Source: ¡A su salud! textbook: http://yalepress.yale.edu/

When we talk about Spanish for healthcare professionals courses, what comes to mind? Lists of medical terminology and phrases translated from English to Spanish? Unfortunately, this is true for many professionals and some course instructors. However, when we only teach grammar and vocabulary, even adding in medical terminology, we omit key elements for good communication, thus failing to help the doctor adequately connect with patients during medical interviews. According to Sabater:

el objetivo [del español con fines específicos] no consiste en potenciar la adquisición de listas de vocabulario, sino hacer que el alumno sea capaz de llevar a cabo tareas de su vida profesional en español […] no es solamente el estudio del léxico sino la capacitación lingüística del alumno… (185-186)

A medical professional needs to be prepared to communicate with patients to the extent that he or she can gain an understanding of their symptoms and medical history in order to provide the most appropriate treatment options. The ability to comprehend and engage in this communication does not just depend on the words used but also on the cultural context of each individual. Aguirre Beltrán (1998) explains:

Tenemos que considerar el hecho de que la comunicación no se puede entender separada de la cultura, puesto que forman parte de un mismo fenómeno. El proceso comunicativo se produce dentro de una cultura, por lo cual se convierte en un proceso cultural [...]  (39)

It has been well-documented that our culture, socioeconomic status, and life situation impact our health. These are factors that the doctor looks for and takes into consideration during a medical interview. When we work with Latino patients, these factors do not disappear but instead become more complicated to understand. In this case, the patient´s immigration status and their beliefs about illness, treatments, family and societal roles, life expectations and religion also play an important part in their health outcomes. Therefore, in addition to medical terminology and grammar, it is essential to include these concepts in Spanish for healthcare professionals courses.

I believe the graphic for this week demonstrates this philosophy well. It is from the Yale University Press website promoting the textbook ¡A su salud! (Cotton et al, 2009). Though I have not analyzed the book in-depth as of yet, its philosophy is right on with its promotion of teaching elements of culture, language and health, as well as the interaction between them, in Spanish for medical professionals courses. In the coming weeks, we will look more closely at these aspects and how to integrate them into course material.

RESOURCES:

AGUIRRE BELTRÁN, Blanca. (1998): Enfoque, metodología y orientaciones didácticas de la enseñanza del español con fines específicos, Carabela, 44, págs. 5-118.

COTTON, Christine E.; ELY TOLMAN, Elizabeth; CARDONA MACK, Julia; BRUNO, Elizabeth (2009): ¡A Su Salud! New Haven: Yale University press.

FELICES LAGO, A. (2005): El español para fines específicos y su desarrollo en España durante la última década, en IDEAS (FH-Heilbronn), número 1, Recovered from the Ministerio de Cultura on 6 December 2012 from http://www.ideas-heilbronn.org/elements/artic/FelicesLago-El-desarollo.pdf

SABATER, M. L. (2000): Aspectos de la formación del profesorado de español para fines específicos.  Actas del I Congreso Internacional del Español para Fines Específicos. Recovered 6 December 2012  from http://cvc.cervantes.es/ensenanza/biblioteca_ele/ciefe/pdf/01/cvc_ciefe_01_0024.pdf

Source: http://www.jostrans.org/issue14/art_ertl.php

In my previous post, I wrote about various complaints and arguments that some medical professionals give regarding Spanish for healthcare courses. I explained the importance of language in healthcare and the consequences a language barrier can have on a person´s health. This week, I am addressing two more arguments: “usually Latino patients have a family member who can interpret so I do not need to learn Spanish” and “my clinic is equipped with an interpreter phone line so I can easily call and have a telephonic interpreter available.” In particular, I will discuss and compare the use of ad hoc interpreters, interpreter phone lines,  professional in-clinic interpreters, and bilingual medical professionals.

An ad hoc interpreter is an individual, typically a family member or member of the clinic staff, who is not trained in medical interpreting and who is often times self-declared bilingual or pulled away from other duties in order to interpret. Research has shown that ad hoc interpreting is currently the most widely used form of medical interpreting.  Yet research has also made it evident that ad hoc interpreting can lead to poorer health outcomes. For example, Flores (2006) explains several dangers of ad hoc interpreting and gives an example of a 12 year old boy interpreting “estaba mareado, como pálido” as “Like I was like paralyzed, like something like that.” While this particular example suggests lack of knowledge or negligence, sometimes ad hoc interpreters hold a personal bias.  For another anecdotal example, a social worker / interpreter in North Carolina spoke with me about a case where the doctor was explaining to a pregnant Latina about postpartum care.  The pregnant woman’s husband was acting as the interpreter. When the doctor mentioned that the woman should not have sexual relations for at least six weeks after giving birth, her husband interpreted the statement as “six days.” Other studies have shown that ad hoc interpreting can decrease patient satisfaction, increase interpreting time and increase the chance that misunderstandings occur.

Another widely used form of interpreting is the use of telephonic interpreters. These interpreters typically work for a company that medical professionals can call on an as-needed basis. They tend to be well-trained and highly knowledgeable and for that reason the use of phone interpreters has provided more positive health and satisfaction results than a lower-level Spanish speaking medical professional or an ad hoc interpreter. However, the use of telphonic interpreters also has its disadvantages.  For example, some studies, such as Locatis (2010), cite that the use of phone interpreters often results in shorter consults, even more so than same language visits, which raises the question of possible misunderstandings. Additionally, using an interpreter phone line implies the risk of technical problems. From a phone line going out to the physical landline needing repair, they are not 100% reliable. Another disadvantage often cited for using telephonic interpreters is the time constraint. There are times when medical professionals are in a hurry and are unable or unwilling to take the time to call. At times this is due to a medical emergency and others it is due to being behind schedule. In any case, the extra time required to call and possibly wait on hold can sometimes seem to be too much of a burden on the already tight clinic timetable. Finally, the use of a phone interpreter can limit the personal aspect of the doctor-patient encounter, which has an impact on trust and communication. Similarly, the telephonic interpreter cannot pick up on any nonverbal cues given by the patient or doctor that may clarify the speaker’s meaning. On an emotional level, the perceived “coldness” and “distance” of a remote interpreter can make receiving serious diagnosis and results more difficult. On the other hand, this last point is disputable as some research has shown the opposite: that with remote interpreters, there are fewer inaccuracies and sessions “feel more private” (Yeo, 2004). Other positive aspects of telephonic interpreters is that they are, at times, faster than using an in-clinic interpreter. Additionally, their cost and availability make the utilization of phone interpreter more accessible for smaller clinics who cannot afford to hire a staff interpreters in order to care for a small number of patients.

Lastly we have professional, in-clinic interpreters. Whether these interpreters are in-clinic staff or travel to various sites on an as-needed basis, research has shown that they are the most effective form of language mediator. Use of a well-trained, in-person interpreter significantly improves health results and patient satisfaction. Their knowledge of both the language and the culture is key to providing personal, patient-centered care. Both telephonic interpreters and in-clinic interpreters are professionals who are wonderful resources, and medical staff should be trained to work with them in order to best serve the patient. Unfortunately, many clinics clinics are unable to afford them.

However, this does not and should not diminish the need for Spanish speaking medical professionals. According to Partida (2007):

Clear communication between caregivers and patients is essential to safe, high quality health care services. Developing rapport and gaining patient trust relies on understanding. When patient and doctor do not speak the same language, there is less opportunity to develop rapport or use “small talk” to obtain a comprehensive patient history, learn relevant clinical information, or increase emotional engagement in treatment. Rather than solving these problems the introduction of an interpreter may raise another set of questions.

As stated in my previous post, language is the means by which the doctor creates rapport with the patient and learns, either directly or through small chat, about their medical history and needs. Though interpreter training programs have become quite adept at educating their interpreters in those aspects, it does not replace the benefit of direct doctor-patient communication. That is to say, as long as the doctor´s Spanish level is at the level where an adequate, meaningful conversation can take place. Another added benefit is that direct conversation saves the precious commodity of time by removing the doubled conversation that takes place as an interpreter repeats what is said. Finally, knowledge of the Spanish language promotes preventative, proactive stances to healthcare in that it prepares staff for the case where an interpreter or interpreting service is not immediately available.

Though I do not negate the benefits of professional interpreting and fully support and encourage its use and promotion, I do not believe it is a logical reason to forgo Spanish language training for healthcare professionals. As educators, we need to promote the medical staff-patient dialog while at the same time being honest with them about their language limits and encouraging the use of interpreters when needed. I hope the information I provide in this blog regarding teaching Spanish for medical professionals is helpful in meeting this goal.

RESOURCES:

BOÉRI, Julie (2012) Ad hoc interpreting at the crossways between natural, professional, novice and expert interpreting. In Amparo Jiménez Ivars and María Jesus Blasco Mayor (eds) Interpreting Brian Harris. Recent developments in natural translation and in interpreting studies. Vienne: Peter Lang. Recovered from: http://www.upf.edu/pdi/julie-boeri/_pdf/PeterLangResum.pdf

DAVID, Rand A y RHEE, Michelle (1998): The impact of language as a barrier to effective health care in an underserved urban Hispanic community. Mount Sinai School of Medicine 65 (6) 393-397.

FLORES, Glenn (2006): Language barriers to health care in the United States. The New England Journal of Medicine 355: 229-23. Recovered the 29 of November 2012, from http://www.nejm.org/doi/full/10.1056/NEJMp058316

KARLINER, Leah 2; JACOBS, Elizabeth A; CHEN, Alicia Hm and MUTHA, Sunita (2007): Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systemic Review of Literature. Health Services Research Journal. 4(2): 727-754. Recovered from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955368/

LOCATIS, Craig et all (2010): Comparing In-Person, Video, and Telephonic Medical Interpreting.  Journal of General Internal Medicine 24(4): 345-350. Recovered from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842540/

PARTIDA, Yolanda (2007): Language barriers and the patient encounter. American Medical Association journal of ethics. (9)8:566-571. Recuperado del Virtual Mentor del American Medical Society de http://virtualmentor.ama-assn.org/2007/08/msoc1-0708.html

YEO, SeonAe (2004): Barriers and access to care. Annual Review of Nursing Research (22) 59-73. Recovered from http://www.ncbi.nlm.nih.gov/pubmed/15368768

Start speakinbg English to Spanish

We’re going to learn Spanish? Vamos a aprender Español?

from  spanish in valencia

Good day!  ¡Bueños días!

! What a great idea!  ¡Que buena idea

Good afternoon! ¡Bueñas tardes!

Good night! ¡Bueñas noches!

How are you? Cómo estas?

Very well! ¡Muy bien!

¡No muy bien! Not very well!

¡Que lástima! What a pity!

¡Gracias! Thank you!

You’re welcome.De nada.

See you tomorrow         s¡Hasta mañana!
¡Hasta luego! See you later!

Los Días de la Semana The Days of the Week

lunes Monday

martes Tuesday

miércoles Wednesday

jueves Thursday

viernes Friday

sábado Saturday

domingo Sunday

Me gusta…I like…

el pan bread

los tacos tacos

escuela school

matemáticas math

¡Que divertido! What fun!

A friend of mine from the States was trying to find an apartment in Madrid. When she was visiting one place, she asked her to-be-roommate about his schedule. He said that he went to work in the morning, came home to eat lunch and touch his balls, and then go back to work. She was in shock. Naturally.

She let it slide at first because she was completely desperate for an apartment. At the end of the conversation she said, “So when you’re home for lunch I shouldn’t be here right? I mean, you’ll want to be alone.” He was confused.

It turns out, “tocarse los huevos” means to do nothing or to be lazy. Good to know, right?

To make matters more complicated, there are at least one hundred ways to use the word “huevos” in Spanish. The most important thing to know is that “huevos” means balls, not just eggs. As do “cojones” and “pelotas”. So take your pick and learn as much as you can!

If you liked this story, check out some of the articles on twisted English written by thelocal.es.

This restaurant is part of the group of restaurants (I don’t want to say “chain” because it might give you the wrong impression) which includes El Recuerdo and El Olvido (translated as The Memory and The Ommission, though olvido has a much more poetic connotation than its English counterpart). http://www.lamision.es/mision.htm

This is the second time I visit this restaurant and I can really recommend it for a special occasion. It’s not cheap, but the food is of fantastic quality and not overpriced at all. The wine is also decently priced and the desserts, at 2.75 EURO, are a delicious bargain!

My main reason for writing about this place however, is the little piece of text that accompanies the bill. I was so impressed by it that I just had to tell you about it. I don’t want to publish it on the net as the restaurant might not want it to be of public domain, but I have “booed” about it through the Audioboo platform. I’ve recorded it in Spanish and then attempted a simultaneous translation of it.

Here is the link, for your pleasure. Enjoy!

Link to Podcast about Gratitude and La Misión.

So here is a short audio piece, which I’ve recorded through Audioboo, where I show you how to say “Merry Christmas”, “Happy New Year”, “Happy Christmas Eve” and where I talk a little bit about the “roscón de reyes”.

So, have a feliz nochebuena, a feliz navidad and a feliz año nuevo.

//

In Spanish, most words carry with them the feminine or masculine gender. For example, a house (“la casa”) is feminine while the sky (“el cielo”) is  masculine. These two are classic examples of words that, ending in “a” are feminine while words ending in “o” are masculine.

However, sometimes this is not the case.

The exception to the rule (and there are lots of exceptions to the rule in Spain) can be illustrated precisely by the word “problema”. Although ending in an “a”, this is a masculine word: “el problema”, “un problema”, “los problemas”. So, you can see how “problema” has become “problemo” in the mouths of non-native Spanish speakers.

The administrative director, resident director, and student interns arrived in a bus to bring us to a small reception where we were to meet our host families. On the bus ride, we all chatted about our flights and basic information about where we were from. We arrived at a social hall where my host mother, Mary, and two (adorable) brothers met me. She have me a hug and a kiss and introduced Alejandro (age 5) and Marco (age 4). She is extremely kind and has a lot of energy! We chatted for a bit and ate. I got to taste traditional Dominican sweets, one made with coco and another with coconut. The are REALLY sweet! I have noticed that everything here is sweeter and I think it’s because they use real cane sugar, it isn’t like our white and perfect crystals, it is in irregular clumps and is tan. After eating, we went home.

I live in un apartamento which is typical for a middle class Dominican family. I have a nice room with a huge closet (:) ), a double bed, and a nice desk. They have una muchacha (like a housekeeper) who comes everyday to help with household chores. They also have a little chiwawa named Buster (said more like “Booster” in Spanish) who is very cute.  After the boys gave me a tour, Mary took me for a tour of Santiago. We rode in the car throughout the city and she (and the boys) pointed out all of the highlights. A few observations: 1) driving there is CRAZY! No one follows any street signs and the lanes are more like suggestions. There are minimal stop lights, just stop signs. People walk whenever they feel like it where ever they feel like it. You really have to be a defensive driver! 2) Most of the buildings are made of stucco and look old and run down, but yet they still function. There is a street called “Calle del sol” and it’s sort of like Chinatown in NY but smaller. 3) We stopped at a salon that Mary’s sister owns (and where four of her sisters work). It was NOTHING like the salons in the United States. Similar to the plane, everyone was talking all of the time. There didn’t seem to be any form of organization like appointment times. Eyebrows were done right in the seat where you get your hair cut and nails were done at a rolling desk and simply involved the nail polish and remover, no extras. 4) The vegetation is very beautiful. There are palm trees and tropical plants that I have never seen before but they make for a nice landscape.

After my driving tour of the city, we picked up my host father, Tomy, from his law office. He was also very gracious and wanted to know how much I knew about baseball. Unfortunately, I don’t know much but he knew of the Baltimore Oriole, only because of Cal Ripken, and he was excited to hear that I live not to far from him. When we arrived home we had la cena (dinner) which consisted of mashed plantanas (a fruit similar to a banana) and scrambled eggs with ham. Then Tommy showed me their TV which they work through the internet. They have a computer hooked up to the television and somehow the stations come through the internet, computer, and to the tv. I asked him if this was advanced technology and he asked me if I was joking. I said no! We just have digital cable. And he explained that cable was very expensive in the DR and the internet tv has been around for quite a while.

After unpacking, I got to bed. I was exhausted after a long day of traveling and so much introduction to the city, the language, and the culture. I woke up early on Saturday because I had to be dropped off at the university where we would start orientation. When the rest of the students arrived we all loaded into a bus to go to el club de la vega. There are students from all over the states who are doing this program, some from Vanderbilt, University of Minnesota, University of Texas, Columbia, Hopkins, and others. It was nice to hear about everyone’s’ host families. Like the United States, the families are of all shapes and sizes here. El club where we had orientation was sort of like a country club I suppose. There was a large banquet hall (again, only 3 sided so open air), a bar and restaurant, a pool, and meeting rooms. It was situated on top of a hill so the view was outstanding. In part of the banquet room there was a furniture store or exhibition of some sort and in the other part there was an event, I think a raffle, for “el día de las madres” (Mother’s Day, which is on May 30th in the DR). At the orientation we were introduced to the resident director, administrative director, secretary, and student interns. They presented basic material about the DR and our schedule of events for the next week. It was great to begin to get to know the other students, I have a feeling we will become a very close group. Almost everyone is premed (with a few nursing students) and we all want to gain similar things from our experience so I think it is going to work out quite nicely.

The general feel of the DR is nothing like the United States. Driving along the highways you see lots of people just sitting on their (mostly destroyed) porches, fruit stands, clothing stands, and various barrios (neighborhoods). There are some very underdeveloped areas, just outside of Santiago. People live in shacks that are falling apart. The city has problems with electricity so there are often apagados (power outages, they say “se fue la luz”) that can last a few seconds to a few hours. Most middle class families have inversors that kick in during the outages. There is also a switch that you have to turn on for hot water about 10 minutes before you need to use it. And most importantly, you cannot drink the tap water, every family has bottled water for drinking.

Overall, everyone seems to take a very relaxed attitude. And people LOVE to talk. It seems that everyone really connects, and quickly. It is customary for family and friends to simply stop by to chat. Tomorrow is el día de las madres and we are going to Tommy’s sister’s house. I’m excited Pictures to come!

Mother’s Day and city/campus tours

My “aunt’s” house is in la moca, which is a neighborhood about 20 minutes outside of Santiago. Her house was about the size of our house! There was a gorgeous porch that opened into a small garden area with a mango tree. The fruit here is absolutely delicious and my Mary loves mangos, so we picked a few to bring back home with us. I met a lot of Tommy’s family. Most of the families here are much larger than the typical American family and they do a lot together. I met one of his brothers who is a doctor here in the DR and one of his nephews who lives and goes to school in NY. They all wanted to practice their English so I got to take a break from the constant language immersion for a day, but not from the cultural immersion. The greeting is a hug and a kiss and everyone greets everyone else without any reservations! They also all share quite a bit- they are ALWAYS talking. Everyone was very open and gracious towards me, and made sure that I ate and that I liked the food. I am always being told to eat more, or “sirvate mas” (serve yourself more). I also found out that one of the family members is getting married in the beginning of July, so I will get to go to the wedding which should be yet another amazing cultural experience.

On Monday, it was time to get back to the university. We met los estudiantes del apoyo (support students) who work with students from abroad who are studying at PUCMM. We went in a taxi all around the city, changed money, bought a cell phone (for only $18!), and toured around the city a bit. The students are our age or a few years older. Most of them live at home until they graduate from school and then they move out (usually to get married). They seem to like the same things we do, one of my classmates asked if there was a club with traditional Dominican music and the students said that all of the clubs play American music! I’m not surprised; many many things here are “Americanized”. Upon returning to the university, we had a very extensive language exam. Mary picked me up at the university and we went to get my brothers at school. They go to a catholic school that is run by nuns, much like the private schools in the United States.

On Tuesday, we had to do a scavenger hunt throughout the city with three other classmates! We were given a sheet with directions and questions to answer (all in Spanish, of course). We took conchos to get around the city. A concho is their main form of public transportation. It’s a really old (think 80s Toyota Corolla), generally partially destroyed, car in which you CRAM in. They fit two in the front seat, and four in the back seat- there is no concept of personal space. It costs 15 pesos (about 40 cents) to ride and there are lots of routes that are marked with letters. You can get on anywhere along the route and get off anywhere along the route, you flag it down a bit like getting a taxi. It’s quite an experience! So the first concho we had to get in for our scavenger hunt kicked one woman out in order to fit all four of us into the car. They enjoy stopping for American girls. After we cleared up where we needed to be dropped off and he figured out that we were students, he asked if he could spend the day with us and told us that we were pretty. That is quite common here. Throughout the day, we were constantly the victims of “piropos” which literally means compliment but it’s more like the equivalent of someone whistling at you on the street. Piropos range from a younger man basically saying “I want to take you home tonight” to an older gentleman saying “you’re so beautiful, God bless”. I can’t even count how many times I’ve been called “rubia rubia” (meaning blonde). So the scavenger hunt was a lot of fun and really encouraged us to talk to people on the street, get used to asking directions, and understand the concho routes. You can ask anyone directions here and they will do their best to help you! People are really extremely kind and always willing to talk. I have noticed that no one wears ipods. That could be because of the socioeconomic situation, but I think it’s also because people are more inclined to talk to each other rather than keep to themselves. Even on campus, no one wears ipods…that is unheard of on a college campus in the states. After completing the scavenger hunt, we took a tour of the university with the students from PUCMM. It’s a nice campus, very beautiful. There is even air conditioning in parts! There is also wireless all over campus and a nice little snack shop outside where students convene between classes. The classrooms are very basic- they have the chairs with desks attached, fans, a desk for the professor and chalkboard in the front of the classroom, and some have projectors.

We started class today, Wednesday June 2, but we only had our morning schedule and we don’t have class again until Monday because tomorrow is a holiday, Corpus Cristi, and Friday we have a trip to the beach! So far the classes are good. I really like my Spanish professor and Medical Sociology seems like it will be an interesting class. It’s going to be mentally exhausting to have all of my classes in Spanish, because not only do you have to understand the material presented but also the language that it’s presented in! Wonderful practice, though. I’m looking forward to continuing with classes. All of the professors so far have said that they generally really enjoy teaching American students because they are all focused and interested in what they came to the DR to study- invested students and teachers make for good classes!

2 de junio- 6 de junio

Wednesday is “Ladies Night” at a few of the clubs in Santiago. The drinking age is 18 here so we all decided to go check out the night life, it was free the whole night! We went to a club called “Camus” and they played music with Spanish lyrics but it was mostly popular American music. It was interesting, everyone knew the English lyrics but I think most of them didn’t have any idea what they meant. We met some Dominicans who we chatted with and danced with. The people here are quick to form friendships, by the end of an hour everyone had exchanged cell phone numbers. By about 10:30pm the club was packed wall-to-wall with young Dominicans. No one had classes the next day, so I imagine the club was packed until it closed.

We headed out around midnight because we were getting up the next day to go exploring in another town outside of the city. We figured out how to call a taxi, I don’t think I have ever witnessed faster or more mumbled language. But, we figured it out and got home safely. You can’t walk anywhere here alone, really at any time. Especially being American, they advise us to always stay in groups and take taxis, not public transportation, at night. After witnessing the club, I came to the conclusion that the nicest things here are the nigh clubs and the gas stations, because seemingly those things bring in the most money. Gas is incredibly expensive here- 150 pesos for one liter, that’s about $5 for less than a gallon!

On our day off, eight of us from our program decided to explore a town called Jarboacoa. We took a taxi to a park where buses depart from Santiago to La Vega and then another bus from La Vega to Jarboacoa. I am proud that we were able to do that- we negotiated prices and everything. Upon arrived in Jarboacoa we hiked in a park called La Sal de la Jimonesa. It was a gorgeous place in the mountains that took about 2 hours to get to in total. There were bridges over a fresh water river that was created from a waterfall. There was also a trail that we hiked for a bit that was extremely steep. It wound up part of the mountain to a point where we were actually above the waterfall. Coming back down was quite a trip, you had to use all fours! We were all drenched in sweat by the end and decided to hang out by the river on a small sandy beach and munch on some things that we had packed for lunch. None of us had brought swim suits, but some of us just jumped in the water anyways, fully clothed. But apparently, that was the norm. By the time we go in the water, there were lots of people there because it was a religious day so no one was working or going to school and I think out of the 30 or so people there, only two were wearing swimsuits. After enjoying the hike, sun, refreshing water, and scenes of men jumping around the rocks in their underwear, we headed back on the bus.

When we arrived back to Santiago we all headed home for a quick shower and got ready for la cena comparativa (a shared dinner). We met at PUCMM and departed in taxi back to our neighborhoods with some Dominican support students. We had salad at one house, soup at another, the main dish at my house, dessert at another, and finally tea and coffee at the last one. It was interesting to see everyones homes and the dynamics of their families. After the dinner, everyone said that I had the best family, and it’s true! My parents asked about all of the other students at the table and everyone got to meet my brothers and Buster (the chiwawa). After the dinner we were all exhausted (and a bit sun burnt from the day spent exploring in the mountains). Off to bed to get up early for the beach the next morning!

The bus left around 9:00am for Playa Ensenada. We arrived in about 2 and half hours to a gorgeous, quaint beach with seafood shacks extending along the coastline. The water was perfectly clear and you were able to go very far out in the water because it was totally calm and never went past mid stomach. It was really nice to lie around for the day and enjoy the water. The sun was incredibly hot, nothing like I have ever experienced! You could only lay for so long before you had to jump in the water or in the shade. And yes Mom, I wore sunscreen but I don’t think anyone left without getting a little burnt. The support students from PUCMM went with us and it was really nice to get to know them and understand the education system here. One of the girls was so fascinated in the whole sorority and Greek life system. After crossing the language barrier and explaining that “greek life” didn’t mean that there were just a lot of people from Greece who hung out together, she really enjoyed the concept of creating a sisterhood within a university community. And of course she asked, “Oh, so it’s like Legally Blonde?” But I can see how the idea would be very appealing here because they focus so much on community and relationships. The support students found it so strange that we were all involved in lots of activities on campus because most of them live at home and simply attend the university during the day for classes (similar to high school). They also elect a major that leads to a career immediately after university. So, for there are people my age already in “medical school” because their major at PUCMM is medicine so after they graduate in 4 years, they will be doctors! They think it’s crazy that we have to take 4 years of pre-med and then 4 years of medical school, 8 years of schooling in total, and I think it’s crazy that they only need 4 years of schooling. After taking in some Caribbean sun, frolicking in the crystal clear water, and sampling the local cuisine (“camarones”, shrimp), we pilled back into the buses and headed back into the city. That night a few of us went to the Plaza International (a mall that is conveniently very close to my house) to see a movie. Guess how much it cost?! 150 pesos. That’s about $4!! The theater was just like our movie theaters at home, complete with ice cold temperatures and overpriced concessions. After the movie, back home to get some sleep before heading off to the mountains for the weekend.

Weekend in the mountains

After getting back from a morning dance class where we learned meringue (a typical Dominican dance), we packed up for two days in the mountains. My host father’s father has a very nice piece of property and house located in a newly developed gated community in San Jose de las Malatas. The houses where very nice and most had a pool and their own fruit trees and various other gardens. They all also shared a wonderful view of the mountains! There was a 360 degree view of mountain sides dressed with palm trees, evergreens, and other tropical vegetation. We spent Saturday and Sunday with family and friends (about 15 in total) playing games, eating, and touring around the small town. The people were extremely nice and very impressed that I was learning Spanish. They were also shocked with how long the education process is in the US. One of the women there just graduated from college and was now a doctor. After high school, you elect a major and after 4 years you are ready to enter the work force. She said that although it’s nice to already be started in the workforce, there are a lot of things that you learn through experience that she feels are a bit rushed and wishes she had learned them in more thorough manner. The weekend was very relaxing and enjoyable; I even had time to squeeze in some vocabulary homework that was due on Monday.

When we arrived home on Sunday night, I played in a poker tournament with my host father, my his brother, his friend, and one of my friends from the program. It cost 50 pesos (about $1.50) and we played until someone had all of the chips. It was a lot of fun and I almost won, emphasis on the almost!

On Tuesday we started our Film Studies class, which is part of our Intensive Spanish Language course. I am really excited about this class! I have never taken anything like a film studies class before and we are watching films that are made in Spanish speaking countries and immerse us further into the language and culture. We will start watching movies next week. Medical Sociology was next- the lecture was on poverty in the DR. The situation here is very sad and just viewing the statistics were nothing compared to what I would see later in the week. After lunch we got assigned our clinics for the week that we will spend in Salcedo. I am going to work with another girl from Yale and I can’t wait! I think it’s going to be a really wonderful learning experience as well as a way to give back to such a needy country. On Tuesday night a few friends came over to use the internet at my house, we really had a nice time. I have a great group of friends here and my host parents are so inviting and always willing to have others in the house. I also played with my little brothers quite a bit, they are starting to get really comfortable with me and I think it’s because I can already communicate so much more effectively. My host Mom said that she has noticed a huge improvement

Wednesday morning we took a field trip to el Centro León, a cultural center that was built in 2003 by a man with the last name of León. We got a tour through a few of the exhibits in the museum. It was very nice and the exhibits were clear, interesting, and informative. The Caribbean culture is truly a mix of many different cultures. Influences from Europe, African, and the indigenous people make of the unique foods, music, and traditions. Spaniards who brought Africans for laborers and slaves lived among the indigenous inhabitants and thus created the Dominican identity of today: una mezcla (a mixture). Wednesday afternoons are free every week so a few friends and I decided to take a trip to “la Sirena” which is the DR equivalent of a Wal-Mart. We spent about an hour just enjoying the air conditioning and familiarity with some American products. I got my brothers some toys, my host father some Pop Tarts (which he has eaten everyday for breakfast since) and my host mother some Nutella (which she LOVED). We bought ingredients and headed home to bake some brownies from scratch for our host families. The process of baking was a bit of a challenge: 1) problem: the ovens here do not have thermometers or temperature controls, you light a flame under a grate so how were we going to “preheat to 350 degrees”; solution: just light the flame 10 minutes before putting the brownies in to bake and check throughout the baking process to see if they were finished. 2) problem: we didn’t have any measuring cups; solution: tea cups for the “cup” measure and the eye-ball method for teaspoon measurements. 3) problem: usually you use a microwave to melt butter, we had a microwave but the power happened to be out; solution: heat the butter over the stove. So by the end of the afternoon we had successfully baked three batches of brownies, and they were quite delicious. We used cocoa that was grown here and I think that really made them. My host family had never had brownies before! They really really really liked them. I also had a talk with my family about the week that I will spend in the clinic. When one of my brothers heard that I would be gone for a week he said “wait, you’re not going to be here for a week?” and I replied that I would be gone for the week but return for a few more weeks in Santiago. After I replied he started crying and said “I don’t want you to leave!” They have become accustomed to sitting on my lap at my computer before bed and watching Michael Jackson music videos on my computer- they love Michael Jackson because they think his dance moves are really entertaining.

Thursday morning was another field trip, this time to hospitals. We visited three public hospitals, two “level three”, meaning the most intensive and specific care, and one “level one”, meaning general primary care. The first hospital we visited was called Hospital Regional Universitario “Jose Maria Cabral y Baez”. Everyone I had spoken to prior to going on these visits had told me that the public hospitals here were horrible, but I still wasn’t expecting what I saw. Jose Maria was a very large complex and housed every specialty. As soon as you walk in, you are hit with a heat wave and people trying to get by. There were people everywhere. An administrator gave a quick introduction to the hospital and then we proceeded on a tour. As soon as we got into the care areas I was immediately struck with sadness. There were lines stretching longer than you can imagine and people waiting everywhere. The floor was just cement that was dirtied with everything imaginable. We proceeded to tour every floor and it took me a while to even convince myself that what I was seeing was not just a dream. All of the treatment rooms were communal, there were people with IVs everywhere (in the hallways included), there were some beds in the hallways because there wasn’t enough room in the rooms, there was trash spread throughout the hallways, there were needles and gloves in the trashcans in the hallways exposed as well as on the floor, I didn’t notice a single computer, and there were very few medical professionals. And because nothing was air conditioned, it was hot, very hot. Another thing that I noticed was that there were at least two family members with every patient. Even though the people may not have resources, it seems as though they always have the support and love of family. There was no sense of order, no one seemed to have authority, and just the amount of people in every part of the hospital added to this sense of inefficiency. For those of us that are accustomed to Hopkins, this was literally unreal. The next hospital that we visited was called Hospital Infantil Regional Universitario “Dr. Arturo Grullón”. This was also a public third level hospital but specifically for children. This hospital was a bit more orderly and clean than Jose Maria but the sanitation was still totally unacceptable by American standards. Again, the rooms were communal and there were at least two family members with each child. The hospital also offered resources for new mothers, like training about healthy development and feeding patterns and had a playroom for the children. In addition, we toured a new oncology unit that just opened 3 months ago. This unit was extremely clean, nicely decorated, and the technology was impressive. In order to be a pediatrician in the DR you have to do an additional 3-4 years of training after graduating from university. After the children’s hospital, we went to a smaller level one clinic. It was one level and about 6 rooms and a pharmacy. It was simple with the bare minimum resources and only 2 doctors and one nurse. I imagine this is much like what the rural clinics will look like. They see patients first, try to take care of the problem, and if they can’t they refer them to another doctor at a larger facility (like Jose Maria).

After that incredibly eye-opening morning, we had Medical Sociology in the afternoon. We discussed the migration into the cities and Zonas Francas (“free zones). The dynamics of the economy really effect healthcare and health literacy. Gym after classes then a few of us went to a dance concert, ballet! It was amazing, some of the best dancing I have seen in a very long time. It was given by a contemporary ballet academy; the choreography was phenomenal and the dancers had incredible technique. It was quite a nice treat! And after, some of the Dominican support students from PUCMM came to pick us up and about 11 of us went out to sushi, yum. It was a lot of fun, a great ending to a very long day.

The Bateys

Friday we visited Bateys. Bateys are small very poor neighborhoods of Haitian immigrant workers. The first Batey we visited was called Batey Chichigwa. It was a community of about 100 people living in the countryside in extreme poverty. It is best to capture the community with pictures, so I have posted a few below. Everyone was wearing clothing that had been mixed and matched together, shoes that were ripping (crocs seemed to be the shoe of choice, the cheapest with the most protection), and no one looked like they had bathed in a few days. There was a small community “building” that acted as the church and a place where a community outreach group went to teach reading and writing. People spoke both Spanish and Creol. They explained to us that their biggest problems were access to drinking water and education. They get one tank of water twice a week for the whole community and there is no school near-by. There are lots about 50 children living in this Batey with no access to education. The men go off during the day to work in the fields and the women stay home to care for the children, cook, and wash clothing. There are members of the community who have been living there for over 40 years. It was incredibly heart-wrenching. After a tour through the shacks, we got to play with the children for a bit. They all loved our cameras- and learned how to use them very quickly. I think they were just so happy to have some attention for a few hours. They also really like Americans because it is an American man who provides their water. Surprisingly, a few of the members of the community have cell phones that they use if there is a medical emergency. There are no clear cut families on the Batey, it is a community in the sense that everyone helps to raise all of the children and everyone works together to accomplish everyday tasks.

Then we visited another community that is called an “arraño” because both Dominicans and Haitians live together. This community had a few more resources like a school, electricity, and some “developed” store fronts but the clothing worn was pieced together and there was trash throughout the streets. There was again a community building but this one had a TV in it and all of the men were jammed in watching a World Cup game…I guess all men are the same! After a quick tour we went to play baseball, soccer, and color with the children. This community was much larger so there must have been at least 150 children there. As we were coloring I noticed that everyone was very content and happy to share. No one fussed about needing a certain color or picture, they worked as a unit even just to color. The field where we went to play baseball was scattered with trash, unlike anything I had ever seen before.

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I wasn’t quite sure how to react to this experience. At lunch, I almost felt guilty being hungry. I am excited to get to work at the rural clinic and be able to give back. I think the part that was the most saddening was the lack of education for the children. The more I learn about poverty and it’s vicious cycle, the more clear it is that education is the key to rising out of and eventually eliminating poverty. With education comes access to information and with access to information comes knowledge about health care and job opportunities. Maybe one day I will be able to return here and build a school.

Saturday was the first day that I had free to just explore Santiago! I went with a few of my classmates to a market basically in the heart of the city on a street called “Calle del Sol”. It’s essentially like a mini version of Chinatown in NY. There are street vendors (the popular thing to sell here is Blackberry cases and sandals), various clothing stores, and a cultural market that sells traditional Dominican jewelry and nick nacks. We spent at least three hours wandering around the market talking, bargaining, and buying. When I got home I forced myself to pound out some homework and then headed back out with a friend and her little host sisters for MORE shopping at the mall. Then we went to sushi (yum!) and of course had the obligatory “Bon”. Bon is frozen yogurt that they mix fresh with any fruits that you chose! (My personal favorite so far is strawberries, cherries, and dates). It was a day full of shopping!

Sunday came around and it was time to hit the gym. We got up early to get to the gym and then head to a cafe to get our homework finished. Our classes have really started picking up so now most of my free time is spent doing homework. We learned quickly that Dominicans are extremely friendly and prefer to talk then to do homework. There were lots of students at this cafe (free wifi) and the only way that any focusing occurred was if you put in your headphones and looked busy, otherwise, you were a target for conversation. After lots of essay writing and presentation making, dinner was a nice break and sleep was a welcome visitor.

In our Medical Sociology class we visited a part of the city that was a huge market place where produce, meats, and botanical healing medicines were sold. It’s hard to describe in words but I have attached pictures to aid in the explanation. It was packed with people, there were fruits and vegetables everywhere, and a smell of rotting food and body odor consumed the streets. As we wandered through the markets, the piropos (compliments, more like cat calls) didn’t stop! They must have been very curious as to why a group of about 30 Americans were walking through their market place. We worked our way to a store that sold botanical healing remedies and other natural products such as good luck rocks. We learned a bit about the healing powers of each of the plants and potions and I was offered “love potion” so that I would fall in love with one of the owners at the store. Good thing it was just perfume

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On Wednesday evening a group of us went to a traditional Dominican club. We passed the night dancing merengue, bachata, salsa, and reaggaeton. I really really enjoyed it! The dancing and music here is so much fun and so much more social than the clubs in the US. I have enjoyed learning each style. It seems to me that every Dominican can dance, although I’m told that is not true. They do, however, learn from a very young age how to dance. I have pretty much mastered merengue and bachata but need some work on my salsa skills.

The rest of the week was spend studying and taking various exams. When Friday came around it was time to pack up and get ready for a weekend excursion to Santo Domingo, the capital of the Dominican Republic.

The guagua ride was spent catching up on sleep! We stayed in the Historical District of Santo Domingo in a gorgeous hotel. We settled into the hotel and headed out for a walking tour of the historical district. Santo Domingo was the first city in the Americas; it was discovered by Columbus and colonized by the Spaniards. We saw Columbus’ house, the first seminary in the Americas, the first hospital in the Americas and various monuments. The district really reminded me of Europe (not that I have ever been but from the pictures that Juliana has brought back they seem to look similar. After the walking tour we had a HUGE meal at an Italian restaurant and went out to experience night life in the capital.

The next day we visited una casa de arte where traditional Dominican house ware, knick knacks, and other such things were sculpted, painted, and sold. After a tour, we sat down to paint a small sculpture of our choice. It was interesting to learn about the traditional goods that Dominicans have constructed from various materials such as wood, plaster, and fruit casings. For the afternoon we were allowed to elect a trip to the aquarium or the botanical garden…I bet you can guess which one I chose! The aquarium was set up on the coast and it was open air so you wandered through a building with just a roof that was full of tanks and other natural exhibits.

We rested for the remainder of the afternoon and then all got dressed up for a big dinner out. Everyone looked so nice in their “fancy clothes”! We had a gorgeous meal in a restaurant that was built in a cavern! It was a three course meal complete with an unlimited supply of wine. It was a very enjoyable meal with excellent food and wonderful company. Our directors have said that this is one of the most likeable groups and I couldn’t agree more. All of us really get along well and there have been no problems (gracias a Dios!).  Before the dinner I was feeling a bit homesick (I am honestly surprised that this was the first time that it hit me). But Lauren was plotting the whole time and I got a surprise visit from a friend from Santiago! It was a wonderful surprise. The night life in Santo Domingo is much like Santiago except the clubs are packed with people, I think I prefer Santiago.

The next day we got up early to take a trip to a national park called “Los tres ojos”. It was an underground cavern with four lakes. It was absolutely gorgeous with the crystal clear water and rock formations. After the tour we headed back to the hotel for a 4^th of July celebration! I was so happy to bite into a hamburger, hotdog, potatoes salad and French fries!! I had no idea how much I had missed “traditional” American food. It was sad not to be in the US for Independence day, but on the bus back home we all sang the national anthem- cheesy I know but at the time very meaningful.

The health system (Juan XXIII) is an interesting model because it is based off of the initiative and kindness of the supervisoras and promotoras. For example, Lauren and I gave one charla and did about 20 house visits while another group gave over 100 charlas. The idea behind the system is that health is a problem of democracy and the community in its entirety should work together to promote health. I think the idea behind the system has a good foundation but the problem is implementation of the practices that are taught. Lauren and I gave a charla on Dengue which is a virus spread by mosquitoes and in the prevention section we spoke about the importance of using repellent and disposing of trash but the people barely have enough money to feed their families much less buy repellent. The community receives the information and understands its importance but because of logistical factors cannot utilize the information or put the theories into practice.

One of the largest problems in la Zona Sur that I observed is the lack of trash collection. The poverty level of the community is probably equivalent to that of the rural community in which I worked, but it’s more of a “dirty” poverty. We visited an overlook where people threw their trash. I asked the promotora why there wasn’t a regular trash collection in a place where there were so many people living in such close quarters. She explained to me that there is a trash collection service run by the government but it doesn’t come on a regular schedule and the people are charged to use it. Imagine that you lived in a one room house without running water and had just enough money to feed and cloth your family, would you spend money on trash collection that isn’t even reliable? So people dump their trash where ever they can and this creates an extreme amount of health hazards. Seeing and experiencing la Zona Sur really opened my eyes to the complexities and challenges that a developing country faces.

I learned how to salsa this week! I really enjoy the dancing here. The music is very appealing and the culture around a night out is very enjoyable. I also got to try some more traditional Dominican food which I have come to love. Although, when I get home I don’t think I will be able to eat rice for a month or so!

On Friday we left for the beach. It was a weekend packed with sightseeing different natural beauties. We spent Friday at Puerto Plata and then Saturday headed to Caberete and from there visited la piscina natural (the natural pool). There is a section on the north coast where a river runs right into the ocean. We took a boat from the river into the ocean and docked for a bit and a gorgeous part of the coast with crystal clear waters and stunning rock formations. Next we visited Dudu, which is a lake (or more like natural spring) that is very deep and sits in between large rock formations such that when the light hits the water, it is pitch black. The next day we spent at Caberete and then headed back to Santiago in the evening. It was a wonderful last weekend in the DR. The beaches are truly beautiful.

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On Monday and Tuesday, each group (based on clinic and Zona Sur assignments) presented their final project. Each group presented a power point about their disease of interest and their work in both the rural clinic and la Zona Sur. It was really wonderful to hear about everyone’s experiences and reflections. Lauren and I presented on diabetes and spoke about the work we did in the clinic and la Zona Sur. In my personal reflections, I spoke about the similarities and differences that I saw in el campo and la Zona Sur. While there was poverty in both places, the resources and standard of living was very different. In el campo, it was a “cleaner” and “healtier” sort of poverty. The streets were generally clean of any trash, bottled water was accessible and present in every household, and food was readily available because they lived on the land that produced large amounts of crops. The clinic was also situated in the center of the community and served anyone who walked through the doors. In la Zona Sur, the poverty seemed to be a “dirty” and “unhealthy” sort of poverty. People lived in cramped spaces and often shared one bed for the family, the streets were lined with trash, food was not as readily available and people tended to eat packaged things that were easy to keep, and water was often kept uncovered. The health system in place in la Zona Sur also seemed to be less effective in terms of providing direct access to medical professionals. There was a primary care center and various clinics located throughout la Zona Sur but the people were not as interested in going to the clinics. The community seemed to rely on the supervisors and promoters of the public health system to dictate their medical care rather than taking it upon themselves to seek medical attention.

On Wednesday, we visited the water treatment center, center for children, and a retirement home. The water treatment center was really interesting especially because one of the first things we were told when arriving in the DR was to not drink the tap water. After an introduction and tour by the director of the center, we had learned that when the water leaves the plant, it is safe to drink. So, I was left wondering why no one drinks the tap water. The director explained that it is the piping system in the city- the pipes are so old that by the time the water travels from the treatment center to the homes it is no longer safe to drink. If this is really the case, I hope that the next investment will be in renovating the pipes so that the processing of the water at the plants isn’t a waste of money and resources and people can take advantage of clean tap water. The next stop we made was to a center for children called “Centro Juvenil” that was located in the heart of Santiago. The center provided education, food, and health services to children who worked on the streets (generally selling things). We got to speak with the director of the center for a bit and I was very impressed with their mission and drive to provide an education for these children. Unfortunately we were not able to take a tour of the facility but from the parts we did see and from what the director explained to us there were lots of resources to help the program achieve their main goal of education. The final visit we made was to a retirement home also located in the city. In the Dominican Republic, the use of retirement homes is not common because it is expected that the family will take care of older relatives. Because of this, there was a sense of sadness that filled the retirement home. These were elderly who either had no family or had been in a sense disowned by their family. The facility had all of the things that you would find in a retirement community here in the states- a work out room, a church, a dining hall, various gardens, and activity rooms. However, the room where the residents slept was more like dorm style. There were no individual rooms and/or bathrooms. There was a large room lined with beds and a communal bathroom with a few sinks and toilets for the women and a similar set up for the men. That night we had a celebration for all of the students, host families, and volunteers whom we worked with in la Zona Sur. It was a lot of fun- the music was lively, everyone was dancing, and it was so nice to thank all of those that made our experience complete!

Finals were on Thursday and Friday. Friday evening, my last night in the DR, my host family took me to the Centro Español (a country club) for dinner. It was a lovely place, complete with tennis courts, pools, activity centers, sports fields, mini golf course, and wonderful restaurant. I really enjoyed the meal and getting to spend time with my parents and brothers before flying out the next day.

Saturday morning came and before I knew it I was at the airport with bags checked and boarding pass in hand. It was hard to say goodbye to my host parents, but I just kept telling myself that this wasn’t goodbye, it was just “see you later!”. I had grown to love the Dominican Republic and I knew that there would be something more for me to do there. When I boarded the plane I was a sad to be leaving but more importantly I was fulfilled and satisfied. I had made wonderful connections to people, learned about and worked in public health systems, and improved my language skills almost to the point of mastery.

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They have been banished from the Royal Academy for being just “dígrafos” that is, a sign representing a sound.

So, in order to be faithful to the Spanish alphabet, I have removed the chapter CH is for Chocolate con Churros (will include them in one of the chapters related to food) and have renamed Ll is for Lluvia (rain), P is for Paraguas (umbrella).

Nunca te acostarás sin saber una cosa más.

(You learn something new every day or, literally, you won’t go to bed without knowing one more thing.)

For those of you who speak Spanish, below is what the Real Academia Española had to say in 2010 and here is the link.

1. Exclusión de los dígrafos ch y ll del abecedario

     Se excluyen definitivamente del abecedario los signos ch y ll, ya que, en realidad, no son letras, sino dígrafos, esto es, conjuntos de dos letras o grafemas que representan un solo fonema. El abecedario del español queda así reducido a las veintisiete letras siguientes: a, b, c, d, e, f, g, h, i, j, k, l, m, n, ñ, o, p, q, r, s, t, u, v, w, x, y, z.

     El español se asimila con ello al resto de las lenguas de escritura alfabética, en las que solo se consideran letras del abecedario los signos simples, aunque en todas ellas existen combinaciones de grafemas para representar algunos de sus fonemas.

     La eliminación de los dígrafos ch y ll del inventario de letras del abecedario no supone, en modo alguno, que desaparezcan del sistema gráfico del español. Estos signos dobles seguirán utilizándose como hasta ahora en la escritura de las palabras españolas: el dígrafo ch en representación del fonema /ch/ (chico [chíko]) y el dígrafo ll en representación del fonema /ll/ o, para hablantes yeístas, del fonema /y/ (calle [kálle, káye]). La novedad consiste, simplemente, en que dejan de contarse entre las letras del abecedario.

     Al tratarse de combinaciones de dos letras, las palabras que comienzan por estos dígrafos o que los contienen no se alfabetizan aparte, sino en los lugares que les corresponden dentro de la c y de la l, respectivamente. La decisión de adoptar el orden alfabético latino universal se tomó en el X Congreso de la Asociación de Academias de la Lengua Española, celebrado en 1994, y viene aplicándose desde entonces en todas las obras académicas.

On February 2, 2011, my colleague Rebecca Brown and I co-presented an online version of  the class “¿No Comprende?  Online Health Resources for English Speakers Serving Spanish Speaking Communities”.  You can view the recording of the class, and download the powerpoint and a pdf of the handout from the class at http://nnlm.gov/mcr/education/online.html#A7

Part Two of the class will be offered online on February 16th at 10:00am Central Time and will run til noon.  You can register for the class at http://www.tinyurl.com/mcrclasses Log in information for the day of the class is available at http://bit.ly/fGUaAZ Class will cover evaluation of Spanish language websites, additional trusted online resources, and examples of searches submitted by attendees.

¿No Comprende?  Online Health Resources for English Speakers Serving Spanish Speaking Communities

The National Network of Libraries of Medicine, MidContinental Region, will present two free online classes for librarians who want to connect their Spanish speaking patrons with good health information.  The NNLM is working with Heartland REFORMA on this.

Where: Elluminate (online)
http://skyways.lib.ks.us/orgs/reforma/nocomprende.html
When: Wednesdays, February 2 and 16, 2011, 10:00 AM – 12:00 PM CDT
To register: http://tinyurl.com/mcrclasses (sign up for both sessions separately)

More information:  http://nnlm.gov/training/nocomprende/

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