Response: February 2017 Issue

Inclusion in the Dominican Republic

International Child Care works for the well-being of children and adolescents with disabilities in the Dominican Republic.

Inclusion in the Dominican Republic
Yariel Acosta, with his grandmother Juanita Gonzales, is being taught using games.

On the same trip during which I visited International Child Care programs in Haiti, I also visited the Dominican Republic, where International Child Care works in the city and neighborhoods of Santiago. There they focus on inclusion of peoples with disabilities and work directly with children and adolescents and their families as well as with the schools and communities.

Upon arriving in Santiago the economic differences between the two countries were immediately apparent, just by noticing the better condition of the buildings and vehicles and the products available for sale in the Dominican Republic versus Haiti.

I again traveled with Internationational Child Care’s Keith Mumma, U.S. national director, and Kirsten McIlvenna, communications director, and in Santiago met up with Trudy Bekker, national director of International Child Care in the Dominican Republic, or Fundación Cuidado Infantil Dominicano. Bekker also served as translator.

Our first visit was to an adolescents with disabilities program, where a group of young men and some young women sat at a table writing numbers, coached by two women health workers.

Estarlin Ortiz, 23, was eager to share what he was learning through the United Methodist Women-supported programs.

“I enrolled in the program to do more for myself,” Ortiz said. “I’ve learned to appreciate my family more. I’m learning to read and write.” His yellow shirt matched his bright smile.

“I’ve learned many words—even some English words, and I’ve learned math as well,” he said. “I would like to help the community and help people who don’t have work. I am interested in music also.” He hummed Michael Jackson’s “Billie Jean” and danced, and when another boy whose disabilities were more severe wanted to dance as well, Ortiz helped lead him in some dance moves.

Outreach at home

Through its community based rehabilitation, part of its Community Inclusion Program, International Child Care sends promotoras, or rehabilitation workers, out into Santiago and into the homes of children and young people with disabilities.

“We offer services to families with children born with a disability or developmental delays or who in the first five years of their lives are developing a disability because of trauma or illness,” Bekker said. “The program consists of home visits, training and orienting parents and caregivers. Many are not aware of the needs of the children. It’s a partnership.”

The promotoras work with the children and also parents and caretakers, teaching them exercises that can help with the child’s development. This community-based approach helps families give their children the chance to be fully part of their communities. International Child Care also works with other organizations to provide services for accessible medical care and school inclusion.

Home visits are key to the program’s success.

We give information to the parents about what the child is ready to learn. It helps the parents know how to deal with the child with a disability or developmental delay. It is a partnership,” said Bekker. “Because parents don’t know how to stimulate their children or haven’t come into the program at a young age, they’ve sort of lost hope. They sometimes become exasperated with the child and push him or her away. When we come in we teach parents to have special time with their children every day, and that changes the relationship immediately.

“It should be the right of the family to have services available at home,” she said. Economic and geographic barriers make access to rehabilitation services difficult for many families in the Dominican Republic, as such services are often institution-based and expensive.

Ramona Rosario is aunt to Angel Reyes, 7. They live in the Santiago neighborhood La Yaguita de Pastor. To visit Rosario and Reyes we traveled down narrow, steep roads that, thankfully, had recently been paved. Before they were dirt and likely much more difficult to navigate in the rain. Rain pounded the tin roof as we spoke with Rosario while Reyes played. He had just finished some activities with promotora Adalgisa Batista.

“He doesn’t really do things other children do who are the same age,” said Rosario, who is Reyes’ caretaker. “He’s been in the program for two months. Before the program he didn’t want to share anything with anyone, not even with other children. But now he is able to be social more and is able to go to school.”

Reyes has a general developmental delay, Bekker explained. He is 7 years old and functions as a 4-year-old.

“He’s been involved in the program for two months,” Bekker said. “He receives a home visitor once a week who will work with him and his aunt, teaching his aunt specific activities he is ready to learn.”

Rosario hopes the Community Inclusion Program will help Reyes feel more like a part of his community.

“I believe the program is very good, and Angel learns a lot of things. I have my expectation for him to develop more skills and be more like other children,” she said.

Teaching autonomy

The houses we visited were simple cement structures—most with the aforementioned tin roofs. The buildings were divided inside with walls that reached about 10 feet, but not all the way to the ceiling, offering visual privacy but no sound block. Our conversations were punctuated with roosters crowing, neighbors’ music playing and cars and motorcycles passing by. The tropical climate encourages lively activity in Santiago.

Another home visit was to Miguel Rodriguez, 12, who has cerebral palsy. He had been in and out of the International Child Care program over the years. His time away left his body stiff.

“Miguel has been in the program since he was 3 years old. He’s been out of the program for four years,” said Bekker, “and we find him in this stiff position because his mother hasn’t been able to do exercises with him. And we’re hoping to loosen him up.” Promotora Batista worked with Rodriguez and his mother, Fatima Jimenez, on some rehabilitation movements.

We also visited the home of Yadiel de Jesus Collado, 7, and his grandmother Juanita Gonzalez. Collado is another one of the 85 children in the Community Inclusion Program in more than 20 marginalized communities. The program provides developmental stimulation using a basic checklist that follows child development from 0-6 years old.

“We make a profile for each child, and, depending on where the child is falling behind, we work on those specific objectives,” Bekker said. “Today the promotora was teaching Yadiel to make sure every time he wants to go somewhere or wants to play with something he asks permission first.”

Angie Gratereaux is a new community health worker in Community Inclusion Program. She’s worked as a promotora for about a year and works with Collado.

“When I started working with Yadiel in this program he wasn’t doing anything for himself. He’d lie down in bed, or a chair, or on the floor—he wasn’t using his hands for anything. His mother did everything for him,” she said. “And now he has learned to walk, feed himself, and is becoming interested in the things around him.”

Collado’s mother is young and had little experience as a mother, let alone with a child with challenges like Collado’s, said Gratereaux.

“She didn’t know what to do, and she was lost. Now with the program we are showing her that Yadiel can do a lot for himself. She is seeing that now, and that’s why they are making so much progress,” she said.

Gratereaux herself has cerebral palsy.

“I chose this program because I identify with the children in the program, as I was born with cerebral palsy myself, and when I found out about the program I thought this is nice and a way I can give support to some children who deal with the same situation.”

Building community

International Child Care helps United Methodist Women put faith, hope and love into action by working to ensure the health and well-being of women and children. They also employ women—in fact, the entire staff is women.

“We hire local women in the community in which they live,” Bekker said. The health workers also use local materials for their work whenever possible. “We focus on the empowerment of women—mothers of the children with developmental delays as well as the community workers. We believe that if we empower women they will be able to lift up the whole family.” A little more than half of the community health workers are mothers of children with developmental delays themselves.

With help from United Methodist Women members’ Mission Giving, the program has been able to grow by 20 percent, said Bekker.

“We’ve used the grant from United Methodist Women to help grow the program,” Bekker said. “It’s helped us support the community workers and provide materials. We’ve also received a technology grant, and it’s really wonderful because we’ve started other groups with other lessons. We had only one group last year, and now we have four.”

Bryan Inoa, 12, participates in one of these programs.

“I would like to do a computer course,” he said. “I know how to play games. I know some games by heart.” Inoa uses a wheelchair and has been coming to the group for about three weeks.

“I like to write my name and to paint,” he said.

Meeting with other young people in the Community Inclusion Program allows the participants to gain social skills with peers while they continue to work on development skills. For many, this time together is the closest thing to schooling they’ll be able to receive. International Child Care helps program participants become more active in their communities and develop skills for the workplace.

Jennifer Peralta, 28, has been attending the program for many years.

“When I came to the program I was about 3 years old,” she said. “I remember I learned how to tie my shoes, to take the laces and tie them up. I learned to do more for myself and to have better self-esteem and to help around the household.”

Longtime United Methodist Women member and registered nurse Ellen Palmer remembers Peralta from when she was a little girl. As a child, Peralta stopped Palmer and said, “All I want to do is go to school!”

“Jennifer has been a part of International Child Care here in the Domin-ican Republic since 1993 thanks to United Methodist Women. She is a true success,” Palmer said. “What the program here does is help children like Jennifer go to school. We are working to be community inclusive and get our children into the school system. Right now, for many of them, International Child Care is the only place they have to come and learn at their ability level.”

Support and partnership

International Child Care collaborates with the National Council of the Disabled (CONADIS) in the Dominican Republic to develop legislation that supports people with disabilities in the country and their better integration into society. They have also begun working with Centro de Atención Integral para la Discapacidad (CAID), or the Center of Integral Attention for the Disabled, a government program through the Office of the First Lady Candida Montilla de Medina.

“We are working together,” said Bekker. “They call us for conferences, for references. Some of our former workers are working with their service now.” CAID will also refer people to International Child Care for treatment.

“We’re always looking for ways we can cooperate,” Bekker said.

Bekker believes the future of the organization lies in becoming part of the country’s public health program.

“If we’re recognized as a service provider by a health administrator of the government in the Dominican Republic, some of the services we deliver would become part of the basic health package of everyone living in the Dominican Republic, whether they can pay into the health system or not,” she said. “If we became part of the public health service, we wouldn’t need to be dependent on international funding.”

For now, Bekker said, they’ve been able to operate thanks to international grants.

“United Methodist Women can continue to support our efforts by helping us sustain the programs,” said Bekker, “and even help us expand them, as we are just now starting the adolescent program. It is a new component.”

Palmer, who lives in McKinney, Texas, serves on the board of International Child Care and has seen how health care has improved in Haiti and the Dominican Republic thanks to International Child Care programs.

“I’ve seen as the years go on that we’re able to provide services for the children and their families and especially for women. It’s very exciting to see where the United Methodist Women dollar goes,” she said.

A United Methodist pastor’s wife, Palmer has been a part of United Methodist Women at every church her husband served. She’s been a member for 60 years and has been serving International Child Care since the 1970s. She’s a registered nurse and also has a doctorate degree.

“I went after the degrees behind my name in order to serve on a board where I felt I’d have input in order to raise funds and awareness,” Palmer said. She has helped secure funding for International Child Care in addition to contributing her health care and international development knowledge. Her delight in seeing Peralta again and spending time with Inoa was obvious.

“What I’ve observed is that we’re involved the community, involved with the families,” she said. “The families are taught how to take care of the child. So it’s exciting for me to see the children grow up.”

What begins in childhood with home visits can grow into so much more for the children of Fundación Cuidado Infantil Dominicano. Like in Haiti, International Child Care in the Dominican Republic is a part of the community, valuing individuals and families as whole people and working toward their full well-being, with the help of United Methodist Women.

“I would like to have my own business selling clothes,” said Peralta, “with someone with me to help me. I’d like to help many, many children to learn things the way I’ve learned them, to be able to do more for themselves.”

Nile Sprague is a photojournalist based in Mendocino, California. Tara Barnes is editor of response.

Posted or updated: 2/8/2017 12:00:00 AM