August 18, 2008

Batey Central, Barahona

The Dominican Republic

and

Burnsville, North Carolina 

Hello, 

I want to update you on the collaborative work that I have had the good fortune to participate in over the past four years in Pakistan and more recently the Dominican Republic. I am still working but this year have become “part-time” ; I will spend only about three months each year in Barahona from now on. More time is now spent on the ‘phone talking with the Barahona team coordinator, and people who can maximize our efforts. It is good to be home with Alice and our family and friends and I have come to recognize how important our family is. 

As everyone is aware, Pakistan is going through some very turbulent times especially in and around Peshawar where the Taliban influence or dictate political and everyday policy. The very recent transition in presidential leadership will probably result in more short term turmoil and tragedy. Two years ago, as this current political climate was unfolding, Dr. Nadeem Khawar, professor of Pediatrics at Khyber Medical College, and I wrote a grant proposal to the Rotary Club of Pisgah Forest (Brevard, NC) concerning the detection and treatment of childhood tuberculosis. A generous donation from a local running club and the First Baptist Church of Spruce Pine, NC had allowed us to develop an earlier pilot program at the hospital where I worked in Peshawar. As of this summer, Dr. Khawar (see below) and his team have received three year’s funding from Rotary International to continue this project despite the considerable tension within the city. Two new sites have been selected increasing the opportunity for disease detection and treatment. (You may not be aware that Pakistan has the sixth highest burden of tuberculosis in the world.) 

Dr. Khawar, Khyber Medical College, Peshawar, NWFP, Pakistan

I have now spent almost 18 months in the Dominican Republic and have had the opportunity to know many people and learn from them. (At many levels I am learning more and more and I suppose that is one of the factors that continues to attract me.) We have built a good educational team drawn from the community which it serves. They seem to help each other along with just getting the job done. So far we have educated 125 families about proper hygiene and how to have potable water through proper water chlorination. All of this education was done in the individual household by a visiting team member. 

While safe water cannot be completely secured though chlorination, it is better than local water sources which are contaminated with coliforms, giardia and at times other pathogens. 

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Boy bathing and drinking contaminated from a community water pipe 

Water chlorination kills bacteria and viruses, but is not effective against the parasites which are prevalent in that region; moreover, there is a need not only for drinking water, but for bathing and food preparation as well. After researching the various methods of purifying adequate water for a family’s daily needs, we selected the biosand filter because of its proven record in the Dominican Republic and its evaluation by external agencies such as the School of Public Health at the University of North Carolina (UNC). 

Beginning in late November, we started selecting families as candidates to receive a biosand water filter; these devices, with proper post filtration chlorination, eliminate bacteria, viruses, and parasitic organisms from the water. To date we have had 50 filters to distribute although we have recently received grants (Food for the Poor, Diocese of Western North Carolina) for 75 more. 

In July and August, Meredith Niess, a UNC medical student and MPH candidate, and I visited all families receiving filters to discern what were the issues with the filters and the opportunities for improvement. We learned that about 30% of families were sharing the filters with other families, a factor we now want to emphasize in order to augment the population covered by a filter. Ms. Niess was instrumental in promoting team discussions and helping develop better team documentation and more efficient function. Her contributions in our summer work are significant and are appreciated. 

We have other grants for water filters in progress and hope to receive at least another 50 filters, in addition to those already funded but not yet placed. 

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Children with a recently installed biosand filter 

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Meredith Niess interviewing a household leader during a domino game 
 

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Team training session to improve follow up of filters and documentation 

In April this year, St. Thomas Episcopal Church in Burnsville had a breakfast fundraiser and we have secured team salary support until next June. This funding allows project security for another year at least and permits enough optimism to add another program to our efforts. Through a very generous donation from Drs. Rhonda and Bill Webb of Shreveport, we are beginning a maternal-early childhood nutrition program; we will focus on how to provide good nutrition beginning with conception and extending to the fifth year of age. Part of the grant will be used for a bilingual educator to teach the team who then will host small workshops for families to educate them on the value of breast feeding, availability of nutritious food sources and the different preparation opportunities. The remainder of the funds will help cover the cost of high quality (USA) prenatal and infant vitamins which will supplement our in-home education program. 

Looking back over the years since late 2003 when I began organizing to work abroad, I feel that I have been very fortunate to have all of you as friends and supporters. As a project we are trying to move away from individual financial requests and seek grants to sustain our nutrition and water filter programs and find a straight forward way to underpin the salaries and general program expenses (about $ 7000/annually). I feel that with the continued interest that everyone has we will find ways to fund our work and these reports in the future will continue to provide interest and thought for you as well as answer the question of “ Who is my neighbor?”. 
 

David Johnson 

St. Thomas Episcopal Church

P.O.Box 591

Burnsville, NC 28714

Pakistan/Dominican Republic Health Project

   
 

    “Three Children Die Every Minute [Worldwide] from Unsafe Water”                  

                                                              UNICEF 2008 
 
 

    We shall not finally defeat AIDS, tuberculosis,   malaria, or any of the other infectious diseases that plague the developing world until we have   also won the battle for safe drinking-water,  sanitation and basic health care.”    Kofi Annan UN