Thursday, March 23, 2017

One Roof down, 7 to go - here is a 3 minute time lapse

with Frank, Victor & Sandro (two of our 3 project engineers)

Started about 10am, finished abut 10pm.
- First Roof Section - Consult/Exam section
- top for main septic tank
- bridge across large canal

Tuesday, March 21, 2017

Ready to Start on the Roof!

Its been a long time coming, but we are finally here.
It is time to start placing concrete and creating the ROOF!
It will be a long process to get the entire building "under roof", but we will be doing this in 8 separate steps, so as we complete a section and move on to the next, we can begin finishing the previous section. So as we progress, the sections can be fully completed. Big Stuff.

Here is a Video showing what's been happening ...

Stay tuned for concrete! 

Thursday, March 2, 2017

March Madness ... in the DR, and first picture from the ROOF!

Yes, it is that time of year for basketball fans in the States. 

Here in the DR more updates will follow this month as we hope March will be the start of a huge step in the construction 

The project construction is moving along well as we move into the month of March. 
Along with the plumbers who are pressure testing the water supply lines, the electricians are installing junction boxes and conduits in the walls and are staying ahead of the carpenters who are assembling the concrete forms for the beams and the roof structure and finally rebar fabricators are hard at work using rebar up to 3/4" in diameter for the beams and roof structures. Concrete workers are also filling forms for various columns and places in the block walls as well. 

We have broken the building into 8 modules in order to more effectively use the available wood for forms and have a reasonable amount of concrete able to be placed in these forms. At this point we hope to place concrete for our first module the week of March 13th in the "consult" module. This area will require close to 100 cubic meters of high strength concrete so our concrete supplier will be getting equipment setup and supplies on hand to mix and place this in the elevated forms. 

Here is the FIRST picture from the ROOF!
These are the plywood sheets that form the bottom of the roof slab

Below are some recent pictures of the site:
Looking west with the consult module in the foreground.

Formwork for the Concrete Roof Slab

Looking straight into the Future Emergency Room Lobby Entrance.

Looking across the consult module being formed, you can see the higher walls that make up the center section of the facility.

Great to see "window openings" !

Panorama shot of the Entrance area .
A local Mennonite farmer is renting his Skid Steer to us for a very reasonable price
- it is a valuable machine to have on-site for moving materials!
   Thanks for your continued support both financially and prayerfully !!

A lone zinnia near the warehouse.

Thursday, January 26, 2017

January 2017 Update - picture summary

This will be a picture update. 

-Plumbing rough-in is completed.
-Government modifications completed. 
-Electrical rough-in is underway.
-Rebar fabrication is underway.
-Door Headers are underway.
-Main Septic Tank only needs
 coconut husks(yep) and a top.

Water pipes are in place and we will clean away any debris from
the pipes and surround with sand - after all have been pressure tested.
This is in one of the lab rooms where HOT WATER will also be
available. Most sinks will only have cold water - the norm in the DR.

A small bathroom added to the right
of one of the main nursing stations

Doorways for patient access have been widened

Location for a panel box for the "consult" section of the building.

Rough-in boxes for wall switches - these conduits run UP
to above the dropped ceilings where we will run
 the wiring to lighting and panel boxes.

A completed outlet installation - wiring will be added later and
 run below the floor slab. Having these in place will allow
 plasterers to finish the walls, the floors will be done after the wall plaster.

Electrical Rough-in work underway.
Here they are cutting in a slot for an outlet.

Gadget used to bend the rebar

Rebar assemblies ready to go

Rebar "cages" are used to assemble long rebar assemblies
 - these will be used for our "vigas"
A water level is used to set the
bottom heights of the header forms

A carpenter hammering a form in place

Forms are in place for the many headers that span doorways.

Looking down the Laboratory hallway
with forms in place for the headers.
Forming a door header

A door header and rebar assembly ready for concrete.
Mixing the concrete for the door headers.
filling the header - one bucket at a time.

The main septic tank is ready for a top once
coconut husks are added that will filter the
water before it leaves the tank.

Many things are underway that don't have the visual impact that 70,000 block do, but we are working on the details that create a functional building. 
Good stuff.

Thanks for your prayers and financial support, please consider helping us with a donation if you have not already done so.

Friday, January 13, 2017

2017 is here, the year of the clinic!

2017 is here, and we are planning and hoping that it is a very productive year. We have much to do here at the project, but after another time period of waiting for further answers from our structural engineer and architect, confirming important design details with other engineers as well as important information from the health department design team we now have all of the information needed in order to push forward. 
It has been a challenge to my patience - wanting to push progress, but this is God's project and we are only completing what we are supposed to be completing according to his timeline. I've often thought about our simple human minds or egos and how we can often even question the reality of something we may have even experienced or witnessed ourselves. The apostles often come to my mind - they witnessed miracles time after time yet would still fall back into a doubting mode. Two thousand years later we do the exact same thing. I've experienced so many really neat coincidences that are in fact God-instances, yet I worry and fret over things not progressing as my ego wants them to. So as I discussed in my last blog, that half-full glass has allowed us to avoid what would have been a mess if my American push-push mentality had resulted in having many door headers in place before our Santo Domingo meeting - we would have had a bunch of rework to do.

It is a new year,  and we have begun work and are getting things rolling. Currently there are workers installing the form work for the door headers and a crew is installing the conduits in the walls that will hold the electrical wiring for the ceiling lights and other electrical devices needing a run up the wall.

Thanks to some wonderfully quick responses from some folks at the Carter Machinery - the CAT dealer in Salem, VA, we have details worked out for the generators and main electrical feeds. I am planning on these being some projects to be completed by the construction teams who will be coming down this winter and spring.
We have also received good news from the government officials allowing us to enclose the strip of land between the two canals - this will let the teams build this east wall and basically get the security walls fully completed.

An optimistic year lies ahead.

We've had to take a very cautious approach so we don't waste the precious funds you have donated, but we are finally at a point to push forward. 

Thanks again to those of you who attended the Revolution meetings and a special thanks to those who have financially committed to helping us reach our new campaign goal. 

This is not just another medical facility for the region, it is the one that will help those with no other real choice. There are people here in need of health care and health education - You might have read about the infant who died in El Cercado and I am thinking of a young boy with disfigured legs our engineer showed me a picture of - this clinic will offer the ability to help these types of situations.  

Time to get to work.

Thursday, December 15, 2016

A glass that keeps looking different

Hard to believe I have now lived here in San Juan de La Maguana for two years. In November of 2014 we officially broke ground and started the clinic project, two years later we have an earthquake resistant foundation supporting about 80,000 concrete block that make the walls with all of the plumbing lines in place.
When I started here I thought it would be a challenge being the "mediary" or middleman between two cultures - one very driven by expectations and one with a slower feel with lower but rising expectations. This has turned out to be the case. 
The Dominicans can get work done as fast as us Americans when things are lined up and available - and they like to do things quickly. What has been a challenge is the "getting things lined up and available" part. This has been due to many factors, one of the main ones being the Dominican government which has very good intentions of requiring the highest levels of quality and design but in reality causing beneficial projects and work to be delayed while trying to meet the governments ever changing moving-target requirements. The clinic has fallen prey to this issue more than once so we continue to work our way through the issues. 
One of our biggest issues we have had to meet was the re-design of the foundation, as I am sure most of you know about. The earthquake in Haiti caused the Dominican government to dramatically strengthen their building standards - similar to what happened in the US after hurricane Andrew swept away building in South Florida. Our platea foundation with it's 100 miles of rebar is designed to resist the effects of an earthquake. 
After getting underway with construction in January of 2015 the government released two new books in the summer listing new specifications required for medical facilities - we had to make make many changes to the floor plan in order to meet these requirements. This essentially made our drawing package obsolete - drawings showing electrical, plumbing and structural details no longer matched the revised floor plan. 
So as a result we have had to work the project as a "design-build" type project ( a common practice in the US), where you have a good plan of what you want to end up with but as you begin a construction phase you can adapt, change and modify aspects of the construction which can help minimize costs and meet the latest requirements. In the States there would be unlimited resources to quickly work through the many issues with each phase, here in the Dominican "urgency" is not a word that describes how things work here. 
This might be the one issue that has been most difficult as a "gringo", I fully realize we cannot impose our American drive on another culture (if you do you will have burned every bridge along the way) but at times my patience runs out. I have to remind myself that the GOAL of this project is what is important, and that the road to that goal will be as it has to be. 

Our latest interaction with the government has led my glass to initially be half-empty but after contemplating and considering things it is over half-full. 

The timing of things related to my life (things working out in Stacy's and my life so I could help oversee this project) and the project have been amazing and forced me to truly appreciate the God-induced timing of everything in life. We do not appreciate this most of the time especially when we want to be in complete control of all aspects of our lives (oh if we could only control the weather!), but of course we are not in control at all. All we should do is carry into each day a positive attitude for what that day brings knowing life will head us down a path unknown. 

So my momentary philosophical pause is due to our latest meeting with an important government official who represents the department of health - the department that will approve our facility and allow it to function and receive financial assistance from the different insurance programs available here. 
Our plans were reviewed and all in all the changes were minor but significant. The main issue being that they now require wider doorways than previously and what our architect designed. After my glass quickly looked half-empty I realized how fortunate we are to have had this conversation BEFORE we have formed and poured the 150+ concrete door headers/beams. Had we been pushing along earlier this fall (as my American self-control mentality hoped) we would have completed a good many of these headers by now and we would have a big problem on our hands. 

Timing again has helped us avoid significant changes with added costs - my glass is half-full.

Trust in the LORD with all your heart and lean not on your own understanding. Proverbs 3:5


Monday, December 5, 2016

Detailed structural work

Construction update December 05, 2016

This fall the workers were working on preparing for and adding additional columns that we will need to in order that this large building can be broken up into 6 different areas and separated with expansion/construction joints. As we have been clarifying structural questions and issues it became apparent that some of the structural issues needed to be recalculated in order to match the floor plan we now have which is the result of changes required by the government and some changes we made to improve the layout of the facility or lower the overall cost of the project (ie: minimize networking wire using data hubs to reduce the length of wire needed). This was slow work as it needed to be done properly and is also labor intensive. 

Here is a picture of Victor checking on work when a team of 10 men poured almost 30 - 2 meter tall columns using a mixer and filling the column forms bucket by bucket. Victor and Sandro (our two onsite Dominican engineers) closely supervised this work.

We are anxious to get working on the beams and roof structure but these structural details need to be in place before we can start. 

Grigorio, our plumbing engineer was at the site again Saturday and he inspected the completed drain pipe and hot and cold water supply lines that are all now installed inside the building.
 The locations where hot water will be needed was determined based on discussion withs Dr Canario and consulting the government requirements book. Hot water is an unusual feature for most facilities in the Dominican, so obviously a healthcare facility does indeed need hot water but not to the extent that you would find in the United States, so thereis no point in going to the expense of installing it everywhere.

 - Some interesting information regarding things like hot water and drinking water that we all take for granted in the US: 
 - most houses here do not have hot water, those that do have a wall switch near the bedroom(s) that turns on the small water heater when you want to use it. This is true even in very nice condominiums in Santo Domingo.
- Water from the faucet is not safe to drink, and this is the case everywhere, even in nicer homes and hotels. A great example of this is the Mirebalais hospital in Haiti built in 2012 by Americans who thought clean water should be provided in all faucets and even water fountains. This is an example of thinking you have a good/practical idea and going through the trouble of providing it only to find out it will not be accepted. None of the Haitians will drink from the faucets of water fountains at the hospital - this is not a normal thing in Haiti or the DR so they were asking the people who grew up here never drinking from these sources to suddenly trust that they could safely do so. 
By the way, there are no such things as "water fountains" - only cooling units that have a 5-gallon water bottle on them.

Our medical gases engineer was also here Saturday and we discussed what we can do to simplify the gas installation and lower it's cost while ensuring that the clinic will be fully able to serve the needs of it's patients. He had some very good ideas.

I am excited that Victor is ready to start "dinteles" or the headers that span doorways, these will be formed and then made with rebar and concrete. He will also begin getting the rebar structures made that will be the skelton of the structural beams that tie exterior walls together.
We continue to confirm the structural components, finalize issues with the structural engineer and architect and ask if there are any cost-saving possible with the beams, roof structure and other features.

This Friday we plan to meet with Health Department officials in Santo Domingo to discuss and seek their approval of our desire to "phase" the finishing of the building - we would like to reduce our initial completion cost by delaying the finishing of 23% of the building - after very positive discussions and input from Dr Canario and Dr Caseres this concept can lower our cost-at-opening by $200,000 or more.

Please consider both the project and me when planning your 2017 donations. We hope 2017 is the year when we can all but finish the building, and with your help we can do it!

Thanks for your continued support both financially and prayerfully!