Field Report: Raising a hand to beat the odds — an early start

by Jean Shin, Board Member & Volunteer

‘You must experience the winter here,’ is what a local partner of The Denan Project (TDP) told me during my visit to Mongolia in July 2017. So, I thought I was being clever by picking September instead: not the tourist-friendly months of July and August, but safe enough from the harsh weather of its long winter. Well, let’s just say…I was only half right 😉

The snow-covered frozen ground near the Tariat Hospital in September

[This report was originally written during my visit to TDP’s project sites in Mongolia in mid-September 2018 in order to share the experiences with my fellow board members and other volunteers of TDP.]

Day 1: A Long Drive Across Frozen Mongolian Steppe

The long drive from the capital city Ulaanbaatar (UB as the locals call it) to Tariat started at 6AM, September 17. UB wasn’t fully awake yet — and neither was I. But I was looking forward to seeing the hospital staff in Tariat and Erdenemandal I met for the first time last year, and experience firsthand the progress they made past 14 months (and for the last 7 years since TDP’s arrival in Mongolia).

Just when I was about to reach my very limit and lean over to ask the driver about the cost of fixing the car’s suspension system, we entered Tariat. (Hooray!) Colorful roofs dotting the gray open field…gave me an instant relief — and made me smile.

Day 2: Promises Made, Promises Kept — and Renewed

doctor
Tariat Hospital’s Head Doctor Dr. Gereltuya is showing the mobile examination tools provided by TDP which enabled her team to provide medical examinations by visiting remote herding villages

Facing a compressed schedule for the day, we started early from our ger (yurt) camp and headed to the hospital to meet the staff and patients. Over a hot cup of kumquat tea (perfect for the cold morning!), the Head Doctor Dr. Gereltuya and her staff went over our regular metrics and new findings, such as how dental checkups revealed that 97% of the population have dental problems. They also shared their goals for the next 12 months. Among the topics we discussed, I was most impressed by how well the Tariat doctors are using the mobile examination tools we provided last year. They showed me medical reports generated from individual checkups. So far they provided baseline checkups for 900 people (measuring glucose, cholesterol, etc. for 18% of the total population), and are working to cover 60% of the total population (4,939) by the end of this year. This initiative will help them provide preventive cares, something that’s utterly lacking in many developing countries.

Another notable new initiative was their goal to become Brucellosis-free soum (district). Brucellosis is an infectious disease caused by a type of bacteria called Brucella that can spread from animals to humans, affecting many herder families. They’ve already examined 500 children ages 10–18, and treated 13 of them. Disseminating prevention information to herder families is a critical part of the initiative. As of now, there’s a vaccine for animals but not for humans. Every newborn animal will be vaccinated, and every animal will be tested but it’s up to the owner to put down the animals when they are infected.

A herder family leaving Tariat Hospital after a child’s treatment

Seeing how snow starts to fall in September, it was no surprise to Dick and I that the hospital is in need of a garage. But I was astonished to learn that they have to spend 40–60 mins just to de-ice the ambulance by burning firewood after receiving an emergency call. ‘Whaaat???’ was my response. That’s what they’ve been doing to cope with the winter temperatures that routinely dip below -40 ° (even -60 ° at some nights) without a garage. It was clear to Dick and I that we simply have to finance a heated garage for the hospital!

Walking around the ward, I saw what-felt-like a miracle. Yes, running water inside the hospital! The long-promised (and long-delayed) water was finally there, hot and cold, hooray! Now the government just needs to connect the hospital to the central sewage system so that they can have indoor toilets!
Tariat Hospital’s general doctor filling in for a pediatrician whose contract expired. The general doctor will be starting her pediatrician education from October 2019.

After the hospital visit, we went over to the Tariat school near the hospital. I had a keen interest in meeting some of the students in our Health Club, and possibly recruiting some more. The vibes inside the school and the dormitory were just what I was hoping to feel: bright, energetic and colorful. Maybe they were just being nice, but we did see all hands raised when we asked who would like to join the TDP Health Club 🙂


Meeting Tariat high school students and eyeing an opportunity to recruit them for our Health Club in the dormitory next door

Day 3 Big Changes. Small Details.

The next morning, we started even earlier to get to Erdenemandal Hospital. The district of Erdenemandal is a bit bigger than Tariat with a population of 5,644 (of which about 10% are under age 5). Although the hospital building is much bigger than that of Tariat, the outdated Soviet-era building was in much need of repair or rebuilding. I was excited to meet the hospital doctors and continue the conversation we started during my last visit.

The Head Doctor (a surgeon) presenting how the surgical equipment TDP provided last year are being used

To my delight, the Head Doctor (who is also the hospital surgeon), joined by his staff, greeted us with a full slide presentation, detailing the surgeries he performed and how each of the medical equipment and supplies we provided are being used (surgical gurney, monitoring screens, etc.). We were also happy to hear that the hospital dentist was finally able to treat her patients (a total of 877 cases during the past 12 months) with the dental supplies we provided.


Erdenemandal Hospital’s dentist treating a boy for tooth extraction

After the staff meeting at Erdenemandal Hospital, we followed a local bagh doctor who’s making a house call to a herder family. Despite the apparent limitations (lack of medications, limited medical training, etc.), I was relieved to see how everyone, no matter where she lives, has access to free medical care.

Edenemandal’s bagh doctor (left, with a medical bag) visiting her patient living in a ger with her husband, daughter, horses and dogs

Day 4 Progress in Sight — and Fast Approaching

On the way back to UB from Erdenemandal, we stopped at Aimag Center (the capital city of the Arhangai province overseeing Tariat and Erdenemandal) to meet Dr. Gandiimaa, Director of the Arhangai Department of Health. Over the years of our partnership in the region, she became an ardent supporter of TDP initiatives and a great adviser. We were particularly thrilled to hear that due to recent improvements we’re making in Tariat and Erdenemandal, the number of patients coming to Aimag Center from those districts has drastically decreased. Furthermore, the success we’re making at Tariat Hospital is becoming an envy of other hospitals in the Arhangai province.

Back in UB, spending hours trying to iron out the details of our next budget year with Dick, before flying back to Munich, I couldn’t help but think how many high school students raised their hands to join our Health Club and get trained by our doctors. Facing a serious challenge in recruiting medical specialists to work in remote places like Tariat and Erdenemandal, it’s clear to me that we need to start getting more active in nurturing the local students, helping them get advanced education — and serve the community. If we can succeed in that initiative here in Mongolia, we can certainly try to replicate it in our other facilities in Peru and Ethiopia. And THAT is a wonderful reason for me to come back next year, and measure our progress with the students who raised their hands.


 

Field Report: It takes a village, sometimes even a continent. Education on the high Andes.

Out of the four medical centers that The Denan Project (TDP) is funding in some of the most impoverished parts of the world, namely Ethiopia, Peru and Mongolia, I must admit that our medical center in Uratari, Peru speaks to me the most. Perhaps it’s because I saw the community people building it themselves, brick by brick…perhaps…

In addition to the routine due-diligence activities, this time I had a special reason to be there. I wanted to work with the six high school students from The Pingry School (including three volunteers of TDP) who are visiting TDP sites as part of their leadership program organized by The World Leadership School.

[This report was originally written during my visit to TDP’s project sites in Peru in late June, 2018 in order to share the experience with my fellow board members and other volunteers at TDP.]

Day 0: A Country of Mountains, Jungle and Ocean

Soaking in the ocean air after a 17-hour journey from Munich to Lima. So began my third visit to this enchanting nation where you can climb the High Andes, turn to the Amazon rainforest, and touch the Pacific ocean.

Day 1: All Roads Lead to Anta

In order to get to any of the five villages on our agenda, we had to go through Anta, one of Cusco’s 13 provinces. In fact, the municipal office of Anta is our partner who’s been handling our local fund distribution so that we can save on money transfers from the US, and local transactions related to medical and micro-loan programs. So, our week-long agenda started out with going over the accounting records with the municipality of Anta.

Day 2: From the Ground Up

After another quick stop in Anta, we started the day with a meeting with the community in Churo. We huddled together and went over the details of a micro loan project the community wanted for raising cuys (guinea pigs which are a major source of dietary protein for the community people as well as a source of income). From Churo, we traveled farther to a neighboring village of Pampahuaylla.

As soon as we entered Pampahuaylla, I could see why this community is considered richer than Churo, our previous stop. A new elementary school, cheerful kids on the street and all others huddled around the only TV in the village to watch the Peruvian team playing in the World Cup 2018…it was lively!

This is where Elio (TDP’s first scholarship student who earned a college degree) came from. We visited Elio’s family and, over some meat and potato, shared our mutual pride in Elio’s success. With a mechanical engineering degree he earned, Elio was getting started to build his own business.

Day 3: Welcoming Pingry School Students to Uratari

Learning together with the volunteer students from the Pingry School was my main reason for the site visit this year. I was curious about the experiences the US high school students would have with the local communities, especially with the local students.

The visit started with a community-wide welcoming ceremony. Although I’ve experienced the warmth and hard labor the entire community puts into welcoming TDP volunteers before, I was deeply moved by the excitements and warm interactions between the students and the villagers.

Day 4: Breaking Potatoes Together

After my first overnight experience at the Uratari Medical Center (shared a room with the resident nurse), I joined the Pingry students to visit the neighboring village Choquemarca, the poorest community in the Limatambo district of the Anta province. We were joined by the TDP medical outreach team headed by Dr. Yair. Choquemarca’s biggest problem is the absence of a water supply. Facing this all-too-common issue across many small communities in developing countries, I was happy to hear that the community of Uratari was exploring ways to share their water with Choquemarca.

In between micro-loan program discussions and medical outreach visits, the team was treated with the local specialty of meat and potato, prepared and served in the way that only the originals can. (Right, potatoes are originally from Peru.)

Dr. Yair (right) examining a patient during TDP’s medical outreach in Choquemarca

Day 5: High Aptitude for Higher Education

As part of TDP’s support for school education, the Golden Condor awards (with cash incentives) are given to top three students in the 8th, 9th, 10th 11th and 12th grade students in Uratari. Our visiting students were joined by the entire community in the schoolyard for the award ceremony.

Day 6–7: TDP Goes to the Peruvian Congress

Discussing TDP’s proposal for building a boarding school with the President of the Peruvian Congress (center)

Back in Lima, a different topic was high on our agenda. Past few months, the TDP team has been working on a proposal to build a boarding school in Uratari (right next to the existing school, above). Our goals were: i) to give the children in neighboring remote villages a chance to get a higher education (there’s no high school in villages like Pampahuaylla we visited on Day 1, above); ii) to proactively reduce the possibility of the high school in Uratari having to shut down at some point in the future.

Our meeting with the Peruvian Congress was to get the support for the boarding school initiative — together with the Pingry School students. Thanks to Congressman Wilbert Rozas, who originally helped TDP select the project site in Uratari, we were able to meet with the Education Committee Chairwoman Paloma Noceda, and the President of the Peruvian Congress Luis Galarreta. After a series of discussions, the team was able to gain the support we were asking for — and walk away with the specific next steps!

Changes are coming…sometime too fast, sometimes not fast enough. I don’t know what changes I’ll see when I return to Uratari next time. Perhaps a shiny new boarding school. Perhaps another ambulance vehicle at the medical center. Perhaps…But I do know this much, the men, women and children of the community will gather around in a big circle and tell us all about it. The changes that happened. The changes they want to bring about.

__ Ends __

TDP’s Pingry High School Group Visits Peru and Studies Sustainable Community-Building Firsthand

By Miro Bergam, Ethan Malzberg, and Ketaki Tavan

In the Spring of 2017, we held our First Annual Charity Night for The Denan Project – a non-profit that supports isolated and impoverished communities around the world.  As the student leaders of the Pingry Denan Project group, we had already organized a few other fundraising events like pizza sales and Dress Down Days. The Spring fundraiser, however, took our efforts to the next level.  Rather than focusing just on fundraising,  it expanded the attention to include education and awareness of the organization.  We also decided to raise money for a particular goal – the funding of a water tanker in Denan, Ethiopia, greatly needed during a country-wide drought.  We asked Dick Young, the President and Founder of The Denan Project (TDP), to be the keynote speaker, and an audience of over 100 attendees took time out of their Friday evenings to learn more about the charity and its mission. In the end, we raised more than $10,000 for the organization.

There was a second unexpected outcome of the event. Towards the end of the night, we were approached by Mr. Jewett, Pingry’s Director of Global Programs, who proposed a trip to one of TDP’s locations. The three of us had already been thinking about planning a trip related to the charity near the end of high school, but having Mr. Jewett to collaborate with, we were able to transform that idea into the first-ever student-driven Pingry Global Program. We led the charge in designing the curriculum and the accompanying itinerary for the trip, guided by Mr. Jewett’s knowledge of experiential education, and set in motion plans for a trip during the Summer of 2018.

Having been involved with The Denan Project for nearly three years, we set out with specific questions about nonprofit work that we knew we couldn’t find answers to in a classroom setting. We wanted to understand how organizations operated from the inside. Eventually, we decided that the purpose of the trip would be to conduct case studies of three NGOs in Peru, including TDP, through the lens of sustainability. Sustainability, as it applies to our research, is the ability of an NGO’s work to foster independence in a community; we hypothesized that, in an ideal world, a sustainable NGO could step away from the community in a finite period of time and the community would thrive on its own (as opposed to a charity pouring endless resources into a project).

Specifically, we compared and contrasted models for building sustainable communities, exploring the following questions:

  • Is this work sustainable, and if not, how can it be improved?
  • Does the work build independence or dependence in local communities?
  • What are the impacts of international donations and/or volunteers in local communities?
  • What roles do these NGOs assume in the structure of Peruvian society?
  • How do factors such as tourism frequency and geography influence the approach and impact of an NGO?
  • Who started these NGOs? Are the voices of Peruvians listened to?

 

We left for our trip in June of 2018. Sacred Valley Health (SVH), also known as Ayni Wasi in Quechua, was the first NGO we visited. Based in Ollantaytambo, SVH serves nearby high-altitude communities by giving health education to elected women called “Promotoras.” Promotoras are trained bimonthly in Ollantaytambo and serve as caregivers in their home communities. Promotoras are trained by “Docentes,” also women from local communities. By giving these jobs to local women, SVH helps set the communities on a path of success regardless of whether SVH is there in the future. SVH’s approach to sustainability relies on the training of Promotoras and Docentes so that they can depend on their own knowledge rather than that of SVH.

Awamaki, the second NGO we visited during the trip, helps register all-female weaving collectives as official businesses. Awamaki assists these collectives in determining the value of their weaving products and helps the women gain confidence in their selling strategies. In doing so, Awamaki hopes to preserve the weaving tradition in rural communities. By instilling confidence in the women and helping the cooperatives become officially recognized, these women are able to continue the tradition of their craft. Awamaki’s model of sustainability depends on women graduating its program and becoming autonomous in the weaving economy.

The Denan Project was the last NGO we visited. Its microloan program, through which TDP loans out cuy (small animals favored in the local diet) and bees to local people, teaches business skills and fiscal responsibility. Because of the nature and success of its microloans (the program has enjoyed a 100% success rate), TDP has never lost money on a transaction. The use of microloans, rather than simply pouring donations into the community, makes the exchange inherently sustainable. Additionally, the recipients of the loans themselves are the ones responsible for turning the loans into a business that stimulates the economy of their community. These skills and the businesses that result can outlast TDP itself.

The greatest finding we learned while investigating TDP’s project was that, oftentimes, sustainability must be compromised for greater change to be impacted. For example, the funding of TDP’s hospital would not be possible without large international donations, but these are rarely sustainable and ongoing sources of money. However, without such donations, TDP would be unable to offer medical care as a service. TDP’s practical outlook on sustainability allows the organization to efficiently provide an array of services; this perspective elucidated us to the limits of an exclusively sustainable approach.

In addition to the three NGOs, we visited sites across Peru including Lima, Cusco, and Machu Picchu. While sightseeing in these locations was highly enjoyable, the immersive nature of our trip made them equally academic. Witnessing the commodification and tourism of Machu Picchu served as a standing reminder of how tourism can shape the landscape for indigenous peoples — something we saw both do and undo the work of charities like Awamaki and Ayni Wasi. For example, tourism funds the work of Awamaki through workshops they run for visitors, while at the same time making their work more challenging by introducing cheaply made souvenirs that undercut the prices of traditional weavers. In this way, tourism is a double-edged sword.

The trip reached its climax when we visited the Congress of Peru in Lima on our final day. The group had the opportunity to meet with Congressman Wilbert Rozas, Secretary of Education Paloma Noceda, and President of the Congress Luis Galarreta. We discussed TDP’s planned construction of a boarding school in Uratari that would allow students from neighboring villages to attend classes. This meeting put to work all of the communication skills and NGO knowledge we had accrued during our two-week trip.

The work of the three NGOs we visited all involved unique ways of helping local communities. Each organization took their own approach to understand the specific circumstances within which they were operating and the local people’s needs. We saw that a one-size-fits-all approach cannot be applied to nonprofit work. Whereas one charity may thrive off a tourist economy, such as Awamaki which sells woven goods to tourists, others must subsist in different ways, such as TDP which actively seeks out locations too remote for tourist engagement. Similarly, all charities had different relationships with governmental structures, with TDP relying on local officials to oversee the execution of their projects and Ayni Wasi having a location in Ollantaytambo that has to collaborate with the government-run health post.

Over the course of our trip we saw that charity work is not inherently perfect. An NGO’s model can only be sustainable with the understanding that the organization must adapt to the needs of and empower the local people. However, we believe that with this awareness, an effective and long-lasting impact can be made.



Where Herders Come for Healing

By Jean Shin, Board Member & Volunteer

Toilet paper? Check. Energy bars? Check. Cipro? Check. Email auto reply? Double check.

Packing light is something I already know how to do. But doing so with basic daily necessities, medicines, and clothing for multiple climates? Well, that turned out to be a rather distracting experience…at least that’s the only excuse I came up with while running for a long taxi line outside the Munich airport, trying to get back home to pick up my passport I forgot to pack. ‘There’s no way I’m missing the flight,’ I announced to the taxi driver. So it began on Jul. 5 – my first visit to The Denan Project (TDP) sites in Mongolia .

It’s not the mileage, it’s the connection.

After landing in Ulaanbaatar (the preferred spelling among locals) via Moscow and filling out a lost-luggage claim form, I was greeted with a news that Dick Young, the founder of our organization, was stuck in China and that his arrival time was unknown (something about his flight being cancelled, re-routed, reshuffled, etc.). Mongolia is not the farthest place I’ve ever traveled to, but definitely one of the places with the fewest direct connections.

Spending the eve of the Mongolian presidential election day in the heart of the capital city, I was trying to figure out why some of the street signs were still written in what-looks-like Russian Cyrillic. Right, the Soviet influence still remains in this country, sandwiched between Russia and China, trying to make their young market economy work.

Standing in front of a TEDx Ulaanbaatar poster against a backdrop of a new shiny building, I was reminded of my walks through Moscow and Shanghai…and some other cities in developing countries with similar shiny buildings in the making, Jakarta, Lima, Addis Ababa… ‘Let’s see how things outside the capital look,’ I murmured.

Economic and political participation of women.

Upon Dick’s arrival (about 30 hours after his departure in New York), the project team (including our local partners from Save The Children) met with the Mongolian Minister of Health Tsongtsetseg. Sitting across the table from the woman Minister and a room full of woman professionals at the same table, I couldn’t help but notice the stark difference from my visits to other TDP sites, especially compared to my meetings with an all-men group of elders in Denan, Ethiopia. As I walked back from the meeting – where the Minister awarded Dick with an honorary medal for TDP’s contribution to the wellbeing of people in the Arkangai province (about 700 km away from Ulaanbaatar) – I added this to my to-do list: google OECD’s report on women’s economic role and sustainable development. Read it again!

Nomadic living in urban ghettos—and in the Land of the Blue Sky.

Heading west from Ulaanbaatar, our 4×4 vehicle passed through some of the ‘ger districts,’ the Mongolian version of urban ghettoes surrounding the city center. Herders who fled the countryside, after having lost their livestock, were now stuck in the outskirts of the city with no running water, or proper sewage. Carrying all trappings of their nomadic lifestyle…but with no animals to herd, no fodder to harvest…

I was told that our drive should be smoother and faster than in previous years, at least for the first 1/3 of the journey, as more of the roads have been paved. ‘Hopefully not all the way,’ I murmured. I didn’t have to worry. The long stretch of paved roads, dotted with a few eateries and outhouses I didn’t dare to walk into, ended soon enough.

Then came something I’ve never seen before. Something I never had to describe before. A land of steppe and sky. Vast pastoral rolling grasslands…under a seemingly endless blue sky. I was beginning to get why Mongolians call their country the Land of the Eternal Blue Sky.

Low mountains started to dot the horizon…and I knew we were getting close to our destination Tariat, the second coldest place in Mongolia where winter temperatures routinely dip below -40 °C. Although my senses told me I was in an endless spread of temperate grasslands with grazing horses and yaks, I had heard enough about the harsh winters of the area to know that the July weather I was soaking in wouldn’t last much longer. In fact, that punishingly cold weather – in addition to the general lack of funds for heat and basic medical supplies – had a lot to do with why TDP came to Tariat in year 2011, and put a stop to the shortages that used to prevent the hospital from treating patients for 4 months a year.

Providing basic human services in developing countries.

So, how do you run a hospital without running water? The same question again. One of the first questions I asked myself while visiting our hospitals in Peru and Ethiopia. It’s a common problem that makes everything that much more difficult to handle – and those difficulties quickly add up. In fact, according to some stats, one-third of all hospitals in the developing world lack running water.

Beyond the glaring similarities across nations classified as developing countries, what I saw in Mongolia was distinctly different. In Denan, Ethiopia, our organization had to start from scratch (building the hospital from the ground up, trucking in water, etc.). In Uratari, Peru, the community rolled up their sleeves early on and built the hospital together brick by brick. In Tariat and Edenemandel in Mongolia, it became clear to me that it’s more about identifying the one last hurdle that prevented medical help from reaching the people in need.

What kind of last hurdles? Something I could only see by shadowing the doctors, meeting their patients, seeing the equipment and supplies they use, following the local doctors making house calls, etc.

Standing next to a young dentist, in front of a brand-new-but-never-used dental chair (a not-so-unique problem in many developing countries), I learned that with only USD1200 the dentist could get all dental supplies she needed for the next 4 months so that she could start taking care of her patients rather than waiting until January next year for the dental supplies, promised by the government, to arrive. In this case, that was the last hurdle. So, we resolved the issue then and there by allocating some of our leftover budget to the dental supplies.

Following a woman local doctor making a monthly visit to a herder’s family on a motorcycle, we learned that she ends up paying half of the motorcycle fuel costs out of her own pocket as the government’s fuel allowance covers only half of what she spends to cover the distance she has to travel every month. Having realized that the shortage is widespread and thinking that not every doctor would be able to make up the difference, Dick and I agreed to bring the issue to our board for next year’s budget.

Talking with a surgeon while shadowing doctors making rounds in Erdenemandal Hospital, Dick and I saw another hurdle we needed to address. The hospital has a surgeon who can perform a wide range of surgical operations, however the hospital has no anesthesiologist, limiting his scope to operations he can handle with partial anesthesia. Apparently there’s a nationwide shortage in anesthesiologists in Mongolia which makes it even harder for a remote hospital such as this one to recruit one. We left the hospital with a plan to provide extra incentives for a new anesthesiologist.

There lies the answer to the question I was asking while running back home to fetch my passport: so, what makes you think you will do more good by going there rather than simply donating that money? Why go there?

The answer? Because it matters. When the end goal is to get the care to the end recipient, we need to understand the entire flow. For many things, I prefer simpler answers. But what we’re trying to accomplish here requires understanding the complexity – and removing the barriers every step of the way. Besides, it’s in TDP’s DNA. We don’t just rely on secondhand reports. We go, inspect and improve.

Back in Munich, I find it easy to romanticize about the nomadic lifestyle I saw in Mongolia and to question the people who were abandoning their tradition and fleeing to the dismal life in urban ghettos. But ultimately, it’s their choice. And for those who decide to stay, I would like to think that they won’t be denied of the basic human care such as medical service. The children and adults who came to a neighboring ger and waited for their turn to see a visiting doctor…they are on my mind.

Roberta and Richard Wool Visit to the Navajo Reservation: Spring, 2017

By Roberta Wool, Volunteer

Visiting the Navajo Nation in Chinle, Arizona, from the metropolitan East Coast feels like being deposited in an America that you know exists because of history texts or a National Geographic special. You are prepared for a landscape of astonishing beauty, but can’t quite comprehend the societal inequities that are so palpable.

I am so pleased to report, however, that The Denan Project, in conjunction with the Johns Hopkins Bloomberg School of Public Health’s Family Spirit program, is having an impact in supporting young mothers living on the Navajo Nation.

Chinle, Arizona

My husband, Richard, and I arrived in Chinle on March 28 and were greeted by Program Manager Kristen Speakman, who introduced us to Family Spirit Senior Trainer Kendrea Jackson and trainers Brandy Bridgewater, Indian Health Service Public Health Nurse (PHN) and Family Spirit Program Coordinator for PHN department, and Delilah Yazzie, Indian Health Service Public Health Nursing Health Technician. They were in the initial phase of a training session with several nurses and one nutritionist who are going to be doing outreach with Navajo women. The training session involved learning to use the Family Spirit curriculum, which is very detailed and offers a specific set of goals for each visit. The training involved a lot of role-playing, which was useful in preparing the outreach workers for a variety of family situations that was grounded in a culturally appropriate manner.

On the second day we visited Tsaile, where we met, Indian Health Service Public Health Nursing Health Technician, Maureen Mitchell and joined her for a home visit to deliver a Family Spirit lesson to an enrolled family that was about to have their fourth child. In our pre-visit briefing, we learned that up to 40% of the families on the Navajo Nation do not have potable water in their homes.  In addition the remoteness of the reservation results in challenges accessing fruits and vegetables. The lack of access to potable water and produce might be a contributing factor  to high rates of gestational diabetes as well as Type 1 and 2.

Our time there was well spent. There were no paved roads on the way to the house, only muddy tracks. The family consisted of the parents and their three children. When we arrived in the afternoon, both parents were at home with their youngest daughter and we were warmly welcomed. We sat in as Maureen used the Family Spirit Curriculum to cover the lesson for that visit. The husband sat with his wife as she responded to Maureen’s questions and eagerly took in the information Maureen was offering.  It was quite clear that the family valued the information conveyed and that they appreciated the one-to-one communication that is a hallmark of the program.

Family Spirit is an evidence based program designed and evaluated by Johns Hopkins School of Public Health. Their research shows their interventions have a long term positive impact on the children. Family Spirit children are less withdrawn, anxious, depressed—outcomes that point to a brighter future in school and life. Chinle Public Health Nursing Department is hoping to replicate these data outcomes and is tracking the impact it has on pregnant women and their children until the children are three years old. The Denan Project is making an important contribution to a program with proven results not just for the Navajo Nation, but for other ethnic minority groups as well. I felt proud that we had the opportunity to visit the Navajo Nation and are able to support the Family Spirit Project that is working in partnership with the Navajo people who have a rich and wise culture to strengthen their families and communities.

To support a happy, healthy future for children in Native communities around the country, visit jhu.caih.edu/giving.

Visit to Denan, Ethiopia

Standing with the women of DenanStanding next to some of the women of Denan

By Alice Norwick, Volunteer

It was a long journey from my small town of Woodbury, CT to reach the small desert town of Denan, Ethiopia, almost half way around the globe.  But as a Board Member of The Denan Project for nearly a decade, I’ve always wanted to visit our original project in Denan, to see first-hand the work that our organization has done for this community.  This February that dream became a reality.

Just getting to Denan was a feat.  After a 13-hour flight to Ethiopia’s capitol, Addis Ababa, we took another 3-hour flight to the small town of Gode.  From there we drove for an hour on a new road across the desert, a chalky moonscape of dust, sand, rocks and low growth shrubs.  Every so often we’d pass a few very small huts made of curved sticks with a covering of fabric from cut-up food aid sacks and nearby we might see a herd of goats and sheep with their young shepherds attending them.

The Denan Health Center is a compound on the outskirts, separate from the small village of Denan and within walking distance of the Internally Displaced Persons (IDP) Camp that has existed  since the major drought and famine of 2000.  All the beds were filled with overnight patients.  These were some of the lucky ones, those who had gotten to the hospital and were now receiving quality care, always for free thanks to The Denan Project’s support.

Some of the images of the people that I saw during my trip will remain with me always.  While accompanying a doctor on his rounds one morning, we came upon a mother holding a small child’s hand and caressing his head.  He looked to be about 4 years old.  But when we asked his age, the doctor told us to our shock that he was 10 years old, and suffering from acute malnutrition.  His mother had brought him all the way across the desert by donkey cart from their village of Harerey, some 250 kilometers away. With IV feeds and the special “Plumpy’Nut” food supplement developed specially to combat African malnutrition, he had a chance of survival. His case, sadly, was all too common and I saw many other children who looked far too thin, or young for their age.  The Denan Project has done so much good in this area, but there is so much more that could still be done, so many more children and people to help.

The poverty is evident everywhere, especially in the clothes the children wear — dusty, some torn t-shirts, flip-flop shoes worn thin.  One little girl had only a skirt, settled around her neck like a poncho.  The women and children spend hours each day walking to the dried up river bed to fetch water from the deep wells that have been dug in the sand there.  The young teenagers use strong rope with a bucket to bring up the water. The women, with many children in tow, carry the plastic, gallon water containers back to their homes.  If they’re fortunate, they’ll have a donkey to help them carry the containers. The water is not free of bacteria and many get sick from drinking it but there is no other choice. In the few short weeks since our visit, the wells in the dry riverbed have completely dried up and now the only source of potable water for the area is our watertanker. We are grateful that recent repairs have put our tanker in working condition, but we worry that it will soon not meet the needs of the community.

Our hospital in Denan is like an oasis in this land of poverty and high temperatures.  It was very, very hot!   Patients come for health care and receive loving attention.  They receive two meals a day and are given vitamins. There is also a learning center that gives information on nutrition and good health habits.  We encourage the women to come to the clinic to give birth and also for pre-natal care. In fact, we just received an award from the government recognizing the excellence of our program to encourage women to give birth at our medical facility rather than at home. One woman we saw had been on the way to the hospital but did not make it in time — she gave birth in the bush and unfortunately the placenta did not come out. She was taken by donkey to our hospital to save her life and remove the placenta.  Happily, she was resting well with her infant beside her.

In addition to our medical outreach, The Denan Project also provides micro-loans to various groups in Denan. While we were there, we met with all the micro-loan groups and were pleased to hear they were all doing very well and on schedule to re-pay their loans.  Most of them have shoats (sheep and goats). One of the women’s groups is also buying and selling fabric and doing well with it.

At the end of our visit we met all the staff together.  Some told us that because of their steady jobs at the hospital and their profits from their micro-loan group, they have been able to upgrade their homes, sometimes gaining even a slightly bigger house or the ability to put up a tin roof.  Their neighbors, who are beginning to see their success, in turn want to better their own lives, and this is starting to create more ambition in some of the townspeople as well.  It was so gratifying to see how The Denan Health Center is empowering people to do more for a better life for themselves and their country-men!

My time in Denan made me thankful for the gifts I’ve been given and my life in the USA where I can turn on a faucet and have clean water, a warm (or cool) home, food in my refrigerator/pantry and quality health care.  I’m also grateful that I’m able to share my good fortune and help people across the globe, through The Denan Project organization, to make their lives better as well. I hope perhaps that those of you reading this might also be inspired to support this organization, which, with your help, could do even more to help those in real need.

Note: since the time of this visit, conditions in Denan have indeed become more dire, with the drought that has been affecting other regions in the country creating real problems for the area’s food and water supply.  We are monitoring this situation carefully and talking daily with our on-the-ground partners. It is likely that The Denan Project may need to step in with emergency funding in the not-too-distant future.

Visit to Denan, February 2016

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By Jarret Schecter, Board Member & Volunteer

I’ve been to Denan many times since my first visit in April 2004, when we first talked about starting an organization to help people of the region. On this trip, like the ones before, I am once again jarred from my usual day-to-day automatic pilot. It’s a very beneficial experience on many levels. Automatic pilot, or automaticity, is not always a bad thing. It’s a way of putting order into life’s chaos. But in a negative sense, it reinforces inertia and detracts from mindfulness and gratitude. My trips to Denan remind me of this, each time.

Cognitively-speaking, when I am in Denan, I am more grateful for the gift of life that have I have been given. Moreover, I realize that there is reason (if acted upon) for much hope in the world, when you can see that so little can go so far. For example, for just a few dollars, a life can be saved with medicines, a rehydration tablet, emergency food supply or a doctor’s care. It is jarring to realize that my typical lunch back home of a slice of pizza and drink costs more then that.

Physiologically, life here also jars me in a very positive way from my usual unreflective habits. In the hundred plus degree-heat in desert conditions, I am hungry, thirsty, and without a shower for a couple of days, I feel tired and somewhat uncomfortable. However, the afternoon siestas with their beautiful rhythm put neuroses in their proper place, and watching the stars light up the night sky while sleeping on the ground in the open-air compound makes the trip all worthwhile. Later in the night, this lovely stillness is magnificently punctuated by animal sounds and a call to prayer that in its own contextual way, elegantly and thankfully ushers in a new day.

Awoken from automaticity my trips to Denan make me appreciate the real and the potential in life.

Visit to Navajo Reservation, Chinle, Arizona

By Richard Wool, Board Member & Volunteer

I recently took a trip to visit The Denan Project’s new venture with the Johns Hopkins Center for American Indian Health on the Navajo Reservation in Chinle, Arizona. We are supporting the Center’s highly innovative Family Spirit program by providing training to tribal public health workers. In home visits, these professionals advise and counsel families, particularly new and expecting mothers, on a variety of subjects, including pre and post-natal care, parenting skills, avoiding pitfalls in child rearing, sound nutrition and diabetes prevention.  Along with fellow Board member Jarret Schecter, I observed two-days of the training program and left with the distinct impression that the “students” were highly motivated, had an excellent grasp of the curriculum and were anxious to start bringing what they have learned and practiced into the community. There is no doubt in my mind that TDP’s “investment” in this worthy program is going to pay meaningful dividends.

By Jarret Schecter, Vice President and Board Member

In December 2015, fellow Board member Richard Wool and I visited the Navajo Reservation in Chinle, Arizona and witnessed first-hand the training program for the expanded Family Spirit program, to which The Denan Project began contributing earlier this year. This is our organization’s first work within the United States, and I am very proud that our efforts are now also helping those within our own borders.

I knew, of course the statistics — 52% of the people are below the poverty line in the Chinle community on the Navajo nation in Northern Arizona. Being there in person, however, made me think more about the links between these statistics, related problems, and the people. Poverty has an ensnaring relationship with all kinds of other pernicious issues — higher than average rates of domestic violence, substance abuse, teen high school dropout rates, and poor health, such as diabetes.

Breaking the cycle of poverty needs to start at the earliest age possible. The Family Spirit program, which focuses on education and health for new mothers and their children, works preemptively through primary preventative education. The program thus helps to improve and enrich individual lives and families, saves in future health care expenses and provides gratifying work options to those who help others. In my view, the money The Denan Project invests today will go a very long way to preventing high and escalating future costs; both human and other.

Why Don’t I Want a Birthday Present?

By Renee Cayer, Volunteer

Since I was a child, I have been receiving birthday gifts from people I have never met, who live in a country I may never visit, yet who have given me something I will use for a lifetime. When I was nine, my mother read an article to me from the newspaper which described the non-profit organization, THE DENAN PROJECT. It was looking for donations to help run a medical clinic in a severely drought-ridden area of Ethiopia. It described how people had walked for up to ten days in order to get health care, at times burying their sick and starving children along the way. Medical aid there was virtually non-existent. Temperatures daily soared well above 110 degrees, which made for the most unbearable conditions in all of Africa.

As she was reading, I noticed a picture of a Denan girl next to the article. She looked about my age, which frightened me immensely. NOT ALL GIRLS ARE LIKE ME? Without letting her finish, I ran upstairs to my room and grabbed my allowance money I had been saving for an American Girl doll. I handed the money to my mother asking “Can you send this money to that organization? I do not need another doll. THEY NEED THE MONEY MORE THAN I DO.” From that moment it hit me that I could make a difference in peoples’ lives, a small difference, but still an incredible one.

When my friends would ask, “Renee, why don’t you want a birthday present? I thought you wanted clothes for an American Girl doll?!!” I would always respond with the simple answer: “Because children need medicine. For one hundred dollars the clinic stays open for one day.” Just knowing that my money is making a difference in peoples’ lives still makes me tear up to this day.

Why do I still collect money for Denan in lieu of birthday gifts? Simply, it gives me joy. Words cannot express the feeling I have when I send them hope. There is just something about that feeling that has become a part of me. It inspires me to do more, and drives me to ask how I can keep making a difference. The haunting image of the dying young girl with crusty eyes and flies on her face has stuck in my mind since I have been nine. I will never know for sure what impact my two thousand dollars has made, but even if I have changed the life of one child, it was money well spent. As most people see my donations as a gift to the people of Ethiopia, I see it as a birthday gift from them.

Back in Uratari, Peru

By Rick Berman, Volunteer

It’s been less than three years since Liz and I visited Uratari.  What a fabulous surprise we were in for when we returned with Dick, and Jarret this May.  The new ultrasound machine and ambulance were just the icing on the cake.  The tiny, roofless, partially-built clinic had turned into a thriving little hospital, complete with a doctor, nurses, a dentist, pharmacist, lab technician, and most importantly, patients filled with hope.

The celebration of the local officials was also joyous, (we even got gold medals). But the recognition really deserves to be directed toward Dick and his colleagues.  For Liz and me, the satisfaction of knowing that we are involved in a small way, was celebration enough.

After meetings with Herben Alvarez, the mayor of Limatambo (a terrific guy), we visited an amazingly modern pre-school, which is a prototype for the one planned for Uratari. We then saw the medical outreach program thriving in Pivil. In the ancient church, the doctor performed ophthalmology exams, while the dentist was at work nearby. The micro-loan beekeepers were proudly showing off their new projects, as were the guinea pig farmers back in Uratari the day before. On our way home that evening, we scouted a possible location for a future trout farm.

We were again honored to be invited to the baptism of the Mayor’s son; a beautiful ceremony in a 16th century church, followed by a four-hour party. Every step of the way, day after day, we were accompanied by our amazing partners from Tengo un Sueno; Salvador, Coti and Lourdes Herencia.

Driving through the magnificent countryside each day, we couldn’t help but feel enormous pride in bringing medical assistance and commerce to people who, by circumstance, live far more difficult lives than we do.  We look forward to our continuing support, and especially our next visit to Peru.