When the electricity goes out, I suddenly have no idea what to do with myself. This morning I was looking forward to sleeping in, having a relaxing morning, and going into the clinic late. It was supposed to be a glorious day. But as the neighbors' crazy dogs barked as usual at 9am, the ceiling fan in my room suddenly stopped turning. I looked up and thought to myself "damn." I laid there getting hotter and hotter by the second, so I pushed the covers off and decided to go ahead and check my email and news for the day on the internet. Whoops! No wireless connection. And my computer was almost dead, and whoops! It wouldn't charge. No electricity. Gosh...ok, let me go ahead and take my shower. Uh oh! No electricity for the heater, so no hot water (and very little pressure).
As I stood under the cold droplets of water and pretended I could actually call that a shower, I thought about all the things I couldn't do without electricity. I've been so spoiled and dependent on it here, I forgot how much I lose when it goes away. As I got dressed and went to eat my breakfast, the yogurt was warm, the juice was warm, the water was warm, the cream chesse for my bagel was warm, my friggin apple was warm. And the fan I usually put directly in my face so as not to sweat out of my business casual wasn't working either.
So I left the house miffed and already sweating, on my way to work where there were so many patients and for some reason the AC wasn't working. It is SO hot here and people who know me, know that in this type of climate I usually look like Shaq right after a championship game (that went into overtime and everything). At one point, one of the ladies in the pharmacy stopped in front of me, smiled and asked, "Do you need some juice?" There was probably steam coming off my bald head.
Anyway, I thought to myself, where could I go to change and cool off? - the gym! of course, they have ice cold water there, plenty of Powerades for sale, fans all over the place. I arrived at the gym with a little swagger in my step. After changing into more comfortable clothes and starting in on the first machine, the electricity went out again! So I worked out in the dark heat for about 45 minutes. The water cooler was even hot. No Powerade today.
I moved on to a place I usually stop to get lunch. I ordered some fried chicken, platanos, and rice, and asked for two huge pineapple juices (one of the times I wish there was a "super size" option). For some reason I wasn't cooling down. The pineapple juice did nothing. I walked home a sweaty mess, saying a small prayer that the electricity would be back by the time I got to the house. I entered the door and flipped the switch and there was light. I almost fell to my knees in gratitude, but I was afraid I'd be too tired to get up...
Thursday, July 21, 2011
Tuesday, July 19, 2011
The Return to DR Part 2: The Culture of Caring
I saw my first patient last week. Since the day I arrived at CEPROSH, I have been saying I'm a student. It's the first thing I usually say in introducing myself. I never want to give anyone a wrong impression, especially seeing the number of patients that visit each day. But there I was, being given a patient chart. A lady came from very far only to find out the doctor couldn't make it that day. She really wanted to see someone, anyone. I tried to say no to the ladies working in the pharmacy, but relented after awhile. So I sat in the big doctor chair, called her in and tried my best. I'm still so amazed at the immediate trust one is afforded as a physician. She launched into the details of her life, and spoke to me about her recent surgery, showing me the scars. She also asked me to feel her ribs where she felt pain. She brought out her many bottles of medication from her purse and told me how often she takes each one. I wrote down everything she told me for the next time so the doctor would know exactly what needed to be done. I explained to her that I was still a student, but that made no difference. She hung on my every word. She had such kind eyes, eyes that reminded me of how right I was to choose this path.
The next day I finally got the chance to shadow at the clinic the other day. For about a week and a half, I've been walking past patients to the room where I sit down to do my work. They usually look at me quizzically, surely thinking things like, "Is he a doctor?" "Why is he carrying patient records?" "He doesn't look Dominican" "Why is he sweating so much?" In thinking about the experience of people living with HIV here in Puerto Plata, it has certainly felt impersonal going through records and collecting data points on these patients while hearing nothing about their life stories. They were becoming simply coded numbers, drug regimens, and clinic visits. So I was really excited when Dr. Queto peeked her head in the door of my room to say hello. She's a short "gordita," as one of the patients affectionately called her, with a young face and an easy smile. She certainly has presence when she enters a room though. I immediately asked if I could shadow her for the day and she happily agreed. You can tell she loves to teach. She's passionate about her work, you can see that in the intensity of her eyes.
As Dr. Queto sat at her desk, I could tell she was preparing herself for the stress of the day, peaking at the stack of about 15 patient folders on her desk. We spoke for a little bit about my project, my first year in medical school, as well as her impressions of care at the clinic and her experience thus far. Then she called in the first patient - a skinny, dark skinned middle-aged man carrying a bunch of bags, looking a bit tired from his trip that morning. Dr. Queto looked at his record and noted that he hadn't been to the clinic since November of 2010. She asked him why he hadn't been in so long, and when he didn't provide an answer, she basically yelled at him for 10 minutes. She raised her voice shot lasers at this patient with her eyes. I thought about all the cultural competency and doctor-patient relationship stuff we learned over the first year - she was basically doing the opposite of everything I learned. I almost laughed at one point because I thought she might be joking.
Everything she said made sense - she wasn't malicious or anything, just saying the obvious things about adherence to meds and the importance of CD4 checks in a much more animated manner. After the patient left the room, she explained to me that she had to talk to him that way or else nothing would change. She explained that patients here, especially ones receiving free care, completely take it for granted sometimes. The gentle reminders don't help. They need to be reminded of the service they're being provided, of the importance of taking charge of their health. Apparently, people here expect their doctors to be more paternalistic. There's less of an expectation to give the patient options and serve as an emotional support. This approach contrasts sharply with the move in the US to provide patients with choice, ensure they have a positive experience during their clinic visits, and make them partners in all healthcare decisions.
It got me thinking, there are different cultures of caring that may work in some places and not in others. Is it always better to handle patients lightly, to politely ask them to change their behavior? Is the model of the doctor-patient relationship I'm learning in school applicable in different countries? Fascinating questions...
But Dr. Queto had varying styles with each patient that came in. Some she laughed with, some she scolded, some she was more impersonal. She certainly commanded respect from them all though.
As for the patients, they had such varied lives. The man who lost 8 pounds in one week and looked terribly frail. His viral load was extremely high and his CD4 count miserably low. Dr. Queto struggled to figure out what to do next - the generic drugs don't work as well with patients sometimes (they're still on the the three drug regimen here). He sat looking defeated as she tapped her foot thinking of ideas. There was the woman who brought in fruits for the doctor, extremely grateful and excited to go over her treatment. Everything was okay, but she complained of frequent seizures. Dr. Queto and I discussed whether it could be a complication of HIV, or unrelated epilepsy. Then there was the man who surely suffered from depression. He sat staring at his shoes as his mother answered many of the doctors questions. We listened to his lungs and looked at his X-ray, his TB had been getting worse over time. He didn't seem to care about what we were saying. I wondered how challenging it must be to treat HIV and depression, since so much of the patients prognosis is linked to their compliance with medications and indeed their desire to keep living.
All in all, it was a good experience. I was able to put some faces to those patient charts, and move from the research side back to the human side.
The next day I finally got the chance to shadow at the clinic the other day. For about a week and a half, I've been walking past patients to the room where I sit down to do my work. They usually look at me quizzically, surely thinking things like, "Is he a doctor?" "Why is he carrying patient records?" "He doesn't look Dominican" "Why is he sweating so much?" In thinking about the experience of people living with HIV here in Puerto Plata, it has certainly felt impersonal going through records and collecting data points on these patients while hearing nothing about their life stories. They were becoming simply coded numbers, drug regimens, and clinic visits. So I was really excited when Dr. Queto peeked her head in the door of my room to say hello. She's a short "gordita," as one of the patients affectionately called her, with a young face and an easy smile. She certainly has presence when she enters a room though. I immediately asked if I could shadow her for the day and she happily agreed. You can tell she loves to teach. She's passionate about her work, you can see that in the intensity of her eyes.
As Dr. Queto sat at her desk, I could tell she was preparing herself for the stress of the day, peaking at the stack of about 15 patient folders on her desk. We spoke for a little bit about my project, my first year in medical school, as well as her impressions of care at the clinic and her experience thus far. Then she called in the first patient - a skinny, dark skinned middle-aged man carrying a bunch of bags, looking a bit tired from his trip that morning. Dr. Queto looked at his record and noted that he hadn't been to the clinic since November of 2010. She asked him why he hadn't been in so long, and when he didn't provide an answer, she basically yelled at him for 10 minutes. She raised her voice shot lasers at this patient with her eyes. I thought about all the cultural competency and doctor-patient relationship stuff we learned over the first year - she was basically doing the opposite of everything I learned. I almost laughed at one point because I thought she might be joking.
Everything she said made sense - she wasn't malicious or anything, just saying the obvious things about adherence to meds and the importance of CD4 checks in a much more animated manner. After the patient left the room, she explained to me that she had to talk to him that way or else nothing would change. She explained that patients here, especially ones receiving free care, completely take it for granted sometimes. The gentle reminders don't help. They need to be reminded of the service they're being provided, of the importance of taking charge of their health. Apparently, people here expect their doctors to be more paternalistic. There's less of an expectation to give the patient options and serve as an emotional support. This approach contrasts sharply with the move in the US to provide patients with choice, ensure they have a positive experience during their clinic visits, and make them partners in all healthcare decisions.
It got me thinking, there are different cultures of caring that may work in some places and not in others. Is it always better to handle patients lightly, to politely ask them to change their behavior? Is the model of the doctor-patient relationship I'm learning in school applicable in different countries? Fascinating questions...
But Dr. Queto had varying styles with each patient that came in. Some she laughed with, some she scolded, some she was more impersonal. She certainly commanded respect from them all though.
As for the patients, they had such varied lives. The man who lost 8 pounds in one week and looked terribly frail. His viral load was extremely high and his CD4 count miserably low. Dr. Queto struggled to figure out what to do next - the generic drugs don't work as well with patients sometimes (they're still on the the three drug regimen here). He sat looking defeated as she tapped her foot thinking of ideas. There was the woman who brought in fruits for the doctor, extremely grateful and excited to go over her treatment. Everything was okay, but she complained of frequent seizures. Dr. Queto and I discussed whether it could be a complication of HIV, or unrelated epilepsy. Then there was the man who surely suffered from depression. He sat staring at his shoes as his mother answered many of the doctors questions. We listened to his lungs and looked at his X-ray, his TB had been getting worse over time. He didn't seem to care about what we were saying. I wondered how challenging it must be to treat HIV and depression, since so much of the patients prognosis is linked to their compliance with medications and indeed their desire to keep living.
All in all, it was a good experience. I was able to put some faces to those patient charts, and move from the research side back to the human side.
Tuesday, July 12, 2011
The Return to DR Part 1: CEPROSH
As I made my way through Latin America a couple of years ago, I always said I would return to learn more about healthcare delivery in this part of the world. My travels then were so focused on my own self-development, and music and politics and culture, that afterwards I was curious about some of the substantive global health issues I got a taste of as I bounced from place to place. This summer ("the last summer" as we say in med school) I made my way back to Dominican Republic, the last stop on my whirlwind tour. I arrived here about a week and a half ago and shockingly I'm already almost halfway through my stay. I'm only here for July though to get back for the big bro's wedding, and things generally move slower in this part of the world, so I'm taking the time to reflect on the past year, eat and sleep quite a bit, and do a lot of reading and writing. My romps to places like New Orleans (for Mardi Gras!!) and Namibia (for a FREE African safari trip with my sister) this past year at times made me question if I was actually in med school. So to be honest, I don't need to be all over the place; I'm happy just relaxing.
I'm staying in Puerto Plata, a vibrant coastal city on the northern side of the island, mostly known as one of those all-inclusive resort destinations in the Caribbean. I'm working at CEPROSH, an HIV outpatient clinic serving a large swath of the island since 1987, providing HIV care, testing, social services, education and prevention, and free antiretrovirals. I'm working with a doctor at Penn on this study looking at the impact of a free lab testing program initiated last year on patient compliance with recommended lab monitoring. It's pretty simple data collection from patient charts, not requiring a lot of mental effort at all. But it's certainly been interesting seeing the model they have set up at CEPROSH and how effective it seems.
Apparently, what originally drove the HIV epidemic in this part of DR was the sex tourism industry. While that is certainly still a player, the rates of HIV infection here seem to be driven by the same factors we've seen globally for the past couple of decades or so - women's lack of power when it comes to contraception in heterosexual sex, and the socioeconomic effect of marginalization (the poor, the migrants, etc.). CEPROSH is great because it employs people from the community, many of whom are HIV positive themselves. I had a brilliant conversation with one of the ladies who works in the pharmacy and helps me pull my patient charts. As we were in casual conversation about our lives, she asked to see my list of patients and pointed out her name to me proudly. Her eldest daughter is also HIV positive. This work means so much to her, and she told me of all the positive change she has seen over time. She explained to me how things used to be - the constant death around her, the lack of life-saving medicine, her own uncertainty. Things are different now - people come in every week to get their drugs and see one of the three doctors who come in daily. And CEPROSH staff like my friend in the pharmacy know who the patients are and truly care about them receiving the necessary, adequate services.
I look forward to shadowing the doctors this week or next. Things have been thrown off a bit due to a national strike about gas prices, jobs and the lack of a government response that shut down public transportation. This kept patients from the clinic the other day because it's simply too expensive to come to CEPROSH without public transportation for the patients. The global economic crisis is really taking its toll everywhere. Hopefully the schedule will return to normal though.
Outside of my project here, I'm staying in the home of one of the social workers at the clinic. Lucia is a sweet lady - always brings me some fresh squeezed fruit juice when I'm in the living room. Her 10-year old daughter Eliany has become my partner-in-crime. This little girl has so much energy. She has pigtails and wears glasses and has braces, and peaks her head in my door at random times of the day. She's obsessed with this one gospel CD, always singing the same songs. And we are constantly playing card games, which I always win even when I don't want to. Maybe I should tell her it's probably because she's not shuffling the deck well enough? I wouldn't want to break my hot streak though.
On the weekends, we've visited her aunt and cousins. Her one cousin Lisa is one of the cutest little girls you'll ever see with her little afro, and her huge beautiful eyes. She's so funny - she's kind of gangster too. The other day she called me a "puta". I almost died laughing. I guess being five times someone's size doesn't mean they can't cock their head sideways and call you a bitch. I'm hoping she has no idea what she said - she's hardly 2 years old. Anyway...
The first year of medical school is a beautiful blur. Since my glorious year off in Latin America, I've moved to Philadelphia, made countless new friends, and learned a whole lot of medicine at Penn. I'm exactly where I want to be. Yet something pulled me back down here for my "last summer ever." And that something is global health office funding. With my twenty or so days left, I intend to delve a bit more into the physician and patient experiences respectively, and to finally get to the beach this weekend. I walked along the coast today and the water was so blue, the breeze so refreshing. The only thing that will keep me away is another torrential downpour like last weekend. Which was actually a bit of a blessing. It turned into a day of watching old Kuumba videos and finally getting into The Catcher in the Rye.
I'm staying in Puerto Plata, a vibrant coastal city on the northern side of the island, mostly known as one of those all-inclusive resort destinations in the Caribbean. I'm working at CEPROSH, an HIV outpatient clinic serving a large swath of the island since 1987, providing HIV care, testing, social services, education and prevention, and free antiretrovirals. I'm working with a doctor at Penn on this study looking at the impact of a free lab testing program initiated last year on patient compliance with recommended lab monitoring. It's pretty simple data collection from patient charts, not requiring a lot of mental effort at all. But it's certainly been interesting seeing the model they have set up at CEPROSH and how effective it seems.
Apparently, what originally drove the HIV epidemic in this part of DR was the sex tourism industry. While that is certainly still a player, the rates of HIV infection here seem to be driven by the same factors we've seen globally for the past couple of decades or so - women's lack of power when it comes to contraception in heterosexual sex, and the socioeconomic effect of marginalization (the poor, the migrants, etc.). CEPROSH is great because it employs people from the community, many of whom are HIV positive themselves. I had a brilliant conversation with one of the ladies who works in the pharmacy and helps me pull my patient charts. As we were in casual conversation about our lives, she asked to see my list of patients and pointed out her name to me proudly. Her eldest daughter is also HIV positive. This work means so much to her, and she told me of all the positive change she has seen over time. She explained to me how things used to be - the constant death around her, the lack of life-saving medicine, her own uncertainty. Things are different now - people come in every week to get their drugs and see one of the three doctors who come in daily. And CEPROSH staff like my friend in the pharmacy know who the patients are and truly care about them receiving the necessary, adequate services.
I look forward to shadowing the doctors this week or next. Things have been thrown off a bit due to a national strike about gas prices, jobs and the lack of a government response that shut down public transportation. This kept patients from the clinic the other day because it's simply too expensive to come to CEPROSH without public transportation for the patients. The global economic crisis is really taking its toll everywhere. Hopefully the schedule will return to normal though.
Outside of my project here, I'm staying in the home of one of the social workers at the clinic. Lucia is a sweet lady - always brings me some fresh squeezed fruit juice when I'm in the living room. Her 10-year old daughter Eliany has become my partner-in-crime. This little girl has so much energy. She has pigtails and wears glasses and has braces, and peaks her head in my door at random times of the day. She's obsessed with this one gospel CD, always singing the same songs. And we are constantly playing card games, which I always win even when I don't want to. Maybe I should tell her it's probably because she's not shuffling the deck well enough? I wouldn't want to break my hot streak though.
On the weekends, we've visited her aunt and cousins. Her one cousin Lisa is one of the cutest little girls you'll ever see with her little afro, and her huge beautiful eyes. She's so funny - she's kind of gangster too. The other day she called me a "puta". I almost died laughing. I guess being five times someone's size doesn't mean they can't cock their head sideways and call you a bitch. I'm hoping she has no idea what she said - she's hardly 2 years old. Anyway...
The first year of medical school is a beautiful blur. Since my glorious year off in Latin America, I've moved to Philadelphia, made countless new friends, and learned a whole lot of medicine at Penn. I'm exactly where I want to be. Yet something pulled me back down here for my "last summer ever." And that something is global health office funding. With my twenty or so days left, I intend to delve a bit more into the physician and patient experiences respectively, and to finally get to the beach this weekend. I walked along the coast today and the water was so blue, the breeze so refreshing. The only thing that will keep me away is another torrential downpour like last weekend. Which was actually a bit of a blessing. It turned into a day of watching old Kuumba videos and finally getting into The Catcher in the Rye.
Sunday, November 8, 2009
Garifuna Inspiration and the End of A Year-Long Journey
Far in the distance is a line separating a purple and orange sky. I'm watching a rainy, dreary day turn into a calm, beautiful evening in Santo Domingo from an apartment window. The sun is setting on my year of thoughts, a year colored with such a huge range of experiences and emotions it makes it difficult to leave behind. I am keenly aware that, like college, this has been a defined, unique period of my life, which I will look back on with countless fond memories. As I prepare for my flight tomorrow, I'm becoming a bit nostalgic already. Even though it's definitely time to head home for me, I know part of me wants to keep going, keep exploring and asking questions and meeting new, interesting people forever. But I'm ready for the next phase and having this extended time away for self-reflection will be helpful in my next steps.
So my time in Belize came and went rather abruptly. Unfortunately it was raining most of the time, just like today, because Hurricane Ida is running all over the Gulf of Mexico. So I had a little less time to walk around, explore and take pictures. My visit to Dangriga was interesting. Dangriga is considered the heart of Garifuna culture, and one of the main points of entry for those Afro-Caribbean immigrants in the early 19th century. They're such an interesting people. I spent most of my time chasing the most famous Garifuna artist in the country, but it just wasn't meant to be. I also spent time in long conversations on the quiet, desolate streets of the small town. This one guy recapped his entire football career in Belize for me. He wasn't humble, which made it entertaining. The summary is that he spoke to me for an hour and basically said, "I'm the sh*t, I'm the sh*t, I'm the sh*t" over and over again until he said bye. He was a nice old man though. In Dangriga, people speak English, Spanish, Creole, Chinese, Garifuna and the list goes on. It's pretty crazy. Everything is relaxed to infinity though, so I did some good napping...
Oh well...I did get to go to the Garifuna museum, which was only two big rooms, but had tons of awesome information, pictures, artifacts, poems, etc. The Garifuna are fascinating. They have such pride because they were never officially slaves and established their own communities on the Atlantic coasts of Belize, Honduras and Nicaragua while fiercely fighting colonial forces for centuries. Some major foods and crops include yams, sweet potato and cocoa. They also eat tons of seafood because of their proximity to the sea. They have different religions, the major of which is Dugu, which like Candomble in Brazil involves trance, music, drums, dancing, and spirit possession. They have countless festivals, many of which include masquerade men doing traditional dances. They have tons of music, the most popular called punta, with famous artists Andy Palacio and Paul Nabor. Punta is really cool! It's slow, elegant music with lots of guitar and drums and vocals. Soothing type of music. There's the more modern version of this called punta rock, which reminds me of Pagode in Salvador. It's faster and the kind of music meant to make you move your hips, but the beat is a little oppressive after a while. It's kind of like reggaeton in that sense, EVERY punta rock song has the same beat. It was funny, in Dangriga I went to lunch and asked the guy behind the counter if he could play some punta for me. He looked a bit taken aback but said ok. Before I knew it, he brought out all this DJ equipment, hooked it all up, put DJ headphones on, and went crazy mixing songs, bobbing his head and ignoring other customers that came in. I created a monster lol. It was entertaining to hear all that music for the next 2 hours - I had nothing better to do. Anyway, back to the museum...beyond the really precise recounting of Garifuna history, I really enjoyed the poems and proverbs they had featured on the walls. It's all really spiritual and meaningful, centered on community and cultural survival. Those people are deep! It was a great trip to the museum.
After resting up, I headed back to Belize City where everyone was talking about Shyne, just back in Belize after like 9 years in prison following that shooting at the NYC club with Diddy and J.Lo (of course, as always, Diddy owes him a ton of money and got away from any blame). It seemed like everyone I met in Belize City had shot someone, been to prison, and then got deported. In my head I was thinking, "why is everyone telling me this right after I say hello?" It must've been some desire to establish that they were not someone to be messed with. It wasn't that cool though. I was staying on the southside of Belize City, which is the rougher side. I wonder if it would've been the same had I stayed on the north side, because it didn't look too different (Belize is quite poor and economically underdeveloped). In all, Belize was charming at times, but a bit disappointing. I'm sure if I went to the supposedly amazing beaches and did the snorkeling, diving, and all that stuff it's known for, and if I had seen some live Garifuna music performances, I'd have a different sense. But I'm tired and ready to go home. So I'm here in Santo Domingo, prepping for the flight tomorrow, and wrapping up whats been a ten-month adventure and thinking of what I'm going home to.
The world always seems to be falling to pieces. At the present moment, its wars, broken health care systems, unemployment, economic inequality, violence, genocide, brutal dictators and regimes, swine flu, climate change, gang rapes, diseases, racism, and the list goes on...What this trip has reinforced for me is that there is as much to be inspired by in the world, as much to behold for its magnificence, as there is to deplore and denounce. This trip has sustained the ideal of the world with which I arrived on my first day of college. That same ideal everyone complains is beaten out of young minds by years of pessimism and being made to feel small and insignificant. It's the ideal that hard work, good ideas, and active participation can produce real changes. Whether it was young activists in Brazilian favelas, or festejo dancing children in Peru, or a seasoned professor with a vision in Panama, or cumbia troupes in Colombia, people were making a difference in their communities all over Latin America, through culture, through music, through politics and indeed saving lives at the same time. This made an impact on me. Furthermore, those moments where I felt like I was dreaming because the moment was so overwhelming, because I couldn't believe how blessed I was to be seeing such blue waters or such vast mountain ranges, will be stored in that compartment of my mind that I'll reach to whenever I need hope. I've met so many amazing people on this trip, and have tons of new friends throughout the world and great memories. As it comes to an end, I'm filled with gratitude, and excitement for what comes next...
Here is a fitting Garifuna proverb to drop as I leave...
Luagu lidise wéibugu wasandirei lihürü wanügü
It is as we proceed on our journey that we feel the weight of our burden
So my time in Belize came and went rather abruptly. Unfortunately it was raining most of the time, just like today, because Hurricane Ida is running all over the Gulf of Mexico. So I had a little less time to walk around, explore and take pictures. My visit to Dangriga was interesting. Dangriga is considered the heart of Garifuna culture, and one of the main points of entry for those Afro-Caribbean immigrants in the early 19th century. They're such an interesting people. I spent most of my time chasing the most famous Garifuna artist in the country, but it just wasn't meant to be. I also spent time in long conversations on the quiet, desolate streets of the small town. This one guy recapped his entire football career in Belize for me. He wasn't humble, which made it entertaining. The summary is that he spoke to me for an hour and basically said, "I'm the sh*t, I'm the sh*t, I'm the sh*t" over and over again until he said bye. He was a nice old man though. In Dangriga, people speak English, Spanish, Creole, Chinese, Garifuna and the list goes on. It's pretty crazy. Everything is relaxed to infinity though, so I did some good napping...
Oh well...I did get to go to the Garifuna museum, which was only two big rooms, but had tons of awesome information, pictures, artifacts, poems, etc. The Garifuna are fascinating. They have such pride because they were never officially slaves and established their own communities on the Atlantic coasts of Belize, Honduras and Nicaragua while fiercely fighting colonial forces for centuries. Some major foods and crops include yams, sweet potato and cocoa. They also eat tons of seafood because of their proximity to the sea. They have different religions, the major of which is Dugu, which like Candomble in Brazil involves trance, music, drums, dancing, and spirit possession. They have countless festivals, many of which include masquerade men doing traditional dances. They have tons of music, the most popular called punta, with famous artists Andy Palacio and Paul Nabor. Punta is really cool! It's slow, elegant music with lots of guitar and drums and vocals. Soothing type of music. There's the more modern version of this called punta rock, which reminds me of Pagode in Salvador. It's faster and the kind of music meant to make you move your hips, but the beat is a little oppressive after a while. It's kind of like reggaeton in that sense, EVERY punta rock song has the same beat. It was funny, in Dangriga I went to lunch and asked the guy behind the counter if he could play some punta for me. He looked a bit taken aback but said ok. Before I knew it, he brought out all this DJ equipment, hooked it all up, put DJ headphones on, and went crazy mixing songs, bobbing his head and ignoring other customers that came in. I created a monster lol. It was entertaining to hear all that music for the next 2 hours - I had nothing better to do. Anyway, back to the museum...beyond the really precise recounting of Garifuna history, I really enjoyed the poems and proverbs they had featured on the walls. It's all really spiritual and meaningful, centered on community and cultural survival. Those people are deep! It was a great trip to the museum.
After resting up, I headed back to Belize City where everyone was talking about Shyne, just back in Belize after like 9 years in prison following that shooting at the NYC club with Diddy and J.Lo (of course, as always, Diddy owes him a ton of money and got away from any blame). It seemed like everyone I met in Belize City had shot someone, been to prison, and then got deported. In my head I was thinking, "why is everyone telling me this right after I say hello?" It must've been some desire to establish that they were not someone to be messed with. It wasn't that cool though. I was staying on the southside of Belize City, which is the rougher side. I wonder if it would've been the same had I stayed on the north side, because it didn't look too different (Belize is quite poor and economically underdeveloped). In all, Belize was charming at times, but a bit disappointing. I'm sure if I went to the supposedly amazing beaches and did the snorkeling, diving, and all that stuff it's known for, and if I had seen some live Garifuna music performances, I'd have a different sense. But I'm tired and ready to go home. So I'm here in Santo Domingo, prepping for the flight tomorrow, and wrapping up whats been a ten-month adventure and thinking of what I'm going home to.
The world always seems to be falling to pieces. At the present moment, its wars, broken health care systems, unemployment, economic inequality, violence, genocide, brutal dictators and regimes, swine flu, climate change, gang rapes, diseases, racism, and the list goes on...What this trip has reinforced for me is that there is as much to be inspired by in the world, as much to behold for its magnificence, as there is to deplore and denounce. This trip has sustained the ideal of the world with which I arrived on my first day of college. That same ideal everyone complains is beaten out of young minds by years of pessimism and being made to feel small and insignificant. It's the ideal that hard work, good ideas, and active participation can produce real changes. Whether it was young activists in Brazilian favelas, or festejo dancing children in Peru, or a seasoned professor with a vision in Panama, or cumbia troupes in Colombia, people were making a difference in their communities all over Latin America, through culture, through music, through politics and indeed saving lives at the same time. This made an impact on me. Furthermore, those moments where I felt like I was dreaming because the moment was so overwhelming, because I couldn't believe how blessed I was to be seeing such blue waters or such vast mountain ranges, will be stored in that compartment of my mind that I'll reach to whenever I need hope. I've met so many amazing people on this trip, and have tons of new friends throughout the world and great memories. As it comes to an end, I'm filled with gratitude, and excitement for what comes next...
Here is a fitting Garifuna proverb to drop as I leave...
Luagu lidise wéibugu wasandirei lihürü wanügü
It is as we proceed on our journey that we feel the weight of our burden
Tuesday, November 3, 2009
Don't Go Chasin' Waterfalls and the Arrival in Belize
Near death experiences are not fun. Yet I had another one, my second of the year, and just as I had decided to have a calm last few weeks before my flight back to Newark. Maybe it's a sign that I need to take a break from traveling?
I had a fun weekend though with a good group of people in Jarabacoa, a small town in Dominican Republic about 4 hours from Santo Domingo. It's known for its water sports and beautiful nature, and it didn't disappoint. The six of us stayed in this real cool resort, with a beautiful river running through the grounds, a swimming pool, restaurant, almost anything you could think of. It was super cheap though because we all split the price. We rode around town on motorcycles, taking in the amazing mountain views and scenery. It was real peaceful. We then visited one of the big waterfall attractions of the town, renown for being the setting of scenes from Jurassic Park. We walked for about twenty minutes until we reached the amazing fall, landing in a small pool of freshwater. We all quickly ran in with excitement, even though it was ice cold. It was pretty cool at first, but soon the currents became stronger and took control, pulling us in different directions. Before I knew it, I was being pulled into the waterfall, unable to do anything to stop it. Then came some of the scariest 30-45 seconds of my year away, as I was caught in the center of the waterfall, hoping the currents would push me back out immediately after pulling me in. Eventually I was able to stand again and gasp for air, but man, for a minute I really thought, what a terrible ending to the year this could be...As I caught my breath back on the beach, I watched helplessly as Kamila was screaming and Mike was fruitlessly trying to help her swim against the current and back to shore. A serene, fun hike to a cool waterfall, turned into a bout with death within minutes. Safe to say I will not go near a waterfall again anytime soon.
We celebrated life that on Halloween eve night to the fullest though. We had these AMAZING platano sandwich snacks called patacones, which were so good I'm still dreaming about them. Then we went to a club where people had some ridiculous costumes - someone was dressed like Michael Jackson, another like a trashbag. We danced to the salsa, bachata and merengue until pretty late and then retired to the hotel. The next day the rest of the group went white water rafting as I took a break from water. We had a fun Halloween night in Santo Domingo, hopping from party to party (the dancing to reggaeton at some of these places was quite crazy). I spent most of my time in conversations with people about not really achieving much in DR and elusively looking for some of the Afro-influences I know are there. Luckily, I'll be back for a day or two at the end of the week so we'll see what happens...
Now, I'm in Dangriga, Belize, a small, quiet and quaint town at the heart of Garifuna culture, the Afro-Caribbean people with roots here from over 200 years ago. They have a such an interesting culture and I'm looking forward to exploring in the days ahead. My two days in Belize City were uneventful - people in Belize are incredibly laid-back, everyone is just chillin to the nth degree. I walked around the city, which felt more like a small town, and I did visit the House of Culture to learn about Belize history. Belize in general is on a smaller scale than other countries, understandably so with only 300,000 people. Reminiscent of Panama, it is incredibly diverse, with Mayans, Europeans, Asians, Garifuna, mestizos, etc., with the major difference being that this formerly British colony sees itself as distinct form the rest of Central America. There's outright animosity at times with Guatemala, and with the rest of the countries, language (English) and culture make Beliceans feel apart from their neighbors. It definitely carries more of a Caribbean feel to the place, with Bob Marley everywhere and people speaking Creole. I actually really love it though, and I've already seen another idea of the Latin American world expressed, and it's even more diversified than I thought!
I had a fun weekend though with a good group of people in Jarabacoa, a small town in Dominican Republic about 4 hours from Santo Domingo. It's known for its water sports and beautiful nature, and it didn't disappoint. The six of us stayed in this real cool resort, with a beautiful river running through the grounds, a swimming pool, restaurant, almost anything you could think of. It was super cheap though because we all split the price. We rode around town on motorcycles, taking in the amazing mountain views and scenery. It was real peaceful. We then visited one of the big waterfall attractions of the town, renown for being the setting of scenes from Jurassic Park. We walked for about twenty minutes until we reached the amazing fall, landing in a small pool of freshwater. We all quickly ran in with excitement, even though it was ice cold. It was pretty cool at first, but soon the currents became stronger and took control, pulling us in different directions. Before I knew it, I was being pulled into the waterfall, unable to do anything to stop it. Then came some of the scariest 30-45 seconds of my year away, as I was caught in the center of the waterfall, hoping the currents would push me back out immediately after pulling me in. Eventually I was able to stand again and gasp for air, but man, for a minute I really thought, what a terrible ending to the year this could be...As I caught my breath back on the beach, I watched helplessly as Kamila was screaming and Mike was fruitlessly trying to help her swim against the current and back to shore. A serene, fun hike to a cool waterfall, turned into a bout with death within minutes. Safe to say I will not go near a waterfall again anytime soon.
We celebrated life that on Halloween eve night to the fullest though. We had these AMAZING platano sandwich snacks called patacones, which were so good I'm still dreaming about them. Then we went to a club where people had some ridiculous costumes - someone was dressed like Michael Jackson, another like a trashbag. We danced to the salsa, bachata and merengue until pretty late and then retired to the hotel. The next day the rest of the group went white water rafting as I took a break from water. We had a fun Halloween night in Santo Domingo, hopping from party to party (the dancing to reggaeton at some of these places was quite crazy). I spent most of my time in conversations with people about not really achieving much in DR and elusively looking for some of the Afro-influences I know are there. Luckily, I'll be back for a day or two at the end of the week so we'll see what happens...
Now, I'm in Dangriga, Belize, a small, quiet and quaint town at the heart of Garifuna culture, the Afro-Caribbean people with roots here from over 200 years ago. They have a such an interesting culture and I'm looking forward to exploring in the days ahead. My two days in Belize City were uneventful - people in Belize are incredibly laid-back, everyone is just chillin to the nth degree. I walked around the city, which felt more like a small town, and I did visit the House of Culture to learn about Belize history. Belize in general is on a smaller scale than other countries, understandably so with only 300,000 people. Reminiscent of Panama, it is incredibly diverse, with Mayans, Europeans, Asians, Garifuna, mestizos, etc., with the major difference being that this formerly British colony sees itself as distinct form the rest of Central America. There's outright animosity at times with Guatemala, and with the rest of the countries, language (English) and culture make Beliceans feel apart from their neighbors. It definitely carries more of a Caribbean feel to the place, with Bob Marley everywhere and people speaking Creole. I actually really love it though, and I've already seen another idea of the Latin American world expressed, and it's even more diversified than I thought!
Wednesday, October 28, 2009
Professor Bernal and the Deficit in Santo Domingo
My last days in Panama were spent with friends. Losing my opportunity to visit Colon, the country's second largest city with the highest percentage of black Panamanians, I felt a little discouraged. As had happened in Esmeraldas, Ecuador and Buenaventura, Colombia, I couldn't find the time or the way to make it to parts of the Afro-Latin world undoubtedly rich with cultural expression, but rife with poverty and violence. People warned me about each place, about how dangerous it was and how it wasn't worth it to go. While I wanted to go regardless, I did want to have an objective or a contact, rather than just dropping myself there with no plans. Unfortunately this always took a longer time than I had in country - to establish the contacts to plan a productive trip to some pretty rough cities. Anyway, I had a good time hanging with some new friends, which involved a bizarre late night trip to the casino until 6am. The casinos are open 24 hours and they don't draw the cream of the crop at 4am. Apparently, there were plenty of Colombian hookers looking for clients. And there were plenty of people running around with no teeth making some ridiculous statements. As we got our late-night pleasure food, it was quite a show.
Two days before I left for Dominican Republic though, I had a great dinner conversation with Professor Miguel Bernal. The law professor was a good man, devoted to human rights and development in Panama. His history spoke for itself. I found him after a quick Google search, and read about his continued periods being thrown in jail by the repressive military government, the many attempts made on his life and his eventual exile. A former mayoral candidate of Panama City, he still teaches today and has a daily radio show where he talks about contemporary politics. Many people acknowledged him as they passed our table, and a few came to chat. Within a short 45 minute conversation, he had given me many leads for my questions regarding Afro-Latin culture. Our conversation was interesting though. He spoke about how the basic rights of people are being compromised in various sectors, especially education. He rightfully connected education with freedom and opportunity and employment, both nationally and internationally. He thought that was the major front to fight on. But he spoke about the political legacy of the military regime in Panama, and while he believed things were better, he still believed people weren't as involved as they should be in the political process. He lamented the lack of private ingenuity (not one Panama-owned magazine being produced) and collective mobilization (with only 9 million people in the country, why is it so difficult to find common ground). One thing he drove home for me though as I pressed him on culture and politics, is how diffuse and diverse Panama's cultural history has been. They've seen the arrival of African slaves and the influence of Amerindian groups, and the immigration of Europeans, Asians, West Indians, Americans, and South Americans, creating an identity that is as worldly as any you can find. While that has created a sense of equanimity among Panamanian people (outside of the judicial system and police brutality among people who are darker-skinned), it has perhaps also engendered some complacency.
Professor Bernal gave me tons to think about, as I compared Panama with the other countries I have visited to this point. I arrived in Santo Domingo to a very different vibe, distinctly Caribbean and overly touristy - to be expected. While Santo Domingo has been fine, it's felt a bit congested at times (the streets are generally smaller) and there's an annoying obsession with Christopher Columbus. Since I was little I have questioned why this man is so celebrated, why the pope would visit his tomb here in DR. I wonder if we need an actual number of the Native Americans he slaughtered. Oh well, it didn't make sense in 2nd grade and it doesn't make sense now. But I have tried to come to terms with Dominican history, especially the racism that came with the brutal regime of Trujillo, and its impact on current prospects for exploring Afro-Dominican culture (rather than going to ANOTHER Columbus landmark, museum or statue). I'm still probing here, asking cab drivers and new friends, but noone seems to really know or be interested in Afro-Dominican history. This is fascinating because the nearby countries of Cuba and Puerto Rico have more openly documented and celebrated African cultural influences.
Other than a merengue/bachata show in the Plaza de Espana and museum trips, I've used my week in DR so far to recharge. The nightly, drunken party outside the grocery store outside my hotel was entertaining as well though. I only watched, didn't participate. It was tempting...I am excited about seeing the Garifuna in Belize in a few days, and even more excited to head home in a little over one week (especially since the NBA season started yesterday, but mostly to reacquaint with friends and wear DIFFERENT CLOTHING). Until then, I'll enjoy other parts of the DR with old college friends and hope to stumble upon something interesting in the days ahead...
Two days before I left for Dominican Republic though, I had a great dinner conversation with Professor Miguel Bernal. The law professor was a good man, devoted to human rights and development in Panama. His history spoke for itself. I found him after a quick Google search, and read about his continued periods being thrown in jail by the repressive military government, the many attempts made on his life and his eventual exile. A former mayoral candidate of Panama City, he still teaches today and has a daily radio show where he talks about contemporary politics. Many people acknowledged him as they passed our table, and a few came to chat. Within a short 45 minute conversation, he had given me many leads for my questions regarding Afro-Latin culture. Our conversation was interesting though. He spoke about how the basic rights of people are being compromised in various sectors, especially education. He rightfully connected education with freedom and opportunity and employment, both nationally and internationally. He thought that was the major front to fight on. But he spoke about the political legacy of the military regime in Panama, and while he believed things were better, he still believed people weren't as involved as they should be in the political process. He lamented the lack of private ingenuity (not one Panama-owned magazine being produced) and collective mobilization (with only 9 million people in the country, why is it so difficult to find common ground). One thing he drove home for me though as I pressed him on culture and politics, is how diffuse and diverse Panama's cultural history has been. They've seen the arrival of African slaves and the influence of Amerindian groups, and the immigration of Europeans, Asians, West Indians, Americans, and South Americans, creating an identity that is as worldly as any you can find. While that has created a sense of equanimity among Panamanian people (outside of the judicial system and police brutality among people who are darker-skinned), it has perhaps also engendered some complacency.
Professor Bernal gave me tons to think about, as I compared Panama with the other countries I have visited to this point. I arrived in Santo Domingo to a very different vibe, distinctly Caribbean and overly touristy - to be expected. While Santo Domingo has been fine, it's felt a bit congested at times (the streets are generally smaller) and there's an annoying obsession with Christopher Columbus. Since I was little I have questioned why this man is so celebrated, why the pope would visit his tomb here in DR. I wonder if we need an actual number of the Native Americans he slaughtered. Oh well, it didn't make sense in 2nd grade and it doesn't make sense now. But I have tried to come to terms with Dominican history, especially the racism that came with the brutal regime of Trujillo, and its impact on current prospects for exploring Afro-Dominican culture (rather than going to ANOTHER Columbus landmark, museum or statue). I'm still probing here, asking cab drivers and new friends, but noone seems to really know or be interested in Afro-Dominican history. This is fascinating because the nearby countries of Cuba and Puerto Rico have more openly documented and celebrated African cultural influences.
Other than a merengue/bachata show in the Plaza de Espana and museum trips, I've used my week in DR so far to recharge. The nightly, drunken party outside the grocery store outside my hotel was entertaining as well though. I only watched, didn't participate. It was tempting...I am excited about seeing the Garifuna in Belize in a few days, and even more excited to head home in a little over one week (especially since the NBA season started yesterday, but mostly to reacquaint with friends and wear DIFFERENT CLOTHING). Until then, I'll enjoy other parts of the DR with old college friends and hope to stumble upon something interesting in the days ahead...
Sunday, October 18, 2009
San Blas Paradise
My visit to the beautiful San Blas islands were by far the highlight of my trip. Last Monday I awoke at 5am to take the 2 hour journey to the dock on the Atlantic coast. Some other travelers and I were greeted by a crocodile creeping in the water, silently stalking the boat...I immediately thought to myself - "What in the world did I get myself into?" Crocodiles and spiders are my worst enemies. Anyway, I got on the small motorboat and we made the 45 minute journey to Franklin island. As we pulled up to the island, one word came to mind immediately "paradise." The waters were a rich color of blue and the sky was clear with strips of clouds. The beach was clean and big, and the island was lined with large palm trees, hammocks everywhere, a volleyball net, and a series of thatch-roofed huts (which were like our hotel rooms, the beds were remarkably comfortable and despite others' complaints of cockroaches and crabs, I slept really without any problems).
San Blas is composed of over 300 islands, and mainly the Kuna people live their, an indigenous Amerindian group who has apparently fought fiercely for continued ownership of their land and the onset of tourism on their own terms. Families run the islands where travelers are able to stay. The Franklin family was very pleasant and the patriarch was awesome. It was really familial, as he learned almost everyone's names. Most of the men are quite short, and they played makeshift basketball everyday. Of course one pointed at me and said Shaquille O'neal. I think more than anything it has become quite clear that in Latin America, if I ever want to travel again and tell everyone that I'm a star player for the New York Knicks, I will be believed quite easily. The women were ALWAYS dressed in their colorful attire, a tight body wrap dress, and large anklets, as well as multiple piercings. I loved it, and wondered if it was cultural for the women to wear the outfits all the time or simply in case tourists wanted to take a picture with them (which cost $1...we came to find out that everything cost $1).
The days were spent mostly lounging in hammocks and reading, listening to relaxing music, playing volleyball, swimming and laying on the beach. It was so wonderful to be isolated like that. I met some great people as well. Along with Carl from the UK, I met two Dutch guys, and we played board game after board game and tons of card games. The island was primarily Israelis, a group I've learned that travels more than most since people leave after their 3 yr plus stint in the national army. Every night they had the rum and cokes out, and got very rowdy. It was definitely entertaining. Lights went out every night at 10pm, so other than flashlights, fires and candelight, the island was completely dark. This meant we went to bed quite early and woke up early as well. I came to enjoy this routine.
One of the days we took a trip to another nearby island called Isla Perro. It was funny because as we wondered why it was called Dog Island, there were the cutest two dogs barking like maniacs as pulled up to shore. It was a pretty secluded island, only about 6 guests were there compared to the 30 or so on Franklin. Isla Perro was ridiculously gorgeous though, just amazing. I snorkeled over this ship wreck near the shore which was awesome. All of it was pretty breathtaking. I extended my trip a day or two to have a bit more fun and relaxation - unfortunately this cost me a day trip to Colon because I returned too late in the week. But it was quite worth it because San Blas was definitely the highlight of my time in Panama. Needless to say, I didn't do as much cultural exploration as I had hoped to do, but it was a great recharge for the home stretch of my trip. I returned to Panama City realizing I had only 3 weeks left of my trip.
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