See how far we've come.
HHI has great things to share with you!
October 2016 Newsletter 
2016: A Year of Growth,
Partnerships and Collaboration
HHI has grown from serving four rural communities in the municipality of Montellano to now, in 2016, having programs being implemented across the province of Puerto Plata that influence policy at the national level  in the Dominican Republic.
Our strategy for improving health and well-being increasingly revolves around partnerships. As HHI Executive  Director, Elizabeth Geier, puts it, "Building partnerships allows us to ensure that the right people have a seat  around the table to help solve problems."

Over the last few years, we have made great strides in expanding the  reach of our work and impact.
  • The number of Community Health Workers we are training and supporting has increased from 16 to 92.
  • We have expanded into training local health care professionals, and are now working with 60 doctors and 30 nurses across the Puerto Plata province.
  • We have deepened our collaboration with the local health system, and now have a presence in 3 hospitals and 12 primary health care centers, providing supportive supervision and facilitating capacity-building initiatives.
  • Through these partnerships, the total population HHI's programs can reach has grown from 2,585 to 334,594 people.
We are proud and grateful to share a snapshot of these exciting changes and accomplishments with you, our  friends and supporters.  

Partnering with The  World Diabetes Foundation 
to  Improve the Response to Diabetes  
World Diabetes Day 2015

In November 2014, HHI entered into a two-year joint partnership grant with the World Diabetes Foundation, Population Services International (PSI) and the Ministry of Public Health.

We are helping to strengthen the local health care system's response to diabetes by improving access to diabetes care and providing training for health professionals on diabetes prevention, diagnosis and treatment.

Here's why this matters:
  • Non-communicable diseases, like diabetes and hypertension, are causing 70% of deaths in the Dominican Republic, according to the World Health Organization (WHO). In the past ten years, diabetes prevalence has doubled in the Dominican Republic. 
  • In 1999 only 5.3% of the population in the Dominican Republic had diabetes, and now the World Health Organization estimates that 10.6% of the population suffers from diabetes. This is over 2% higher than the global average, setting off alarm bells, and the number will only continue to rise if action is not taken.
  • Often, diabetes goes undetected until it is too late. The International Diabetes Federation estimates that 50% of diabetes cases are undiagnosed. This is often due to poverty and lack of access to quality health care. 
  • At a global level, diabetes creates a health crisis that is silently cutting 415 million lives short, three-quarters of whom live in low - and middle - income countries like the Dominican Republic. 
HHI and Ministry of Public Health staff jointly monitor the laboratory at Hospital Imbert

Our work in partnership with the Ministry of Public Health and PSI has yielded promising results:
  • 60 primary care doctors and 30 nurses have received specialized training on diabetes prevention, diagnosis and care.
  • The first diabetes prevention manual geared to Community Health Workers was completed and 60 Community Health Workers have now been trained. 
  • Newly trained Community Health Workers have so far assessed 1,378 people in their communities for diabetes risk factors, and are referring patients to primary health care centers or specialists when needed.
  • Three hospital labs were provided with equipment to test hemoglobin A1c levels, along with applied training for lab technicians.
  • Our bi-monthly capacity-building visits to the 12 primary health care centers and 3 hospitals we are partnering with have demonstrated a 13% improvement on quality of care measures.
  • More than 200 people from Puerto Plata participated in World Diabetes Day 2015 outreach and awareness events.
HHI is excited to be at the forefront of such significant change and progress at the local and  national level in the continuing pursuit of improved health care.

Working in collaboration with the  Ministry of Public Health means that this progress will remain a part of the national health care  system, well beyond when the project is over.
What Does it Take t o be a Community Health Worker i n the Dominican Republic?
Community Health Workers, Grace, Lourdis and Candy
Top: Attending an HHI training. Bottom: Serving at their primary health center.

Community Health Workers, or  Promotores de Salud as they are known here, are the link between the health system and the communities where they live. 
That link is what makes all the difference between a child with or without life-saving vaccines, a mother understanding the importance of breastfeeding, or a person being referred in time to receive treatment for their diabetes before losing their eyesight or a limb.
Community Health Workers in the Dominican Republic are an important part of the public health system and they receive a small stipend each month to cover their costs, but their time and commitment is voluntary. 
HHI is linking up with the country's Community Health Worker network to help improve the current system in the province of Puerto Plata. Many primary health centers lack the number of Community Health Workers necessary and the ones that do exist normally do not receive regular training or supportive supervision at the community level. This means that very little formal monitoring of their work is taking place. 
What motivates these Community Health Workers to keep going? 
HHI sat down with three Community Health Workers who recently took part in an HHI training about diabetes prevention to learn what keeps them motivated. 

Grace, Lourdis and Candy are from the El Javillar community and all three of them work with the primary health center of CPN El Javillar.

The Dominican Ministry of Public Health has the goal of putting in place one Community Health Worker for every 100 households in urban communities and one Community Health Worker for every 90 households in rural settings.  

There is a long way to go in many places to reach this goal. Across the province of Puerto Plata there are primary health centers below the goal, but these three Community Health Workers do not let that get them down.
Grace, Lourdis and Candy told us that their motivation "comes from the heart" when they are working together with fellow community members. 

The connection that they feel with the people in their communities who are neighbors, friends and family to them is what gives them motivation to help improve health. Their dedication is an inspiration to us all!  
HHI is in a unique position to help the Ministry of Public Health continue to improve the Community Health Worker system in the Dominican Republic.  We have successfully trained and worked with Community Health Workers in the DR since our founding in 2009. We are currently training and providing supportive supervision to 92 Community Health Workers across the Province of Puerto Plata.  
How Collaboration Creates Success:
Meet Dr. Pou

"We are not trying to change anything to the way
we want it.   We are working to collaborate and 
strengthen what's possible with the system in place." 
~ Dr. Pou, Clinical Program Coordinator, HHI

On any given day, you could find Dr. Maria Teresa Pou in one of many locations.

She might be giving leadership to the team of Community Health Workers in HHI's home base in Montellano. It's possible she could be out in the community helping to educate and inspire people to learn how to monitor and advocate for their own health. Perhaps she could be working alongside the public health team at Hospital Maternidad in Montellano, Puerto Plata.

She's busy and on a mission. But that's not the first thing you notice about her. The first thing you actually notice is her commitment to something bigger than herself.

When asked why she is working with Health Horizons International, Dr. Pou's reply was simple:"Teamwork. That's why I love what I do. I believe that true health depends on a whole team and we all play an important part in the story of the treatment of chronic disease. We are not trying to change anything to the way we want it. We are working to collaborate and strengthen what's possible with the system in place."

By "we" she is referring to the collaborative partnership between HHI and the local Ministry of Public Health in the Dominican Republic.

Dr. Pou is a family physician. She was raised in Puerto Plata and went to medical school in Santiago at Hospital Juan XXIII. Before joining our team in January of 2016, she had spent the previous four years working within the local health system.

Dr. Pou is a welcome member to the growing team, and her passion shows in everything she does. In particular, Dr. Pou is focused on the management of HHI's Clinical Program. A large part of this is helping to make life saving treatment more available to people with chronic diseases who lack access to basic care.

The World Health Organization estimates that 70% of deaths in the Dominican Republic are caused by chronic diseases such as cardiovascular disease and diabetes.  Those are alarming numbers when you consider the consequences for individuals, families and communities.
HHI and Partners from Hospital Maternidad on World Health Day

But numbers are only part of the story. Intentional and strategic leadership are part of the backbone that can change the future for many lives in this country. The collaborative work between HHI and the government of the Dominican Republic is about saving the lives of fathers, mothers and future generations. We are working to  help empower people to take charge of their own health - no matter what their socioeconomic status is. 

In short, it's about recognizing the value of every single life.
Our Team is Growing in Size and Diversity -  
Learn How This Contributes to the Sustainability of HHI's Programs
HHI Team Gathering
Here at Health Horizons International, sustainability is reflected in the partnerships we build within the healthcare system, collaboration with local community leaders  and  how we build our own team of staff members.
As we build our team of HHI staff to meet the needs of our work at every level,
we have been intentional with the search to hire and engage local Dominican staff. Our persistence is paying off!
Our team has grown from 5 staff members to 12 in the past year and we are growing in a way that helps improve the quality and sustainability of our work!   For every open position, HHI seeks out local Dominican staff first.  Currently, 10 of our 12 staff members are local Dominican staff.  One of the non-Dominican staff is HHI's Administrative Director based in the United States and the other is our Executive Director
There is a wide range of diversity among them representing different parts of the Dominican Republic, different ethnic backgrounds and different socio-economic backgrounds.   The team has benefited from bringing on experienced and highly qualified local staff who understand both the realities being experienced by ordinary people in the communities where we work and the local health system.
  • Our Director of Programs, Dr. Luis Manuel Rosa, completed medical school in Santo Domingo before earning Masters degrees in Epidemiology and Public Health, and worked for several years leading international health programs in Afghanistan, Jordan, and the Philippines.
  • Our Coordinator for the World Diabetes Foundation Project, Sheila Calderón, is an expert program manager and relationship builder with years of experience implementing complex health programs with other NGOs across the north coast.
  • Our Clinical Program Coordinator, Dr. Maria Teresa Pou, is a talented and dedicated physician who completed her residency in Family Medicine in Santiago.
  • Our Administrative and Logistics Coordinator, Marinelly Gutierrez, is a diligent and detail oriented office manager from the nearby town of Sosua.
  • All of our field-based staff - Carlos Castillo, Catherine Balbuena, Elisa Ruben, Marc Nicoleau, and Willy Destin -- hail from the communities where we implement our programs.
Our team is strong because of our diversity, bringing knowledge and experience to every level of HHI's work. 

We have now begun searching for three new local positions to be based in the capital city of Santo Domingo.
Farewell to our First International Health Fellow, Lis Ganter Restrepo

Lis Ganter Restrepo has played a special role on our team for the past year.

Joining HHI in early July 2015, Lis was our first ever International Health Fellow. Lis has completed her time with HHI and our team wants to send out a big Thank You!

HHI began the International Health Fellow program to be able to bring on board young professionals who have specific experience and skills who can devote at least one year to volunteer with HHI.

International Health Fellows must be fluent in Spanish, have already completed a Masters degree, and have relevant experience compatible with specific areas of programmatic need to HHI.


Prior to becoming HHI's first International Health Fellow, Lis graduated with a Masters in Public Health from Oxford Brookes University in the United Kingdom. She then went on to work as a data analyst for the District Secretary of Health and the National Institute of Health in Colombia, and then worked in Fundraising and Communications for International Child Care Trust in the U.K. 

She was able to draw on these experiences, as well as her fluency in Spanish, to be able to contribute a lot during her time volunteering with HHI.  Lis worked under and got to learn from Dr. Luis Sosa, HHI's Program Director, and was able to get hands-on experience helping out with HHI's projects. 

During her time with HHI, Lis helped with planning and carrying out training for Community Health Workers, helped to create promotional materials for HHI's project with the World Diabetes Foundation, assisted in monitoring and evaluation of various projects, lent a hand during field clinics and helped with HHI's facebook page, just to name a few of the areas she helped out with!

We are sure that Lis, with her passion for public health, will build successfully on her time with HHI to continue to contribute to making a difference improving health and the health systems through out the world!

We wish you all the best, Lis!
Meet the Two Newest Members of HHI's 
Board of Directors
We are thrilled to welcome two fantastic new leaders to the HHI Board of Directors. The Board is responsible for guiding HHI's growth and impact, and relies on the dedication, passion, and diversity of ideas, expertise, and backgrounds of its members to drive the success of our vision in the Dominican Republic. 

We are excited for  Cynthia and Romiya to join our team.
     Cynthia McMurry

Cynthia comes to HHI with an impressive career in international development. For the past seven years, she  worked for the micro-lending platform, focused on providing access to finance for poor entrepreneurs in the developing world. She has worked in more than 20 different countries, including extensive field work in Latin America.
         Romiya Barry 
Romiya is a clinical researcher with a passion for bringing "benchwork to the bedside" and improving health  systems through community-engaged research and training. Her work has supported the development of  medical devices for patients with critical care health issues and chronic diseases such as HIV, thrombotic and
bleeding disorders, and Type 2 diabetes.

On The Horizon...
  • This Fall, HHI will begin organizing a conference on diabetes to take place in 2017, concentrating on sharing strategies and best practices. 
  • We will also be opening a satellite office in the capital city of Santo Domingo.
  • Mark your calendars for November 14, 2016.  HHI is already working together with the Ministry of Public Health to organize World Diabetes Day 2016 events in the Dominican Republic. 
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