Things change!! That was the theme of one of the church sermons we heard a year ago and that’s certainly proved true for us. Up until two weeks ago I hadn’t had enough hours in the day to get everything done for two months and now I’m sitting and waiting ……….for many things.
First, Gary has been medically evacuated to the US. He’s been diagnosed with moderate stage prostate cancer. It appears he may not be allowed to return. The PC policy for medical care is that when it takes more than 45 days to resolve they separate you from the PC. They will take care of him but he will no longer be able to serve. As one of the medical officers said to me last night, “you never know; miracles do happen”, but the expectation is that he’s finished. Our first clue was in preparation for departure the PC completed all closure paper work in the event he didn’t return.
After many tests in Kingston over six weeks, he left two days ago for Boston armed with all his results from PSA scores, digital exams, and a sixteen site biopsy report with accompanying tissue slides [Considering that a prostate is about the size of a walnut I can’t imagine much is left of his now]. He will need a few more tests in the US to see if it’s spread. Then he’ll consult with doctors before deciding which procedure and by whom the procedure will be done. The Jamaican urologist recommended he get this taken care of within the month, so that’s the target.
He sees his first doc Monday morning and after that we ought to have a pretty good idea as to which procedure and when it can be done. He’s scheduled to see another doc Friday morning and then will decide from there if more need to be consulted. With that information I’ll have an idea of when to schedule my emergency leave to be with him.
What comes next is up in the air. As we understand it oncology test results are simply estimates of a patient’s status and not until the doctor is able to see and test surrounding tissues do you have a reasonable idea of what is next. If it turns out to be a routine prostatectomy and he has laparoscopic and/or robotic surgery he’ll be up and at ‘em in about 3 weeks. If he needs standard surgery it could take six to eight weeks. If they find it’s spread beyond the prostate other interventions will be required.
So, here I am waiting and hoping all will be well for him. It’s tough and lonely without him. At this point [I may change my mind] the plan is for me to stay on here in Jamaica and just take the brief leave [I’ll get to the rationale for that shortly] if the first or second situations occur. If the latter occurs I will separate and stay home to be with him.
Another thing I’m waiting on are the results of a mega-grant proposal I submitted in January. [It’s unbelievable how things unfold and then appear to collapse before your very eyes]. In late October I was asked by a Jamaican leader to submit a proposal to the National Health Fund [a Jamaican Foundation] to take the concept of the Healthy Lifestyles Seminars I mentioned in the July 30 blog to a national level. That’s why I’ve been so busy. There have been meetings and consultations with Ministries of Health and Education officials, parish leaders and educators, and local people I have already worked with on this project. That plus the research and writing process took up 90% of my time and focus for the last two months. The grant was submitted January 26 with the understanding that it must be funded no later than March 15 [all along NHF officials have said “no problem mon”….we’ll see about that]. If it goes through it might become a major contributor in the island’s fight against the chronic disease epidemic. Over three years it will cost more than JM$300,000,000 [US$264,000] to fund the project and if it goes to the six years I recommend it will be in the JM billions. Below is the proposal’s executive summary so you get an idea of what is proposed.
If healthy lifestyles are the bedrock of wellness the Jamaican health care system has been ‘rocked’ in the last ten years with a precipitous 10% increase in chronic diseases associated with unhealthy lifestyles. The financial and human costs are rising annually. Jamaican research suggests inactivity is the leading cause for obesity and overweight in 90% of women; 28% of males smoke; 98.5% of all Jamaicans eat less than one fruit and/or vegetable per day; and 30% fry all protein foods [Wilks, 2008; Ferguson, et al 2008]. Further, up to 38% may suffer from depressive disorder (Brown, 2005). Diet, activity levels, overweight/obesity, stress, and smoking, each modifiable lifestyle behaviors, positively correlate with the incidence of chronic diseases that Jamaicans now face at an ever increasing rate: Type 2 diabetes, heart disease, hypertension, stroke, breast and prostate cancers, dyslipidemia, and osteoporosis.
Chapelton Hospital and the US Peace Corps are partnering to address this issue in Upper Clarendon. Presently three all age schools, St. Augustine Boys Home, and the Seventh Day Adventist Church of Chapelton, all in the Chapelton Health District, have had teachers, parents, youth and/or church members trained in healthy lifestyle practices (hygiene, exercise, nutrition, and stress management) during six-day (nine hours total) seminars at their respective sites. The aim of this model was for each participant who qualified for certification (according to written and practical examinations) to teach others: adults and children. Three all age schools, Chapelton, Rock River, and Wood Hall used HLS:TT certified teachers to instruct parents at PTA meetings and professional colleagues at staff meetings. As well, parents reached out to church members during services. The intent was to provide training for their colleagues to teach students and for parents to sustain the instruction at home. The objective was to provide a consistent message and skills that support the goal of reducing rates of chronic disease.
Acting within the structure of the Ministry of Education’s Health and Family Life Education Project (HFLE), the current proposal intends to test the Chapelton model, expand the concept of the HFLE project, and broaden the outreach of the Healthy Lifestyle Seminar to two parishes with distinctly different demographics, rural Clarendon and urban Kingston. In year one a random selection of 20% of public all-age and primary schools in both areas will test the template (with smoking cessation added) used in the Chapelton Health District. Certified Healthy Lifestyle teachers will conduct these seminars in their respective schools. Pre- and post-testing will identify knowledge gained as well as assess participants’ likelihood of changing their lifestyle behaviors in any or all of the five topic areas. On a monthly basis, certified teacher trainers will provide support, follow-up and further evaluation of progress at each participating school. During site visits trainers will also work with parent leaders regarding their skills development and participation in the effort.
The HLS:TT two-stage pilot and all-island project will: 1) be a partnership between MOE, Clarendon Health Department of the Southern Regional Health Authority, and the US Peace Corps; 2) run 39 months from March 2010 to June 2013; 3) reach 25 pubic schools in stage 1, 122 in stage 2 and 605 in the all-island effort ; and 4) cost $15, 194,761 in stage 1, with $ 13,106,761 requested from NHF, and an estimated $72,000,000 in stage 2. Yet to be set, costs for the all-island stage are estimated to be 3 ½ times those for stage 2. Pilot stages will identify successful strategies that best apply in rural and/or urban settings, allow for refinement of procedures, and ascertain more precisely the required materials/equipment. Using information and procedures developed in the two stage pilot, a revised effort will be developed for an Island-wide program designed to reach each parish with a similar concept. As we attempt to dramatically reduce the incidences and rates of chronic disease in Jamaica, this project will be a two-front attack from home and school on the current lifestyle practices known to be the sources of the current chronic disease epidemic.
So, I wait…..to see what happens with Gary…… and the proposal. Regardless of the outcome of the grant I won’t stay to implement it if Gary needs me, but it would be fulfilling to be able to see it through.
On the upside we’re still waiting on the Computer Center opening but it is eminent. There is a management committee in place, a J$983,777 grant was awarded to the Citizens’ Association for this, equipment is ordered and expected to be delivered next week, the room is secured, all tables and chairs are set up and waiting, phone and internet lines are in the cue for installation and the same is true for the burglar alarm. We’re planning a Grand Opening for the end of February [I’ll be away in the US but am sure they’ll carry it off in fine Jamaican style].
Another positive is that Gary’s situation may have accelerated the rate of project ownership by many of those in the community. Several of those we’ve worked along side appear to have realized they have to take over from us or all their efforts and money will have been wasted. With our scheduled departure only seven months away many have recognized the need.
What has been interesting to watch is how over time the belief and trust in what we’ve facilitated has been accepted and owned by the residents. It’s a demonstration of why two years is necessary. Initially, Gary and I had to do most of the work and we rarely had any leads on who to go to. Just last month someone stepped up and offered to find a truck to pick up five metal drums from a Kingston distillery who was donating them to the Citizens’ Association for water storage and garbage collection. When it was time to clean and set-up the Computer Center room people I’d never seen before showed up. A carpenter offered to donate his time to install a secure door for the Computer Center and a furniture maker is building a storage cabinet for the computer room tomorrow morning. Now that we’re about to leave we’re seeing residents appear from seemingly nowhere to contribute. All of this is reassuring that there may be a measurable residual once we leave.
I’ll keep you posted on Gary’s status; in the meantime keep everything you have connected to your body crossed for him. More lata, Margaret
Monday, February 8, 2010
Wednesday, January 6, 2010
FRIENDS - HAPPY NEW YEAR FROM JAMAICA
It’s been a while since our last blog sometime in October. We got sidetracked with activities here in Jamaica and with the expectation of heading back to the U.S. Our family got together in the US for Thanksgiving and a good time was had by all. While it wasn’t particularly cold it was a relief to get away from the heat and the first time we were back in the states for any length of time since last Christmas. We arrived in Hartford on November 24 in order to beat the Thanksgiving traffic. Our destination was Hardwick, MA with our good friend Art Dell Orto. Our two boys arrived on the evening of the 25th when the celebration began in earnest (See Pics). In addition to good food, family, friends, and good ole’ R & R our time home was great. This is our last trip home until we depart in late July or early August. In addition to the R&R I ended the trip in Boston and specifically at Boston University, where I attended the dissertation defense of my last doctoral graduate student (we’ve been communicating via email and phone for the past year). She did a great job and will finalize her writing prior to the birth of her second child in April.
On the Jamaican front it was pretty quiet during the month of December---the English influence brings things to a slow (slower than normal) pace during the Christmas holidays. As soon as we returned from the US Margaret found out that we (the community) were awarded a $983K grant for a computer center at our local Community Center. This application began over 6 months ago. The next goal is to get the Center secure so that we can house the 10 computers and peripherals. Exciting times for the community!
Stephen came to visit for Christmas. It was great fun to have him here. He spent 2 ½ days in Chapelton and saw us at work. He even helped the Senior Citizens’ group deliver food packages to elderly shut-ins. Then we took him to the north coast and Ocho Rios where we spent the day at Dunn’s River Falls. The Falls are about ¼ mile long and we climbed them together with him then he did a timed climb of 8 min. 50 seconds. It was fun and exciting. We stayed in a villa of a couple US missionaries we’ve met. We had a beautiful view of the Caribbean .
Leaving Ochi our destination was to get indirectly to Kingston. So, we headed east along the coastal highway to Port Maria. It seems that the southwest [recall Treasure Beach] and the northeast coasts are the nicest places on the island, relatively untouched by tourism. Yet both areas are distinct in vegetation, dry and arid in the south and wet and tropical in the north.
Stephen’s last 24 hours were in Kingston. We stayed at our favorite hotel where it was very plush: a pool, gym, internet service, cable tv, wonderful food, a tropical ambiance, and great service. Then we walked over to the Peace Corps office where he met several staff members. We ended his stay with a taxi trip to downtown through the grand market [blocks and blocks of higglers in stalls selling anything and everything] and over to the rural bus park where we got out to catch a bus home and he was taken to the airport. He headed back to Florida to start his new job as a scout for the Texas Rangers [team not police].
I (GS) have written two grant proposals for two different communities. The Canadian Fund for Local Initiatives funds projects all over Jamaica for democratic governance and human rights. I worked with the Social Development Commission in an attempt to provide funds to move a rural Basic School that currently is held in the last five rows (pews) of a local church to a one room Community Centre. The CC needs an addition so that there is a kitchen and toilet facilities for faculty and students. The problem with holding the school in the church is that when they have events during the week (conferences or revivals) the school takes a back seat and is closed during this time.
The second grant, also to the CFLI, is for sanitation facilities for seven residents here in Sangster Heights. When the Health Inspector did a survey last spring they discovered that almost 10% of those surveyed had no toilet facility in their dwelling. This proposal simply asks for money to provide pit latrines or toilets for seven of these residences. I submitted a similar grant last June to another agency that has yet to fund our request…though they haven’t rejected the proposal. The CFLI meets in May to decide whether to fund these projects.
Not to be outdone Margaret has been working on a LARGE grant from the National Health Fund to establish a healthy lifestyles program that basically will train teachers and parents on the essence of health lifestyles (exercise, nutrition, hygiene, and stress management). They will then train others…a pyramid type methodology. The chairman of the grants section of the NHF is a friend who we have played golf with on a number of occasions. Sometime during October Margaret had spoken to him about a series of lectures she was doing on lifestyle. He was impressed with the content and asked Margaret to submit a grant so that this program could be implemented Island wide. She is currently working on a submission deadline of January 15th. This grant has the potential of being in excess of $1 B Jamaican which is the equivalent of 11 million US. Margaret may stay in Jamaica for the next 10 years to run this grant! NOT!
NOT is right. The six year project is designed to be self sustaining by the end of the first year. I expect that after we leave in August that I’ll have to return on a consulting basis a few times over the next 18 months but after that they ought to be fully operational on their own. Twice I’ve told our friend that I’ll be leaving and will need to return on a consulting basis and he never blinked.
On the Jamaican front it was pretty quiet during the month of December---the English influence brings things to a slow (slower than normal) pace during the Christmas holidays. As soon as we returned from the US Margaret found out that we (the community) were awarded a $983K grant for a computer center at our local Community Center. This application began over 6 months ago. The next goal is to get the Center secure so that we can house the 10 computers and peripherals. Exciting times for the community!
Stephen came to visit for Christmas. It was great fun to have him here. He spent 2 ½ days in Chapelton and saw us at work. He even helped the Senior Citizens’ group deliver food packages to elderly shut-ins. Then we took him to the north coast and Ocho Rios where we spent the day at Dunn’s River Falls. The Falls are about ¼ mile long and we climbed them together with him then he did a timed climb of 8 min. 50 seconds. It was fun and exciting. We stayed in a villa of a couple US missionaries we’ve met. We had a beautiful view of the Caribbean .
Leaving Ochi our destination was to get indirectly to Kingston. So, we headed east along the coastal highway to Port Maria. It seems that the southwest [recall Treasure Beach] and the northeast coasts are the nicest places on the island, relatively untouched by tourism. Yet both areas are distinct in vegetation, dry and arid in the south and wet and tropical in the north.
Stephen’s last 24 hours were in Kingston. We stayed at our favorite hotel where it was very plush: a pool, gym, internet service, cable tv, wonderful food, a tropical ambiance, and great service. Then we walked over to the Peace Corps office where he met several staff members. We ended his stay with a taxi trip to downtown through the grand market [blocks and blocks of higglers in stalls selling anything and everything] and over to the rural bus park where we got out to catch a bus home and he was taken to the airport. He headed back to Florida to start his new job as a scout for the Texas Rangers [team not police].
I (GS) have written two grant proposals for two different communities. The Canadian Fund for Local Initiatives funds projects all over Jamaica for democratic governance and human rights. I worked with the Social Development Commission in an attempt to provide funds to move a rural Basic School that currently is held in the last five rows (pews) of a local church to a one room Community Centre. The CC needs an addition so that there is a kitchen and toilet facilities for faculty and students. The problem with holding the school in the church is that when they have events during the week (conferences or revivals) the school takes a back seat and is closed during this time.
The second grant, also to the CFLI, is for sanitation facilities for seven residents here in Sangster Heights. When the Health Inspector did a survey last spring they discovered that almost 10% of those surveyed had no toilet facility in their dwelling. This proposal simply asks for money to provide pit latrines or toilets for seven of these residences. I submitted a similar grant last June to another agency that has yet to fund our request…though they haven’t rejected the proposal. The CFLI meets in May to decide whether to fund these projects.
Not to be outdone Margaret has been working on a LARGE grant from the National Health Fund to establish a healthy lifestyles program that basically will train teachers and parents on the essence of health lifestyles (exercise, nutrition, hygiene, and stress management). They will then train others…a pyramid type methodology. The chairman of the grants section of the NHF is a friend who we have played golf with on a number of occasions. Sometime during October Margaret had spoken to him about a series of lectures she was doing on lifestyle. He was impressed with the content and asked Margaret to submit a grant so that this program could be implemented Island wide. She is currently working on a submission deadline of January 15th. This grant has the potential of being in excess of $1 B Jamaican which is the equivalent of 11 million US. Margaret may stay in Jamaica for the next 10 years to run this grant! NOT!
NOT is right. The six year project is designed to be self sustaining by the end of the first year. I expect that after we leave in August that I’ll have to return on a consulting basis a few times over the next 18 months but after that they ought to be fully operational on their own. Twice I’ve told our friend that I’ll be leaving and will need to return on a consulting basis and he never blinked.
Thursday, October 15, 2009
We;'ve been so busy
There's only 18 minutes left on our computer time for today and so much to tell. Some ups and downs to report. Our camera is broken so no more pics until we get one in Novemeber when we return for Thanksgiving. John and his girfriend, Ashley, visited for a long Columbus Day weekend. They had a whirlwind tour of western JM. They spent 2 days in Chapelton, two in Negril and 2 in Rose Hall at that Ritz. They saw the full range of Jamaican life. It was wonderful to have them with us, albeit too brief. We've struggled to help the hospital get a major fundraiser off the ground; the second effort was just canceled but we're ever optimistic that the next effort will be the right one. They desperately need things like reliable water, a washing machine to launder the linen, computers for the records room, garbage bags for the garbage. Items you and I take for granted in the most basic hospitals. Hopefully, we're on the right track this time. Gary's writing more grants to get toilet facilities for homes and schools. I'm preparing to teach certificate programs to teachers and parents in Healthy Lifestyle Living. A few friends have indicated they may or will visit us in the winter. We'll be glad to have more American's around. Many of the volunteers who started with us and who are still here are counting the days until they come home. Although we're still busy and doing meaningful work we too are anxious to come home next summer.
Keep everting crisp, Margaret
Keep everting crisp, Margaret
Friday, September 4, 2009
Wickets, Overs, Bowlers, and the White Witch
Two weekends ago (August 23) one of the coaches that Margaret is tutoring in exercise physiology decided that it was time to go on a day trip to a part of Jamaica we hadn’t visited. So on Sunday morning we took off at 8 am (scheduled for 7am) and headed to the south shore to a place named Alligator Pond…the beach was called Little Ochi (named after the north shore town of Ochi Rios). The beach was pleasant, not crowded and different in that the sand was black…the picture attached to this blog doesn’t really show the color very well but believe me it was black. After an hour or so beach walk, some lazy Sunday morning lounging and some wonderful shrimp and Red Stripe for lunch we ventured back on a little different course and stopped off in Mandeville (a town nestled up in the mountains and always cooler than wherever else we’ve been) to take in a cricket match.
I will not bore you with the details of the match except for a few common-like features that were similar to baseball. It really didn’t matter who the match was between…we were trying to decipher which were the offense and the defense because they all wore the same color, except for the umpires. The “pitch” (similar to a baseball field in that it had an outfield and an area that was representative of a diamond – although not a diamond but a rectangular shape) was the playing field. The “bowler” was the counterpart to the pitcher. The main difference with the offense was that there was no such thing as a foul ball…everything hit was in play….and that balls that were hit and rolled past the outfielders and past the limit of the outfield were scored as 4 runs and balls that were hit over the limits of the outfield (like a homerun in baseball) were counted as 6 runs. Anyway we finally got the knack of the game after a couple hours…the winning team won 102 – 101 in a game that had a limit of 15 overs for each team. Each “over” consisted of 6 deliveries by the bowlers of each team. GOT IT?!!!!
Last weekend (Fri) was my birthday. We celebrated by playing two rounds of golf in Kingston and staying in our favorite hotel which had the last of its “summer specials.” It sounds crazy but we were in heaven and enjoyed a king size bed, air conditioning, wonderful Jamaican breakfast buffet, pool, and gym…in a quiet area of Kingston called New Kingston (which BTW is where the Peace Corps office is located). My present from Margaret was six books…I’ve already read 17 books since we landed in Jamaica……that’s essentially a result of no night life after 6pm.
Summer is basically over, just as in the US but you’d never know it with regard to the temperatures….(not like the temps I noticed on the NY channel we get which showed 50s and 60s for nighttime lows near the end of August). Children go back to school after Labor Day, just as in the US, but it’s not called Labor Day here…that was back in May.
We are anxiously awaiting the arrival of our first guests (John and his new girlfriend, Ashley) scheduled for Columbus Day weekend (US). We plan to show them around Chapelton for a day or so and then venture to Negril (the capital of “chill”) in the far west of Jamaica. We’ve not been there yet so it will be an experience for all four of us. They will be treated to Jamaican taxi and minibus transportation on the way. After chilling for two days we will end the long weekend in Rose Hall (Montego Bay) with a round of golf at the White Witch Golf Club…which is named after the ‘White Witch’ of Rose Hall…an old sugar cane plantation back in the 1800’s…Rose Hall is the name of the main house located on the plantation, where the White Witch (Annie Palmer) lived and supposedly murdered three of her lovers (husbands and slave lover)…it was burned down by the slaves during a rebellion and then restored in the mid 1900’s by an Englishman. The course is now located on part of the old plantation grounds and is supposed to be very scenic overlooking the Caribbean on many holes. Johnny Cash’s Jamaican home is very close by on the grounds of Cinnamon Hill Golf Course [it does sound as if we only play golf in JA, trust us, that’s not the case, it’s an escape on the occasional weekends we have nothing to do].
Till next time…walk gud!!!
I will not bore you with the details of the match except for a few common-like features that were similar to baseball. It really didn’t matter who the match was between…we were trying to decipher which were the offense and the defense because they all wore the same color, except for the umpires. The “pitch” (similar to a baseball field in that it had an outfield and an area that was representative of a diamond – although not a diamond but a rectangular shape) was the playing field. The “bowler” was the counterpart to the pitcher. The main difference with the offense was that there was no such thing as a foul ball…everything hit was in play….and that balls that were hit and rolled past the outfielders and past the limit of the outfield were scored as 4 runs and balls that were hit over the limits of the outfield (like a homerun in baseball) were counted as 6 runs. Anyway we finally got the knack of the game after a couple hours…the winning team won 102 – 101 in a game that had a limit of 15 overs for each team. Each “over” consisted of 6 deliveries by the bowlers of each team. GOT IT?!!!!
Last weekend (Fri) was my birthday. We celebrated by playing two rounds of golf in Kingston and staying in our favorite hotel which had the last of its “summer specials.” It sounds crazy but we were in heaven and enjoyed a king size bed, air conditioning, wonderful Jamaican breakfast buffet, pool, and gym…in a quiet area of Kingston called New Kingston (which BTW is where the Peace Corps office is located). My present from Margaret was six books…I’ve already read 17 books since we landed in Jamaica……that’s essentially a result of no night life after 6pm.
Summer is basically over, just as in the US but you’d never know it with regard to the temperatures….(not like the temps I noticed on the NY channel we get which showed 50s and 60s for nighttime lows near the end of August). Children go back to school after Labor Day, just as in the US, but it’s not called Labor Day here…that was back in May.
We are anxiously awaiting the arrival of our first guests (John and his new girlfriend, Ashley) scheduled for Columbus Day weekend (US). We plan to show them around Chapelton for a day or so and then venture to Negril (the capital of “chill”) in the far west of Jamaica. We’ve not been there yet so it will be an experience for all four of us. They will be treated to Jamaican taxi and minibus transportation on the way. After chilling for two days we will end the long weekend in Rose Hall (Montego Bay) with a round of golf at the White Witch Golf Club…which is named after the ‘White Witch’ of Rose Hall…an old sugar cane plantation back in the 1800’s…Rose Hall is the name of the main house located on the plantation, where the White Witch (Annie Palmer) lived and supposedly murdered three of her lovers (husbands and slave lover)…it was burned down by the slaves during a rebellion and then restored in the mid 1900’s by an Englishman. The course is now located on part of the old plantation grounds and is supposed to be very scenic overlooking the Caribbean on many holes. Johnny Cash’s Jamaican home is very close by on the grounds of Cinnamon Hill Golf Course [it does sound as if we only play golf in JA, trust us, that’s not the case, it’s an escape on the occasional weekends we have nothing to do].
Till next time…walk gud!!!
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