Tuesday, February 11, 2014

Study Abroad: Global Public Health and the Future of Water

Elizabeth Krawczun, a Verrazano and CUNY BA student studying Epidemiology in the Class of 2014, had the opportunity to spend the winter intersession in the Dominican Republic on a global public health study abroad program.  This was the second study abroad program in which Elizabeth participated, having spent last winter in rural India.  Below she shares her experience in the Dominican Republic.

I was very excited to be accepted into CIEE (Council on International Educational Exchange)/Macaulay Honors College's Global Public Health and the Future of Water program in Santiago in the Dominican Republic. The experience ​reaffirmed my choice of ​​study, and my fellow students ​made my time there enjoyable and emotional at the same time. The reading and daily morning classes were informative and interactive. Dr. David Simmons​​, a medical anthropologi​st at the University of South Carolina, was a wonderful teacher, site instructor and mentor​.

​During class, we read articles related to public health in the Caribbean and Hispaniola, focusing ​primarily ​on vector and water borne diseases, such as cholera and malaria. To highlight our ​readings and ​classroom​ activities, we visited two water treatment plants​, one urban and one in the countryside, ​and learned of the filtration and transportation systems of water. We traveled to several communities in the Dominican Republic to study the effects of water inadequacy, access and abuse.

​However, in these communities, it was difficult to concentrate on the tour of the water system as nearly all the children from the village swarmed us to hold our hand​s​, be carried or to ride on our shoulders.  We met several physicians who travel through these poor communities, called "bateys,” monthly and take care of those who are ill and cannot afford to travel and receive treatment at a health care facility. In conjunction with water scarcity, we studied the discrimination of Haitians in the Dominican Republic; all the bateys we visited were Haitian communities. Often, when Haitians contract a water borne disease, they are unable to travel to a hospital as many Haitians are not issued a birth certificate, ID or passport​. The Dominican Government has implemented checkpoints, so that Haitians are stopped and deported if they cannot provide Dominican paperwork. We saw the devastating effects of the denial of healthcare in the condition of the sick community members.​

​For the course, ​we were assigned two papers, a final presentation and a final exam. For my final presentation, my group decided to focus on our visit to one of the bateys. At this particular community, Baraguana, the ​group​ of us was split into smaller ​groups of four, provided a translator, and conducted interviews with members of the community to determine if they knew where their water came from, when water was clean, how they received their water (trucks, bottles, the river, etc) and ​which water was used for what household activities, etc.

We saw that many members knew when water was dirty and understood which sources were the cleanest. However, most members did not have the means to buy bottled water and had to use the polluted river or rain water as their primary water source. ​When we traveled to ​Baraguana​, we stayed at a hotel that had first been described as

​"​rustic​" by our guides​. When we arrived, the hotel ran out of water within twenty minutes. This hotel, like the communities in the area, was ​only supplied with water for a certain amount of time​ during the day​ and was​ only ​provided ​a limited amount. That night we did not have water to brush our teeth, flush the toilet, or take a shower. We all took "baby wipe​"​ baths. The next day, water was supplied to the hotel for ​only a few hours, so we all took three minute shower​s​, as the water ​was only available for five minutes on each floor​. This was certainly an experience I was not expecting and it was extremely difficult to adapt to having no access to water, a privilege that I had taken for granted.

We took classes at ALPI (American Language Partnership International), a language institute in the center of Santiago and a ​forty-five​ minute walk from the hotel. When we were not visiting ​communities or in class, we were allowed to explore on our own. Dr. Simmons encouraged us to walk around the area and explore the city, beli​e​ving that the best way to learn the language and the culture was to live it, and not to learn about it in a classroom. Some of us visited Santo Domingo and the beach in Sosua on the North Coast. CIEE provided each of us a stipend for meals. Ordering ​in a restaurant for almost every meal was a challenge in itself. Navigating the city by "concho", the equivalent of a New York City taxi but which has a specific route and "fits" up to six people, was also an unforgettable experience and squeezing into the back seat with five other students definitely brought all of us a little closer. ​Not knowing more than a sentence or two ​of Spanish​ before arriving ​was ​certainly a disadvantage, but the group of us often traveled together and many students were proficient.


I had not expected the group to become as close as we did in such a short amount of time. The ​community visits were ​emotional experiences that ​exposed certain insecurities ​in ourselves. I​ believe that many of us became close because we were emotionally vulnerable together. In the afternoon of our second to last day we held a reflection session on the professor's roof, where students had the option to share their experiences .The majority of students shared felt that this trip showed ​them that it is impossible to change the world, but it is possible to affect and change a few lives for the better. ​It is important to recognize this and to understand that we have to be open to change too​, and in doing so we become better people. Meeting the physicians and community members of the bateys ​showed us how true this can be.

The trip was an adventure and I am extremely glad I was accepted into the program. I met people who have the motivation and intellect, as well as the emotional maturity,​ to go very far in their discipline. Dr. Simmons ​("DSimms") is a wonderful person, whose thoughtfulness and care was evident when we spoke in class or walked through the villag​es​. He made the experience what it was and made sure that we ​interacted with physicians and community members. He is an example of someone who loves what he does and dedicates his time and influence for the populations that do not have the means to ask for help. Dr. Simmons opened his home to all of us as a personal space and ​a ​break from the impersonality of the hotel. No matter when we showed up (usually with bags of dirty ​laundry to do), he would spend hours talking with us, trying to help us figure out what type of future goals we had. What I took away from the experience is that projects like this are important and that caring for the underprivileged is important, that seeing the globe as one entity with many pieces is important, particularly for health and global health, and that it takes effort to affect change.

Photo Descriptions

The first photo is of me with a child in the Baraguana community.

The next two photographs are of the group of us on the first day. We took a tour of the major landmarks of Santiago. The picture was taken from atop "the monument". This monument was located in the middle of the geographic basin that Santiago was in and it was erected after Dominican independence.

The following three pictures are from the community of Baraguana. We interviewed and interacted with the community members and the children.

The next photo is of the "bus" that we traveled in to get to the communities. We were tossed around for up to an hour and a half in this open-air seat belt-less vehicle. There was no door, gate or other safety feature in the back and so those of us who sat back there was very afraid that we would fall out. It was quite an experience.
These two group photos were taken from the optional trip to "27 Charos", or 27 waterfalls, in English. We climbed to the top of a mountain and trekked through streams and rivers to 27 different waterfalls of varying heights and types. Some areas along the trail were very treacherous and all of us left with many cuts and bruises on our legs. This tourist attraction lasted over three hours. I am very glad I decided to do it because it was a fun opportunity and certainly a once in a lifetime adventure.
The last picture was taken on our second to last night in the Dominican Republic. We had our farewell dinner with the professor, the Dominican students whom we interacted with, the staff of CIEE, and the physicians we worked with.
To learn more about study abroad programs and opportunities, please explore the following three online resources:
Center for International Servicehttp://www.csi.cuny.edu/international/

CUNY Study Abroad Opportunitieshttp://www.cuny.edu/studyabroad

College Consortium for International Studieshttp://www.ccisabroad.org/