Goals for the Establishment of CotB’s Community Casa de Salud

Welcome to those of you who are visiting our site for the first time!  As you may have noticed from recent posts, we are now focusing our efforts heavily on the establishment and operation of our new community health center. Below, I discuss why we believe this is so important, and what we hope to accomplish with it in 2009.

The Problem:
In the communities of immigrant Haitian sharecropping families living in the southwestern Dominican Republic, the vast majority of people live in destitute poverty and no institutional safety nets exist to prevent the hunger, illness, and mistreatment endured by this population.  One of the most deplorable consequences of this demographic group’s marginalization and poverty is the high rate of maternal and child death associated with pregnancy and labor complications.  Because of malnutrition, poor sanitation, and inability to pay for prenatal care or delivery in a hospital, rates of premature birth, miscarriage and birth defects are very high and routine complications often become life-threatening emergencies when a woman goes into labor on the dirt floor of her hut, miles from the nearest medical center.

The Solution:
This year, Children of the Border plans to establish a “Casa de Salud,” a community health center, in the town of Pedernales, Dominican Republic.  The house will serve as a base of operations for our community monitors, and will allow us to provide multiple services aimed at preventing much of the unnecessary suffering endured by many mothers and children in the border region.

Steps to Achieving the Solution:
1.    Finish our census of the community. In order to measure the change that the Casa de Salud aims to bring about in the coming year, we must complete our comprehensive census of the community.  In the coming two months, our Community Monitors will be working hard to visit each and every family in CotB’s catchment area to determine the exact size of the population we serve, the breakdown by gender and age, the number of pregnant women, the potential demand for provision of family planning services, and the prevalence of certain health and welfare problems in the community.
2.    Provide family planning options to every woman that requests them. The benefits of birth control in this setting cannot be overestimated.  Most families already support between six and ten children, and most women say that if they could choose to stop having children, they would.  Allowing women freedom from the repetitive cycle of pregnancy and labor gives them time and energy to work and to focus on caring for the children that they already have.  The bottom line is that the cost of providing oral contraceptive medication, condoms, and even more complicated solutions like fallopian tube ligation surgery is negligible compared to the potential health and economic benefits to the families we serve.
3.    Provide prenatal care services to every expecting mother. Once our census is complete, and we have made all families aware of the Casa de Salud’s services, our next job will be to start every pregnant woman on a program of prenatal care.  This will involve taking each woman in for an ultrasound examination, establishing the expected due date of the baby, and setting a schedule for regular check-ups. We will also provide folic acid and other nutritional supplements for the purpose of preventing vitamin deficiencies and other effects of malnutrition that can lead to birth defects and low birth weight babies.
4.    Provide a clean, safe, and comfortable home for women on the days approaching and immediately following their due dates. Three days before a pregnant mother’s expected date of delivery, she will come to stay at the Casa de Salud, where she will be fed three nutritious meals per day, receive a final ultrasound examination, and sleep every night in one of the Casa’s beds.  When she goes into labor, she will be taken promptly to the Pedernales hospital, where she can give birth, and any complications can be dealt with quickly and effectively.  After her delivery, she can expect to spend another three nights in the Casa de Salud, resting with her baby, eating nutritious food, and getting ready to return home with her new, healthy child.
5.    Provide neonatal care and childhood immunizations to all babies born in our catchment area. All children born within CotB’s catchment area will receive the necessary prenatal care, including care for low birth weight babies, to ensure that they can return home healthy.  Additionally, all children should receive the routine course of vaccinations provided free by a government program.

Thanks to everyone for your interest in, and support of the Casa de Salud project.