The Batey Relief Alliance
The Batey Relief Alliance (BRA) is a non-profit, non-political, humanitarian aid entity uniting grassroots groups, faith-based organizations, government agencies, and the international community in a strategic partnership to help create a productive and self-sufficient environment, through health care and development programs, for children and their families severely affected by poverty, disease, and hunger in the Caribbean.

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Ulrick Gaillard_1.jpgWASHINGTON, DC. - On a three-hour train ride that started on the early cold morning of December 12th, the Batey Relief Alliance’s CEO, Ulrick Gaillard, left his Brooklyn base at 3:00am to arrive on time at the New York’s Penn Station to catch the Amtrak train at 5:30am bound for Washington DC with one goal in mind – seek the support of United States Representatives and agencies for more food for those who are very hungry and sick in the Dominican Republic’s impoverished batey and urban/rural communities.

Haitian_cane_cutter.jpgThe Batey Relief Alliance (BRA Dominicana) received a grant of $272,800 from the United States Agency for International Development (USAID) to distribute 75 metric tons of food to more than 5,000 at-risk individuals who are severely affected by disease, poverty and hunger, including people living with HIV/AIDS, Tuberculosis sufferers, orphaned/vulnerable children, pregnant women and the elderly. Local partner groups helped BRA distribute the food in their own HIV/AIDS prevention and treatment programs, including the Dominican’s Presidential AIDS Council (COPRESIDA) and General Directorate for the Control of Sexually transmitted Infections and AIDS (DIGECITTS), the Clinton HIV/AIDS Initiative, etc.

The problem is the program grant, under the USAID’s Title II International Food Relief Program-Food for Peace, is only for one year and if not renewed for at least another two years, the lives of these disenfranchised people will be at stake, particularly those receiving antiretroviral treatment and potent medicines to fight opportunistic infections.

Before returning back to New York the same day on another three-hour train ride at 6:10pm, Gaillard crammed up six different meetings with representatives at the offices of Senator Hillary Clinton, Brooklyn’s Congresswoman Yvette Clarke, USAID, and other organizations that are involved in the production and distribution of food in impoverished regions of the world. “I am very pleased by the positive response and offer of support from Senator Clinton and Congresswoman Clarke,” said Gaillard.

The USAID encouraged Gaillard to submit another proposal to the agency in January seeking more funding for the food program. If approved, many lives will continue to be saved. If not approved, Gaillard plans on going back to Washington and lobby more.
The journey ended, for now, with Gaillard arriving home on the 12th at 11:15 pm after having to wait and wait for local trains to take him back to Brooklyn, and then a cab home to sleep.

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BATEY RELIEF ALLIANCE
Celebrating 10 Years of Success in the Dominican Republic

child with vitamins_1.jpgThe Batey Relief Alliance—BRA celebrates on October 23rd, 2007, ten years of humanitarian services for children and families severely affected by poverty, disease and hunger in the Caribbean, particularly those suffering inside the bateyes, rural slums, and urban barrios of the Dominican Republic.

With your support, we have impvroved the lives of 200,000-800,000 Dominicans and Haitian immigrant cane cutters and their descendants who live inside the impoverished rural communities of the Dominican Republic’s 220 sugar cane plantations bateyes.

In just ten years of humanitarian service in the Dominican Republic, we have accomplished so much:

• Installed two modern medical facilities fitted with state-of-the-art equipment, the first of their kind inside any bateyes
• Secured more than $40 million in essential medicines, vitamins and antibiotics to distribute to impoverished patient populations
• Implemented 15 lifesaving projects in HIV/AIDS, tuberculosis, primary care, blindness prevention, malnutrition, water/sanitation, preventive health education, micro credit and more
• Developed bona fide partnerships with more than 75 local and international groups working side by side with our personnel and volunteers to provide critical health services to 200,000 people around the country

Thanks to your generosity, BRA is now treating more than half of the province of Monte Plata’s HIV population:

• Children and adults receive free testing, antiretroviral therapy and opportunistic medicines at our new HIV/AIDS Treatment Unit
• 75,000 children receive free multivitamins and anti-parasitic medicines
• 5,000 vulnerable/orphaned children, people living with HIV/AIDS, pregnant women and the elderly receive free nutrition
• Thousands more receive complete medical, vision and dental care, and water filters

We are proud of our achievements, but even prouder to know that we are making a difference – a difference that was published in a recent Columbia University study finding more than 95 percent of the population we serve is extremely satisfied with our work.

As we embark on our next ten years of humanitarian effort, we know there are many challenges and obstacles that await us merely because of the complexity of the world – the harsh effects of globalization to say the least. But they are the consequences of life and we will face them with the same professional skills and creative wisdom that have permitted us to succeed in the previous years. What we cannot do, however, is to abandon those who need us because helping them is enriching ourselves, our lives, and our future.

My sincere thanks and appreciation go out to everyone who has helped make our first 10 years a tremendous success. May all the great achievements of our first decade embolden and inspire us as we forge head into the future.

Respectfully,
ulrick_signature.thumbnail.jpg
Ulrick Gaillard, J.D.
Founder/CEO

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BACKGROUND OF REPORT

As we do every year, we want to share with you our annual work report covering our accomplishments, and the many activities we undertake to carry out our humanitarian mission on behalf of the poor in the Dominican Republic. We hope you will find the results satisfying and will continue to help us whenever is possible. Should you have any questions or need further information about this report, please contact us at (917) 627-5026 or bra@bateyrelief.org. We thank you for your attention and continued support. Below are some of the key highlights of the BRA’s 2007 work:

I. INTRODUCTION TO BRA’S HUMANITARIAN WORK

A. BRA’s Institutional Proven Model

The Batey Relief Alliance—BRA was created in 1997 in the State of New York of the United States of America under the Internal Revenue Service Code 501(c)(3), as a tax-exempt, non-profit, humanitarian aid organization to address the adverse socio-economic conditions of children and families severely affected by poverty, disease and hunger in the Caribbean. Toward that end, BRA created in year 2000 its regional arm inside the Dominican Republic, the BRA DOMINICANA, a legally-incorporated non-governmental organization—NGO designed to help the Batey Relief Alliance carry out its humanitarian mission inside the Dominican Republic’s bateyes, rural/urban slums and border localities with Haiti.

The Batey Relief Alliance has a board of directors that meets once a year to run the legal and policy affairs of the organization, and a Chief Executive Officer who is charged to promote and mobilize public resources for the work of the institution . BRA Dominicana runs the entire field operation for the Batey Relief Alliance, raises local funds, operates and office in Santo Domingo with paid staff and volunteers, and implements projects in the province of Monte Plata. BRA Dominicana has its own board of directors and an Executive Director who are charged to manage the programmatic, financial and administrative affairs of the organization. BRA’s CEO, however, oversees the entire field operation and management, the sustainability and growth of the institution. BRA’s Board of Directors is the ultimate body on policy decisions affecting the institution as a whole.

BRA’s CEO mobilizes public resources from the United States that are cash and/or in-kind donations. Most cash gifts are from individual donors, international organizations, foundations and the US government. In-kind donations are mainly from international groups. When non-restricted cash is received, it is used to sustain the virtual operation of the Batey Relief Alliance in New York, sustain part of the field operation’s costs of BRA Dominicana, and implement projects. All restricted funds are transferred entirely to BRA Dominicana to implement our projects overseas. BRA Dominicana puts all funds received in bank accounts, registers them in its accounting books, uses them for the projects, and sends to Batey Relief Alliance annual reports which are then submitted to funders, donors, volunteers and friends. BRA Dominicana’s Board of Directors maintains a strict day-to-day control over the organization’s management of donated funds, accounting, and projects’ implementation.

As for in-kind gifts, BRA’s CEO receives requests from the field office of the needs (in medicines, supplies and equipment) to sustain our operation. BRA’s CEO then forwards that wish list to foreign donors for support. When donations are considered, a detailed list is sent to BRA’s CEO in New York for acceptance. Once BRA’s CEO accepts the donations, the donors then send a list, with dollar values, to BRA Dominicana notifying the donation’s shipment and preparing to retrieve them out of the DR customs. Once the donations have arrived at the DR customs/port, BRA Dominicana is the main consignee to receive the donations duty and customs free – a support from the Dominican government.

BRA Dominicana then transports the donations to its main warehouse in Monte Plata for an inventory. Once an inventory is completed, a product report is sent to Batey Relief Alliance of the receipt of the donations and the quantity received. BRA Dominicana is then free to use the donations for its humanitarian projects. BRA has a strict policy of not selling or exchanging donated products designated for specific projects. A portion of the donations, however, is sometimes distributed to key BRA’s local partner organizations and the Ministry of Health raising their capacity to deliver improved health services to various impoverished communities around the country – thus expanding BRA’s humanitarian effort. All BRA’s patients receive low-cost or free medical consultations, but receive free of charge the services, medicines, eyeglasses, nutrition, and multivitamins.

B. Humanitarian Health Intervention

The Dominican Republic, although has been known to have Latin America’s fastest growing economy in recent years and host millions of tourists annually, behind the resort walls, however, the country still remains poor with a great portion of the population facing severe economic challenges. Those living inside the bateyes, 200,000+ or approximately 8% of the general population, face even greater obstacles due to their undocumented status, and a long history of neglect principally in the areas of healthcare and education. To help alleviate the plight of the impoverished population, the Batey Relief Alliance, through its regional arm, BRA DOMINICANA, delivers critical health care and social services inside the bateyes, urban barrios, rural communities and frontier-zoned localities, through medical/eye care mission trips, its medical clinic and health center, and a network of community-based health promoters.

The Batey is the (Taino Indian) Dominican word for sugar plantations rural community where Haitian immigrant workers and their Dominican-born descendents traditionally lived and worked. Today poor Dominicans as well as Haitians share the Batey habitat. Conditions in these quasi-isolated communities, however, are abysmal; there is often no water, latrines, or garbage collection. Access to healthy food, medicines, employment, and education are extremely limited. Malnutrition and disease are rampant. People in the bateyes bear the additional burdens of fear of racial discrimination or deportation to Haiti—a result of their non-legal status in the country. The population is vulnerable and practically unprotected. These conditions make it difficult, if not impossible, for batey residents to freely access health services outside of their communities.

BRA’s pioneer community-based approach to health care—bringing the care to the population inside their batey communities, starts with volunteer health promoters, who work in over 62 bateyes in the province of Monte Plata. BRA’s promoters provide education and counseling and referrals to BRA’s health services. At the BRA’s medical clinic and health center, teams of health professionals provide primary and dental care, essential medicines and preventative health services. BRA also runs five major programs that target specific health problems faced by the batey communities. These programs focus on HIV/AIDS, Tuberculosis, Blindness, Nutrition, and Potable Water. BRA’s 2007 staff includes 43 full-time and part-time employees and foreign volunteers covering a wide range of tasks at its Santo Domingo offices and in the Monte Plata field operation, including executive management and assistance, accounting, healthcare and education, clerical, resource acquisition, control and distribution, security, and transport. Through medical mission trips and long-term health projects, BRA provided critical health care and social services to over 80,000 people from January 2007-July 2007. According to a recent Columbia University study of BRA’s humanitarian health intervention in the Dominican Republic, more than 95 percent of the recipient population is extremely satisfied with the organization’s work. For many people, BRA still offers the only viable source of quality healthcare in the province of Monte Plata – the second poorest of the country.

Today, BRA is expanding its humanitarian effort at the Dominican border areas with Haiti where the most extreme poverty rates are registered in the country. Through the partnership with local NGOs and the Ministry of Health’s Nutrition Department, BRA delivers multivitamins, antiparasitic medicines and nutrition to impoverished children and adults.

II. BRA’S INTERVENTION IN THE PROVINCE OF MONTE PLATA

Summary results of Health Care Intervention in 2007

 19,132 persons received health services from the Batey Relief Alliance’s health facilities, medical mission trips and referrals, in the areas of general medicine, dentistry, pediatrics, gynecology, laboratory, optometry/ophthalmology, emergency, prevention and treatment of HIV/AIDS and Tuberculosis, and health-related domestic violence. Other assistance included, preventive health education and training, psychological support, counseling and educational workshops.
 55,939 persons received other forms of assistance/services in donations of medicines, multivitamins, food, eyeglasses, condoms, school, clothing and medical supplies; referrals to local medical clinics and hospitals; vocational assistance, follow-up medical attention, health contacts and homecare visits.
 7577 educational and promotional materials were distributed.
 1956 TB and symptomatic suffers were referred to local hospitals for follow-up treatment, and received from the BRA homecare attention and emotional support.
 196 persons living with HIV/AIDS received preventive attention and antiretroviral therapy, medicines to fight opportunistic infections, food, vitamins, pre-post testing counseling, and homecare visits.
 179 workshop and training sessions took place within the batey communities.

Other aspects of BRA’s Health Care Intervention

BRA’s health facilities include a 30-foot, fully equipped and staffed Medical (Mobile) Clinic stationed inside Batey Cojobal, in operation since 2003, and a new Health Center built inside Batey Cinco Casas, in full-time since 2006. In addition to the permanent facilities, BRA carried out in 2007 six other major health programs. In its fight against AIDS since 2005, BRA runs a comprehensive HIV/AIDS program that delivers to impoverished AIDS sufferers living inside the bateyes and other rural communities antiretroviral treatment—ARV and a cadre of associated services free of charge. BRA’s community-based AIDS treatment strategy is a model that is being repeated countrywide. BRA also worked closely with the Dominican National Tuberculosis Program to identify and treat Tuberculosis among Batey residents. BRA implemented a Blindness Prevention Program that provided vision care and free prescription eyeglasses. Another key program being implemented in partnerships with the Vitamin Angel Alliance and the Ministry of Health (SESPAS) is the Multivitamin and Deworming Program distributing multivitamins and antiparasitic drugs to 55,000 children around the country. In addition to these programs, BRA coordinated two one-week-long medical and eye-care missions in April and October.

In 2007, BRA launched three additional programs: The Art of Saving Lives – a fundraising initiative that engages local and international artists in our work and solicits art work from them to sell, the proceeds of which to help support BRA’s mission; The Food Assistance Program, with the technical and financial assistance of the USAID – distributes 75 tons of dehydrated vegetable soup to 5,000 impoverished children and adults. BRA has also secured the support of the Presbyterian Church USA’s Hunger Program, the Week of Compassion Disaster Program, and Dominican-based Fundacion ADEMI to purchase local food products in order to strengthen the USAID food program; and The Living Well Program providing EKG testing to help patients detect and prevent diseases.

The following projects are at a planning stage and will be implemented when funds are available: Permanent Home for children infected by HIV/AIDS and those who are vulnerable/orphaned; Community Organizing involving the training and education of batey-based community health promoters in the areas of preventive health and water and sanitation.

A. MEDICAL CLINIC AND HEALTH CENTER

 BRA’s Medical Clinic is permanently located inside Batey Cojobal near the town of Sabana Grande de Boyá, and remains the only fully equipped and staffed facility in the entire zone providing complete health services with free medicines and eyeglasses to batey and rural populations. Now residents can also receive free multivitamins and nutrition. The clinic opens five days a week, year round with consultations for a symbolic administrative contribution . The clinic also offers specialty services: on Thursdays, optometrists provide vision consultations and free eyeglasses; on Wednesday, pap smears are performed; and now on Saturdays, EKG testing will be performed. Laboratory tests for Clinic’s patients are performed at BRA’s health center. As in the last year, it is likely that the clinic will see an increase in patients due to the food distribution program – an incentive that will help BRA reach deeper into the communities and treat their health problems covering a wide range of diseases such as HIV/AIDS, Tuberculosis, sexually-transmitted infections, fungal infection, Diabetes , Hypertension, cold, intestinal parasites, scabies, headache, bronchitis, skin sores, back pain and dizziness.

 BRA’ healthcare center is the most modern medical facility inside any batey since the creation of sugar plantations more than 400 years ago and in the region of Monte Plata. Located inside Batey Cinco Casas, the facility includes a medical building with consultation rooms and a fully equipped laboratory, a building for education, emergency, training seminars, and patient counseling, a warehouse, and a dormitory to house local doctors and foreign volunteers. There is a playground and a garden where patients and children can wait and play. The center’s includes a full-time personnel of 32, including physicians, psychologists, optometrist, dentists, nurses, administrators, receptionists, pharmacy workers, volunteer health educators, community health promoters, and foreign volunteers. Opens five days a week, the facility provides medical, dental and vision services. It is also where BRA provides comprehensive antiretroviral therapy to Batey and non-batey AIDS sufferers in partnership with the Clinton HIV/AIDS Initiative—CHAI (discussed below) and the Dominican Ministry of Health’s DIGECITTS. The complex provides consults in general medicine, vision care, dentistry, gynecology, educational seminars, and counseling. BRA will use the facility as its main site to distribute food to hundreds of at-risk persons living with AIDS, pregnant women, the elderly and children. A new diagnostic ward will be created this year to perform electrocardiogram (EKG) tests on patients on Saturdays. An ambulance is already available to provide emergency transport services.

Last year, a complete ophthalmology department was installed at the center to provide advanced ophthalmology and optometry care to patients. This year, a brand new dental clinic is being installed with the generous support of two of BRA’s board members, Dr. Thomas and Mrs. Sara Beague.

 Since January 2007, the Mobile Clinic and the Health Center combined delivered direct health services to 13,875 patients, including complete medical, dental and ophthalmologic care, HIV/AIDS treatment, laboratory, medicines, food, and counseling.

B. WATER/SANITATION PROJECT

BIOSAND WATER FILTERS
Last year, BRA distributed 60 Biosand Water Filters to families in Batey Cojobal and to HIV/AIDS patients in bateyes surrounding Sabana Grande de Boyá. The project is sponsored by the Rotary Club of Mirador in Santo Domingo and has the objective of disease prevention. BRA is now negotiating with the New York Rotary Club and the Presbyterian Church-USA International Service Program to join the project with training, education and funds to purchase additional filters to distribute to more families in the bateyes.

Access to clean water/sanitation for Batey residents is a major institutional goal for BRA, a grave concern in the bateyes, and a major source of illness in our patient population. With no potable water available, most batey residents rely on rivers, rain, or open wells as a source of water—all of which contain water-borne pathogens. In recent focus groups conducted by BRA, batey residents listed clean water as their number one priority. Based on BRA’s current statistics, 14% of patients who visit the Mobile Clinic in Batey Cojobal are seeking treatment for intestinal parasitic infections. Parasitic infections are a common cause of death in children under five and can also contribute to anemia and other health problems. Imagine being constantly plagued by gastrointestinal pain, vomiting and diarrhea. This is the reality for people without access to clean water. While BRA has been treating water-borne illnesses for years at their health facilities, this initiative gets to the root of the problem, preventing people from getting these infections and reducing their spread within the community.

Access to clean water is especially more problematic among HIV/AIDS patients who do not have a hardy immune system to defend against water-borne pathogens. Infection with multiple parasites is very common among these patients and can begin a downward spiral of weight loss that eventually leads to death. Not only will these filters impact the health of these patients directly, it will also improve the health of the family members caring for these patients and their immediate neighbors and reduce local transmission of water-borne pathogens to these patients.

BRA’s model water filtration project will benefit over 200 families. Each family that receives a filter also learns about health and hygiene and how to care for their filters. BRA also trained community stewards to provide continued education and support for filter users.

This year, BRA hopes to expand this project to other bateyes in Monte Plata, providing clean water—a basic human right for all.

PUR WATER PURIFICATION TABLETS
As another approach to dealing with the water/health crisis in the bateyes, BRA has partnered with the Public Service International (PSI) to distribute affordable PUR water purification tablets, a product of Procter & Gamble. One PUR tablet costs 5 pesos or about 20 cents and will disinfect 2.5 gallons of water. BRA and PSI are working with local businesses, HIV/AIDS patients and health promoters to sell the tablets and to educate people in the bateyes about how to use them. This project provides a much-needed income for these individuals while promoting access to clean water and hygiene education.

C. COMPREHENSIVE HIV/AIDS PREVENTION AND TREATMENT

HIV/AIDS INSIDE THE BATEYES
The people living in the bateyes are among the most affected by HIV/AIDS in the Western Hemisphere. A recent study found that 8.8%, or approximately 1 in 11, of women in the bateyes are HIV-positive, as compared to a prevalence of 1.25% among low-income women in the Dominican Republic. This has already had a devastating impact on these communities, leaving behind orphans who may or may not be infected, as well as unstable family units. The issues surrounding HIV/AIDS in the bateyes are complex; they are impacted by socio-economic and political structures such as unemployment, migration, stigma, and gender inequality that require solutions that reach beyond the boundaries of health care. BRA’s insight into the broader, structural issues, along with its mission to provide community-based health care as well as education and social services inside the bateyes underlies its HIV/AIDS intervention—the concept of bringing the care home to the population.

“Arco Iris – RAINBOW” COMMUNITY SUPPORT OF HIV/AIDS PATIENTS
Since 2005, BRA provided community health support through the CONECTA Project funded by the USAID/Family Health International. The program permitted BRA to identify and register into its HIV/AIDS prevention and treatment program those who carry the virus or/and already living with AIDS. With the official end of the program in May 2007, many aspects of BRA’s life-saving services also ended, including the identification of more HIV/AIDS sufferers, community health support and homecare to patients.

The direct results of BRA in the Rainbow project were competitive. BRA started the project in 20 bateyes in the province of Monte Plata and during its evolution, integrated another 17 bateyes in Monte Plata and the Sanchez Ramirez bordering region covering a total of 37 bateyes. We proposed to identity and treat 1750 vulnerable/orphaned children but reached 1430 – 82% of our goal. We proposed to treat 1100 people living with AIDS/affected but reached 1489 - 135% of our goal.

We concentrated our efforts and strategies mainly on identifying HIV people, orphaned/vulnerable children and pregnant women and providing them with the quality care and psychological attention they need to live productively and dignifiedly with the virus. We taught them at the schools and churches about prevention, and encouraged them to come out and get tested. BRA offers free comprehensive health care to all AIDS patients inside its Cinco Casas’ Center, including antiretroviral therapy and treatment for opportunistic infections. BRA also offers a cadre of social services including psychological support, economic assistance, nutritional aid, vocational training, education, and HIV counseling and testing at our mobile clinic and health center. BRA provides patients with continuing medical and follow-up attention and referrals, and a companion to take them to outside clinics for specialized tests, support to families and AIDS sufferers about home and self-care, educational and psychological assistance to orphaned/vulnerable children, pre and post testing counseling, and funds for transportation, food and specialized tests not performed at BRA’s center.

BRA conducted more than 2,000 home visits where our promoters individually evaluated the health and psychological conditions of each patient, and provided them with donated personal hygiene and clothing materials, nutrition, vitamin, etc. BRA has also worked to unite and empower 255 individuals with their families affected by HIV/AIDS through patient/family workshops. Other workshops focused on teaching patients and their families on how to protect themselves and their health against the virus. Some of the topics covered included: self-esteem, drug and alcohol abuse, nutrition, hygiene, sexual contact, and exercise. BRA also conducted 18 vocational trainings. Many of our AIDS patients are among the most destitute in their communities, and providing them with tools to earn an income is essential to improving their health and economic independence—thus working towards human productivity and dignity.

This year, five of the HIV/AIDS children who are registered in the BRA’s HIV/AIDS prevention and treatment program participated in the Sol de Verano Camp sponsored the Fundacion Mir in the province of Jarabacoa. The children spent a weeklong enjoying themselves, having fun, and sharing their lives with other kids experiencing similar health conditions. The project helped BRA’s effort to ensure the psychological and mental growth and stability for those kids. BRA’s partner – the Clinton HIV/AIDS Initiative helped secure the camp for the kids.

Services offered to HIV/AIDS patients

Types of services offered # Services

Referrals/healthcare: Medical exams and specialized attention, donations of medicines and eyeglasses, laboratory tests, referrals to PNRTV, PNCTB, UAI and other services
8,872
Nutritional Assistance: Food (vegetable soups, rice, beans, oat meal, vegetable oil), and vitamins.
8,122
Follow-up care: Through homecare visits and visits at BRA’s health facilities.
6,693
Improvement of the home: Donations of mattresses, bed sheets and hygiene kits.
5,800
Educational Assistance: Workshops about home and self-care. This also takes place through peer group counseling and meetings.
5,340
Emotional support: Psychological help; formation of peer counseling group.
4,383
Economic support: Training in technical-vocational activities. They learn how to design curtains, fabricate beds, and receive referrals for micro credit loans.
4,157
Educational support: Donations of school materials – and learn about transmission, protection, prevention and treatment techniques.
2,354
Home visits: Realized by BRA’s health personnel (doctors, nurses and promoters)
2,308
Clothing: Clothes and shoes
861

HIV/AIDS Treatment Unit

BRA’s HIV/AIDS Treatment Unit is the only one in the entire region of Monte Plata, and the only one operating inside a batey with such a high level of quality. The Unit is administered by BRA’s HIV/AIDS/Health specialists at the health center. The Unit receives from the Clinton HIV/AIDS Initiative and the Ministry of Health’s DIGECITTS and offers to HIV/AIDS patients antiretroviral therapy and medicines to fight opportunistic infections, and offers pre-post testing counseling to adults and children, rapid tests, emotional support to AIDS sufferers, orphaned/vulnerable children and affected persons, laboratory tests, home visits for the handling of secondary effects. Currently BRA services 212 persons living with AIDS in the following ways: 117 adults receives supervisory attention (71 females, 46 males), 81 adults receives ARVT (44 females and 37 males), 6 children receives ARVT (4 females and 2 males), and 8 children under supervisory attention (5 females and 3 males)

HIV Testing breakdown

MONTH TOTAL FEMALE MALE TESTED POSITIVE
JAN 23 19 4 4
FEB 32 21 11 6
MAR 55 20 35 3
APRIL 75 47 28 10
MAY 82 49 33 11
JUN 42 26 16 3
TOTAL 309 182 127 37

Condom Distribution

Through the collaboration with and support of the PSI, BRA distributes low-cost condoms to the youth and adults in an effort to curb the rising rate of HIV infection inside the bateyes. The condoms, accompanied with basic information materials, are easily placed and found at the local bodegas. BRA’s promoters worked closely with young people and use them as Multiplicadores to expand the preventive health information into other segments of the batey communities. More than 864 condoms have been distributed into various communities, including Don Juan, El Cacique, Bosque Arriba, and La Mina. While the promotional activities have ended with PSI, BRA continued solo its own educational effort and held 10 activities in several communities that participated in the project. During the month of March, BRA reached out to 423 persons through educational and training workshops on the prevention of HIV/AIDS, sexually transmitted infections (STIs) and unwanted pregnancies. Those 30-45-minute workshops discussed themes about proper use of a condom and the myths and erroneous facts surrounding sexual pleasures. To finish each workshop, promoters involved the audience in acts to show how to use a condom and many eagerly participated. Also, PSI created a Soap Opera called “Amor Del Batey” in which 36 communities participated, showing the seriousness of the AIDS situation. The actors were all residents from the bateyes and helped the community connect better with the message.

Capacity Building to Stop HIV/AIDS from Integral Perspectives - Alianza Bateyes

This program is part of the National Plan to Fight and Control HIV/AIDS, for which COPRESIDA is the beneficiary of a Global Fund grant to coordinate strategies to fight AIDS, Tuberculosis and Malaria in the Dominican Republic. Thus, the creation of Alianza Bateyes, of which BRA is a member, is an effort coordinated by COPRESIDA to attack the AIDS situation inside the bateyes from a community-based stand point where NGOs are key players in the fight. BRA has reached 606 youth, adolescents and promoters from six bateyes, with whom we worked the issues of prevention of infections, HIV and AIDS, and identified other youths that may themselves be positive or interested in participating in the project.

Pre-packaged Therapy for the Handling of HIV Syndromes

This program is supported by the DIGECITSS and CHAI with the goal of detecting and preventing STIs. Women and men in their reproductive years or/and are sexually active are evaluated for specific body signs by our physicians and received counseling, therapy, and treatment (when appropriate).

The program has reached 1,170 patients who were identified through the following symptoms:

STIs Female Male
Genital Ulcer 51 20
Lower Abdominal Pain 178
Bubon Inguinal 8
Vaginal secretion - cervicitis 387
Urethral secretion 0
Vaginitis 525

The Sumando Uno (Plus 1)

This program is being implemented from the BRA’s HIV/AIDS Treatment Unit as part of the CHAI’s broader objectives in its HIV/AIDS intervention in the Dominican Republic. The program strengthens the capacity of patients living with HIV/AIDS and health promoters to help BRA easily identify new cases of HIV and AIDS. Our health counselors have identified 17, health promoters 3, psychologist 5, and nurse 2.

Some of the activities included meetings with church leaders and pastors, traditional “vodoun oungan” healers, and workshops about stigma and discrimination. The themes treated were how to identify signs of HIV infections, hygiene and nutrition, use of a condom, clean hands, and theater acts based on HIV/AIDS/STI in which members of the community participated.

PREVENTIVE HIV/AIDS EDUCATION – NEW YORK

Aside from addressing HIV/AIDS in the Dominican Republic, the BRA also promotes HIV/AIDS education in New York’s Brooklyn where some of the highest HIV/AIDS rates in the United Sates are registered. This year, BRA received a second grant of $10,000 from the New York State Department of Health, through the support of the Brooklyn’s office of Assemblywoman Rhoda Jacobs, to carry out radio shows to educate about HIV/AIDS among low-income and ill-educated immigrant communities. The program is implemented with the collaboration of the Brooklyn-based Radio Soleil and the Association of Haitian Physicians Abroad (AMHE). Physicians who are HIV/AIDS experts, and are fluent in Haitian Kreyol, are recruited to host the shows in English and Kreyol. Listeners have the opportunity for questions and answers, and receive referrals for testing sites, hospitalizations or counseling.

D. TUBERCULOSIS PREVENTION

In conjunction with USAID’s Project CONECTA and the National Tuberculosis Control Program, BRA initiated a region-wide program to control tuberculosis inside the province of Monte Plata. This project, which began in August 2005, has trained a network of 220 community health promoters in 62 bateyes to identify patients showing signs of tuberculosis symptoms and refer them for testing at hospitals. BRA is responsible for the largest percentage of TB referrals in the region.

Those who test positive are referred to local hospitals for further observation and for treatment. The health promoters also give educational seminars in their home bateyes on the identification and treatment of tuberculosis symptoms. BRA has captured 1956 persons through 35 activities of information, education and communication; distributed 2371 brochures and flyers of Promotion de Health Services in TB of the PNCT; referred 81 respiratory symptomatic patients; realized 362 home visits and provided follow-up attention to 7 persons with co-infection of TB/HIV. Through these activities, BRA distributed 770 hygiene kits and provided nutritional assistance.

Part of our intervention also is to ensure that our health promoters who are in the frontline identifying and educating TB-infected persons about the disease are constantly being educated about their knowledge of health-related information that is transmitted to the public. Meetings and workshops are organized for the promoters by BRA and government hospital’s staff to share information and to strengthen the capacity of new promoters. 11 new promoters have joined the campaign.

BRA also took the leadership by mobilizing 75 tons of food to be distributed to some of the TB patients in an effort to rebuild their physical strength after or while taking their medicines. TB patients, in order to successfully rid of their infection, need to maintain a strong nutritional diet, something that lacks severely in the bateyes due to extreme poverty. These patients will receive the food over ten months.

Given BRA’s successful TB prevention campaign, the organization was invited to participate in a workshop to evaluate the National Program for the Control of Tuberculosis, which was assisted by a health delegation from the National Plan to Fight Tuberculosis in Haiti. At the workshop, speakers spoke of a critical need for a bi-lateral program between Haiti and the Dominican Republic; identified the weaknesses and strengths of the proposed joint program; and evaluated possible solutions to contribute to the welfare of the infected population. At the workshop, it was acknowledged the positive collaborative effort to combat TB by local NGOs, through their promoters, and under the auspices of support organizations such as USAID, Pro Familia and Global Fund.

This year, BRA celebrated the Fight Against Tuberculosis Day on March 22 in Sabana Grande de Boyá where 234 people attended, including the Health Director of Monte Plata, directors from local hospitals, BRA’s health personnel, community leaders, church representatives and promoters. At the activity, we presented the results obtained in the TB project where the Ministry of Health’s representatives publicly praised BRA’s effort in the province.

BRA’s TB project integrates different groups of volunteers who assist with the implementation of the Strategies DOTS/TAES of the Program National to Control Tuberculosis (PNCT) of the Ministry of Health, including the reduction of stigma and discrimination inside the bateyes.

E. FOOD ASSISTANCE

This program is being implemented with the technical and financial support of the USAID. $173,000 have been allocated for the purchase of 75 metric tons of Breedlove dehydrated soups to be distributed to 5,000 children and adults who are malnourished and HIV/AIDS, Tuberculosis sufferers, pregnant women, vulnerable/orphaned children, and retired elder sugar cane cutters. More than 10 grassroots and government organizations have joined to help distribute the rations in 64 bateyes, 11 urban slums and 7 rural and border zoned communities. The locations include Monte Plata, Santo Domingo, Barahona, San Pedro de Macoris, Monte Cristi, Dajabon, Pedernales, Hato Mayor, Samana, and La Romana. Distribution starts in August 2007 through June 2008. Three other organizations, the Presbyterian Church USA Hunger Program, the Week of Compassion’s Disaster Program and the Dominican-based Fundacion ADEMI have contributed funds to purchase local food products in rice, beans, corn, oil, and plantains to complement the Breedlove soup. The Food program complements BRA’s Multivitamin Deworming Program. The Fundacion ADEMI grant is particular important for us as it demonstrates the integration of Dominicans in their local issues for solution. The ADEMI grant of about $6000 will reinforce the USAID/BRA food program and the BRA/VAA Multivitamin program engaging 26 health promoters in the bateyes to educate 4700 pregnant women, children and breast-feeding women about proper diet, antiparasitic medicines, and multivitamins.

F. MULTIVITAMIN AND DEWORMING

This three-year program which started in February 2007, with the technical and financial support of the Vitamin Angel Alliance, distributes daily multivitamins and bi-annual worm medicines to 55,000 children around the country. The program aims at building the physical and psychological make-up of children by riding them first of the intestinal worms, then providing them with daily doses of the multivitamins. Our objective is to ensure that the kids are physically and mentally conditioned to learn in school and thrive. Some of those kids will also receive food rations. More than 10 local grassroots and government organizations, including the Ministry of Health are collaborating in the distribution of the products in Monte Plata, Santo Domingo, Barahona, San Pedro de Macoris, Monte Cristi, Dajabon, Pedernales, Hato Mayor, and La Romana.

G. BLINDNESS PREVENTION

BRA’s Blindness Prevention Program continues to provide complete eye exams, eyeglasses, eye drops, and medicines to patients at the Medical Clinic and the Health Center. In 2007, over 2000 patients were attended in Monte Plata. An additional 1200 received free vision care and eyeglasses from BRA through an ophthalmologic mission trip organized in April in the province of Hato Mayor in collaboration with the Student-VOSH of the New England College of Optometry, the Lions Clubs Arroyo Hondo Santo Domingo, the Foundation Pringamosa, and the Foundation ADEMI. During the short-term intervention, committees of health promoters also received training in preventive vision education, testing and care. The Lions Clubs International Foundation and the New Jersey Eyeglasses Recycling Center have been great supporters of the BRA’s blindness prevention in the bateyes.

H. CHILD SPONSORSHIP

This program helps address the basic human needs of impoverished children living in the bateyes of Monte Plata. Currently BRA has three sponsors from the United States who donate small funds to purchase school and clothing supplies, and help deliver basic medical care for eight children. All these children have free access to BRA’s health facilities and receive free medical care, medicines, multivitamins and nutrition. Members of their families too receive access to BRA’s health facilities and free clothing and household materials, when available.

I. MUSIC

In collaboration with the Fundacion Gisela, the BRA started the first music “Suzuki” program offering batey kids in Monte Plata the unique opportunity to learn to play the violin and the cello – an effort to help nurture and expand the minds of the children. BRA has recruited 15 kids living in the bateyes to obtain free music lessons from local violin and cello teachers at the Dominican Conservatory of Music. Those kids travel weekly to the capital Santo Domingo to receive classes (supported by the Fundacion) and perform small concerts for the public. This summer, the kids participated in their first Suzuki Festival of the Caribbean where they performed successfully. BRA’s partnership in the program includes logistical and technical assistance, and supporting the kids with free medical assistance, clothing, nutrition, and multivitamins.

J. VOLUNTEERS AND MISSIONS

As part of its humanitarian intervention and in addition to its permanent healthcare programs, BRA mobilizes and sponsors short-term medical, dental, and eye care mission trips to the Dominican Republic, on which volunteer health care providers, medical students and residents from North America spend one to two weeks providing free care and medicines, alongside their Dominican counterparts, inside the bateyes and other impoverished communities where BRA or its partner organizations operate. Follow-up care is often provided by BRA at its permanent health facilities. BRA also recruits non-medical volunteer groups to assist in special projects of construction and education. BRA’s long-term volunteers are supported by the Catholic Medical Mission Board with free air fares, monthly stipends, and insurances.
This year, 41 volunteers traveled to the Dominican Republic to work with BRA doing medical, public health and administration work. Local health professionals share their expertise with the visitors who do the same from a western healthcare point of view.

HAÏTI-LÉVIS FRIENDSHIP MISSION
In may, a group of 14 young students and adults from Canada’s Quebec with the “Haïti-Lévis Friendship Mission” to volunteer at the BRA’s medical center in Batey Cinco Casas. The group completed the construction of BRA Center’s children playground; built a new home for a patient living at batey El Bosque; built a dining table for the BRA’s volunteer dormitory; rebuilt the school’s doors at batey el Bosque; organized dinners with local batey families; and conducted workshop and training sessions for the residents in the art, health, human productivity techniques.

ALLIANCE FOR YOUTH SERVICES
In June, a group of thirteen young people and adults from the Church of Jesus Christ of Latter Day Saint traveled to Monte Plata where they installed a new ward for preventive health education inside BRA’s second build on the Center’s ground. The area now has a new door, lighting, bookshelves, bathroom, and protective window bars. The group also conducted fellowship sessions with the local residents.

BRA/AMHE MEDICAL MISSION TRIP
In October, BRA will receive 12 volunteers from the US-based Association of Haitian Physicians Abroad—AMHE, including two dentists, two dental assistants, a pediatrician, an internist, and medical students. This mission will take place in a locality of Monte Plata called Yamasa and serve approximately 1000 persons who have limited access to basic health care or are living far from BRA’s health facilities.

BRA/SOVH-NECO OPHTHALMOLOGY TRIP
In April, more 15 optometry students and faculty from the Student/VOSH of the New England School of Optometry traveled with BRA to the province of Hato Mayor where they provided free eye exam, care and eyeglasses to 1200 impoverished people living in the bateyes and rural communities. The SVOSH also produced and donated free specialized-made eyeglasses to 10 patients who had advanced eye problems and are too poor to purchase the glasses.

COLUMBIA UNIVERSITY
From 2006-2007, BRA received a group of nine Public Health graduate students from the Columbia University School of Public and International Affairs and Mailman School of Public Health who performed a comprehensive study on the BRA’s 10-year humanitarian health intervention in the Dominican Republic focusing on Primary Health Care, HIV/AIDS Prevention and Treatment, and Health Promotion. The study found more than 95% of the population is extremely satisfied with BRA’s services, the care is of quality, and the organization is filling an important healthcare gap in the bateyes and the region of Monte Plata. But the study also founded that the organization lacks the necessary resources to meet the population’s growing healthcare needs and a strategic plan to move forward into the next decade. A copy of the Columbia study will be made available via email upon request.

This fall, BRA also hosted two other students from Columbia University’s Mailman for eight weeks who worked on two projects: obtain the history on persons living with HIV/AIDS and are recruited in the BRA’s HIV/AIDS prevention and treatment program, and design a guide for the promotion of preventive health education in the bateyes.

K. MEDICAL DONATIONS: ALLIANCE ORGANIZATIONS

As part of its humanitarian health care expansion in the Dominican Republic, BRA distributes donated medicines, medical supplies and equipment to local partner grassroots organizations or/and government agencies working to provide health care inside impoverished bateyes, urban slums, and rural communities where the population cannot afford basic medical care and medicines. Through these donations, BRA raises the partners’ capacity to become more effective in delivering care in locations where BRA does not operate directly. Aside from medicines and medical supplies, this year BRA donated new products including multivitamins, antiparasitic medicines and nutrition to 26 public and non-profit organizations. Each year, BRA mobilizes and collects more than $2 million worth of donations in the United States from international groups. Recipient organizations sometimes collaborate with the costs of customs and transport of the donations.

Table 6. Donations to BRA’s Partners

Organization Type of Donation
Colectivo de Salud Popular (COSALUP) Medicines, materials, nutrition, multivitamins
Fundación Todo por la Salud (FUNTOSALUD) Medicines, materials, medicines
Servicio Social de Iglesias Dominicanas (SSID) Medicines, materials, nutrition, vitamins
Consejo Estatal del Azucar (CEA) Nutrition
Dirección Provincial de Salud de Monte Plata Medicines, materials, nutrition
Dirección General de Control de ITS y SIDA Medicines, materials, nutrition
Fundacion Amparo Infantil Medicines, materials, milk
Club de Leones Santo Domingo Arroyo Hondo Medicines, materials
Hogar de Ancianos San Francisco de Asís Medicines, materials
Hospital Provincial de Monte Plata Medicines, materials
Hospital Municipal de Sabana Grande de Boya Medicines, materials
Clínica Rural Distrito Municipal Don Juan Medicines, materials
Clinical Rural El Cacique Medicines, materials
Clínica Rural de Villa Jaragua Medicines, beds, materials
Clínica Rural de las Clavellinas Medicines, beds, materials
Clínica de Rural Postrer Rió Medicines, beds, materials
Fundacion Genesis Medicines, materials
COPRESIDA Nutrition
SESPAS Nutrition, multivitamins, worm meds.
CHAI Nutrition
Buen Samaritano Nutrition, multivitamins
DPS Hato Mayor Nutrition
Funda Prin Nutrition
FUSABI Nutrition
Iglesia Evangelica Nutrition
Fundacion Samana Nutrition

III. INSTITUTIONAL RELATIONSHIPS AND PROMOTION

 As part of the Batey Relief Alliance’s 10-year anniversary celebration of its creation, on April 10th, the BRA Dominicana celebrated its 6th-year anniversary at the Santo Domingo-based UNESCO locale where more than 80 public, diplomatic and media personalities, donors, partners, and friends gathered to share the joy and pay respect. A video of BRA’s work was shown, including well wishes and testimonies from BRA’s partners and friends.

 BRA Dominicana participated in the elaboration and presentation of the COPRESIDA’s 2007-2015 Strategic Plan to Control and Fight HIV/AIDS in the Dominican Republic, at the Dominican Republic National Palace.

 BRA Dominicana signed a working agreement with the Ministry of Health to distribute multivitamins and antiparasitic medicines to 55,000 children around the country. The Vitamins Angel Alliance donated the multivitamins and worm medicines to BRA to distribute. The Ministry of Health helped get the containers of the products out of the DR customs free of charge.

 The Batey Relief Alliance signed a working agreement with the USAID to distribute 75 metric tons of dehydrated vegetable soup, valued at $173,100, (commodities) and $99,700 for the receipt, rapid transportation, delivery of the commodities, to 5000 vulnerable children and adults. The program receives the complete technical and financial assistance of the USAID.

 In February, BRA Dominicana received and hosted the world famous Haitian singer Emeline Michele who visited the bateyes and sang for her compatriots in the province of Monte Plata. The singer recently produced a song in honor of a young girl who is vulnerable/orphaned and living with HIV/AIDS, and whose parents have perished from the disease.

VI. CHALLENGES

1. Increased Financial Independence
BRA does not have major sponsors to support its program expenses. BRA only relies on limited financial support from its boards of directors, faith-based groups, foundations, and individual donors to carry out the many ambitious projects it undertakes. A high percentage of the organization’s total budget covers project delivery. BRA’s operation is generally under-funded. As the organization grows steadily into a well-developed institution and undertakes large-scale projects, it is crucial that we receive enough funding to develop a professional and capable operating staff.

BRA is often forced to rely on project-funding organizations to contribute almost the entire operating budgets to the projects. This limits BRA’s ability to design and carry out the projects as it sees fit. An increase in BRA’s general budget would free the organization from constraints imposed by other institutions and allow it to break ahead of the pack and implement the most effective projects in the Dominican Republic.

The following specific needs could be addressed by an increase in funding:

• Improved operation of BRA’s health care facilities: as patient visits increase, BRA must increase its health personnel and supplies of medicines to meet increased patients’ health needs.
• Energy: BRA’s health center is fully equipped with equipment to deliver care. But there is very limited supply of energy to power the equipment. BRA needs funds to install inverters and generators to receive permanent electricity.
• Transportation costs for patients: many patients that cannot be treated directly through BRA’s health centers go untreated because they lack the money to travel to other sites for essential, and at times, free treatment. Many patients cannot even afford to travel from their home bateyes to BRA’s clinics. Transportation is one of the biggest and most frequently ignored challenges facing healthcare providers working in the bateyes. Funding organizations often neglect to provide BRA projects with sufficient transportation budgets.

2. Increase Organizational Capacity
BRA lacks the organizational capacity to keep up with its fast-growing projects and the number of people in need of health care assistance in the bateyes and other rural areas. Our staff is limited in number and in expertise. We need to improve our capacity in order to perform adequately. Funding support in workforce development is urgently needed. BRA also needs to create a strategic plan that would help move forward into the next decade.

3. Increase Support Capacity
BRA’s two health facilities service a population of approximately 22,000 annually. More than 70% of the patients are too poor to afford basic medicines. While the number of our patients is expected to triple in the coming year, the amount of donations BRA receives annually has decreased dramatically because of sudden cuts from pharmaceutical companies to our donors. It is absolutely essential that BRA addresses the issue of medical re-supply if its projects are going to survive. With the increased patient load of the Cinco Casas facility, irregular donations of medicines will not be a viable supply system. In order to efficiently and effectively supply its two clinics, BRA needs to secure a regular source of monetary donations to buy low-cost medicines not received in donations.

4. Increase Support for HIV/AIDS Intervention
It is imperative that partner institutions that work with BRA to implement its HIV/AIDS treatment program do understand the need to put funds aside for the transportation and nutrition of the patients. The lack or absence of healthy nutrition perhaps is our greatest barrier for the effectiveness of the ARV treatment. Our patients simply cannot undergo their treatment without food in their stomach. It does not help to only implement the program entirely on testing, treatment and prevention, while ignoring other key factors, such as food, that could be detrimental to the effectiveness of the program. Healthy food + ARV treatment = Healthier patients. They go hand in hand. The lack of funds to transport patients to clinics to receive their life-saving treatment is also a serious problem.

5. Increase medical clinic’s space capacity
Since the installation of the mobile clinic at Batey Cojobal in 2003, the demand for health care has increased tremendously. The clinic, as a result, has become too small to accommodate all of our personnel working at one time and the increased number of patients. There is no waiting area for patients to protect against heavy rains or the burning sun. There is no bathroom for patients and personnel. The clinic’s limited space (one consultation room and a waiting room) has often challenged patients’ privacy and visits. BRA loses each month a great percentage of patients who return home uncared for as the waiting time is hours long. BRA seeks to expand the clinic’s space capacity by building an expansion ward to facilitate a proper health care environment. The new ward will be built with separate consultation rooms for general medicines, pediatrics, HIV/AIDS testing and counseling, and areas for reception/registration, data collection and filing and waiting.

V. INSTITUTIONAL EFFORT

A. STRENGTHENING OUR FUNDRAISING BASE

Aside from our regular annual fundraising efforts (please see BRA’s IRS 990 Return), BRA creatively designed other strategies to help strengthen its fundraising base and meet the financial challenges. These donations have strengthened the organization’s ability to deliver quality health services and sustain its field operation. Below are some of the new strategies being implemented in 2007:

 The “Art of Saving Lives” initiative involves local and international artists in the BRA’s humanitarian efforts and receives donations of artwork to sell, the proceeds of which to help advance the organization’s humanitarian health intervention. As of July, seven artists have donated their artwork for a value of $7,550.
 One of BRA’s donors, William, Betsy and Fred Moyer have created the “Moyer Matching Fund” whereby BRA would secure local money donations from Haitian and Dominican nationals living and working in their countries, which would later be matched dollar for dollar. The effort is not only to raise money, but also to encourage Haitians as well as Dominicans to take ownership of issues affecting their compatriots.
 BRA created the “Goodwill Ambassador Program” offering Ambassadorship to prominent figures in the fields of art and literature to use their fame to promote the organization’s work and to mobilize resources for the effort. BRA will extend its first Ambassadorship position this year to Haiti’s famed female singer, Emeline Michel.

B. STRENTHENING HEALTHCARE DELIVERY CAPACITY

 Two EKG machines will be installed this year at BRA’s medical clinic and health center to provide the populations the opportunity to do important tests.
 The laboratory at BRA’s health center is now complete performing basic and major tests.
 The center will have a new dental clinic this year.
 The center is now recognized as the most modern medical facility filling an important healthcare gap in the country. More than 15,000 travels yearly far away to receive improved health care they considered rare and of quality.

C. STRENGTHNING OUR INSTITUTIONAL POSITION

Raising the staff professional capacity
Given the leadership position of the BRA in the community, it is imperative that we grow with a staff that is skillful, conscientious and ready to perform complex tasks. This is why we devote a great attention in their day-to-day performance and development. Our staff has received training and workshops continuously in racial tolerance, quality care for patients, prevention of stigma and discrimination, prevention and treatment of HIV/AIDS and Tuberculosis, etc. In July, BRA sponsored a trip for its Senior Health Psychologist to Madrid, Spain, where she has obtained a scholarship from the Foundation Carolina to study “Psychopathy of the Emotions and Stress in Health.” We feel that her increase in knowledge would better her as a professional and also enhance our services to patients.

VI. SUPPORT FOR BRA’S WORK IN 2007

INCOME AND EXPENSES
A copy of the Batey Relief Alliance’s latest annual report may be obtained, upon request, from the New York State Office of the Attorney General, Charities Bureau, 120 Broadway, New York, N.Y. 10271. The same may be obtained from the Batey Relief Alliance’s website at www.bateyrelief.org (and click on the GuideStar button).

IN-KIND DONATIONS OF MEDICAL SUPPLIES AND MATERIALS
Each year, BRA mobilizes and raises millions of dollars in ink-kind donations of medicines, medical supplies and equipment to support its own health projects in the province of Monte Plata or/and to raise local partner organizations’ capacity to deliver improved health services in other impoverished areas of the country. BRA’s patients receive free medicines, eye glasses, vitamins, nutrition and other basic materials and affordable medical services.

WHO SUPPORTED BRA 2007
The Bill Clinton Foundation’s HIV/AIDS Initiative, St. Joseph Hospital Exempla Foundation, Google Grant Program, New Jersey Lions Eyeglass Recycling Center, Club de Leones Arroyo Hondo Santo Domingo, Club Rotario Arroyo Hondo Santo Domingo, Club Rotario Mirador, USAID/CONECTA/Family Health International, USAID, Columbia University’s Mailman School of Public Health & School of Public and International Affairs, Catholic Medical Mission Board, Direct Relief International, Food for the Poor, Disciples of Christ’s Week of Compassion, Dominican’s Ministry of Health (SESPAS), COPRESIDA, DIGECITTS, Fundacion ADEMI, the New York State Department of Health (Assemblywoman Rhoda Jacobs), Washington-DC Order of Malta, Presbyterian Hunger Program, Presbyterian-Church USA, Foundation for Peace, Public Service International, International Foundation, International Aid, SVOS-New England College of Optometry, Fundacion Gisela, Vitamin Angel Alliance, BRA’s Boards of Directors, Canada-based HAÏTI-LÉVIS organization, Church of Jesus Christ of Latter Saint’s ALLIANCE FOR YOUTH SERVICES, international volunteers and missionaries, and generous individual donors like you.

VII. INTERNET UPDATE OF BRA’S HUMANITARIAN INTERVENTION

It is of great importance that we keep you up-to-date of our work and progress by visiting the BRA’s interactive website at www.bateyrelief.org.

VIII. BOARDS OF DIRECTORS OF THE BRA

The Batey Relief Alliance’s Board of Directors is based in the United States and runs the legal and policy affairs of the institution. The BRA Dominicana’s Board of Directors is based in the Dominican Republic and oversees the legal and day-to-day programmatic, financial and administrative affairs of the organization.

Batey Relief Alliance
Carol King, Esq., Acting President
Dr. Thomas Beague, Vice President
Sara Beague, Treasurer
Alice Fernley, Acting Secretary
Dr. Kathleen Kearns, Trustee
Dr. Raymond Thertulien, Trustee
Dr. Pierre Leger, Trustee
Dr. Paul Nacier, Trustee

Ulrick Gaillard, J.D.
Chief Executive Officer

BRA Dominicana
Lic. Nexcy De León, PRESIDENTA
Dr. Jorge Méndez, VICE PRESIDENTE
Lic. Miguel A. Puente H, SECRETARIO
Lic. Edilgardo Peña, TESORERO
Dr. Raymond Thertulien, VOCAL
Dr. Ulrick Gaillard, J.D., VOCAL
Lic. Júnior Arias, VOCAL

Lic. Maria Virtudes Berroa
Directora Ejecutiva

IX. MISSION, VISION, VALUES, AND FUNDAMENTAL OBJECTIVES

 The mission of the Batey Relief Alliance is to help create a productive and self-sufficient environment for children and families severely affected by poverty, disease and hunger in the Caribbean, including those living inside the bateyes, urban barrios, rural slums and border localities of the Dominican Republic.

 The vision of the Batey Relief Alliance is to be a leader organization with the capacity, dependability and integrity to respond adequately to the humanitarian needs of economically-deprived populations.

 The core values of the Batey Relief Alliance are to bring people together, alleviate sufferings and save lives regardless of race, sex, creed, religion, national origin or political affiliations.

 The fundamental objectives of the Batey Relief Alliance are to 1) help create a productive and self-sufficient environment for those affected by extreme poverty and marginality, 2) educate, train and organize the affected population about relevant issues in order to cause sustainable and positive changes in their lives, based in equity, responsibility and education for all, where the recipient communities, the government and the international community are bone fide partners, and 3) increase the level of sustainability to strengthen the organization and to guarantee the continuity of quality humanitarian services for all.

X. CONTACT THE BATEY RELIEF ALLIANCE

The Batey Relief Alliance
Ulrick Gaillard, J.D., CEO
P.O. Box 300565
Brooklyn, N.Y. 11230-0565
Phone: 917.627.5026 (New York)
Phone: 809.961.2948 (Santo Domingo)
Email: bra@bateyrelief.org
Email: bateyrelief@mindspring.com

Batey Relief Alliance - BRA Dominicana
Maria Virtudes Berroa
Directora Ejecutiva
Avenida Winston Churchill, No. 71
Edificio Lama, Suite 212
Ens. Piantini, Santo Domingo
Republica Dominicana
Phone. 809.540.4947, fax. 809.540.0786
Cel. 809.696.7848
Email: bradominicana@codetel.net.do

XI. THE FUTURE

The BRA endeavors to undertake and implement the following programs and projects:
 Build an expansion medical ward for its Medical Clinic inside batey Cojobal
 Build a Residential Home for batey HIV/AIDS and vulnerable/orphaned children
 Establish a permanent humanitarian mission in the Republic of Haiti

THANK YOU!

The Boards of Directors, Officials and Staff of the Batey Relief Alliance and BRA Dominicana are thankful for your support enabling us to do important work on behalf of the poor. You are the partners we depend on to serve those in desperate need. There is much more to be done. And we need your continued support. We look forward to a productive partnership with you in the years to come.

___________________

The Batey Relief Alliance is tax-exempt under section 501(c) (3) of the United States’ Department of Treasury Internal Revenue Code. Donations are tax-deductible to the extent allowed by law

I. INTRODUCTION TO BRA’S HUMANITARIAN WORK

BRA’s Institutional Model

The Batey Relief Alliance—BRA was created in 1997 in the State of New York, United States, as a 501c3, tax-exempt, non-profit, humanitarian aid organization to address the socio-economic conditions of children and families severely affected by poverty, disease and hunger in the Caribbean. Toward that end, BRA created in 2000 its regional arm inside the Dominican Republic, the BRA DOMINICANA, a non-governmental organization—NGO designed to help the Batey Relief Alliance carry out its humanitarian mission inside the Dominican Republic’s bateyes, rural/urban slums and border localities.

The BRA has a board of directors that meets once a year in New York and a Chief Executive Officer who is charged to mobilize public resources for the work of the institution and the BRA Dominicana to implement BRA’s projects. BRA Dominicana, as a legally created Dominican entity, runs the entire field operation for the Batey Relief Alliance, raised local funds, has an office in Santo Domingo with paid staff and volunteers, and runs projects and manages two modern medical facilities in Monte Plata. BRA Dominicana has its own board of directors and an Executive Director who is charged of running the show for the Batey Relief Alliance in the Dominican Republic. BRA’s CEO, however, oversees the entire field operation, the sustainability and growth of the institution. BRA’s Board of Directors is the ultimate body on policy decisions affecting both the Batey Relief Alliance and BRA Dominicana.

BRA’s CEO mobilizes public resources from the United States that are cash and/or in-kind donations. Most cash gifts are from individual donors, international organizations and foundations. In-kind donations are mainly from international organizations. When non-restricted cash is received, it is used to sustain the virtual operation of the BRA in New York, sustain part of the field operation’s costs of BRA Dominicana, and implement projects. All restricted funds are transferred to BRA to implement projects overseas. BRA Dominicana puts all funds received in bank accounts, registers them in its accounting books, uses them for the projects, and sends to BRA annual reports for funders and donors. BRA Dominicana’s board maintains a strict control over the organization’s public-raised funds, accounting, and projects’ implementation.

As for in-kind donations, BRA’s CEO receives requests from the field office of the needs (in medicines, supplies and equipment) to sustain the operation. BRA’s CEO then forwards that wish list to donors for support. When donations are considered, a detailed list is sent to BRA’s CEO in New York for acceptance. Once BRA’s CEO accepts the donations, the donors then send a list, with dollar values, to BRA Dominicana notifying the donation and preparing to retrieve them out of the DR customs. Once the donations have arrived at the DR customs/port, BRA Dominicana is the consignee to receive the donations. BRA Dominicana also receives the support from the Dominican government to custom free retrieve the donations. BRA Dominicana retrieves the donations and transports them to the organization’s warehouse in Monte Plata for an inventory.

Once the inventory is completed, a product report is sent to Batey Relief Alliance of the receipt of the donations and the quantity received. BRA Dominicana is then free to use the donations for its humanitarian projects. BRA has a strict policy of not selling or exchanging donated products designed for its projects. A portion of the donations is sometimes distributed to key BRA’s local partner organizations increasing their capacity to deliver improved services to various other impoverished communities around the country. All BRA’s patients receive low-cost or free medical services and free medicines. Annual work reports are prepared by BRA Dominicana and sent to Batey Relief Alliance for evaluation and forwarding to international donors, partners and volunteers.

Humanitarian Health Intervention

Since 1998, the Batey Relief Alliance—BRA, through its regional arm BRA DOMINICANA, has provided health care and social services inside the bateyes and rural communities of the Dominican Republic through medical/eye care mission trips, its mobile clinic and health center, and a network of community-based health promoters. The Batey is the Dominican word for sugar plantations rural community where Haitian immigrant workers and their descendents traditionally live and work. Today poor Dominicans as well as Haitians share the Batey habitat. Conditions in these quasi-isolated communities are abysmal; there is often no water, latrines, or garbage collection. Access to healthy food, medicine, employment, and education are extremely limited. Malnutrition and disease are rampant. People in the bateyes bear the additional burdens of racial discrimination and fear of deportation to Haiti—a result of the deep-seated anti-Haitianism that has persisted in the Dominican Republic for years. This discrimination makes it difficult, if not impossible, for batey residents to freely access health services outside of their communities.

BRA’s pioneer community-based approach to heath care—bringing the care to the population inside their own batey communities, starts with volunteer health promoters, who work in over 62 bateyes in the province of Monte Plata. BRA’s promoters provide education and counseling in their communities and referrals to BRA’s health services among a population of over 200,000 people. At our mobile clinic and health center, teams of health professionals provide primary health care, essential medicines, and preventative health services to batey residents including special services of optometry, gynecology, and HIV/AIDS care. BRA also runs four major programs that target specific health problems faced by the batey communities. These programs focus on HIV/AIDS, Tuberculosis, Blindness Prevention, and Access to Potable Water. Additionally, we provide primary health, dental, and vision care through short-term medical missions within the bateyes. BRA’s 2006 staff includes 46 full-time and part-time employees and foreign volunteers, 38 of which are health related. Through medical missions and long-term health projects, BRA provided critical health care and social services to over 60,000 people from August 2005-July 2006. For many people, BRA offers the only viable source of healthcare and social services in the region.

II. BRA’S OPERATION IN THE PROVINCE OF MONTE PLATA

BRA’s health facilities include a 30-foot, fully equipped and staffed Mobile Health Clinic stationed inside Batey Cojobal, in operation since 2003, and a new Health Center inside Batey Cinco Casas, open full-time since January 2006. In addition to its permanent healthcare facilities, BRA carried out in 2006 four other major health programs. In its fight against AIDS since 2005, BRA runs a comprehensive HIV/AIDS program that delivers to impoverished and marginalized AIDS sufferers antiretroviral treatment—ARV and a cadre of associated services free of charge. BRA’s community-based AIDS treatment strategy is a model that is being repeated countrywide. BRA also works closely with the Dominican National Program to identify and treat Tuberculosis among Batey residents. BRA also implements a Blindness Prevention Program that provides vision care and free prescription eyeglasses. This year, BRA began a Potable Water Program , distributing Biosand Water Filters and PUR water purification tablets in the bateyes. In addition to these programs, BRA coordinated a weeklong medical and eye-care mission in April.

In 2006, BRA launched four additional programs: Condom Distribution making low-cost condoms available to Batey residents to reduce rates of infection; a Suzuki Music Program providing cello and violin lessons to 18 kids from the bateyes with the long-term plan of creating a Batey Youth Orchestra; a Medical Sponsorship Program helping to support the professional service of local healthcare providers working at BRA’s medical facilities; and a Child Sponsorship Program.

The following three projects are at a planning stage and will be implemented in the near future: Vitamin/Deworming distributing for three years multivitamins+A and worm medicine to 55,000 children (2-10 years of age); and a Permanent Home for children infected by HIV/AIDS and those who are abandoned and severely affected by the disease, poverty and hunger.

A. MOBILE HEALTH CLINIC IN BATEY COJOBAL

BRA’s Mobile Clinic is permanently located in Batey Cojobal near the town of Sabana Grande de Boyá. The clinic is the only one in that zone fully-equipped and staff providing complete health services with free medicines to the population. It is open five days a week, year round. Consultations are available for a small fee and medicines are provided free of charge. The clinic is staffed by an American physician’s assistant, a Dominican general practitioner, a Dominican optometrist, an American volunteer administrator, a Dominican nurse, and two clinic assistants from Batey Cojobal.

In addition to general medical consultations, BRA’s clinic offers specialty services. On Thursdays, BRA’s optometrist provides vision consultations and glasses through our blindness prevention program. The clinic’s staff performs pap smears every Wednesday (To date, sixty-one Papanicolaou were provided to patients). The following demographic groups received services:

Table 1. Mobile Clinic Patients

Patient Group No. of Patients
Boys (0-10) 983
Girls (0-10) 1081
Adolescent Boys (11-18) 76
Adolescent Girls (11-18) 102
Men 1229
Women 2153
Total 5624

From August 2005-July 2006, the Mobile Clinic saw 5624 patients for primary care. Based on the clinic’s data , approximately 60% of the patients are new. Accordingly, in 2006-2007, BRA expects to see a patient visit increase of over a thousand new patients. BRA is now reaching out even more to the community through publicity, words of mouth, and its permanent establishment in the area over the past 3 years. It is necessary for us to respond to this patient increase by augmenting our clinic’s space and staff and assuring that we have sufficient medicines and materials to serve the needs.

Among the patients who visited the clinic, about 33% are from the bateyes, 41% from Sabana Grande de Boyá, and the remaining 26.6% from rural communities. Although there is a hospital in Sabana Grande de Boyá, many patients cannot afford to buy the medicines prescribed by the doctors. Our Clinic is the only full-time healthcare facility in the region that offers medicines free, and for this reason, many poor Dominicans also turn to BRA for help. For many living in isolated bateyes, transportation is still a major obstacle to reach our clinic. BRA has begun addressing this problem among our HIV/AIDS patients by providing free transportation to our health care facilities.

Health providers at the BRA’s clinic treat a wide variety of health problems. The most prevalent are listed in Table 2.

Table 2. Common Health Problems at the Mobile Clinic

Health Problem Prevalence
Fungal infection (skin) 18.2%
Cold 16.7%
Intestinal parasites 13.8%
Scabies 13.2%
Headache 12.9%
Hypertension 12.1%
Bronchitis 7.2%
Skin sores 5.9%
Back pain 5.7%
Dizziness 5.3%

The BRA’s Clinic receives medicines regularly from BRA’s storage warehouse at the Health Center in Batey Cinco Casas. However, maintaining a steady supply of essential medicines continues to be one of the biggest challenges the mobile clinic faces. Approximately 97% of patients who visit the mobile clinic receive medicines and about 23% receive prescriptions. While few are going home empty handed, about a quarter still purchase medicines with their own resources. Virtually all medicines distributed through the Mobile Clinic are first donated to BRA by international charitable organizations and BRA is constantly soliciting new donations. Additional medicines are purchased on the local market by physician assistant, Alan Kerr, about $700 per year, with the support of the First Congregational Church of Albany, New York.

About 36% of patients in the clinic are sent for lab analyses, usually at the public hospital or private labs in Sabana. Stool and blood analyses are the most commonly required tests. This not only represents a significant additional cost for patients in terms of transportation, cost of medicine, and lab fees, but can also be a barrier to health care considering the discrimination and fear that patients from the bateyes may face entering the Dominican public health system. BRA has resolved this problem by establishing a brand new, fully equipped and capacitated laboratory at the health center in Cinco Casas.

B. HEALTH CENTER COMPLEX AT BATEY CINCO CASAS

By the end of 2006, BRA will be completely finishing construction of the bateyes’ first modern Health Center located in Batey Cinco Casas in the province of Monte Plata with funding from the Lions Clubs International Foundation, the Dominican’s State Sugar Council and the Clinton Foundation. Local Dominican Newspaper HOY said in its 2006 April article—VIVIR that BRA’s Center is the first modern medical facility ever built inside the bateyes since the start of sugar cane plantations on the island more than 400 years ago. The Cinco Casas facility includes a medical building with consultation rooms and a laboratory, a building for education, training seminars, and patient counseling, a warehouse, and a dormitory to house local doctors and foreign volunteers. There is a playground and a garden where patients and children can wait and play.

The Health Center’s includes a full-time personnel of 32, including physicians, psychologists, optometrist, dentist, nurses, administrators, receptionists, pharmacy workers, volunteer health educators, and community health promoters.

Since January, the health center has been open five days a week providing medical, dental and vision services. It is also where BRA provides comprehensive antiretroviral treatment to Batey AIDS sufferers in partnership with the Clinton HIV/AIDS Initiative—CHAI (discussed below) and the Dominican Ministry of Health’s DIGECITTS. The health complex provides consults in general medicine, vision care, dentistry, gynecology, educational seminars, and counseling. BRA plans to equip the center in the future with diagnostic equipment including an electrocardiogram and x-ray scanner. An ambulance is already available to provide emergency transport services.

The Health Center has seen 16,793 patients since January 2006. The Center also saw 96 patients for Papanicolaou. The following demographics were served at Cinco Casas:

Table 3. Cinco Casas Patients

Patient Group No. of Patients
Boys (0-10) 2,835
Girls (0-10) 4,350
Adolescent Boys (11-18) 2,008
Adolescent Girls (11-18) 1,500
Men 2,400
Women 3,700
Total 16,793

C. COMPREHSNSIVE HIV/AIDS INTERVENTION

HIV/AIDS IN THE BATEYES

The people living in the bateyes are among the most affected by HIV/AIDS in the Western Hemisphere. A recent study found that 8.8%, or approximately 1 in 11, of women in the bateyes are HIV-positive, as compared to a prevalence of 1.25% among low-income women in the Dominican Republic. This has already had a devastating impact on these communities, leaving behind orphans who may or may not be infected, as well as unstable family units.

The issues surrounding HIV/AIDS in the bateyes are complex; they are impacted by socio-economic and political structures such as unemployment, migration, discrimination, stigma, and gender inequality that require solutions that reach beyond the boundaries of health care. BRA’s insight into the broader, structural issues, along with its mission to provide community-based health care as well as education and social services inside the bateyes underlies its HIV/AIDS intervention—the concept of bringing the care home to the population.

HUMANITARIAN HIV/AIDS CARE

Since 2004, BRA has brought life-saving resources to HIV-positive people in the bateyes. Science Magazine in its August 2006 Internet report recognized BRA’s HIV/AIDS program as one of the most innovative in the Dominican Republic. BRA offers free comprehensive health care to AIDS patients inside its Cinco Casas’ Center, including antiretroviral therapy and treatment for opportunistic infections. BRA also offers a cadre of social services including psychological support, economic assistance, nutritional aid, vocational training, education, and HIV counseling and testing at our mobile clinic and health center. Currently, there are 250 adults and 33 children living with HIV/AIDS enrolled in BRA’s program, as well as 1026 family members. BRA has 59 patients who receive antiretroviral treatment directly from BRA at the health center and has conducted 66 CD4 tests. A number of BRA’s patients continue to receive their treatment from other sites in the country and seek medical care and other services from BRA.

THE AIDS PATIENT FUND

In February 2006, BRA received over $22,000 in donations to establish the AIDS Patient Fund through the Dessalinian efforts of one of its full-time volunteers, Morgan Chessia. BRA is uniquely able to assess the needs of HIV/AIDS patients living in the bateyes through monthly check-ups at our clinic and health center and through regular home visits. BRA decides on a case-by-case basis what types of support each patient needs in order to distribute this fund as equitably as possible. The goal of this fund is to enable our patients to access the free antiretroviral drugs provided by the government, through the support of the CHAI that is now available at a few sites in the country, including BRA’s health center since May ’06. The AIDS Patient Fund covers costs associated with:

· Transportation
Many of BRA’s patients live in bateyes that are isolated and not generally serviced by public transportation. The cost of transportation from patient’s homes to our clinic, health center, or to the capital is prohibitively expensive and can discourage or prevent patients from receiving the health care and treatment they need. Many of our Haitian and Haitian-Dominican patients also fear discrimination because of their ethnic background or because they are too sick to seek care on their own. In these situations, the AIDS Patient Fund also covers accompaniment for these patients to health care services.

· Testing
Even in the public hospitals, patients must pay for their own laboratory tests. The AIDS Patient Fund covers the cadre of tests necessary for our critically ill patients to initiate antiretroviral treatment, including the CD4 tests and to properly treat opportunistic infections.

· Essential Medicines
BRA’s clinic provides primary healthcare and free medicines Monday through Friday. When the clinic does not have the necessary medicines to treat AIDS-associated opportunistic infections, the AIDS Patient Fund is used to purchase these medicines. Many AIDS-associated illnesses are expensive to cure. Having this fund available means that uncomfortable conditions like Shingles or Chancroid won’t be left untreated.

· Nutritional Aid
Lack of access to food is a major problem in the bateyes. This is especially a concern for AIDS patients who lose weight rapidly in the later stages of their illness. While administering the ARV treatment will certainly help fight many infections associated with AIDS, but if the patients do not have access to healthy food while undergoing their treatment, they will die. Moreover, as they become weak and physically unfit to work, they cannot produce for themselves, their families and their community. The AIDS Patient Fund is used to supplement the diets of these patients with symptoms of wasting until they recover enough to be self-sufficient with the help of antiretroviral drugs. Thirty (30) families have received food ration from the BRA, of that number there are 30 persons living with AIDS, 155 vulnerable/affected children, 65 men and women affected, a total of 250 beneficiaries. It is our goal that once BRA has helped stabilized the patients’ physical, mental and health state; they can then go back to work and produce for their communities and families. The Disciples of Christ’s Week of Compassion also supports the program.

THE CHAI—ANTIRETROVIRAL TREATMENT IN BATEY CINCO CASAS

In May, BRA began offering antiretroviral treatment—ARV directly to patients at its health center in Batey Cinco Casas—the first time ever this type of treatment is being administered to Batey AIDS sufferers inside their own communities. In collaboration with the CHAI and the Dominican Ministry of Health’s DIGECITTS, the life-saving program also provides a pediatric AIDS specialist, Consuelo Beckett and a psychologist, Matilde Marcia Contreras. BRA’S AIDS patients visit the health center every 15 days for treatment and medical attention. In addition to the ARVs, each patient receives protein, vitamins, and prophylaxis against opportunistic infections. Our patients have lab work including the CD4 count—a measure of the body’s immune system that is essential for initiating and monitoring antiretroviral treatment, done free at the health center.

HIV/AIDS PREVENTION AND EDUCATION— MOTHER/CHILD HEALTH AND PREVENTION of VERTICAL TRANSMISSION PROJECT

From August to December 2005, BRA extended its infant health and prevention of mother-to-child transmission of HIV project, which began in 2004. This project, funded through the Canadian Embassy’s “Fondo Canadiense para Iniciativas Locales” (FCIL), trains BRA’s local health promoters and medical teams, educates batey residents on the subjects of vertical transmission of HIV and child nutrition, and provides primary health care to mothers and children under the age of five. The project worked with seven bateyes in the Monte Plata province: El Bosque, La Cerca, Cinco Casas, Cruce de la Jagua, Deán, Payabo, and Triple Ozama.

Over the course of the project, BRA put on four training seminars—two on the subject of vertical transmission of HIV/AIDS and two on the subject of sexually transmitted diseases (STDs). The seminars were given in Batey Cojobal and in Monte Plata for the health staff of the BRA, and 13 people attended these training sessions. In addition to these training sessions, BRA provided 2 educational seminars for 41 health promoters working in the bateyes surrounding the Health Center at Batey Cinco Casas residents of each of the seven bateyes. These seminars covered the topics of infant and child nutrition and prevention of the vertical transmission of HIV from mother to child.

In addition to the educational aspect of the Infant Health project, BRA provided primary health care to 1378 people through “mobile clinics” opened within each community. This included 378 women, 534 girls, 428 boys, and 38 men. BRA’s health intervention targeted mothers and their young children, but was also available to other batey residents. Patients received free medicines and baby formula as needed, and 147 women received pap smears.

An important long-term effect of this project was to increase awareness of mother-to-child transmission of HIV/AIDS in the bateyes. Since the project ended in December 2005, we have had three HIV positive mothers enroll in our HIV/AIDS program. Each took the proper precautions to prevent HIV infection of their child. Each received antiretroviral medicines at the time of birth from a public hospital, one underwent a caesarian, and all three exclusively fed their infants formula.

“RAINBOW” HIV/AIDS PROJECT FOR COMMUNITY SUPPORT OF AIDS PATIENTS

BRA also provided community support and home care through a yearlong project funded by USAID and Family Health International in 2005. Through this project, called the Rainbow—Arco Iris project, BRA has worked to identify HIV-positive people by teaching about HIV/AIDS prevention and treatment in schools and churches and encouraging them to come and get tested at our health facilities. From August 2005-July 2006, BRA conducted 40 educational sessions in the bateyes of Monte Plata. During this time, BRA also conducted more than 2,000 home visits where program staff had the opportunity to individually evaluate the health of each patient and provide them with donated personal hygiene materials. BRA has also worked to unite and empower individuals affected by HIV/AIDS through workshops for patients and their families. BRA conducted 5 workshops for HIV/AIDS patients and their families teaching them how to protect their health. Some of the topics covered in this workshop included: self-esteem, drug and alcohol abuse, nutrition, hygiene, and exercise. BRA also conducted 18 vocational trainings. Many of our AIDS patients are among the most destitute in their communities, thus providing them with tools to earn an income is essential to improving their health and economic independence—thus working towards human productivity and dignity. This project will continue through May 2007.

MARGARET SANGER CENTER INTERNATIONAL HIV/AIDS/VIOLENCE PROJECT

This project, funded by the MAC AIDS Funds, sought to prevent violence and educate people about the connection between HIV/AIDS and violence. Violence, especially against women and children, is deeply connected to HIV/AIDS. Rape and sexual abuse is a known cause of infection among some of our HIV/AIDS patients. Violence in a relationship can preclude negotiating safe sex and prevent family members from seeking and/or receiving medical care, also problems we have experienced first hand in our patient population.

To reduce violence and educate people about its relationship to HIV/AIDS, BRA conducted two workshops with thirty-five youths and health promoters. The first workshop taught about the forms of HIV transmission, the causes and consequences of HIV/AIDS among youth, the effects of stigma and discrimination on people living with HIV/AIDS, and how to prevent stigma and discrimination. The second workshop dealt specifically with the influence of violence on sexual and reproductive health and strategies to promote equality among the sexes.

BRA also conducted a workshop in July specifically for health its personnel about violence against women and its connection with HIV/AIDS. By the end of this year, BRA will also have conducted 12 educational sessions reaching at least 500 men and women about violence against women and its relationship with HIV/AIDS. Already 188 people have benefited from these sessions.

“ALIANZA DE BATEYES-BATEY ALLIANCE” YOUTH HIV/AIDS EDUCATION

This year, BRA is organizing and training networks of young people to prevents HIV/AIDS in their communities. This project is part of the National Program Against HIV/AIDS with funding from the United Nations Global Fund for AIDS, Tuberculosis, and Malaria. Six bateyes will be the beneficiaries of this project: Batey Cojobal, Las Taranjas, Juan Sanchez, El Bosque, La Cerca, y La Fria. BRA will be recruiting and training group leaders and HIV/AIDS counselors, developing educational activities, facilitating group leaders in organizing and training groups of young people, monitoring and evaluating the activities of the youth networks, and promoting and offering HIV counseling and testing. The Project is supported by the Dominican Republic’s COPRESIDA.

BEHAVIOR CHANGE AND SOCIAL MARKETING OF CONDOMS WITH POPULATION SERVICES INTERNATIONAL (PSI)

This year BRA began working on a 20-month project with PSI to reduce the incidence of sexually transmitted infections including HIV in the bateyes through behavior change and the social marketing of condoms. The project has two central strategies: 1) Social marketing of condoms. This project will make high-quality condoms available to local vendors at a subsidized price. By requiring customers to pay a nominal payment for condoms, the project aims to impart a sense of value in the decision to purchase and use a condom. By selling the condoms, the project also supports the local economy and contributed to the sustainability of condom sales in these communities. 2) Education. PSI will launch a communication campaign focusing on behavior change in adults aged 20-49. Specifically, to reduce the number of sexual partners among and increase the correct and consistent usage of condoms in this age group. A secondary objective of this project is to create a sense of cooperation between bateyes that although geographically dispersed, share similar characteristics and challenges. By creating a common bond among these communities through this project PSI/BRA hope to increase solidarity at the national level and contribute to a process of economic and social empowerment to generally improve the situation of the bateyes within the Dominican Republic.

PREVENTIVE HIV/AIDS EDUCATION – NEW YORK

BRA received one-year funding from the New York State Department of Health, through the office of Assemblywoman Rhoda Jacobs, to carry out radio shows addressing HIV/AIDS among low-income and ill-educated immigrant communities of Yew York. The program was implemented with the collaboration of Brooklyn-based Radio Soleil.

C. TUBERCULOSIS INTERVENTION

In conjunction with USAID’s Project CONECTA and the Dominican Republic’s National Tuberculosis Control Program, BRA initiated a nationwide program to control tuberculosis inside the Dominican Republic’s bateyes. This project, which began in August 2005, has trained a network of 220 community health promoters in 62 bateyes in the province of Monte Plata to identify patients showing signs of tuberculosis and refer them for testing. So far BRA has referred 174 patients to hospitals in Monte Plata since August 2005. Now, with the recent donation of a motorcycle from USAID, Ignacio “PAPO” Pierre, the supervisor of the TB program and one of BRA’s key promoters, is able to collect sputum samples directly from patients in the bateyes surrounding Sabana Grande de Boyá and bring them to the hospital preventing them from having to travel. BRA is responsible for a large percentage of TB referrals in the state of Monte Plata.

Table 4. Respiratory Symptoms in the Hospitals of Monte Plata (Jan 2006-Jun 2006)

Hospital # Referred # Referred by BRA % Referred by BRA
Monte Plata 96 28 0.29
Sabana Grande de Boyá 92 32 0.35
Yamasa 46 11 0.24
Don Juan 4 4 1.00
Total 238 75 0.32

Table shows BRA made about a third of all referrals between January and June 2006.

Those who test positive are referred for treatment with directly observed therapy. This past year, 4 BRA patients were treated for TB: two were cured and two are currently receiving treatment. None of BRA’s patients have abandoned their treatment regimens.

The local health promoters also give educational seminars in their respective bateyes on the identification and treatment of tuberculosis. This year promotoras have offered 63 such seminars. These have included 4,425 people. Informational materials were also distributed to 6,867 people. In addition to identifying cases and educating rural communities, BRA has provided support to patients and their families through 58 home visits and 5 families have received food donations.

E. BLINDNESS PREVENTION

This year, BRA’s Blindness Prevention Program continued to provide complete eye exams, eyeglasses, eye drops, and medicines to patients in the Mobile Clinic and began offering vision care in Cinco Casas. Over 800 pairs of glasses were distributed to patients. The following demographic groups were represented at the Mobile Clinic:

Table 5. Vision Consultations Mobile Clinic

Patient Group No. of Patients
Boys (0-10) 18
Girls (0-10) 14
Men 208
Women 339
Total 579

This year, BRA began offering vision care at the Health Center in Cinco Casas and 475 patients have received vision consultations. There continues to be a great need for surgical missions to correct pterigiums, cataracts, and strabismus.

F. WATER PROJECTS

BIOSAND WATER FILTERS

This year, BRA will distribute 60 Biosand Water Filters to families in Batey Cojobal and to HIV/AIDS patients in bateyes surrounding Sabana Grande de Boya. Already, 10 of BRA’s HIV/AIDS patients have received emergency filters. This project is sponsored by the Rotary Club of New York, Rotary Club of Wallkill Valley, and the Club Rotario Arroyo Hondo Santo Domingo.

Access to clean water/sanitation for Batey residents is a major institutional goal for BRA, a grave concern in the bateyes, and a major source of illness in our patient population. With no potable water available, most batey residents rely on rivers, rain, or open wells as a source of water—all of which contain water-borne pathogens. In recent focus groups conducted by BRA, batey residents listed clean water as their number one priority. Based on BRA’s current statistics, 14% of patients who visit the Mobile Clinic in Batey Cojobal are seeking treatment for intestinal parasitic infections. Parasitic infections are a common cause of death in children under five and can also contribute to anemia and other health problems. Imagine being constantly plagued by gastrointestinal pain, vomiting and diarrhea. This is the reality for people without access to clean water. While BRA has been treating water-borne illnesses for years at their health facilities, this initiative gets to the root of the problem, preventing people from getting these infections and reducing their spread within the community. Next year, BRA hopes to expand this project to other bateyes in Monte Plata, providing clean water—a basic human right for all.

BRA’s model water filtration project will benefit over 200 families. Each family that receives a filter also learns about health and hygiene and how to care for their filters. BRA also trained community stewards to provide continued education and support for filter users.

Access to clean water is especially more problematic among HIV/AIDS patients who do not have a hardy immune system to defend themselves against water-borne pathogens. Infection with multiple parasites is very common among these patients and can begin a downward spiral of weight loss that eventually leads to death. Not only will these filters impact the health of these patients directly, it will also improve the health of the family members caring for these patients and their immediate neighbors and reduce local transmission of water-borne pathogens to these patients.

Last August, the BRA partnered with the New York-based Suzie Reizod Foundation to distribute 50 new pairs of shoes to children between the ages of 1-18 years living in the bateyes of Monte Plata where families are often too poor to buy shoes for their children. Because they don’t have shoes to protect their feet, these children contract parasites and skin infections. The beneficiaries of this project will receive the shoes and learn about the importance of wearing them and their capacity to prevent disease.

PUR WATER PURIFICATION TABLETS

As another approach to dealing with the water/health crisis in the bateyes, BRA is partnering with PSI to distribute affordable PUR water purification tablets, a product of Procter & Gamble. One PUR tablet costs 5 pesos or about 20 cents and will disinfect 2.5 gallons of water. BRA and PSI are working with local businesses, HIV/AIDS patients and health promoters to sell the tablets and to educate people in the bateyes about how to use them. This will provide a much-needed income for these individuals while promoting access to clean water and hygiene education.

G. VOLUNTEERS AND MISSIONS

As part of its humanitarian health intervention inside the Dominican Republic, BRA mobilizes experienced volunteer health care providers and medical students from the United States and Canada to work alongside their Dominican counterparts at its health facilities and on mission trips. BRA also places volunteers at some of its partner organizations’ health facilities. This year, 41 volunteers traveled to the Dominican Republic to work with BRA in medicine, public health and administration. Local health professionals share their expertise with the visitors who do the same from a western healthcare point of view.

APRIL MEDICAL MISSION TRIP

In addition to its permanent healthcare programs, BRA also sponsors short-term volunteer medical, dental, and eye care missions to the Dominican Republic, on which volunteers from North America spend one to two weeks providing free care and medicines inside the bateyes and other impoverished communities where BRA or its member/partner organizations operate. Follow-up care is provided by BRA after the missions end. In April, BRA received a group of 14 volunteers from the US-based Association of Haitian Physician Abroad—AMHE, including two dentists, three dental assistants, two pediatricians, an internist, a medical assistant, and five medical students. This mission served a total of 1,010 persons including 397 children and 613 adults. This population included people from 24 bateyes and 3 rural communities and 2 cities with 93% of the patients from bateyes.

HAÏTI-LÉVIS FRIENDSHIP MISSION

From May 22 to June 6, a group of 14 young people from Canada’s Quebec with the “Haïti-Lévis Friendship Mission” volunteered in Batey Cinco Casas. The group conducted educational sessions for young people and adults and created a playground for children at BRA’s Health Center.

LONG-TERM VOLUNTEERS

This year, BRA had 14 long-term volunteers who spent a month or more working at its health facilities in Cojobal and Cinco Casas. They are professional physicians, medical students/residents, and non-health volunteers.

Medicine: Alan Kerr, Jacinthe Bordeleau, Jade Theriault, Yaron Friedman, Eric Echenfeld, Marie-Anne Gagnon, Yann Tissier, and Philippe Chouinard.

Public Health and Administration: Chitra Akileswaran, Naira Arrellano, Morgan Chessia, Colleen Reinert, Jessie Clyde, and Rhett Massey.

III. PARTNERSHIPS AND MEMBERSHIPS

ASSOCIATION WITH THE UN’S DEPARTMENT OF PUBLIC INFORMATION

On 7 July 2006, the Committee on Non-Governmental Organizations of the Department of Public Information (DPI) at the United Nations approved the Batey Relief Alliance (BRA) for association with the Department. The association constitutes a commitment on the part of the BRA to disseminate information and raise public awareness about the purposes and activities of the United Nations and issues of global concern. Associated NGOs, like BRA, are expected to focus a portion of their publications and information activities on the work of the United Nations. As an associated NGO, BRA is entitled to designate a representative, who will be granted a UN photo grounds pass. The pass will give the representative access to the UN facilities and to all open meetings of the UN bodies, which he/she can attend as an observer. BRA’s representative will also be invited to attend Thursday NGO briefings organized by the Department, featuring high-level UN officials, government delegates and other experts, including NGOs. BRA’s representative will be allowed to consult UN print, audio and video materials at the NGO resource Centre. BRA will receive monthly mailings of relevant UN materials and information on UN conferences, seminars, briefings and other events.

BRA also received the new partnership of the Columbia University’s Mailman School of Public Health, through the Dominican Exchange Program, providing the organization with a Public Health student to conduct in August health service surveys of its medical facilities. The results will help BRA study and evaluate its patient/service relationship, and enhance its humanitarian health intervention inside the Dominican Republic.

LOCAL MEMBERSHIP

This year, BRA DOMINICANA joined the memberships of the Dominican-based Alianza de Bateyes and the ONG-SIDA. These two groups provide a platform for collective lobbying on and community services for health-related issues.

MEDICAL DONATIONS: ALLIANCE ORGANIZATIONS

As part of its humanitarian health care expansion in the Dominican Republic, BRA also distributes donated medicines and medical supplies to partners of its Dominican-based Alliance working to provide health care in impoverished bateyes, urban slums, and rural communities where the population cannot afford basic medical care. Through these donations, BRA raises the partners’ capacity to become more effective in delivering care in locations where BRA does not operate directly. This year BRA donated medicines, beds, milk, and materials to 18 public and non-profit organizations.

Table 6. Donations to BRA’s Partners

Organization Type of Donation
Colectivo de Salud Popular Medicines, materials
Fundacion Todo por la Salud Medicines, materials
Servicio Social de Iglesias Dominicanas Medicines, materials
Alas de Igualdad Medicines, materials
Consejo Estatal del Azucar Medicines, materials
Dirección Provincial de Salud de Monte Plata Medicines, materials
Dirección General de Control de ITS y SIDA Medicines, materials
Fundacion Amparo Infantil Medicines, materials, milk
Club de Leones Santo Domingo Arroyo Hondo Medicines, materials
Hogar de Ancianos San Francisco de Asis Medicines, materials
Hospital Provincial de Monte Plata Medicines, materials
Hospital Municipal de Sabana Grande de Boya Medicines, materials
Clínica Rural Districto Municipal Don Juan Medicines, materials
Clínica Rural El Cacique Medicines, materials
Clínica Rural de Villa Jaragua Medicines, beds, materials
Clínica Rural de las Clavellinas Medicines, beds, materials
Clínica de Rural Postrer Rio Medicines, beds, materials
Fundacion Genesis Medicines, materials

Approximately 40,000 persons have been served as a result of BRA’s donations.

IV. SUPPORT FOR BRA’S WORK IN 2005-2006

IN-KIND DONATIONS OF MEDICAL SUPPLIES AND MATERIALS
BRA continues to provide free medicines and glasses and low-cost medical services to its patients. It does so by soliciting donations of medicines, medical supplies and equipment from the United States and Canada. Between August 2005 and July 2006, BRA received US $6.287,907.43 worth of medicines, supplies and equipment for its humanitarian health care operation in the Dominican Republic.

BRA’S FINANCIAL ANNUAL REPORT
A copy of BRA’s latest annual financial report may be obtained from the Office of the Attorney General, Charities Bureau, 120 Broadway, New York, N.Y. 10271.

WHO SUPPORTED BRA’S WORK IN 2006
The Bill Clinton Foundation’s HIV/AIDS Initiatives, Lions Clubs International Foundation, St. Joseph Hospital Exempla Foundation, Google Grant Program, New Jersey Lions Eyeglass Recycling Center, Wallkill Valley Rotary Club, New York Rotary Club, Club Rotario Arroyo Hondo Santo Domingo, USAID/C