Mental Health in a Third World Country

We tried to understand what he was saying when we saw him walking on the downtown streets of Santo Domingo, but he made little sense as his words were slurred together. His appearance was disheveled and his clothing dirty. He was standing in the middle of the road when I walked away.

Mental illness in the Dominican Republic is similar to the problem we face in America. A lot of it goes untreated.

The World Health Organization reported on the Dominican, “With respect to financing of mental health services, this study shows that allocation of resources is very low. SESPAS allocates less than 1% (0.38%) of health care expenditures to mental health services, and 50% of these resources are directed towards Padre Billini Mental Hospital.”

In addition to the one dedicated mental hospital (only 150 beds), there are also 56 mental health outpatient facilities in the country, of which 4% are for children and adolescents only. However, there is no review body to oversee inspections at the mental hospital in the Dominican nor sanctions on any of the facilities that violate a patients’ rights. Furthermore, physical restrain or seclusion of patients is not monitored by any organization in the Dominican Republic, according to the World Health Organization in 2008.

What I found interesting is that the World Health Organization reported that 30% of the patients in the single mental hospital in a rural area of the country, have been patients for 10-years or more. In other words, new treatment for patients is hard to come by. Affective disorders (depression, bipolar disorder, and anxiety disorder) and schizophrenia are the most common mental disorders in the Dominican.

Families have stepped up to monitor mental health care facilities in the Dominican. 45 family members have formed committees to defend the rights of persons with mental disorders in the country.

A 2011 report by the World Health Organization showed that the majority of primary health care doctors and nurses in the Dominican have not received official in-service training on mental health within the last five years. So the problems continue to grow. The American Public Health Association reported this year (2015) that residents in low income countries fail to receive care for mental health. The organization wrote, “80% of patients with severe mental illness do not receive necessary care.”

Clothing brands? Who needs that?

The kids, the shoes, the clothing… No one cares and you don’t hear children making fun of one another for the brand of shoes one wears or the other one does not.

In America we have become a brand driven society. I am sure that parts of the Dominican are like that today, but I have yet to see it with my own eyes.

In places like El Caobal, Dominican Republic most of the children wear shoes that were donated by churches in America. You see boys wearing pink and purple New Balance shoes, yellow Converse, Keds, Reebok’s from the 1990’s, girls wearing boys Nike’s and more, but no one cares. Another thing I noticed is that school uniforms are a part of the dress code at the schools I visited – and kids don’t care.

When the bell rings and school is over, I love how I see traces of Murfreesboro, Tennessee all over El Caobal and LaRepressa. I see MTSU shirts, Blackman High School clothing, Oakland, Riverdale and Smyrna just to name a few. I think it is neat that local residents in my very own community have made such an impact on the Dominican in small villages most of us will never see. New Vision in Murfreesboro has played a huge role in bringing love to these areas.

Protecting Schools:

Schools in the Dominican take the protection of school grounds serious. The schools I visited were wrapped with concrete walls topped with razor wire protecting them from the outside world during school hours.

The children at the schools in the Dominican, while poor financially, are filled with joy. For me, it was like stepping back in time watching kids play together without a playground or a video game to keep them occupied. They wholeheartedly played together.

Children, a camera and a little protest

I sat down on the hot concrete with my camera and was instantly surrounded by about 15 kids. I was in the city of Caobal in the Dominican. 

As I snapped photos of the children hovering around me, each one wanted to see what the photo looked like after I took it. I don't think any of them had ever seen a regular camera before. Sure, they have all seen cell phone cameras, but a real camera, no. 

While we were behind the concrete walled and razor topped confinements of the elementary school, there was fear of a protest taking place outside the building. Evidently, one had occurred the night before that included the burning of debris in the streets that acted as a road block of sorts. The problem... a lack of electricity for about five days. Residents feared that the government had shut down the electrical grid to their communities over political arguments. 

While there was not a protest going on when we left, there was one later in the day. It was said that when National Police arrived to disperse the crowd, they fired they guns into the air. No one was hurt. 

The National Police force in the Dominican is the largest police force in the Dominican Republic under the control of the Ministry of Interior and Police. When the U.S Occupied the Dominican from 1916 to 1924, the United States Military helped to create the Dominican Constabulary Guard (DCG), which acted as national police. It later became the Dominican National Police.

A group known as "InSight Crime" reported in March of this year, "A top-level prosecutor in the Dominican Republic said the military and police are involved in 90 percent of organized crime cases, putting a hard number to official involvement in criminal activity after years of high-level corruption scandals."

InSight Crime is a foundation dedicated to the study of the principal threat to national and citizen security in Latin America and the Caribbean: organized crime.

Speak Life to all

Photo taken in the Dominican Republic.

"Lift your head a little higher,
Spread the love like fire,
Hope will fall like rain,
When you speak life with the words you say."

"Raise your thoughts a little higher,
Use your words to inspire,
Joy will fall like rain,
When you speak life with the things you say."

-Toby Mac

Hide and Seek in a Third World Country

The traditional game of hide and seek is not just found in your backyard. It is also found on the small streets of the Dominican Republic.

This young boy was walking with a group of his friends when he quietly ducked behind a rock as his buddies continued to walk. He then peeked over the large stone to see if they noticed that he had mysteriously vanished. They noticed and started laughing when they saw his head appear behind the rock that was sitting in front of a small roadside store that normally sells fresh avocado's. However, the store was closed as it was a Sunday.

It was refreshing to see all the children in the Dominican playing outside as opposed to the quiet streets in America. It seems as if many children here lock themselves in their bedrooms while glued to gaming devices and telephones. In some areas of the U.S., sounds of children no longer fill the air because parents are overly concerned about their children being kidnapped or attacked in some way. I too have that fear at times, but have to remind myself that it is unlikely.

When I was younger, I would ride my bike to Kroger with friends and hit the candy aisle. I bet I did that when I was as young as 11 and we lived about 3-miles from the store. I know times are different, but I dislike the fact that a few thugs in our community have risen the fears that parents face to an unreasonable level. And to think crime is higher in most third world countries, but the children feel more freedom when compared to our own backyard.

"Children learn as they play. Most importantly, in play children learn how to learn." - O. Fred Donaldson

Sleeping on the streets

His bone structure could clearly be seen through his leathery skin as he slept next to the street. This photo was captured in Santo Domingo this past week. I shot this in an area that is well-traveled by locals and rarely seen by tourist. This man was asleep on a busy sidewalk using his hands to cradle his head and to protect it from the hot concrete. When I walked back by 30-minutes later, he was gone. 

WAGES: In the overcrowded and dirty capital of the Dominican Republic, the average wage amounts to $86 U.S. dollars per month. Those who are paid a bit more earn a whopping $172 U.S. dollars monthly. In Pesos, that is between 3,000 to 6,000 each month.

TRASH: While sections of the Dominican are beautiful, most areas are littered with trash, discarded tires, water bottles and more. However, most Dominicans are more resourceful than those in America. 

Here (America), we may gather with family for a cookout and utilize paper plates, plastic forks and styrofoam cups. After we use those products, we throw them away. In the Dominican, residents will re-use the same materials for a week and sometimes longer. While Americans throw their products into the garbage which will eventually head to a landfill, many residents there will throw the same items into the street and later burn them. In other words, our trash collects in larger quantities and it ends up in a nice neat pile. Their trash is less in quantity, but piles up in the streets to eventually be burned. 

CRIME: Crime in the Dominican is something that you can’t ignore. In a national report filed by the United States Department of State, the crime rate for the Dominican is recorded as HIGH listing Santo Domingo as one of the top cities for Robbery, Assaults and rape. Alcohol abuse and drug trafficking is also listed in the report as being major problems in the third world country. 

GOOD NEWS: Churches throughout the world are slowly taking notice of the growing problems in third world countries like the Dominican and Haiti. New Vision Baptist Church in Murfreesboro has literally changed the face of LaRepresa, Dominican Republic in more ways than one. The church is now aiming their sites on other nearby areas as well. New Vision has even opened a Christian School in one village that has a state of the art computer lab to help children learn more about technology. One missionary even stated that he feels more comfortable allowing his daughters to walk through the LaRepressa village than he does allowing them to walk around Murfreesboro. To me, that speaks volumes of the changes taking place in the hearts of those who call that area home. 

Ramone at age 80

80-Year old Ramone lives in a small concrete home with curtains for doors. He invited us in asking his guest to sit on his vanilla colored sofa. He then started to talk about the passing of his wife just two months ago. Tears of sadness mixed with the joys of his memory of her ran down his face as he talked about how she loved to sit and talk with visitors.

Prior to living in the village he calls home today, he lived on a mountain side in the Dominican Republic. He was a farmer by trade and spent years and years in the field. He would then sell plantains, beans and bananas that he harvested to locals.

A woman who was in the home helping him fixed us coffee just like his wife once did in years past. Ramone loved his wife so much and brought out a small photo album with pictures of the two captured by missionaries in LaRepresa. Those photos are his prized possession of his memories.

“Remember that creating a successful marriage is like farming: you have to start over again every morning.” - H. Jackson Brown, Jr.

My birds

Residents in the small village of LaRepresa, Dominican Republic don’t have tons of possession’s, but what they do have are possessions they love. 

This older woman is showing us her prized birds that she keeps in her small wooden home with a rusty metal roof. The birds are kept in a cage hanging from the rafters in her home. As you can see, this room is her kitchen / living room. 

Electricity is scarce in most Dominican villages. The week I was in LaRepresa next to the town of Caobal - the electricity was out for about five days and the river where the locals go for bathing, washing clothes and recreation is nearly dry as rain has been something that has lacked in recent weeks. 

Despite the lack of “stuff,” residents invite strangers inside their homes and sometimes offer the only chairs they own for visitors to sit in as they stand. They also work hard to be hospitable by serving visitors coffee made with freshly harvested coffee beans. 

"Unnecessary possessions are unnecessary burdens. If you have them, you have to take care of them! There is great freedom in simplicity of living. It is those who have enough but not too much who are the happiest." - Peace Pilgrim

Her kindness

I met this woman in La Represa, Dominican Republic. She was sitting on her front porch when she heard me walk up. She quickly grabbed a bowl of freshly dried rice and offered me some. It always makes me smile when someone who has little, is fast to offer others a lot. 

“Kindness is a language which the deaf can hear and the blind can see.” ― Mark Twain

The curious child

"The important thing is not to stop questioning. Curiosity has its own reason for existing."   

- Albert Einstein

Third World Journey: Life is relaxing

The laid back life in the Dominican Republic. Photo taken in LaRepresa with an older Canon T2i and a kit lens. Sometimes, you shoot with what is available.

“To find the universal elements enough; to find the air and the water exhilarating; to be refreshed by a morning walk or an evening saunter... to be thrilled by the stars at night; to be elated over a bird's nest or a wildflower in spring — these are some of the rewards of the simple life.” ― John Burroughs, Leaf and Tendril 

Third World Journey with New Vision Baptist Church

I recently went on a mission trip with New Vision Baptist Church in Murfreesboro, TN. We journeyed to the Dominican Republic and visited the small village of La Represa. The team I was on had a goal of teaching children how to play soccer (baseball is the main sport played in the DR). Needless to say, the children picked up on the sport extremely fast. They loved it. 

Quick Facts: 

• The Dominican Republic was explored by Columbus on his first voyage in 1492
• Population is over 10.3 million
• Capital is Santo Domingo with 2.1 million residents
• Degree of risk of obtaining a disease: High
• Food or waterborne diseases include bacterial diarrhea, hepatitis A, and typhoid fever 
• Medical care is limited
• Water - not recommended to drink
• Official drinking age is 18

Third World Journey: Amazing Athletes

The children in the Dominican have some amazing athletic abilities. While there, I witnessed a 19-year old make a 20-foot jump from the side of a dam into 1-foot of water. As Gaba landed he made the perfect roll as if her were a stunt man practicing a movie shot. One teen can even throw a fast ball at 87 mph, according to some. 

Third World Journey: Fishing, the old way

In this photo, you can see that fishing the old way with a net and a motor-less boat is still popular. The Dominican's are master fishermen. 

Third World Journey: Children are the same

During my recent visit to La Represa, Dominican Republic it became quite clear... children can instantly relate to one another in a way that adults can never mimic. Children pick up on body movements, smiles, laughter very quickly. It is awesome to watch the Dominican children play with the American children from our church. 

Third World Journey: Unlike anyplace you have been

This photo was captured in a small village just outside La Represa, Dominican Republic. The majority of those living in this area get from point A to point B on small scooters or motorcycles.

Alcohol was extremely prevalent and the rules of the road were totally open to interpretation. You may see four people on a 100cc motorcycle or three people on a small scooter. The legal drinking age is 18, but that is seldom enforced. 

Despite the poverty in this third world country, everyone we came in contact with was filled with joy and hospitality.