Help Me With This Letter

SKing

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Nov 22, 2007
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The next post will house a letter that I wrote that will be sent by various Midwives to various companies in their respective states here in the United States. The letter that we will send to individuals will be the same except we will offer their picture to be put in our frame instead of a logo.
Please check for grammatical errors as I was never an English major, also I would like feedback in what you think...should I include something? Is it too long? Too short? etc. The Midwives will read it also before it is sent out and then we will be having a conference call to set up our plans.
We are very serious about this project and I will take all criticism constructively as my ultimate goal is to make this happen.
Also, I would like you guys opinion on whether we should become a non-profit org or no. My answer is yes as I fully intend to beg for money from organizations such as UNICEF, WHO, etc...who only give to non-profits but there are some of the Midwives who think not as it is too much money upfront for a lawyer for all of the paperwork. I say we can raise the money but what are your opinions....

SHALENA
 
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SKing

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Shalena King, RN
c/o Midwives for the Dominican Republic
P.O. Box -------
Raleigh, NC 27610

Contact Name
Company Name
Address
City, State, Zip

Dear Contact,

We are a group of American Midwives and Midwifery students who are dedicated to decreasing the Maternal/Infant mortality rate in the Dominican Republic through high-quality Midwifery care, education, and training of local Midwives. Although the rates have been declining through the years, the Dominican Republic continues to have moderate to high rates of Maternal and Infant mortality, and even higher rates of Maternal and Infant Morbidity. These rates are astounding considering the fact that 98% of the infants born in the Dominican Republic are born with a skilled birth attendant present. The World Health Organization defines a skilled attendant as “an accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns”. Why then are the Maternal and Infant mortality and morbidity rates still high? Although there has not been a formal presentation on this answer, we believe that the lack of Midwives in the Dominican Republic has attributed to these numbers.
The United Nations Population Fund, who recently released a 180 page publication titled “THE STATE OF THE WORLD’S MIDWIFERY 2011: DELIVERING HEALTH, SAVING LIVES” states “Maternal mortality and morbidity cannot be reduced without midwives and others with midwifery skills. Yet the numbers of these skilled providers have not significantly increased”. The Dominican Republic has NO recognized Midwives working in the country except those that volunteer their time in missions each year for maybe 2-4 weeks at a time. The country desperately needs Midwives and we are passionately working on changing the culture to one of acceptance and collaboration. The current maternal death rate in the United States is 7: 100,000 births. In the Dominican Republic the rate is 159: 100,000 births. 22 times our rate! The infant mortality rate in the United States is 6: 1,000 births, in the Dominican Republic it is 22: 1,000 births! Why is this happening if 98% of the women receive prenatal care and are delivered by skilled birth attendants??? This has been termed by Dominican medical experts as “The Dominican Paradox”. The answer, we believe, lies in Midwifery.
We are committed to decreasing these horrible statistics slowly but surely but we need your help. We are committed to starting one freestanding Birth Center in the city of Santiago, Dominican Republic. The Birth Center will be staffed by Certified Professional Midwives, assisted by volunteer Midwives, and Midwifery students. Our goal is to become the flagship Birth Center so that other Midwives from other countries will come to the Dominican Republic and set up other Birth Centers throughout the country. We are committed to collaborating with local physicians, educating them on a variety of issues that we have seen in the hospitals in the country and training local Dominican Nurses who would like to become Midwives in order to serve the women and infants of their country. We will collaborate with Midwives for Haiti who have an astounding program of which we can only dream of arriving to the level that they are now.
We need your support to make this happen. Our Midwives are holding several fundraising events in order to collect donations and support for our upcoming endeavors. Our first step is our Birth Center where we will provide prenatal, intrapartum, and postpartum care (including contraception education and family planning) to all women on a sliding scale and regardless of ability to pay, we will educate Midwifery students in the United States on all Midwifery skills and the history and culture of the Dominican Republic in hopes that they will volunteer their services to the people of the Dominican Republic once they are certified, even if only for 1-2 weeks per year. Once the Birth Center is operational and we have enough donors, we will start a small training program for a select group of Dominican nurses that will train them in Midwifery skills and assist them in receiving their certification from the United States which will prepare them to return to their home towns of the Dominican Republic and do their part in decreasing Maternal and Infant mortality and morbidity rates in the country. For this program we will recruit Dominican Nurses who have a desire to remain in their country and give back to their communities.
We have many costs associated with this dream. We will have operational costs, equipment costs, costs of supplies, advertising, staff, etc. We hope that your company can help us with this very important project. Whether it be with a financial donation or a donation of equipment or supplies, we would be forever grateful. The Birth Center will house a large picture frame at the entrance, where for your generosity, around a picture of the Birth Center, we will place a your company/organization’s logo along with the logos of other donor companies/organizations. You will receive a quarterly newsletter informing you of the progress of the Birth Center, each newsletter highlighting a mother and infant whom we will interview so that she may state in her own words how the Birth Center has affected the community. These newsletters will also house the logos of donating companies/organization. You may rest assured that your donation will be used solely for the purpose and benefit of the Birth Center. No donations will be used to pay Midwife staff or employees of the Birth Center. Our goal is simple…to decrease the maternal and infant mortality and morbitity rate in the Dominican Republic through high quality Midwifery care, and education.
Won’t you help us?

Sincerely,


SHALENA KING, RN
MIDWIVES FOR THE DOMINICAN REPUBLIC

Some of the positioning of things (My name, address, ect. did not copy correctly for some reason.)Also my indentations for the paragraphs
 
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Chirimoya

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Here are my 2 centavos:

Compose a much shorter cover letter that outlines the following three points: the problem, what you are planning to do about it, and how they can help. In the current format your "ask" is too hidden in a lot of text. Put all the detail in a one page summary document attached to the letter.
 

SKing

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So make the cover letter with that information: the problem, what we are planning to do about it, and how they can help. Short and all of the statistic type information in a different page (summary document)
Because it sounds like it will still be 2 pages unless you mean just getting down to the nitty gritty first and giving them the facts of the state of Midwifery in the DR, afterwards.
I think thats what you're saying right?

SHALENA
 

Chirimoya

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Yes, two pages: cover letter and proposal summary. If it has to be on one page, start with those three elements as bullet points and go into detail below.
 

Hillbilly

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Jan 1, 2002
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Point of fact: No way in hell that 98% of birthing mother have receive prenatal care or even oral information of the birth process beyond what neighbors say to each other. A major percentage of birthing women are brought from Haiti for that purpose. (I will not go into ulterior motives)

The ignorance level is so incredibly high as to defy my ability to describe it.

What you are trying to do is fantastic. I wish you good luck. You can count on institutional help here in Santiago, I am almost sure. If you play your cards right, you can even get some of the more prestigious OB/Gyns to help.

Now, as to being an NGO?? ABSOLUTELY!!

HB

AND please pay attention to what Chirimoya says, she is a professional in this field...not kidding or BSing..
 

SKing

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Nov 22, 2007
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Yes, two pages: cover letter and proposal summary. If it has to be on one page, start with those three elements as bullet points and go into detail below.

Thanks, I will rewrite again tonight and post. I truly appreciate this help

SHALENA
 

SKing

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Point of fact: No way in hell that 98% of birthing mother have receive prenatal care or even oral information of the birth process beyond what neighbors say to each other. A major percentage of birthing women are brought from Haiti for that purpose. (I will not go into ulterior motives)

The ignorance level is so incredibly high as to defy my ability to describe it.

What you are trying to do is fantastic. I wish you good luck. You can count on institutional help here in Santiago, I am almost sure. If you play your cards right, you can even get some of the more prestigious OB/Gyns to help.

Now, as to being an NGO?? ABSOLUTELY!!

HB

AND please pay attention to what Chirimoya says, she is a professional in this field...not kidding or BSing..

You are right HB. Those statistics state that 96% get prenatal care but they consider prenatal care as at least one visit so we have no real statistics on the amount of women who get real prenatal care which we consider in the us to be 12-15 visits. Also I read an article on the "MIDWIVES FOR HAITI" site about the problem of women crossing Haiti to the DR to give birth. Yet we don't want to lose sight that there are still Dominican women and infants dying although I would love for some of the studies to address that issue.

One if our Midwives took a group of students to Cabral y Baez in May for 2 weeks. She said the OBs loved the help and said that they would support us. We also need collaboration with OBs from Las Corominas, HOMS, and the other hospital (canter remember the name) as we need MDs to refer high risk patients to.

SHALENA
 

laurajane

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May 23, 2005
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I think this is a fantastic idea and I hope it is a success Shalena, Having had two children here I am well aware of the lack of prenatal and postnatal care....so much so I had my best friend who is a Health care visitor and special care baby unit nurse in the UK come all the way over to help me with the birth or my second daughter.

Let me know if this idea spreads further in my direction here in the east as i would love to be involved in some way.
 

SKing

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Nov 22, 2007
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I think this is a fantastic idea and I hope it is a success Shalena, Having had two children here I am well aware of the lack of prenatal and postnatal care....so much so I had my best friend who is a Health care visitor and special care baby unit nurse in the UK come all the way over to help me with the birth or my second daughter.

Let me know if this idea spreads further in my direction here in the east as i would love to be involved in some way.
Great! We also know of another Midwife who has contacted us as she would like to start a Birth Center in Sosua/Cabarete area. We are hoping that even though we may be the first, that the idea will catch on and more centers will be started around the country.
Funny, one Dominican stated that it was a class symbol in DR to be attended by a doctor at a clinica and have a c-section, it shows you have money, so he doesn't think our center will fly. I explained to him that those are not the women that we are targeting although they are welcome. We are targeting women who desire the best outcome for themselves and their babies, a birth with dignity and exceptional care.
I think that once we have 10 patients word of mouth will be our best advertising.
We will gladly accept volunteers, even those with no medical experience. There are many things to be done that are not necessarily medical.

SHALENA
 

laurajane

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Great! We also know of another Midwife who has contacted us as she would like to start a Birth Center in Sosua/Cabarete area. We are hoping that even though we may be the first, that the idea will catch on and more centers will be started around the country.
Funny, one Dominican stated that it was a class symbol in DR to be attended by a doctor at a clinica and have a c-section, it shows you have money, so he doesn't think our center will fly. I explained to him that those are not the women that we are targeting although they are welcome. We are targeting women who desire the best outcome for themselves and their babies, a birth with dignity and exceptional care.
I think that once we have 10 patients word of mouth will be our best advertising.
We will gladly accept volunteers, even those with no medical experience. There are many things to be done that are not necessarily medical.

SHALENA

Well i think all women of all classes need to be targeted, I paid 35,000 pesos for my recent c-section and 2 days in a respectable clinic. It was a much better experience than my first but not one nurse, doctor or any member of staff spoke to me about breast feeding, taking care of my incision or any kind of new born care...i.e how to clean the babies belly button blah blah blah. Now of course i know all these things as it was not my first and i read alot whilst pregnant, but many women do not know. Every dominican woman i know puts their new born baby to sleep face down.

In the UK as well as the US i presume a health care visitor visits mother and baby at home every week for the first month, my friend also teaches brestfeeding and tips to all mothers even if it is their fourth child.

Really hope it goes well and please let me know how i can help or even start one here on the east coast.
 

SKing

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I don't want you to think that we will not serve a certain type of woman because we will serve all, rich, poor, and in between. What I meant by targeting is that women that opt to have c-sections for no medical reason, are probably not the ones who care to listen to our "Midwives model of care", there are Dominican women who feed their infants formula instead of breastfeeding because they want to show that they can afford it, formula feeding is a status symbol. Also, they don't want their breasts to sag. If you have no medical reason to NOT breastfeed your child, yet you choose not to for selfish image issues and statistic symbols, I don't think you want to be delivering at a Birth Center that will feed infants formula only in case of an emergency (severe hypoglycemia, jitteriness, etc).
I hope that I didn't come off as meaning that we will not care for all women, we will. The Midwife that spent 2 weeks at Cabral y Baez in Santiago states that there are some doctors that still believe that infants get no nourishment from the breast until day 3. They are TEACHING this to new moms, robbing infants of the precious benefits of colostrum! Our center will follow our moms for 6-8 weeks after the birth, give ongoing breastfeeding and newborn care information. And if you don't come to your Postpartum visit and we can't reach you by phone....we will hunt you down.
As we will be the first, it is our duty to have strict medical records and especially Postpartum records to show how our Center is helping the community.
We also will have other services.....I specialize in Adolescent Reproductive Health and preventing Adolescent pregnancy so my project will be a monthly meeting for all girls who care to cone, ages 12-19, where I will discuss everything from hygiene, puberty to STDs. I will entice them by feeding them at the meetings...Pizza Hut, Mickey D's etc. I figure fast food once a month won't be too horrible!

Yes, the biggest difference between Midwifery care and Hospital care is education. Every woman....everytime.

SHALENA
 

laurajane

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May 23, 2005
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Laurajane what city are you in?

SHALENA

Higuey and its not a tourist town so something like this is really needed. I was actually thinking some time ago to open up a mother baby store here as the basics are soooo expensive or not available...I realize its not the same thing but lots of pregnant women and nothing for them here.
 

laurajane

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May 23, 2005
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I don't want you to think that we will not serve a certain type of woman because we will serve all, rich, poor, and in between. What I meant by targeting is that women that opt to have c-sections for no medical reason, are probably not the ones who care to listen to our "Midwives model of care", there are Dominican women who feed their infants formula instead of breastfeeding because they want to show that they can afford it, formula feeding is a status symbol. Also, they don't want their breasts to sag. If you have no medical reason to NOT breastfeed your child, yet you choose not to for selfish image issues and statistic symbols, I don't think you want to be delivering at a Birth Center that will feed infants formula only in case of an emergency (severe hypoglycemia, jitteriness, etc).
I hope that I didn't come off as meaning that we will not care for all women, we will. The Midwife that spent 2 weeks at Cabral y Baez in Santiago states that there are some doctors that still believe that infants get no nourishment from the breast until day 3. They are TEACHING this to new moms, robbing infants of the precious benefits of colostrum! Our center will follow our moms for 6-8 weeks after the birth, give ongoing breastfeeding and newborn care information. And if you don't come to your Postpartum visit and we can't reach you by phone....we will hunt you down.
As we will be the first, it is our duty to have strict medical records and especially Postpartum records to show how our Center is helping the community.
We also will have other services.....I specialize in Adolescent Reproductive Health and preventing Adolescent pregnancy so my project will be a monthly meeting for all girls who care to cone, ages 12-19, where I will discuss everything from hygiene, puberty to STDs. I will entice them by feeding them at the meetings...Pizza Hut, Mickey D's etc. I figure fast food once a month won't be too horrible!

Yes, the biggest difference between Midwifery care and Hospital care is education. Every woman....everytime.

SHALENA


Oh no i understood what you meant, what i meant is every woman here needs to learn that no matter what there financial pr status is information and help is avaliable to them. As i said my best friend is a breastfeeding expert in the UK and as you have said Colostrum is infact better than the milk and yes many women dont know that, they also need to learn that breastfeeding does not mean saggy boobs, I have breastfed two daughters, one of them for 15 months and mine are still good... I think genetics has alot to do with it.

Anyway I think what you are doing is needed and i will help and support you in any way I can, even though i am not a massive company!! Allthough i do have an idea which i will talk to you about in private ;)
 

La Profe_1

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Oct 15, 2003
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Shalena, I agree with Chrimoya. You need a one page summary - a sort of project proposal - and a "presentation letter" to accompany.

I would reduce the number of citations and give the information in as clear and concise a manner as possible. Most people would not want to slog through a letter heavy with citations and verbiage.

PM me if you would like more assistance or information.

LP
 

cobraboy

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Jul 24, 2004
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IMO, you're in for a heap of trouble without physicians being the champion in the DR.

Fine intentions, but you're treading on ground that others occupy...
 

SKing

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Oh no i understood what you meant, what i meant is every woman here needs to learn that no matter what there financial pr status is information and help is avaliable to them. As i said my best friend is a breastfeeding expert in the UK and as you have said Colostrum is infact better than the milk and yes many women dont know that, they also need to learn that breastfeeding does not mean saggy boobs, I have breastfed two daughters, one of them for 15 months and mine are still good... I think genetics has alot to do with it.

Anyway I think what you are doing is needed and i will help and support you in any way I can, even though i am not a massive company!! Allthough i do have an idea which i will talk to you about in private ;)

Thanks so much, we cannot do it without people like you.

SHALENA
 

Chirimoya

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Dec 9, 2002
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cobraboy said:
IMO, you're in for a heap of trouble without physicians being the champion in the DR.

Fine intentions, but you're treading on ground that others occupy...

It depends how they go about it - first of all it has to respond to an existing need that is recognised by at least some local professionals/potential service users, as opposed to an imposition by foreigners who think they know best. Cultivating alliances with professionals who are sympathetic or open to the idea is the way to approach it - as they seem to be doing in this case. It may not replace the current model but it can start off as a minority niche and the results ought to speak for themselves.

I agree with everything that Shalena and Laura have said about the prevailing attitudes here. There are however some gynaecologists who share her views on childbirth and breastfeeding and plenty of women too if the membership of La Leche League is anything to go by.