Rachel Gilfarb | Miami, FL – Neuroscience, 2018
Rachel Gilfarb is a sophomore from Miami, Florida. She is a neuroscience major with a minor in Women and Gender Studies. Rachel is active in Hillel, AOII, the Imperfection Project, Gluten Free at Vandy, and Tap That. This summer, she will be volunteering in the Dominican Republic to help establish a sustainable type one diabetes community there. She will be working as a facilitator, mentor, and peer educator with the local community.
Blog Post One:
Today was absolutely incredible. Today was our first day on our AYUDA trip that we were able to work with youths with diabetes in the Dominican Republic. We went to the foundation we were working with, Aprendiendo a Vivir (meaning “Learning to Live”), where we were able to meet some of the campers we will be working with during Campo Amigo. I was assigned to the Green Group, which means I specifically will be working with children between five and eight years old. The foundation didn’t have any air conditioning and few chairs, but the energy in the room was astounding. Around 15 families crammed themselves into this tight space to learn about diabetes from us volunteers who have had diabetes longer than their children have been alive.
Considering that today was the 16th anniversary of my diagnosis, I found it incredibly rewarding that I am able to use my disease to help others like me. When Tia (Aunt) Sandra, the director of the foundation, was giving a lesson about the relationship between diabetes and puberty, a mother of a child attending camp stood up abruptly. She started speaking very quickly and began crying in the middle of her speech. She shared about how her four-year-old son was diagnosed six days ago and how she felt like they were both going to die: him of diabetes and her of grief. She was telling all of us how grateful she is for the existence of this program and how speaking about it often moves her to tears. Then many volunteers started crying, as well. After the days activities of field games, educational activities, and crafts ended, I went up to the previously mentioned family and shared my story, specifically emphasizing that I also was four when I was diagnosed with type one diabetes. The mother thanked me and the child smiled, and I felt like I made a difference.
When we came back to the hotel, we were able to share our experiences with each other and with Tia Sandra. We were then able to get feedback from our fellow volunteers and Tia Sandra. For the rest of the day, we used the momentum from the morning to plan activities for camp. After, we went to dinner at Adrian Tropical, a gorgeous restaurant standing partially on stilts in the ocean. Victoria and Jasper’s birthdays are at the end of this week, so we asked the waiters to sing to them. The Dominican flair added to “Happy Birthday” was so unreal and made you want to get up and dance. Total, dinner took three hours tonight! In Spanish, we say that this is explained by la hora latina, which translates to “the Latino hour,” because Latino people are very lax about time. We returned to the hotel at night and went immediately to sleep because of our busy day tomorrow. Buenas noches!
Blog Post Two:
Today was El Dia de La Familia. The whole objective of today was to acquaint ourselves with our campers, the age group we will be working with, and how diabetes care in the Dominican Republic works in action. Our age group included children eight and under. Our oldest camper was a little girl with special needs who is nine, and our youngest is a nonverbal 2-year-old. Our morning activities went incredible well in my opinion. The parents found all of our information interesting and we counselors had no problem matching the energy level!
Unfortunately, one of campers had an extremely low blood sugar, which led to him coming in and out of consciousness and a small seizure. It was a difficult experience because they do not use glucagon in the DR due to accessibility issues.Glucagon acts in reverse to fast acting insulin, therefore rapidly elevated blood sugar, and is used rarely. In the States, the protocol for a treating a blood sugar with symptoms similar to what the camper exhibited would have been treated with a glucagon. It was an extremely nerve-wracking, but very culturally interesting experience.
The rest of the day was a little slower. We played a ton with the kids and got to know them better, but they didn’t enjoy the second-half of the day’s activities as much as the activities before lunch. We had a scavenger hunt and I answered parents’ questions about how to help their children manage their diabetes. The counselors put on a show of specially choreographed dances for camp, hip rotations and shimmying included! We got back to the hotel and immediately crashed…. It was a very emotionally trying and physically exhausting day. But, we are all still super hyped up about the coming weekend!
Blog Post Three:
Today was Day 1 of Campo Amigo. Our day started at 5:30 am with Dominican music blaring, mangu cooking, and excitement ringing throughout our hotel rooms. Green group had very few campers show up in the first half of the day. Because of that, I was working in the medical care room administering morning insulin shots. Later, green group combined with blue group to hear a dentist speak about the importance of oral hygiene in relation to diabetes. It was so cute to see how much noticeably smaller our campers were compared to the older group of campers we were staying with that morning. We split off once we got a few more green group campers and we started the day’s activities. We played many ice breakers, got to know the campers and their siblings (who were also “campers” so their parents could go to the educational sessions Tia was hosting), and taught campers to check their blood sugars. Ruth, a four year old newly diagnosed camper, was having trouble checking her own blood sugar, so we are working with her to make her more independent in her diabetes care. We also had a little girl with Down’s syndrome return from El Dia de la Familia, but this time with her little brother. It was extremely difficult, but rewarding to work with her and help her learn how to treat her low blood sugars she experienced at camp. We finished an activity with extra time left over and decided to break out bubbles…. And the whole camp joined in with Green group’s fun! Everyone at any age enjoys bubbles. We let the campers blow bubbles if they answered questions about diabetes correctly, which ended up working really well. We had a group evenly split between males and females, so all of our activities turned into “boys can girls” thanks to the age group! Every single one of our campers left with an “in-range” blood sugar that day and with a smile on their face! It was rewarding, but absolutely exhausting. I had the morning dance session songs stuck in my head for the rest of the night. The morning dances we’re my favorite part of the day because of how ridiculous we all looked doing these silly dances together… Especially all the 20-year old Americans! We knocked out when we got home, some of us still in our camp clothes from that day… That’s how tired we all were. Well, we’ll be ready to do it again tomorrow!
Blog Post Four:
Today was the second day of Campo Amigo. We woke up the same way: music, mangu, screaming, etc. Green group started with more campers than the day before, which was a relief because we had great activities planned and didn’t want to share activities with Blue Group. In the morning, I was still in charge of giving morning insulin to campers. A girl who is deaf came in and her sister said that she would act as translator. Someone had told me that the camper got 28 units of NPH, which is a large dose of the only cloudy insulin available (because other insulins are clear, making NPH very distinguishable). I drew up the syringe full of NPH, gave her the syringe, and she gave herself an injection. The sister came in and told me that she had made a mistake and that apparently she takes Lantus (another kind of long acting insulin) and NOT NPH. I started shaking because I thought I hurt her by giving the wrong kind of insulin. Tia came over and calmed me down, and put the three long acting insulins we had in front of her and asked her to choose which one she uses at home. She was unable to identify which one she uses, so it was better that I gave her the NPH because it is more the more generally-used long-actin insulin. Apparently, this happens often with campers because not everyone knows that there are different kinds of insulin or they do not know the name of the insulin they regularly take. Another camper came in and gave herself one shot of long-acting insulin in her forearm and a shot of short-acting in her calf… Two spots you are NEVER supposed to give insulin. If you give insulin in a spot without fat, the insulin is not as effective and you waste the insulin, along with maybe causing scar tissue in your muscle. The rest of the day, counselors from AYUDA and AAV were showing her proper spots to give her injections as needed at mealtimes, etc. We had a 2-year old camper join Green Group. He was newly diagnosed and was asymptomatic when it came to hypoglycemia, so I was in charge of monitoring his food intake, blood sugar, and exercise. He was such a mush! What a cute kid. He wouldn’t eat anything unless he fed himself, as we learned the hard way when his blood sugar was low and we were trying to feed him chocolate. Even at a 26 blood sugar (which is abnormally low), he demanded to hold his food. The day was equally as challenging, but equally as inspiring and rewarding as the day before. This time, most of us took a shower before falling asleep.
The next day, we celebrated the Fourth of July at the beach. The day after, the program ended. I have a break for three days and then return back to Santo Domingo for En El Camino. I plan to see my family who lives in the DR and hit the beach for some well-deserved rest!
Blog Post Five:
Today we went to San Pedro at 6:15am and set up outside a hospital in the parking lot. It was actually very pretty! We set up each of our three groups underneath three separate trees. The shade was forgiving but the heat was not and everyone was sweating off their bug spray after being outside for a few minutes. We were much more organized than we were in Bani, which was good for the attendants as well.
The bathroom situation there was very surprising. I thought that because we were in a hospital that there would be clean bathroom facilities. However, there was no toilet paper, running water, garbage cans, toilet seats, or soap/hand sanitizer anywhere. You had to ask the cafeteria across the hallway for napkins to wipe and throw in the corner of the stall. It was definitely an experience.
I was assigned to help attendants fill out surveys, which was very language intensive and it was difficult to communicate the information we actually wanted to know due to the vocabulary. Mid-survey, I was pulled to work with a young woman named Mabel. Mabel is 16 years old and her parents recently died. She is living with her uncle and was dropped off today for our workshop without instruction from her uncle. When asked what kind of diabetes she had, she was unable to answer. She also said that she took pills and insulin injections, which are two different treatments for different types of diabetes (injections are usually for type one, and pills for type two). She was telling me that she has never checked her blood sugar outside of a hospital and that she hadn’t taken her insulin in weeks. After deliberation with the doctors, we decided to treat her as a type one. I talked with her about her life as the line for registration was dying down, and finally convinced her to complete her intake to stay for the day at our camp. She would only take her insulin injection if I gave it to her and stuck by my side the rest of the day. When I was teaching, she was sitting right next to me, as well as when I was eating lunch and playing soccer with other attendants. By the end of the day, she was much more sure of herself and told me that she felt more confident in managing her diabetes, especially on the front of nutrition and food choices.
The rest of our day was successful. We seemed to really make sense to the people we were teaching. There was an eight year old girl that was 15-days old to diabetes who came to the program for the last hour and was shocked to see how many “beautiful, healthy people” she saw, in her mothers’ words. Her name was Lucero and she plans on returning to AAV to learn more about her condition and to get more involved with volunteering (even though she’s eight years old!). Once everyone starting sharing their final thoughts about the education they received that day, one attendant said that G-d is saving a special place in heaven for people who help others like we have helped them: “Di-s te bendiga.”
It kept raining on and off throughout the day, and it was funny to see everyone’s reactions because they were so extreme. They ran for cover under the trees and never left even after it stopped. Our ride home was just as beautiful as our ride there. We stopped for “pastel en hoja,” which is a plantain or yucca mash surrounding either ground beef or ground chicken. It was greasy and delicious… The whole bus shared eight. We then went to an extremely late lunch (as in, we got our food at 4:15pm) at a local fishery and restaurant on the water. We went swimming, dodged vendors, and took pictures while we waited for our food. I got an amazing filet of fish and tostones with lime juice. We debriefed and regrouped for tomorrow once we got back.
Tomorrow we get to leave a little bit later… Yay!!