 4. Our hospital donation pharmacy is very empty! We need just about everything so don't count on us having a certain medicine down here when you come. We had several groups with little or no meds this year as well as distributing more medications to the batey promoters for first line health care. 5. Pre-printed labels are a great suggestion that one of the groups had for the pharmacy. That way we don't have to spend time labeling the baggies. If you use the pre-printed labels, please find a way to show the expiration date on the medications as we often have to throw out medicines that are pre-bagged and labeled but have no expiration showing. Here are some examples of labels that can be used with English translation following: For general medication label: Toma _____ pastilla ______ veces al día por _____ días (take __ pills __ times a day for __ days) For vitamins or other once daily meds: Toma una pastilla cada mañana (take one pill each morning) For pain medications: Para dolor o fiebre: Toma _____ pastilla ______ veces al día cuando tienes dolor o fiebre. (For pain or fever: take __ pill __ times a day when you have pain or fever) Many teams have a "pill party" at their church just before leaving on their trip. This allows many members of your church or community who are unable to come on the trip to still participate in your mission work. It is important that when you are bagging medicines that you do not touch the pills with your hands as the moisture can damage the pills. Also, no one really wants someone else's hands on their medicines even if the hands are washed. Please use gloves, pill counters or other methods to avoid touching the pills. Here is a list of the medications that we generally need with every medical group. If you want more specific information, please contact me by email. Ibuprofen (infant, kids, adult) Tylenol (infant, kids, adult) Antacids Vitamins (infant, kids, adult) Cough syrup/meds Antibiotics Antibiotic cream Anti-fungal cream/oral Selsun Blue Steroid cream Birth Control Condoms Anti-hypertensives Sulfur cream (see recipe) Eye/Ear drop Anti-Scabies Ointment (Sulfur Cream) 1 part sulfur in 20 parts Vaseline = 5% sulfur ointment (may also be used for cradle cap) Piperazine Dosing(worm medicine) (500mg/5cc Syrup) For Roundworms (Ascaris): Adults 7 teaspoons (35cc) per day for 2 days 8-12yrs 5 teaspoons (25cc) per day for 2 days 3-7 yrs 3 teaspoons (15cc) per day for 2 days 1-3 yrs 2 teaspoons (10cc) per day for 2 days under 1 yr 1 teaspoon (5cc) per day for 2 days I hope this information will help your groups prepare for the upcoming year of missions work. We are definitely looking forward to seeing each of you and working with you again. I am excited about how many new groups have expressed interest in coming here and encourage each of you to continue spreading the word and inviting new people on this trip. Please feel free to contact me by email at: kristynurse23@hotmail.com if you have any questions. I will try to get back to you as soon as possible but sometimes have electricity problems and can't use my computer! Love in Christ, Kristy Engel, RN