United States Agency for International Development Bureau for Humanitarian Assistance Office of Food for Peace

Final Performance Report

Awardee Name and Host Country CitiHope International Host/Implementation Country Award Number 72DFFP19FA00003 Project Name USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación Activity Start Date 9/30/2019 Activity End Date 2/28/2021 Submission Date 3/30/2021 Awardee HQ Contact Name Paul Moore II Awardee HQ Contact Address PO Box 626, Margaretville, NY 12455 Awardee HQ Contact Telephone Number 845-586-6202 Awardee HQ Contact Email Address [email protected] Host Country Office Contact Name Tim Tuccelli Host Country Office Contact Telephone 809-729-9099 Number Host Country Office Contact Email [email protected] Address

LIST OF ACRONYMS

ADS Automated Directives System AER Annual Estimate of Requirements AIDS acquired immune deficiency syndrome AOR agreement officer’s representative (formerly agreement officer’s technical representative or cognizant technical officer) ARR annual results report ARR PRT Annual Results Report Partner Reporting Tool ART Anti-retroviral therapy BEHT Bill Emerson Humanitarian Trust BHA Bureau for Humanitarian Assistance CHI CitiHope International CHI-DR CitiHope-Dominican Republic DEC Development Experience Clearinghouse DIP detailed implementation plan DQA data quality assessment FFP Office of Food for Peace FFP/M/R Office of Food for Peace/Mission and/or Regional Office, as appropriate FFP/W Office of Food for Peace/Washington FFPIB Food for Peace Information Bulletin FY fiscal year (October 1st - September 30th) HIV human immunodeficiency virus IDP internally displaced person IFRP International Food Relief Partnership IPTT indicator performance tracking table LOA life of award LOP life of program NGO Non-governmental organization OVC Orphans and Vulnerable Children PPE personal protective equipment PREP pipeline and resource estimate proposal SAPQ standardized annual performance questionnaire USAID United States Agency for International Development

1 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

1. Report Narrative

A. Activity Interventions and Results

Award Summary: Objectives and Beneficiaries

The objective of this food aid program is to provide critically needed nutritional support in the form of Breedlove Harvest Lentil Pro® food supplement to community health programs, hospitals and care centers serving vulnerable populations at risk of malnutrition, including orphans and vulnerable children (OVCs), pregnant women and lactating mothers (PWLM), people living with HIV and AIDS (PLWHA), hospital patients, and elderly in the Dominican Republic (DR).

These beneficiaries were selected because they are the most vulnerable children and adults in the region with very limited access to sufficient food or nutritional supplementation. The recipient institutions are maternal and children’s health care centers, community health care programs, general nutrition programs, orphanages, HIV treatment programs, schools, geriatric care programs, special needs centers, medical operatives and a nutritional aid program for undernourished patients preparing for humanitarian surgical operatives in the Dominican Republic. CitiHope International-Dominican Republic (CHI-DR) works directly with beneficiary institutions across the island and initially targeted 24,408 OVCs, PWLM, PLWHA, hospital patients, and the elderly in this program, delivering 150.08 metric tons (MT) of Harvest Lentil Pro®.

Several factors affected our original distribution plan. The COVID-19 pandemic has created an extreme food shortage in the Dominican Republic due to loss of income from the shutdown and to the ongoing effects of the 2019 blight and drought in agricultural areas.

As educational and daycare centers were closed our distribution plan adjusted to provide increased support to family nutrition programs. Prior to the pandemic, CHI-DR had planned to distribute a portion of the Harvest Lentil Pro® to school feeding programs which prepared meals on site for students. When these school feeding programs closed and schools shifted to providing food distribution to students’ entire families, CHI-DR shifted to providing Harvest Lentil Pro® to these family distributions, resulting in significantly more beneficiaries than originally planned. The ration size per beneficiary was adjusted based on updated needs assessment and consultation with participating institutions, allowing for entire families to be reached.

In addition, the Dominican Ministry of Health and military, which led the Dominican Republic’s network of COVID-19 first responders, requested that CHI-DR add COVID-19 patients to the

2 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación food distribution. Military hospitals were set up in March for isolation and COVID-19 patient care. The military medical directors requested assistance from CHI-DR for COVID-19 related personal protective equipment (PPE), medicines, and nutrition. CHI-DR, through its Sanar una Nación (Heal A Nation) alliance with leading Dominican corporations which provide financial and in-kind support, provided PPE, medicines and the USAID Breedlove Harvest Lentil Pro® for hospitals, isolation centers and to families in home isolation. Over 500 COVID-19 patients and families in isolation received Harvest Lentil Pro®, which was also provided to medical professionals serving in hospitals and traveling around the island tracking the pandemic.

In total, 63,115 persons, including children, families, PWLM, OVCs, PLWHA, elderly persons, COVID-19 patients, and their families, have been reached with nutritional assistance through this program.

This IFRP program assisted the local medical infrastructure in caring for vulnerable patients through the following objectives:

1.) Provide nutritional support for populations at risk of chronic malnutrition so that they may reach their potential in physical and behavioral development. 2.) Provide urgent nutrition for COVID-19 patients and their families, during isolation treatment and recovery. In addition, provide nutritional support to the many thousands that were affected by the COVID-19 shutdown and quarantine. 3.) For those patients with HIV/AIDS, provide the additional nutritional support necessary to complement antiretroviral therapy (ART). Patients with HIV/AIDS need to consume 10 to 20 percent more calories than those who are HIV negative. 4.) Provide safe, non-contaminated nutritional supplementation in areas where environmental hazards can traditionally cause parasite/bacterial contamination. 5.) Provide nutrition training to community leaders, health care providers, and caregivers to encourage behavior changes in targeted at-risk populations. 6.) Improve quality, efficiency, and safety of institutional food service capabilities by providing supplemental nutrition to add to complementary foods. 7.) Provide greater food security for an institutionalized segment of the population of the DR.

Distribution

CHI worked with Breedlove staff to secure a freight-forwarder to manage the international shipping of the commodity from the U.S.A. to CHI-DR warehousing facilities in San Isidro, via Rio Haina port. CHI-DR, which currently clears several shipping containers of humanitarian aid per month in collaboration with Grupo Rica customs services, facilitated the clearing process of the commodities through Dominican Customs. CHI-DR then coordinated directly with recipient institutions to transport the commodity and safely store it 3 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación in existing pre-approved storage facilities for further distribution to urban and rural areas, drawing upon its extensive experience in such large-scale distributions in Dominican Republic based on its ongoing medical and nutritional humanitarian program, Sanar Una Nación.

The 8 40-foot containers of Harvest Lentil Pro® were shipped to the Dominican Republic in two installments. The first four containers shipped from Breedlove Foods on February 4, 2020 and arrived in the Dominican Republic in early March. The final four containers shipped from Breedlove Foods on March 6, 2020 and arrived in the Dominican Republic in early April.

As the COVID-19 pandemic began to spread through communities in late March, CHI-DR reevaluated needs with government authorities, such as the Ministry of Health and the military, and the corporate leadership of our Sanar una Nación alliance. Upon careful evaluation with our beneficiary organizations, distribution was reestablished focusing on the COVID-19 response and keeping sight on our established nutrition programs with our trusted network of institutions. CHI-DR staff and distribution partners were trained and observed protocols to prevent the spread of COVID-19 during the distribution of the food commodity. COVID-19 protocols included mask wearing, physical distancing, and handwashing/hand sanitizing. Where prudent, face shields and overalls were provided for staff and partners during distribution activities.

Local travel restrictions and the temporary closure of some beneficiary institutions during the early months of the pandemic delayed the distribution. Through September 30, 2020, 100.7 MT (67%) of the Harvest Lentil Pro® had been distributed. The remaining 33% (49.3 MT) of the product was distributed to beneficiary institutions from November 2020 to February 2021, targeting individuals and families most affected by the COVID-19 pandemic and its economic impacts.

Award Outputs

Table 1: Institutions Receiving Harvest Lentil Pro, Distribution Summary

Institution Program Program Number of Quantity Total kg Location Type beneficiaries kg per person ACHIEVE Nationwide HIV 5,376 0.8 4,060 Treatment Program

4 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Aid For Aids Santo HIV 150 3.4 504 Domingo, Treatment Distrito Program Nacional Armada de Nationwide General 1,568 2.8 4,410 República Nutrition Dominicana Program Asociación Nationwide Health 150 3.4 504 Dominicana de Center Rehabilitación Asociación Santo General 90 5.6 504 SHALOM Domingo, Nutrition Distrito Program Nacional Banco de Santo General 840 1.2 1,008 Alimentos de la Domingo, Nutrition Arquidiócesis de Distrito Program Santo Domingo Nacional Casa Albergue Puerto Plata, Orphanage 35 14.4 504 de Martina Puerto Plata Casa del Pobre Duarte, San Infant 40 12.6 504 Divino Niño Francisco de Development Jesús Macorís Program Casa Madre Santo General 106 4.8 504 Ersilia Crugnola, Domingo, Nutrition fma Distrito Program Nacional Centro Cristiano Santo Health 431 1.2 504 de Servicios Domingo, Center Médicos Centro de Puerto Plata, Health 1,398 3.5 4,956 Acopio Salud Puerto Plata Center Comunitaria, Puerto Plata Centro de Nationwide National 5,437 1.3 6,972 Operaciones de Emergency

5 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Emergencia Operation (COE) Center Centro Puerto Plata, Health 941 2.8 2,646 Diocesano De Puerto Plata Center Medicamentos San Felipe Apóstol De Puerto Plata Centro Nacional Nationwide Geriatric 314 2.8 882 de la Persona Care Envejeciente (CONAPE) Clínica Rural Peravia, Health 225 2.2 504 Palmar de Ocoa Ocoa Center Club deportivo y Santo General 30 4.7 140 cultural Profesor Domingo, Nutrition Juan Bosh Distrito Program Nacional Club Rotario, La Altagracia, General 303 2.8 854 Higüey Higüey Nutrition Program Club Rotario, San General 98 5.1 504 San Cristóbal Cristóbal, Nutrition San Cristóbal Program Comité Olímpico Nationwide General 249 2.8 700 Dominicano Nutrition Program Compassionate Puerto Plata, General 566 4.9 2,772 Care Programs Puerto Plata Nutrition Program Despacho de la Nationwide Community 7,859 1.1 8,820 Primera Dama and Health Operatives Dominican Eyes Puerto Plata, Infant 44 11.5 504 Plus Puerto Plata Development Program

6 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Escuela Hogar San Pedro de School 209 8.4 1,764 Nuestros Macorís, San Pequeños Pedro de Hermanos Macorís Fe Y Alegría Santo Orphanage 312 2.8 882 Domingo, Distrito Nacional Fuerza Aerea Nationwide General 987 2.8 2,769 Dominicana Nutrition Program Fundación A Puerto Plata, Maternal and 393 1.3 504 Mother's Wish Puerto Plata Infant Health Care Fundación Santo General 189 14.0 2,646 Almuerzo Infantil Domingo, Nutrition Haití-RD Distrito Program Nacional Fundación Santo General 303 2.9 882 Ayudar es Domingo, Nutrition Posible Santo Program Domingo Este Fundación Santiago, School 616 0.8 504 Cometas de Santiago Esperanza Fundación Santo General 509 2.7 1,386 Comunitaria de Domingo, Nutrition Apoyo Integral Santo Program los Amigos de Domingo Jesús Oeste Fundación Santo General 537 4.9 2,646 Creciendo en Domingo, Nutrition Gracia Distrito Program Nacional

7 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Fundación del Santo General 306 2.9 882 Pobre Lázaro Domingo, Nutrition (FUNIDEPOLA) Distrito Program Nacional Fundación Divino Santo General 42 12.0 504 Niño Domingo, Nutrition Distrito Program Nacional Fundación San General 179 2.8 504 Domínico Cristóbal, Nutrition Alemana para la San Cristóbal Program Salud Fundación Santiago, General 75 6.7 504 Educativa Acción Santiago Nutrition Callejera Program Fundación Grupo La Altagracia, Health 935 3.4 3,150 Puntacana Higüey Center Fundación La Romana, Health 450 0.8 350 Hospital General La Romana Center el Buen Samaritano Fundación La Santo General 3,100 0.6 1,764 Merced Domingo, Nutrition Santo Program Domingo Oeste Fundación Manos Santo Geriatric 87 10.1 882 Arrugadas Domingo, Care Distrito Nacional Fundación Elías Piña, General 1,005 2.6 2,646 Mariana San Comendador Nutrition Isidro labrador Program (FUMSIL) Fundación María Primary 824 2.8 2,268 Mariano Alonso Trinidad Health Care Center

8 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Sánchez, Rio San Juan Fundación Santo General 72 5.3 378 Melerich Cohn - Domingo, Nutrition Lois Distrito Program Nacional Fundación Santo General 790 3.3 2,646 Ministerio Pasos Domingo, Nutrition de Fe y Amor al Distrito Program Prójimo Nacional Fundación Niños Barahona, General 1,299 2.8 3,654 de las Naciones Barahona Nutrition Program Fundación Santo Maternal and 279 8.4 2,352 Pediátrica Por Domingo, Infant Health Un Mañana Distrito Care Nacional Fundación Pedro Santo School 205 8.6 1,764 Martínez Domingo, Fundación Santo General 20 44.1 882 Pleiades for Domingo, Nutrition Christ Distrito Program Nacional Fundación Red Santiago, General 62 8.1 504 Misericordia Santiago Nutrition Program Fundación Santo General 142 3.5 504 SOLCA - Domingo, Nutrition Solidaridad Distrito Program Calasancia Nacional Fundación St. Santo Infant Health 32 15.8 504 Jude Domingo, Care Distrito Nacional

9 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Gabinete de Nationwide General 3,064 2.7 8,316 Política Social de Nutrition la Presidencia Program Grupo Santo Health 1,120 2.8 3,150 Consultivo de la Domingo, Center Calidad de los Distrito Servicios Nacional Clínicos Hogar Crea Santo General 1,936 1.4 2,772 Dominicano Domingo, Nutrition Santo Program Domingo Oeste Hogar de Santiago, Geriatric 149 3.4 504 Ancianos Eliseo Santiago Care Álvarez Luna Hogar de La Romana, Geriatric 34 14.8 504 Ancianos Padre La Romana Care Abreu Hogar de Niñas Santiago, Orphanage 55 9.2 504 con Dios Santiago Hogar de Niños Santo Orphanage 40 12.6 504 Casa de Luz Domingo, Distrito Nacional Hogar del Niño La Vega, La Orphanage 32 15.8 504 Padre Fantino Vega Hope Ministries Santo General 197 4.5 882 Domingo, Nutrition Distrito Program Nacional Hospicio San Santiago, Geriatric 23 21.9 504 Vicente de Paul Santiago Care Hospital Santo Maternal and 115 4.4 504 Materno - Infantil Domingo, Infant Health San Lorenzo de Distrito Care los Mina Nacional

10 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Hospital Santo Maternal and 140 3.6 504 Universitario Domingo, Infant Health Maternidad Distrito Care Nuestra Señora Nacional de la Altagracia Iglesia adventista Santo General 32 4.4 140 del séptimo día Domingo, Nutrition Distrito Program Nacional Instituto Santo General 1,852 1.2 2,268 Dominicano de Domingo, Nutrition Desarrollo Distrito Program Integral (IDDI) - Nacional Hospital PAP Jackie’S House, Santo Orphanage 210 8.4 1,764 Ministerios Domingo, Tsidkenu Junta De Santo Geriatric 791 2.9 2,268 Desarrollo Domingo, Care Gualey Distrito (JUDEGU) Nacional Junta Municipal La Vega, General 40 12.6 504 de la Sabina Constanza Nutrition Program Ministerio Banco Santo General 1,229 2.6 3,150 De Alimentación Domingo, Nutrition - Iglesia Jehová Distrito Program Reina RD Nacional Ministerio de Nationwide General 1,067 4.1 4,410 Defensa Nutrition Program Ministerio de Nationwide General 314 2.8 882 Obras Públicas y Nutrition Comunicaciones Program (MOPC)

11 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Ministerio de Nationwide Health 570 5.7 3,276 Salud Pública y Center Asistencia Social Ministerios Bet- Santo General 43 11.7 504 el Domingo, Nutrition Distrito Program Nacional Missionary Puerto Plata, General 846 2.8 2,380 Ventures Puerto Plata Nutrition Program Operación Santo Facial 538 0.9 504 Sonrisa Domingo, Maxillary Distrito Surgery Nacional Program Parroquia Santo General 29 17.4 504 Santísima Domingo, Nutrition Trinidad Distrito Program Nacional Pastoral De Santo Primary 882 1.0 882 Salud - Red De Domingo, Health Care Centros De Distrito Center Salud Católicos Nacional Y Asistencia Social Pastoral Materno Santo Maternal and 149 15.8 2,352 Infantil Domingo, Infant Health Distrito Care Nacional Pastoral Santo General 206 5.6 1,162 Penitenciaria de Domingo, Nutrition la Arquidiócesis Distrito Program de Santo Nacional Domingo Pastoral Social Santo Geriatric 38 13.3 504 San Francisco de Domingo, Care Asís Distrito Nacional

12 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Patronato La Romana, School 955 2.8 2,688 Benéfico La Romana Oriental Patronato Cibao Santiago, Health 123 7.2 882 de Rehabilitación Santiago Center Patronato de la Espaillat, Health 98 9.0 882 Lucha Contra el Moca Center Cáncer de la Provincia de Espaillat Plan Sierra Santiago, San General 2,600 1.1 2,772 José de las Nutrition Matas Program Policía Nacional Nationwide General 627 2.8 1,764 Nutrition Program Rescate Ámbar Puerto Plata, Emergency 657 2.8 1,848 Puerto Plata Puerto Plata Health Care Servicio Nacional Nationwide National 1,195 2.8 3,360 de Salud (SNS) Health Care Siervas de María Santo Primary 99 10.2 1,008 Domingo, Health Care Distrito Center Nacional Sociedad Santo General 75 11.8 882 Benéfica Amor y Domingo, Nutrition Paz Distrito Program Nacional Sociedad Santo General 164 3.1 504 Benefica la Domingo, Nutrition Española Distrito Program Nacional Sur Futuro Santo General 179 2.8 504 Domingo, Nutrition Distrito Program Nacional

13 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

T.E.A.R.S. La Vega, La Infant Health 80 11.0 882 Vega Care Techo RD Santo General 178 2.8 504 Domingo, Nutrition Distrito Program Nacional Voluntariado Puerto Plata, Health 54 9.3 504 Jesús con los Puerto Plata Center Niños Filial Puerto Plata Waves of Health Dajabón, Health 81 6.2 504 Dajabón Center Total 63,115 149,979

Table 2: Planned Beneficiaries

Age Group Male Female Total

0-23 months 488 732 1,220

24-59 months 1,220 1,464 2,684

5-17.9 years 1,709 1,221 2,930

18-49.9 years 2,929 2,685 5,614

Over 50 years 5,614 6,346 11,940

Totals 11,960 12,448 24,408

Table 3: Actual Beneficiaries

Age Group Male Female Total

0-23 months 1,262 1,893 3,155

24-59 months 3,156 3,787 6,943

5-17.9 years 4,418 3,156 7,574

14 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

18-49.9 years 7,574 6,943 14,517

Over 50 years 14,516 16,410 30,926

Totals 30,926 32,189 63,115

Table 4: Cost per Beneficiary

Program costs Number of beneficiaries Cost per beneficiary $174,211 63,115 $2.76

Cross-Cutting Elements

An understanding of discriminatory and harmful socio-cultural practices with vulnerable and marginalized populations was paramount to the design and implementation of this IFRP. The protection, safety and empowerment of women, gender equality with children, and inclusion of marginalized Haitian communities, was carefully monitored during program implementation. As the COVID-19 “stay at home” policy and government-mandated quarantine came into effect, low-income, urban communities experienced an increase in domestic tension and violence. Rising economic instability from loss of income amongst a large percentage of the population further exacerbated the tension. For example, a large percentage of domestic workers, largely low-income mothers with children at home, lost their employment and had to stay at home. CitiHope collaborates with institutions to ensure that services for victims of domestic violence are provided and considered essential services for victims, providing security and well-being to girls and women both in the context of the pandemic and on an ongoing basis. CitiHope also has longstanding relationships with institutions that provide education, technical training, daycare, health services, and psychological guidance for adolescent and young pregnant women and abused new mothers. Through counseling the course of these young women’s lives is changed, as are the lives of their partners, however many needed to be rescued and convinced to leave abusive and often dangerous relationships with assistance by the national police. Nutritional education is provided and included in the IFRP with the Harvest Lentil Pro® for pregnant women, and supplementary food is provided relative to the age of their children.

CitiHope, through its health alliance, Sanar una Nación, has agreements signed with the World Food Program and the National Service of Health to provide social aid and social services to the neediest, including the communities along the impoverished Dominican-Haitian border. Haitians are often reached by community health workers and educated on the benefit of

15 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación correct nutrition and their inclusion in the program. A small number of Venezuelan refugees were also reached through this IFRP.

B. Challenges, Successes, and Lessons Learned

Challenges

The primary challenge for 2020 was the dynamic response to the COVID-19 pandemic. Several factors affected our original distribution plan. The COVID-19 pandemic has created an extreme food shortage in the Dominican Republic due to loss of income from the shutdown and to the ongoing effects of the 2019 blight and drought in agricultural areas.

While there has been a strong and consistent outcry for food, CHI-DR has carefully evaluated each request and responded with prudence to balance these new requests while keeping a keen focus on planned nutrition programs with established needs.

As educational and daycare centers began closing just as the food arrived in country in the spring, our distribution plan adjusted to provide increased support to family nutrition programs. Prior to the pandemic, CHI-DR had planned to distribute a portion of the Harvest Lentil Pro® to school feeding programs which prepared meals on site for students. When these school feeding programs closed and schools shifted to providing food distribution to students’ entire families, CHI-DR shifted to providing Harvest Lentil Pro® to these family distributions, resulting in significantly more beneficiaries than originally planned. The ration size per beneficiary was adjusted based on updated needs assessment and consultation with participating institutions, allowing for entire families to be reached.

Additionally, the Dominican government directed CitiHope to provide a portion of the food assistance to COVID-19 patients and their families, in collaboration with the Ministry of Health and military first responders. Working on the front lines of the COVID-19 response with dozens of health institutions is a life-threatening challenge for all concerned. Ensuring that all related institutions diligently follow all protocols, particularly social distancing during distribution and hand disinfection and mask wearing, was and is a continual training exercise. Providing the additional training and PPE required also increased the costs of the program.

Local travel restrictions and the temporary closure of some beneficiary institutions during the early months of the pandemic delayed the distribution. Through September 30, 2020, 100.7 MT (67%) of the Harvest Lentil Pro® had been distributed. The remaining 33% (49.3 MT) of the product was distributed to beneficiary institutions from November 2020 to February 2021,

16 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación targeting individuals and families most affected by the COVID-19 pandemic and its economic impacts, especially the most vulnerable elderly demographic.

CitiHope also faced logistical challenges with the first shipment. The boxes of Harvest Lentil Pro® were packed on the floor of the shipping container without pallets. CHI protocols require palletization to facilitate unloading and loading with a forklift and for storage protocols including elevation of all boxes off the floor. CHI-DR purchased pallets and hired extra personnel to unload box by box and correctly store the shipment for storage and for loading onto the trucks for beneficiary distribution. We also learned that the boxes are somewhat fragile and that they open easily, so we cannot palletize them in large quantities because they do not hold the weight. We had a loss of 7 boxes (98 bags) due to their arrival wet and crushed from the container, which was damaged in transit.

Successes

The greatest success was receiving the USAID-provided 150.08 metric tons of Harvest Lentil Pro® in March and April 2020, as the unforeseen COVID-19 pandemic began community spread in the Dominican Republic. Institutions, including the frontline pandemic healthcare centers run by the Dominican military, reported that the strategic needs-based distribution to the at-risk population, patients, and health workers contributed to mitigating the effect and spread of COVID-19. The fortified food strengthened the immune system among the beneficiary population, especially the elderly and immune-compromised individuals, and the delivery to homes and health centers allowed beneficiaries to minimize travel in searching and shopping for food.

The Harvest Lentil Pro® was safely delivered, cleared through customs, and distributed to participating institutions, including COVID-19 health and isolation centers, maternal and children’s health care centers, community health care programs, general nutrition programs, orphanages, HIV treatment programs, schools, geriatric care programs, special needs centers, medical operatives and a nutritional aid program for undernourished patients preparing for humanitarian surgical operatives in the Dominican Republic.

As mentioned earlier, while the program initially targeted 24,408 beneficiaries, adjustments based on the increased need for nutritional support faced by families during the ongoing COVID-19 pandemic have allowed for CHI-DR to reach 63,115 beneficiaries total. CHI-DR’s strong relationships with the Dominican government and with beneficiary institutions across the island through its ongoing Sanar una Nación partnership allow for real-time updates and information and rapid, dynamic response to the evolving pandemic situation.

17 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación

Success Stories

Jackie and Reverend Hernando have invested their lives in caring for children who have been abandoned or were destined for a very difficult future. Hernando explained, “in 2003, following a call from our beloved Father (God), we came to the Dominican Republic with the intention of serving the vulnerable children of the island.” Investing their life savings, they moved to Santo Domingo in a small house in the city where they began to receive the children of sex workers who could not, or would not, take care of them due to their lifestyle and drug addictions. “Jackie and I sold empanadas to cover expenses,” related Hernando. “One night during our nighttime ministry with the sex workers we found three small children in a garbage dumpster. Thank God we were able to rescue them and welcome them to our family. They have grown to become three loving, well-adjusted young adults.” Over the years many more vulnerable children came into Jackie and Hernando’s open arms of love, each with different tragic beginnings, but all with the same needs of shelter, food and education with a loving, protecting family.

Through a donation, they acquired the property where they currently have a home, housing 40 children from different communities, including the Santo Domingo’s garbage dump, La Duquesa. “Our children receive education, food, love and hope for a bright future,” Jackie and Hernando shared. “Through this program, our children have become productive and accomplished citizens in society.”

While each child is a wonderful success story, we would like to share a little of the life of Nicole, now 20 years old. Nicole has been living in Jackie's House for 9 years. Before that she lived in La Duquesa, a dangerous community on the edge of Dominican Republic’s largest garbage dump. As a child she stood out from the rest because of her love of studies, her willingness to help and desire to progress. Life in La Duquesa is a generational cycle of poverty from which there is virtually no escape, so when Nicole was becoming an adolescent, the age of being “put to work,” she heard about Jackie’s House and sought refuge with the hope of finishing her studies and entering university. Nicole, now 20 years old, is a strong-willed adult, determined to achieve her goals. Jackie explains how proud she is: “Nicole is a persevering young woman who always takes on challenges. We imagine Nicole in the HAGUE, UN or WHO. Through the Rica Foundation (one of CitiHope’s partners in the Dominican Republic) she has access to a full scholarship at one of the top Universities in the country where she is now a law student.”

When Nicole was a child, the food available to her was often taken from the garbage dump. “We tried to eat three times a day, in the morning we ate some bread or dry cereal, in the afternoon white rice or spaghetti and sometimes beans, at dinner it was almost always a piece of bread or oatmeal. All family members ate the same carbohydrate-based foods,” she recalled. “After arriving 18 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación at Jackie’s House our nutrition improved a lot and when we ate the USAID Harvest Lentil meals we loved it and began to feel stronger. All the children feel much better, because it’s a food rich in vitamins and protein, which allows us to have a healthier and more complete diet. It is important to be able to eat this fortified food because it makes our immune system stronger and all of my brothers and sisters are full of energy.”

“We have learned more about nutrition from CitiHope and the children have learned to eat healthier, they understand the benefits of a balanced diet.” During Nicole’s day to day she tells us that, “the older kids help Mami (mom) Jackie prepare food, I love to experiment with cooking and help her. We make different dishes with the Harvest Lentil Pro, we make soups with it, locrio (Dominican risotto), we even separate the ingredients and create unique dishes with each ingredient, which is lots of fun and gives variety for the children.”

Figure 1: Nicole assists with a food distribution in La Duquesa. Photo submitted by Tahni Tuccelli, CitiHope.

Rev. Hernando explained how they were going through a difficult time, “During a very difficult period, financially speaking, due to the pandemic, with cupboards almost empty and 40 mouths to feed, we prayed that a blessing would come. One of my sons suggested dividing lunches into less portions so we wouldn’t run out. My wife told him that we had never reduced the food 19 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación portions and that she trusted that our Father would give us the provision. About two days later we received a call from CitiHope, through the Fundación Rica, which informed us that we had a substantial fortified food donation. We were over the moon.” explained Rev. Hernando.

“For a long time, not only in times of crisis, you (CitiHope/USAID) have accompanied us, helped us and have not just saved one life, there are so many lives that have been saved. We want to thank you from the bottom of our hearts, on behalf of our children, for everything you have done. You are a strong pillar of support for the work we do.”

Lessons Learned

This was CHI-DR’s first experience with Breedlove Harvest Lentil Pro® and we discovered that stakeholders preferred the taste compared with other fortified food that CHI-DR has provided.

Instructions on the package stated 1 portion of food to 8 portions of water, 1:8, however, we discovered that most beneficiaries prepared approximately 1:3.5 food mix to water. While this significantly reduced the Breedlove projected 35 portions per 1 kilo bag, it produced a more nutrient dense food with a flavor profile preferred by the Dominican palate. To more accurately calculate usage, CHI-DR reduced the portions to 16 per 1 kg bag.

After experiencing the challenges of receiving and unloading the unpalletized boxes from the first four containers, CitiHope worked with Breedlove to palletize the subsequent shipment, resulting in a much smoother process, which will be followed with all future shipments.

20 Submitted: 3/30/20 72DFFP19FA00003 USAID’s Food for Peace IFRP Program – CitiHope Sanar una Nación