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.

Diabetic in a Third World Country

For those who know me, you know I don’t like to be real serious. I prefer to see people smile and laugh. When I was in the area of LaRepresa I met this woman who had a great sense of humor. 

She lives in a small wooden home made of what appeared to be wooden slats or clapboard. My friend Leslie greeted her by saying “Feliz Navidad (Merry Christmas).” That is just about the only thing that Leslie can say in Spanish, but this young lady got a real kick out of it considering it is October. She even did a little dance for us and then invited us to sit on her front porch. 

Her home, with a thick concrete floor, was very neat and clean inside. I noticed on a shelf she had several whiskey bottles, all empty. I jokingly said to her with the help of a translator, “I see you are a big fan of whiskey.” She laughed and said, “No, no – I like the bottles, they are good for decoration (No, no - Me gustan las botellas, que son buenos para la decoración).” 

Our conversation then turned a little more serious. She told of how she suffers from diabetes and her blood sugar level is currently too high. I felt bad for her because high blood sugar levels can make you feel sick to your stomach, weak and groggy. Despite those pains, she still managed to laugh at some of the things I had to say when I told her I was a crazy American (Americano loco). 

She told me she receives her medication from the nearby Farmacia del Pueblo El Caobal (The Pharmacy in El Caobal). I asked if she was out of medication and she smiled and said, “No.” 

In 2014, there were 669,000 cases of diabetes in the Dominican Republic. Keep in mind the country is about half the size of the state of Tennessee, but has well over 10-million residents. 

Despite her illness she had a great laugh. She loves her husband who works hard daily and she loves her home. You can’t get much better than that. 

“I see skies of blue, and clouds of white,
The bright blessed day, the dark sacred night
And I think to myself
What a wonderful world.”

-Louis Armstrong

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.

Sitting in Santo Domingo

He was quietly sitting on a concrete bench in an area of Santo Domingo, Dominican Republic. This is an area where locals shop the market that is filled with chickens, fruit, shoes and even cellphones. It is an area that tourist rarely visit, but filled with thousands of daily shoppers buying food and merchandise for their families.

Santo Domingo is the capital of the Dominican Republic and one of the Caribbean's oldest cities. The city was founded in 1496 and some of the roads are still made of old cobblestone. 

I was told that many of the clothes and shoes that are sold on the streets come from Haiti. Evidently, people donate clothing by the truckload in Haiti and some Dominicans will meet with Haitians at the border to gather the clothing and then sell it to support their families.

The population in Santo Domingo is around 3-million, according to some of the residents who live in the city.  lthough, the last census in 2010 showed just under 1-million. However, the census is next to impossible to get accurate counts as many live on the streets, under bridges and share small apartments with multiple families. 3-Million is likely more accurate. When you are in Santo Domingo you literally brush shoulders with thousands of people as everything is so busy. 

The city and the villages in the Dominican are filled with trash on every corner, some trash burning in the streets. The water is unsafe to drink for both locals and tourist. Therefore, water is sold in plastic bags, jugs and bottles. 

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

The secret to life

Mr. Collier told me he is 85-years old so I asked, “What’s the secret to a long life,” as he puffed away on his cigarette. He smiled and said, “Pray a lot, go to church and be nice to your neighbors.” In our conversation on Wednesday night he talked about how he put in 20-years at General Electric in Murfreesboro before the company closed the plant down. One year passed after the company closed and in 2007 they auctioned off machinery that was still in the structure.  The building was later torn down in 2013. 

In the GE heydays’, the Murfreesboro plant manufactured electric motors for washers and dryers. The facility first opened in 1957. At the ground breaking ceremony an actor visited Murfreesboro to announce that General Electric would soon be opening a new plant on Broad Street. The actor was hired in California. In case you are curious as to who that actor was, his name was Ronald Reagan.
 
“After GE I delivered flowers for Rion’s Flower Shop for 15-years,” he told me. He then said that he is now retired. As our talk continued he said that his wife just passed away. Apparently, she died about 4-months ago and she was in her fifties. “My first wife died at age 72,” he told me. His son Ronald died in 2014 at the age of 58. Changing the subject he said, “My other son  has spent 22-years in the service.” 

“How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of the weak and strong. Because someday in your life you will have been all of these.” - George Washington Carver

It was for our granddaughter

How many times have you driven past someone on the street corner and wondered, “What’s their story?” 

Meet Vivian and Donald Morton. They are both in their seventies and have been married for 54 years. Both are retired, but are having a hard time with money. Not because of bad decisions they made, but because of a domestic violence situation involving their granddaughter whom they have raised since age 2. 

Vivian said, “She got married and they were living with us for a while and we were paying their bills. The husband got back on his feet and they moved to Detroit where he started to abuse our granddaughter.” Donald then told me, “We weren’t gonna’ allow someone to do that to our granddaughter. We moved her back here and have helped her financially and we have helped her to be safe.” Donald knew it had gotten worse prior to them bringing their granddaughter home when his great granddaughter was sitting on his lap and told him that “Daddy” punched mom right in the face. The punch knocked the front teeth out of the 28-year old woman. 

The Morton’s had both retired several years ago. Everything was paid for until they had to take out a loan to help the granddaughter cover court costs, medical bills and more. Donald estimated that they spent at least $100,000 on keeping her safe and supporting her over the last couple of years. Because of that, he can’t pay their day to day expenses. However, he would not have it any other way. He is just happy to see his 28-year old granddaughter and her two young children living in a safe environment and being cared for by people who love them with all their heart. “She’s very thankful,” said Donald when talking about his granddaughter who lives with them off the Old Woodbury Highway. 

“I’ve applied for multiple jobs,” Donald said. He then told me that no one will hire him because he is 75-years old. In the past, he worked at the same Murfreesboro company for 40-years. Vivian then said that she worked for the schools for over 20-years, but diabetes has taken the best out of her today. “We didn’t plan for this, but I could not watch my granddaughter be abused,” said Donald. He then said, “Some people drive by and make fun of us, laugh while others help.” “It’s humiliating for us, but what are we to do – if people knew our story it would be different, but people don’t listen,” said Vivian.

The couple sits in front of Walmart on Memorial Boulevard or the Walmart on Rutherford Boulevard in Murfreesboro almost daily from about 11am to about 3pm. So why not help?

“Generosity is not giving me that which I need that you do, but it is giving me that which you need more that I do.” ― Kahlil Gibran, Sand and Foam

Poker is my game

"I spent 30 of my 62-years of life in a federal prison," he told me.

During our conversation I asked, "So you play cards I see?" He smiled and replied, "Wanna play me in poker?" I laughed as I told him that I am not very good. "I'm the best, people didn't even play with me in prison after a couple of years because I would always win," he said with a slight chuckle.

Despite his good game hand, he had a lot of hurt in those squinted eyes and his toothless mouth.

"I'm not like a poker player. I'm not into bluff. My way is to look someone in the eye and tell them the way I'm intending to go. My cards are always on the table." - Tori Amos

The haircut introduced me to the real Lamont

His eyes always had that famous Jack Nicholson look, but his heart was always kind, soft and giving - despite his lack of "stuff" to give. 

It was during this haircut that I learned more about Lamont Randolph Lindsey than I ever imagined. He talked about how he was struck by a car when he was younger and how it left him in pain during much of his adult life. I learned that he was a very soft spoken and a kind individual who I doubt had a mean streak in him. He talked about some of his mental illnesses while under the bridge as the scissors quietly cut through his long and dirty strands of brown hair.

His love for music was obvious as he sang throughout some of his haircut. That music was his getaway in life, I believe.

He could name every Black Sabbath album, every Ozzy Osborne song and told me about his large collection of music that he lost somewhere in between apartments and homelessness over the years. Led Zepplin, Pink Floyd… he knew his songs and artist by heart. 

Today, he is only about 35-years old, but it was always like a young boy was trapped inside of him and that was whom I always saw. A young, non-complicated soul who loved both his mother and his music. 

For years I would see Lamont quietly walk in his unusual upright stance behind his mother Loretta Lindsay who was always in front of him in her wheelchair. The two would easily cover 10 miles in a day throughout Murfreesboro several years ago. Now, not so much. 

I recently gave Lamont a walker as his legs have gotten weaker as time has gone on. He appreciated it very much. 

Nearly every time I saw him he asked, “How’s your dad? I love ole’ Bart.” I would always tell him that he is doing good and he would always reply, “I grew up listening to him on the radio every morning.” 

Lamont had a massive stroke on Friday while under the bridge in which he calls home today. His friends quickly called for help and he was rushed away in an ambulance.He later passed away on Sunday (9/27/15). 

American writer and Mental Health Advocate Andy Behrman once stated, “The guilt I felt for having a mental illness was horrible. I prayed for a broken bone that would heal in six weeks. But that never happened. I was cursed with an illness that nobody could see and nobody knew much about.”

Lamont Randolph Lindsey quietly passed away on Sunday (9/27/15) at 3:15 pm. His organs were donated to save the lives of others in Tennessee. 

It cost me one McDonalds Value Meal

It cost me a McDonalds value meal for this photo. When he saw the camera, he told me it would cost me a good meal to take his picture. I asked where he was going to get that good meal and he smiled real big and said, “McDonalds [pointing to his right].” I then asked, “How much will a good meal cost?” He laughed a little as his eyes grew larger, “$5 will get me a real good meal there.” He reeled me in with his smile as I gave him a $5 bill.

I saw this man sitting at the back of what use to be a motel that now serves as a low income apartment. The rooms are tiny and the floors concrete. Each room has a small bathroom, just like you would imagine in an old motel. The tiny spaces rent for $550 per month, but serve a vital purpose in getting people of the street. It’s all the room that this man who moved to the Nashville area from New York needs.

In New York, he paid over $900 per month for an apartment that was similar in size. He moved here about two years ago to be near his children who live in the same complex.

“A little bit of mercy makes the world less cold and more just.” - Pope Francis

On the Streets: Standing Up for Women

Life on the streets: “I was drinking when I saw a man push a woman, trying to get her to leave. I stood up for her and told him not to do that to her and that she was a grown woman, she can do what she wants to do. That’s when he hit me,” he told me. He now has two black eyes and stitches above his right eye.

Desmond Mpilo Tutu stated, “It is by standing up for the rights of girls and women that we truly measure up as men.”

Bishop Tutu is a South African social rights activist and retired Anglican bishop who rose to worldwide fame during the 1980s as an opponent of apartheid. Apartheid was a system of racial segregation in South Africa enforced through legislation by the National Party (NP), the governing party from 1948 to 1994.

Fatherless or the wrong kind of father?

He told me that he has been in and out of prison, jail and juvenile detention for the past 17-years. Today, he is only about 35-year old. “Assault, mainly for assault on my dad,” he said. “We don’t get along,” he said while looking to the side. He then described how he hit his dad with a sledge hammer once. "Always fighting," he said. 

Despite the fact that he had a father, he was usually jailed so he had little time with Dad. The time with him turned into fights, according to his memories. 

Many theories have come to light over the years that without a proper father figure, the majority are doomed for unsuccessful life events. Now I will say, I have known plenty of successful people who grew up fatherless and plenty of people who grew up with a father and still failed and ended up homeless, but statistics are quite strong showing that a father makes a huge difference in the lives of children growing up. 

According to a report filed by the Homes for the Homeless & Institute for Children and Poverty, “Numerous studies have shown that children benefit from a two-parent family, yet nearly one in four children in the United States (23%) is being raised without a father present. Among homeless children, 77 percent grow up in families headed by single mothers” The report was released in year 2000 and the numbers are said to be even greater in year 2015. 

A report filed by the National Federation of Families showed that 63% of youth who grow up without a father are more likely to commit suicide, 70% of children who are in a state operated institution come from homes without fathers and 85% of youths sitting in prisons grew up without a resident father. 

In the United Kingdom similar studies show similar results. The Institute for the Study on Civil Society reported in 2002 that children who do not live with their biological father have more problems in school, have a higher risk of health problems, are more likely to drink alcohol and use drugs and are more likely to suffer from long term emotional and psychological problems. 

Jim Valvano, a former American college basketball player, coach, and broadcaster once stated, “My father gave me the greatest gift anyone could give another person, he believed in me.”

Spoon Man

I call him Spoon Man because he plays the spoons. In fact, I have given him three sets of spoons in the past year, but people keep stealing them from him. I even lifted one pair from the Hard Rock Café once. Well, I walked in and asked for them and they handed the spoons to me and I walked back out. So theoretically I asked for them, but they looked surprised when I left out the same door I walked in.

Anyway, Spoon Man has lived on the streets for the past 8 years. However, he quit drinking 11 years ago. 11-years was too late because it caused serious neurological problems. He told me that one night he blacked out a total of three times. The drinking is what is believed to have led to his Cerebellar degeneration, which is a disease process in which the neurons in the cerebellum - the area of the brain that controls muscle co-ordination and balance - deteriorate and die. That being said, he has some trouble getting around.

A few days ago I bought Spoon Man a foot long steak and cheese sub. I watched as he ate a little less than half and then he carefully wrapped the remainder of the sandwich in paper and then placed it in his bag. I asked why he did not eat it all and he said, “I want to give the rest to a friend of mine.” He later told me that his friend is also homeless and that she is likely hungry.

Those who are homeless often give everything they have to others.

Rest in Peace. He was found dead on the morning of Saturday 9/26/15.

“We make a living by what we get. We make a life by what we give.” ― Winston S. Churchill

Age 22 and alone on the streets

She is only 22-years old and lives in a small tent with her dog secluded from others in the woods of Nashville. She has a cross around her neck and works hard to sell the "Faith Unity" paper to passerby's. She told me, "This was the only job I could get." I bought five, assuming that would help in some little way.

Before I could walk away, two different well dressed, but intoxicated men approached her asking to pet the dog. I questioned their intentions, but not out loud. It left me thinking, "This is someones young daughter or are her parents even living?"

"Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat." - Mother Teresa

Running Away

I met John in Nashville this past Saturday night. It was almost poetic to see him standing on the sidewalk with the lights of Music City behind him as he tilted back his beer. Almost.

He told me that he moved here from another state to start over, but it wasn't working as he planned. I asked, "What are you running from?" With curiosity, he said, "What do you mean?" I replied... "Drugs, a girl, alcohol?" His smile turned to a frown as he replied, "Alcohol, these streets are going to kill me. I've tried to stop, but every penny I get goes to buy more. I can't stop."

I then asked the soft spoken 65-year old man, "Do you want to stop drinking?" He smiled, "I sure do!"

John did not have a cell phone so I knew looking for him on a sober morning would be like hunting down a needle in a haystack, but I hit the streets on Monday in Nashville in search of John. I found him.

Long story short, he did a phone interview to get into a treatment center located in North Carolina. He is now on the short list to be accepted. Hopefully, he will be on his way to the 65-day treatment program within the next three weeks.