DR – Go Lean…Caribbean

Tag: DR

Unequal Justice: Bullying Magnified to Disrupt Commerce

Posted on September 28, 2019 in Economics, Government, Industries, Tactical

Go Lean Commentary

“You had better get control of that boy or we will for you” – typical admonition of a Peace Officer to the parents of a young bully!

There is a certain reality that we all have had to contend with:

Bullies are inevitable!

We have all been to Grade/Elementary/Primary School; we have all played on the playground. We can simply look at our own lives, cite examples of bullying and glean this Truth and Consequence:

Slippery slope …
Snowballing …
From an acorn comes a Mighty Oak …

Analogies abound … as to why it is important to “nip bullying in the bud”. If we do nothing – or not enough – then conditions of Unequal Justice go from “bad to worse”. The bad actor can emerge from terrorizing a family, to a neighborhood, to a community, to a nation, to a region, to a hemisphere, to the whole world. Think: Nazi Germany, Imperial Japan, Soviet Russia, British Empire, Napoleonic France, Spanish Inquisition, and more …

Unchecked, bad actors in the community become tyrants – they can even affect the local economic engine. This is where the opening statement of a typical Police Officer to a “parent of a bully” become relevant. Either that parent mitigates that situation, or the legitimate authorities will have to get engaged. It is easier to remediate a local bully; beyond that, the bad actions can escalate to gang activity, organized crime and/or domestic terrorism. An escalated villainy would require an escalated response. There is a plan for regional mitigations of gangs, organized crime and/or terroristic activities..

This is the focus of this commentary. This is entry 2-of-4 in this series on Unequal Justice. The previous submission traced that bad history of the County Sheriff in the American South and how that person’s tyranny imperiled the entire Black American population. That previous blog-commentary related how the Sheriff served as a bottleneck in the execution of justice , and the only way to eliminate that tyranny was with legal “soft” tyrannicide. The full series on Unequal Justice is cataloged here as follows:

Unequal Justice: Soft Tyrannicide to Eliminate Bottlenecks
Unequal Justice: Economic Crimes Against Tourists and Bullying
Unequal Justice: Envy and the Seven Deadly Sins
Unequal Justice: Student Loans Could Dictate Justice

In this series, reference is made to the fact that Tourism, as the Number 1 economic driver in the region, is vulnerable to Bad Actors disrupting peaceful hospitality trade – we must protect our societal engines from tyrants, bullies and terrorists. So there is always the need to ensure justice institutions are optimized in the region; visitors will refuse to come and enjoy our hospitality if there are active threats or perceived instabilities. (At the same time, residents flee to foreign shores in search of refuge). So the need for justice in the Caribbean tourism deliveries transcends borders, politics, class and race.

Consider this actuated consequence in the Dominican Republic, due to some recent incidents regarding public safety for tourists; (there are some suspicions that Bad Actors persist):

VIDEO – Is travelling to the Dominican Republic dangerous – https://www.travelandleisure.com/travel-news/tourist-deaths-dominican-republic-safe

——–

Title: Tourism to the Dominican Republic Has Dropped 74 Percent, According to New Study

By: Stacey Leasca

In the past year, 10 American citizens have died in the Dominican Republic, some as tourists others as long-term visitors. While the deaths have been attributed to natural causes, would-be visitors are reconsidering their plans to visit the island.

Is traveling to the Dominican dangerous for Americans? Here’s what travelers need to know.

Many travelers are re-booking their flights to new destinations

According to a report by ForwardKeys, which analyses more than 17 million flight bookings a day, bookings for July and August from the United States to the Dominican Republic have fallen by 74.3 percent compared to the same period in 2018.

“My deepest sympathies go out to the families of the American tourists who have passed away. Their recent and tragic deaths appear to have had a dramatic impact on travel to the Dominican Republic,” Olivier Ponti, vice president of insights at ForwardKeys, said. “Our analysis of leisure travel shows a striking correlation.”

…

See the full article here: Travel and Leisure Magazine – posted June 27, 2019; retrieved September 28, 2019 from: https://www.travelandleisure.com/travel-news/tourist-deaths-dominican-republic-safe

Allowing bullies or tyrants (real or perceived) in the community to disrupt economic engines – crimes against tourists, etc. – is just plain wrong and a failure of the unwritten Social Contract. This refers to the arrangement where citizens (and visitors) surrender some of their freedoms and submit to the authority of the State in exchange for protection of remaining natural and legal rights. So unchecked bullying, street gangs and organized crime require an escalated response, [“soft”] tyrannicide.

Tyrannicide is even presented in the Holy Bible with the drama of the woman “Jael” in the Book of Judges Chapter 4 & 5 where she killed the villainous Sisera in order to save the people in her village. That account relates:

The Canaanites were defeated [by Judge Barak] and [the Army Commander] Sisera fled the scene.^[1]

Sisera arrived on foot at the tent of Heber on the plain of Zaanaim. Heber and his household were at peace with Jabin, the king of Canaan, who reigned in Hazor.^[4] Jael, however, sympathized with the Israelites because of the twenty-year period of harsh oppression inflicted on them by Jabin, his commander Sisera, and his nine hundred iron chariots. Jael (whose tent would have been separate from Heber’s) ^[5] welcomed Sisera into her tent and covered him with a blanket. As he was thirsty, she gave him a jug of milk. Exhausted, Sisera lay down and soon fell asleep. While he was sleeping, Jael took a mallet and drove a tent peg into his temple, killing him instantly.^[1]

This is an example of “hard” tyrannicide.

Tyrannicide – hard and soft – is a reality in the modern world. Just today September 28, 2019, the former President of Zimbabwe was laid to rest, only in a private ceremony; no State Funeral. He was finally deposed 2 years ago by a military coup that ended his tyrannical rule of 37 years.

Also in the Bahamas in 2017, the parliamentary government in power was overwhelmingly defeated due to the people’s desire to just get rid of what they perceived as an ineffectual and “bottlenecking” Prime Minister. See this quotation from a previous blog-commentary from May 11, 2017:

Title: UPDATE: Understand the Market, Plan the …
“The Prime Minister bet his administration on the prospect of Carnival and now, its election time.”

It’s official, that bet has failed! The Prime Minister (PM) of the Bahamas and leader of the Progressive Liberal Party (PLP) – Perry G. Christie – has been defeated. …

This commentary has observed-and-reported on the Bahamas for the last 5 years and the “bet” that the PM made was related to more than just Carnival; he also bet on:

Music Festival-Event – The Fyre Festival event was a fiasco; it went up in flames on April 28, 2017 after getting government permissions and support beforehand. The mass population of Bahamian stakeholders – other than the government – knew nothing of this event until it was an international embarrassment – a “Black-eye”.

Value-Added Tax – New 7.5% Sales & Use tax implementation increased the tax burden on the poor more than the rich.

Baha Mar Resort & Casino – $2 Billion Resort & Casino stalled due to government meddling in the Developer-Banker conflict.

Grand Bahama (Freeport) – 2^nd City economic progress stalled; decisions on extending Investment Tax Credits were inexplicably stalled and extended for 6-month intervals, until it was finally granted for a reasonable period.

So when the outgoing PM dissolved Parliament on April 11, 2017 and called elections for May 10, it was the only chance for the people to vocalize their displeasure. They shouted an almost unanimous veto of Christie’s policies and administration, giving the Opposition Party (Free National Movement) 35 of the 39 seats in the House of Assembly.

The near “unanimous veto” in the Bahamas in May 2017 was an example of a “soft” tyrannicide. (Many of the candidates for Parliament were political novices with no track record, experience or reputation; they were believed to be embraced by the voting public just because they represented a dissenting Party).

The need for economic justice can never be undermined, undervalued or questioned. This was related in many previous Go Lean commentaries; consider this sample here:

https://goleancaribbean.com/blog/?p=17267	Way Forward – For Justice: Special Prosecutors
https://goleancaribbean.com/blog/?p=16668	Justice and Economics – Both needed to forge change
https://goleancaribbean.com/blog/?p=16408	Bad Ethos on Home Violence – Spilled into Tourist Resorts
https://goleancaribbean.com/blog/?p=14424	Repairing the Breach: Crime – Need, Greed, Justice & Honor
https://goleancaribbean.com/blog/?p=14211	Urging to “Enjoy Carnival”, but Be Safe!
https://goleancaribbean.com/blog/?p=11054	Managing the ‘Strong versus the Weak’ – Bullying in Schools
https://goleancaribbean.com/blog/?p=5307	8th Violent Crime Warning to Bahamas Tourists – Bad Model
https://goleancaribbean.com/blog/?p=392	The World Bank gives Jamaica Economic Help to Mitigate Crime

For the foregoing, the situation in the Dominican Republic is a Cautionary Tale. There must be an adequate response and escalation when there is a threat to the public safety of tourists and trading partners. The subjects must be able to “Dial 911“.

The community institutions themselves must also be able to “Dial 911” and call for additional help:

We must protect the economic engines.
We must optimize our regional justice institutions.

Both of these missions are in parallel. This is the quest of the Go Lean movement.

We hereby urge all Caribbean stakeholders – governments, citizens, visitors and trading partners alike – to lean-in to this comprehensive Go Lean roadmap to elevate Caribbean society. We must make our homeland a better place to live, work and play. 🙂

About the Book

The book Go Lean…Caribbean serves as a roadmap for the introduction and implementation of the technocratic Caribbean Union Trade Federation (CU), for the elevation of Caribbean society – for all member-states. This CU/Go Lean roadmap has these 3 prime directives:

Optimization of the economic engines in order to grow the regional economy to $800 Billion & create 2.2 million new jobs.
Establishment of a security apparatus to ensure public safety and protect the resultant economic engines.
Improve Caribbean governance to support these engines, including a separation-of-powers between the member-states and CU federal agencies.

The Go Lean book provides 370-pages of turn-by-turn instructions on “how” to adopt new community ethos, plus the strategies, tactics, implementations and advocacies to execute so as to reboot, reform and transform the societal engines of Caribbean society.

Download the free e-Book of Go Lean … Caribbean – now!

Who We Are
The movement behind the Go Lean book – a non-partisan, apolitical, religiously-neutral Community Development Foundation chartered for the purpose of empowering and re-booting economic engines – stresses that reforming and transforming the Caribbean societal engines must be a regional pursuit. This was an early motivation for the roadmap, as pronounced in the opening Declaration of Interdependence (Pages 11 – 13):

iv. Whereas the natural formation of the landmass is in a tropical region, the flora and fauna allows for an inherent beauty that is enviable to peoples near and far. The structures must be strenuously guarded to protect and promote sustainable systems of commerce paramount to this reality.

xi. Whereas all men are entitled to the benefits of good governance in a free society, “new guards” must be enacted to dissuade the emergence of incompetence, corruption, nepotism and cronyism at the peril of the people’s best interest. The Federation must guarantee the executions of a social contract between government and the governed.

xvi. Whereas security of our homeland is inextricably linked to prosperity of the homeland, the economic and security interest of the region needs to be aligned under the same governance. Since economic crimes … can imperil the functioning of the wheels of commerce for all the citizenry, the accedence of this Federation must equip the security apparatus with the tools and techniques for predictive and proactive interdictions.

xxiv. Whereas a free market economy can be induced and spurred for continuous progress, the Federation must install the controls to better manage aspects of the economy: jobs, inflation, savings rate, investments and other economic principles. Thereby attracting direct foreign investment because of the stability and vibrancy of our economy.

Sign the petition to lean-in for this roadmap for the Caribbean Union Trade Federation.

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Civil Rights, DR, Security, Transform

State of the Union – Spanish Caribbean

Posted on June 20, 2017 in Government, Social, Strategy

Go Lean Commentary

There was a time when all of the Spanish Caribbean – Cuba, Dominican Republic (DR), and Puerto Rico – was ruled under the same flag; that goes way back to the year 1865. There has been no Spanish Caribbean territorial unity ever since.

Too sad! They badly need to confederate, collaborate and convene to tackle so many societal challenges: economics, security and governance.

These 3 member-states constitute 59 percent of the Caribbean’s total population of 42+ million people, according to 2010 census numbers (Cuba – 11.24 million, DR – 9.52 million, PR – 3.99 million). They share the same Spanish language, the same colonial heritage, the same legacy of African Slavery, the same color flags (Red, White and Blue) and the same American tutelage; (some say tutelage while some say abandonment) see here:

Cuba – This country was ceded from the Spanish Empire in the 1898 Spanish-American War and allowed to pursue their Independence dreams. Their autonomous rule history was dysfunctional; punctuated with a Communist Revolution in 1959 led by Fidel Castro. See more here: America’s War on the Caribbean. After 55 years of economic and political alienation from the US, the Barack Obama administration worked to normalize relations with Cuba. But there is a new American federal governmental administration; they claim to adhere to a different foreign policy than Obama; but so far, the policies that have been introduced or modified have only tweaked trade rules a little – see Appendix A.
DR – This country benefited from the same movement that granted independence to Haiti; the Haitian Revolutionary forces overran the entire island of Hispaniola and self-extracted from the European powers of France and Spain. Later (1844) the DR sought independence from Haiti and had to contend with many other threats from foreign aggressors. A treaty was drafted and presented to the US Senate to annex the DR as a US Territory with the prospect and pathway to eventually become a US State; it was defeated in 1870 and never ratified. See more here: American Annexation of Santo Domingo. The country has had one troublesome political history since – 3 Presidential assassinations.
Puerto Rico – This island territory was ceded from the Spanish Empire to the US as a result of the same 1898 Spanish-American War. It never obtained independence, but instead experienced one dependent status after another until today. There have been many attempts to assuage the colonial status, in fact a fifth referendum was held just recently on June 11, 2017. 97% percent of those participating voted for statehood, though there was only 23% voter turnout^[10]. See more here: Statehood movement in Puerto Rico.

The US is the richest and most powerful Single Market country that has ever reigned in earth’s history, but this fact has not borne fruit for these Spanish Caribbean neighbors. They have never shared this disposition.

One thing more these former Spanish territories have shared: Failed-State status.

This has been a familiar theme for the movement behind the book Go Lean…Caribbean. We have consistently conveyed how the economic, security and governing eco-systems of these 3 countries are dysfunctional and defective – along with the other 27 Caribbean member-states. The solution for these countries is not a closer annexation with the United States – America is not the panacea of Caribbean ills – but rather the solutions lie in the adoption of a regional brotherhood among these geographic neighbors – the 3 Spanish Caribbean member-states integrated with the other 27 in the region.

This is the quest of the Go Lean movement!

The book Go Lean…Caribbean – available to download for free – serves as a roadmap for the introduction and implementation of the technocratic Caribbean Union Trade Federation (CU), for the elevation of Caribbean society – for all member-states. This CU/Go Lean roadmap has these 3 prime directives:

Optimization of the economic engines in order to grow the regional economy to $800 Billion and create 2.2 million new jobs.
Establishment of a security apparatus to ensure public safety and protect the resultant economic engines.
Improve Caribbean governance to support these engines, including a separation-of-powers between the member-states and CU federal agencies.

The book stresses that reforming and transforming the Caribbean societal engines must be a regional pursuit. This was an early motivation for the roadmap, as pronounced in the opening Declaration of Interdependence (Pages 12 – 13):

xi. Whereas all men are entitled to the benefits of good governance in a free society, “new guards” must be enacted to dissuade the emergence of incompetence, corruption, nepotism and cronyism at the peril of the people’s best interest. The Federation must guarantee the executions of a social contract between government and the governed.

xvi. Whereas security of our homeland is inextricably linked to prosperity of the homeland, the economic and security interest of the region needs to be aligned under the same governance. Since economic crimes … can imperil the functioning of the wheels of commerce for all the citizenry, the accedence of this Federation must equip the security apparatus with the tools and techniques for predictive and proactive interdictions.

xxiv. Whereas a free market economy can be induced and spurred for continuous progress, the Federation must install the controls to better manage aspects of the economy: jobs, inflation, savings rate, investments and other economic principles. Thereby attracting direct foreign investment because of the stability and vibrancy of our economy.

This commentary is 2 of 5 in a non-sequential series on the State of the Caribbean Union. This series depicts the dysfunctional and defective state of affairs (economics, security and governance) throughout the entire region; there are some common traits. These have been assessed by the Go Lean movement. The full entries of all the blog-commentaries in this series are as follows:

State of the Caribbean Union – Lacking Hope and Change
State of the Caribbean Union – Dysfunctional Spanish Caribbean
State of the Caribbean Union – Deficient Westminster System
State of the Caribbean Union – Unstable Volcano States
State of the Caribbean Union – Self-Interest of Americana

The State of the Caribbean Union prominently includes these Spanish-speaking islands. These islands need all the remediation and mitigation they can get. Notice the dire state of affairs as portrayed in the Appendices below.

These references align with previous Go Lean commentaries related to …

Cuba – (see Appendix A):

https://goleancaribbean.com/blog/?p=10201	Farewell to Obama and to ‘Wet Foot/Dry Foot’
https://goleancaribbean.com/blog/?p=9813	Fidel Castro Is Dead; Now What for Cuba?
https://goleancaribbean.com/blog/?p=3662	Migrant flow [from Cuba] into US from Caribbean spikes
https://goleancaribbean.com/blog/?p=3455	Restoration of Diplomatic Relations with Cuba – Need for Re-boot Now
https://goleancaribbean.com/blog/?p=3354	CARICOM Chair calls for an end to US embargo on Cuba
https://goleancaribbean.com/blog/?p=2547	Miami’s Success versus Caribbean Failure
https://goleancaribbean.com/blog/?p=2330	‘Raul Castro reforms not enough’, Cuba’s bishops say

Dominican Republic – (see Appendix B):

https://goleancaribbean.com/blog/?p=11033	US Warnings on Low-cost Dominican Surgeries
https://goleancaribbean.com/blog/?p=10820	Miami: Dominican’s ‘Home Away from Home’
https://goleancaribbean.com/blog/?p=2818	DR President Medina on the economy: ‘God will provide’

Puerto Rico – (see Appendix C):

https://goleancaribbean.com/blog/?p=12126	Commerce of the Seas – Stupidity of the Jones Act
https://goleancaribbean.com/blog/?p=11963	Oscar López Rivera: The ‘Nelson Mandela’ of the Caribbean? Not!
https://goleancaribbean.com/blog/?p=11647	Righting a Wrong: Puerto Rico’s Bankruptcy
https://goleancaribbean.com/blog/?p=6693	Ten Puerto Rico Police Accused of Criminal Network
https://goleancaribbean.com/blog/?p=4551	US Territories – Between a ‘rock and a hard place’
https://goleancaribbean.com/blog/?p=599	Ailing Puerto Rico open to radical economic fixes

The Caribbean Union needs the Spanish Caribbean; the Spanish Caribbean needs the Caribbean Union.

We can reboot the Spanish Caribbean; we can reboot the economic, security and governing engines. The end results:

1. Spanish Caribbean unity;

2. Total Caribbean unity;

3. A better homeland to live, work and play. 🙂

Download the free e-Book of Go Lean … Caribbean – now!

Sign the petition to lean-in for this roadmap for the Caribbean Union Trade Federation.

————–

Appendix A – News Article: In Miami, Trump toughens Obama’s Cuba policy ‘like I promised’

…

Trump, spurring a standing ovation, billed his appearance as a campaign promise kept to Cuban-Americans to take a harder stance on Cuba. He told the crowd he was canceling Obama’s Cuba policies, though in actuality he’s not. Rather, he’s taking a different approach to pressure Cuba to open its economy and eventually its political system.

…

Trump signed a national security presidential memo — not a presidential policy directive, as originally envisioned by the White House — ordering federal agencies to start writing regulations within 30 days to promulgate his new policy. The State Department will have to compile a list of entities tied to Cuba’s sprawling military conglomerate, Grupo de Administración Empresarial, S.A., or GAESA. Americans will be prohibited from transacting with those corporations, except for enumerated exemptions to, among other things, allow for commercial air and cruise travel and payments to private businesses, such as Airbnb rentals.

Travel to Cuba will also become more difficult. Cubans will still be able to visit family and send money. But Americans will have to travel as part of formal groups with set itineraries if they want to qualify under categories that allow educational and people-to-people cultural exchange trips. Another category, for support for the Cuban people, is more stringent but will still allow for individual travel. U.S. travelers will be prohibited from spending money at hotels and restaurants tied to the Cuban military. That includes many brand-name hotel chains. <<< Insert Photo 4 >>>

…

See the full article from the Miami Herald; posted June 16, 2017; retrieved June 20, 2017 from: http://www.miamiherald.com/news/politics-government/article156586134.html

————-

VIDEO – US Senator Marco Rubio: Cuba will be free ‘in 6 months or 6 years’ – http://www.miamiherald.com/news/politics-government/article156571009.html

————–
Appendix B – “Dominican Watchdog” – Relating the DR’s Dire Status

June 12 – MonkeyBiz.dr, Audit Detects Corruption in 68 Dominican City Halls – MONKEY BUSINESS AS USUAL IN THE DOM REP – CORRUPTION AND FRAUD FROM A-Z. Forty percent of the monetary resources that should have been destined to infrastructure works, were NOT. Years of real estate fraud prompts purge of officials, foreign investors and buyers of holiday homes have lost hundreds of millions of dollars…….
June 12 – STAY HOME, Dominican Republic Chikungunya Cases Skyrocket to 53000 – TRAVEL WARNING – Taiwan recently raised its ALERT about Dom Rep to YELLOW !! Doctors in the DR is fighting 24/7, but he number of chikungunya cases in the Dominican Republic continues to rise at an alarming rate as the Ministry of Health’s Department of Epidemiology reports 52,976 cases, time to stay home, there is NO PROVEN CURE against this virus…..
June 12 – Another Agent Killed as Chilling Attacks Grip Dominican Republic – Dominican Republic Becoming Most Dangerous Country in the Caribbean – Metropolitan Transit Authority (AMET) agent Carmen Torres Báez, 41, on Monday became the latest victim in a chilling wave of attacks on law enforcement officers gripping the entire Dominican Republic. Torres, mother of four, was gunned down on the Maximo Gomez bridge to Villa Mella around 7:15am as she was walking to work…..

Source: Retrieved June 20, 2017 from: http://www.dominicanwatchdog.org/dominican_news/p-1

————–

Appendix C AUDIO-PODCAST – INTERSECTION: STATEHOOD FOR PUERTO RICO? – https://www.wmfe.org/intersection-statehood-for-puerto-rico/74667

Published June 16, 2017 – Puerto Rico voted for statehood in a referendum last Sunday. At first glance the results seem pretty clear: 97% of voters said yes to statehood. But less than 25% of Puerto Ricans actually cast a vote in the referendum.

Meanwhile, there’s support from lawmakers here in Central Florida for statehood, where there’s a growing Puerto Rican population, but what kind of impetus is there in Washington to add another star to the US flag?

Florida International University’s Cuban Research Institute director Jorge Duany joins the program, along with orlandolatino.org founder Maria Padilla, tecnetico.com founder Wilton Vargas & Ronald Morales who moved to Florida from Puerto Rico in 2015.

Source: Posted June 12, 2017; retrieved June 20, 2017 from Central Florida’s WMFE Public Radio: https://www.wmfe.org/intersection-statehood-for-puerto-rico/74667

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Cuba, DR, History, PR, Transform

[Top]

ENCORE: US Warnings on Low-cost Dominican Surgeries

Posted on April 1, 2017 in Economics, Ethos, Industries, Strategy, Tactical

UPDATE – Go Lean Commentary

The warning was sounded 3 years ago, today. What is the status now? Have the warnings been heeded?

Surely, we have paid attention and we have put in the risk mitigations so as to preserve life-and-limb in the activities of cosmetic surgeries in the Dominican Republic.

Sad to report, but the answer is “No”.

The risks continue; the disfigurements continue; the deaths continue.

Say it ain’t so!

See the news article in the Appendix relating the details of a fresh warning from the US Center for Disease Control and Prevention (CDC).

In this previous Go Lean blog-commentary – being ENCORED below – the prospects of Medical Tourism were heralded, with the caution for proper regulatory control. The appeal was made for the new Caribbean Union Trade Federation (CU) to serve as that regulator, under the guise of a Self-Governing Entity. That appeal is echoed again here-now. There is too much …

… money at stake.

… jobs at stake.

… lives at stake.

But while this original blog-commentary below published on April 1, 2014 related the death of Beverly Brignoni (28), there have been other deaths; as with these women:

See the related October 3, 2016 story: Pretty Hurts – Dishing on the dangers of Plastic Surgery

———–

ENCORE Title: Low-cost Dominican surgeries spark warnings by US

To the family of Beverly Brignoni, according to the foregoing news article, the publishers of the book Go Lean … Caribbean, SFE Foundation, extend condolences for the loss of their dearly departed loved one. This article – as follows – shows the down-side of medical tourism, an accidental death from an apparent lax oversight in a cosmetic surgery clinic.

By: Ben Fox and Ezequiel Abiu Lopez
Beverly Brignoni was a young New Yorker seeking a less expensive way to enhance her appearance and she did what many other people are now doing: travel to the Dominican Republic for cosmetic surgery; (see undated “selfie” photo posted to her Instagram account, courtesy of the Brignoni family).

It went horribly wrong. The 28-year-old died Feb. 20 from what the doctor told her family was a massive pulmonary embolism while getting a tummy tuck and liposuction at a clinic in the Dominican capital recommended by friends. Family members want local authorities to investigate.

“We want to know exactly what happened,” said Bernadette Lamboy, Brignoni’s godmother. “We want to know if there was negligence.”

The district attorney’s office for Santo Domingo says it has not yet begun an investigation because it has not received a formal complaint from Brignoni’s relatives. Family members say they plan to make one.

Shortly after Brignoni’s death, the Health Ministry inspected the Vista del Jardin Medical Center where she was treated and ordered the operating room temporarily closed, citing the presence of bacteria and violations of bio-sanitary regulations. The doctor who performed the procedure and the clinic have not responded to requests for comment.

Brignoni’s death is unusual, but it is not isolated. Concerns about the booming cosmetic surgery business in the Dominican Republic are enough of an issue that the State Department has posted a warning on its page for travel to that country, noting that in several cases U.S. citizens have suffered serious complications or died.

The U.S. Centers for Disease Control issued an alert March 7 after health authorities in the United States reported that at least 19 women in five states had developed serious mycobacterial wound infections over the previous 12 months following cosmetic procedures in the Dominican Republic such as liposuction, tummy tucks and breast implants.

There were no reported deaths in those cases, but treatment for these types of infections, which have been caused in the past by contaminated medical equipment, tend to involve long courses of antibiotics and can require new surgery to remove infected tissue and drain fluid, said Dr. Douglas Esposito, a CDC medical officer.

“Some of these patients end up going through one or more surgeries and various travels through the medical system,” Esposito said. “They take a long time typically to get better.”

The Dominican Republic, like countries such as Mexico, Costa Rica and Thailand, has promoted itself as a destination for medical tourism, so-called because people will often tack on a few days at a resort after undergoing surgery. The main allure is much lower costs along with the promise that conditions will be on par with what a patient

would encounter at home.

In 2013, there were more than 1,000 cosmetic procedures performed in the Dominican Republic, 60 percent of them on foreigners, according to the country’s Plastic Surgery Society.

The Internet is flooded with advertisements and testimonials from people who say they have had successful procedures in the Dominican Republic, and an industry of “recovery houses” has sprung up to serve clients, along with promoters who canvass for clients in the United States. The price is often about a third of the cost in the United States.

Dr. Braun Graham, a plastic surgeon in Sarasota, Florida, says he done corrective surgery on people for what he says were inferior procedures abroad. He warns that even if a foreign doctor is talented, nurses and support staff may lack adequate training.

“Clearly, the cost savings is certainly not worth the increased risk of a fatal complication,” said Graham, past president for Florida Society of Plastic Surgeons.

Brignoni was referred to the Vista del Jardin Medical Center by several acquaintances in the New York borough of the Bronx where she lived, said Lamboy and Lenny Ulloa, the father of the 4-year-old daughter she left behind.

“Supposedly, it was a high-end clinic, one of the best in the city,” Ulloa said.

The doctor who performed Brignoni’s procedure, Guillermo Lorenzo, is certified by the Plastic Surgery Society, but there

are at least 300 surgeons performing cosmetic procedures who are not, said Dr. Severo Mercedes, the organization’s director. He said the government knows about the problem but has not taken any action. “We complain but we can’t go after anyone because we’re not law enforcement,” Mercedes said.

The number of people pursuing treatment in the Dominican Republic doesn’t seem to have been affected by negative reports, including a previous CDC warning about a cluster of 12 infections in 2003-04.

In one recent case, the Dominican government in February closed a widely advertised clinic known as “Efecto Brush,” for operating without a license. Prosecutors opened a criminal case after at least six women accused the clinic of fraud and negligence. The director, Franklin Polanco, is free while awaiting trial. He denies wrongdoing.

There was also the case of Dr. Hector Cabral. New York prosecutors accused him of conducting examinations of women in health spas and beauty parlors in that state in 2006-09 without a license, then operating on them in the Dominican Republic, leaving some disfigured. Cabral pleaded guilty to one count of unauthorized practice of medicine in October 2011 and returned to the Dominican Republic, where he still practices.

In 2009, Dominican authorities charged Dr. Johan Tapia Bueno with illegally practicing plastic surgery at his apartment after several women, including a local television personality, accused him of malpractice that left them with infections. Awaiting trial, he has pleaded innocent to charges that include fraud.

Juan Linares, a lawyer hired by Brignoni’s boyfriend, said he is still awaiting an autopsy report.

Because she arrived in the country late at night on a delayed flight and was on the operating table early the next morning, a main concern is whether she received an adequate medical evaluation before the procedure. Graham, the Florida surgeon, said sitting on a plane for several hours can cause blood to stagnate in the legs and increase the risk of an embolism.

Brignoni paid the Dominican clinic $6,300 for a combination of liposuction, tummy tuck and breast surgery. Lamboy said she had decided not to have the work done on her breasts and was expecting a partial refund. The woman, who worked as a property manager, had lost about 80 pounds about a year earlier after gastric bypass surgery.

Brignoni was clearly excited about the procedure. Her final post on Facebook was a photo she took of her hands holding her passport and boarding pass for the flight from New York to Santo Domingo.

“She wanted it so bad,” her godmother said. “It felt like she was going to have a better outlook on life, getting this done.”

Associated Press writer Ben Fox reported this story from Miami and Ezequiel Abiu Lopez reported in Santo Domingo.

Source: Associated Press (AP); retrieved 03/31/2014 from: http://news.yahoo.com/low-cost-dominican-surgeries-spark-warnings-us-042418398.html

This is a very important issue for the planning and execution of the new inter-governmental agency: Caribbean Union Trade Federation (CU). First of all, someone died – life is too precious to skim over this issue with indifference. The Go Lean book serves as a roadmap to introduce and implement the CU, so as to re-boot the region’s economic engines, including avenues of medical tourism.

There are also peripheral issues associated with this news story, many of which are examined, as missions, in great details in the Go Lean book. The issues/missions are:

Image: Confidence in the competence of service providers is sometimes based on reputation and branding. This is para-mount in medical fields. While the Caribbean is home to many excellent medical schools, facilities and practitioners, there is no regional “sentinel” role-player. The CU mandate is to zealously protect and promote the image and branding for industrial developments. So now when the media portrays “negative” depiction of Caribbean life, culture and people, there is no formal response mechanism. But with the CU’s implementation, there will be an entity to effectuate an anti-defamation response and better manage the region’s image.
Health Administration: The Go Lean roadmap recognizes healthcare as a basic need for the people of the Caribbean. As such, there is the acknowledgement that health delivery systems generate excessive costs and risks for a community. As a planning tool, the roadmap commences with a Declaration of Interdependence, pronouncing regional integration (Page 11) as the strategy for optimized benefits:

IX. Whereas the realities of healthcare and an aging population cannot be ignored and cannot be afforded without some advanced mitigation, the Federation must arrange for health plans to consolidate premiums of both healthy and sickly people across the wider base of the entire Caribbean population. The mitigation should extend further to disease management, wellness, obesity and smoking cessation programs. The Federation must proactively anticipate the demand and supply of organ transplantation as developing countries are often exploited by richer neighbors for illicit organ trade.

Self-Government Entities: The foregoing news story involves a clinic regulated by a Caribbean member-state, the Dominican Republic. The Go Lean roadmap institutes an arrangement for medical/research campuses as SGE’s (Self-Governing Entities) that are only regulated by the CU federal authorities. Had this tragedy occurred on such a facility, the response would have been immediate and comprehensive, employing best-practices of trauma medicine arts and sciences, thusly requiring a post-mortem lessons-learned process that would be fully transparent and accountable.
Lean Government: The Go Lean roadmap also extends optimizations to the member-states governments, requiring a separation-of-powers dictum to transfer oversight and administration of certain state functions to federal authorities. This includes standards, licensing and administration of healthcare facilities. The application of best-practices would most assuredly minimize the risk of medical negligence.
US Exceptionalism: The Go Lean roadmap maintains that other countries have their own version of the American Dream. The quest for life, liberty and the pursuit of happiness is not exclusively American. Whereas there are millions of negligent deaths in the US hospitals/clinics every year, one American dying in a Caribbean facility does not constitute an exceptional event; bad things do happen to good people … everywhere, in the US, in the Caribbean and in the Dominican Republic. Having a tourism-based regional economy means we always want to extend hospitality to our American guests, but embarking on medical tourism, also means assuming some degree of risks, for the facilities, the doctors and most importantly the patients.

The foregoing article crystalizes the need for the CU Trade Federation, a super-national administration to regulate, protect, promote and foster quality delivery of the most vital public services. The publishers of the Go Lean roadmap will hereby “sit back”, observe-and-report on the manifestations of this case, hoping for the quest for justice and accountability to be fulfilled. And remembering the unconscionable loss of the beautiful 28-year-old woman, Beverly Brignoni; RIP.

Download the book Go Lean … Caribbean – now!

Sign the petition to lean-in for the roadmap for the Caribbean Union Trade Federation.

———–

Appendix – CDC warns of dangers of plastic surgery in Dominican Republic

(HealthDay) — U.S. health officials are warning about the dangers of “medical tourism” after at least 18 women from the East Coast became infected with a disfiguring bacteria following plastic surgery procedures they had in the Dominican Republic.

The infections, caused by a type of germ called mycobacteria, can be difficult to treat. At least several of the women had to be hospitalized, undergo surgery to treat the infection and take antibiotics for months, according to the report from the U.S. Centers for Disease Control and Prevention.

One expert said the effects can be devastating.

“It’s a very mutilating infection. They’re going for cosmetic surgery, and they will be scarred. It’s a terrible scenario for people to go down there, get surgery and come back worse than they imagined they could be,” said Dr. Charles Daley. He is a Denver infectious disease physician whose clinic has seen patients infected after undergoing these kinds of procedures in the Dominican Republic.

According to the CDC, 21 women from six Northeast and Mid-Atlantic states appear to have been affected by mycobacterial infections after visiting five plastic surgery clinics in the Dominican Republic, a nation in the Caribbean. (Eighteen of the cases are confirmed, and three are considered probable.)

Mycobacteria, which are found worldwide in the environment, “usually infect the skin or lungs, and are responsible for chronic and recurrent infections that are notoriously resistant to antibiotics and difficult to treat,” said report co-author Dr. Douglas Esposito. He is a medical officer and epidemiologist with the CDC’s Travelers’ Health Branch.

More than 80 percent of the infected women reported swelling, pain and scarring. Daley, who works at the National Jewish Health respiratory hospital in Denver, said infected people often need to undergo reconstructive surgery.

It’s not clear how the women were infected, although Daley said it’s possible the bacteria entered their plastic surgery wounds through tap water or instruments used in surgery. Most underwent liposuction and at least one other surgery, such as procedures to expand the size of the breasts and buttocks, or breast reduction.

Daley said his clinic has seen two patients infected after plastic surgery and consulted on a third case. It’s not clear how many, if any, are among those in the CDC report.

The risk of this kind of infection is higher in countries like the Dominican Republic and Brazil, he noted, but patients have become infected in the United States, too. “We are definitely seeing more of these postoperative infections, particularly ones that are related to cosmetic surgery,” Daley said.

The CDC report warns about the risks of medical tourism, a term that describes leaving the United States for medical procedures to save money. According to the report, many of the women—most of whom were born in the Dominican Republic—said they went to the country for plastic surgery to save money.

People who have undergone plastic surgery in the Dominican Republic should talk to their doctor about getting tested, Daley suggested. And, people who plan to go there for a procedure should ask the clinic whether they’ve had infections, he added.

“I would never go to one of those places,” he said. “I know too many stories about what’s happened to people. It has ruined people’s lives.”

The study was published online July 13 in Emerging Infectious Diseases.

Reporting by: Randy Dotinga, Healthday Reporter

Source: Posted July 14, 2016; retrieved March 30, 2017 from: https://medicalxpress.com/news/2016-07-cdc-dangers-plastic-surgery-dominican.html#jCp

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Miami: Dominican’s ‘Home Away from Home’

Posted on March 13, 2017 in Locations, Social, Strategy

Go Lean Commentary

There is something really wrong in the Dominican Republic (DR) in particular and all of the Caribbean in general:

Citizens are beating down the doors to get out!

This failing assessment is accelerating faster and faster as every year goes by. In 2010, there were approximately 1.41 million people of Dominican descent in the US; now the absolute latest number is an estimate from 2015: 1,873,097; see the full details in Appendix A below.

According to the book Go Lean…Caribbean, the population on the island for 2010 was reported at 9,523,209. So one-fifth of the population of Dominican heritage live in the US. There appears to be no progress in any movement for repatriation to the island, rather there is progress in movement to the South, to Florida. Of the Top 7 US states that the Dominican Diaspora lives in, Florida is the only one in the Sunbelt. The tropical landscapes in Greater Miami is reminiscent of the DR for many people. Now, the Miami neighborhood of Allapattah is emerging as the new Home away from Home and thusly branded: ‘Little Santo Domingo’ – see full details in Appendix B.

In a previous Go Lean blog-commentary, it was detailed how the Greater Miami area has benefited from failures in the Caribbean region. We saw this dynamic at work this weekend with the World Baseball Classic tournament in Miami. For this round in the tournament, these 4 teams were assigned to Miami for “Pool C” play:

Canada
Colombia
Dominican Republic
USA

Source: https://www.worldbaseballclassic.com/schedule?affiliateId=DC-9422074-109104352834-9906034-1161695674

See this news article here detailing the game between the Dominican Republic and the US – this article shows that despite the address, playing in Miami was a Home Game for the Dominican National Team:

Title: Miami, WBC are big winners as Team USA, Dominicans set records for attendance … and volume
By: Greg Cote
How perfect that the World Baseball Classic’s only first-round games in the United States are happening at Marlins Park. This event is so Miami.

It beams us to the rest of the world so accurately and with splendor, and I mean beyond the tourism/postcard aspect we saw Saturday night with the ballpark roof open, fresh breeze wafting in from the ocean and the downtown skyline majestic as a Goodyear blimp and a full moon floated overhead.

This international event speaks our language(s), reflecting the multi-ethnic, multi-national flavor that defines us. While much of the rest of the country recoils from diversity and retreats to jingoism — or I should say as our new government does — Miami remains steadfastly a savory, year-round gumbo of personalities and backgrounds.

On Saturday night, Dominican fans cheered a first-inning strikeout of Team USA’s Adam Jones as if it were the final out in a World Series Game 7. The sound was sonic, numbing. U.S. (and Marlins) fans countered with a roar of their own as Christian Yelich doubled to right field. I’m not sure a I had heard (or felt) such high-pitch passion at a South Florida sports event since the last time the Heat hosted an NBA Finals game.

The ballpark concourses filled with celebrating Dominicans before the game, a carnival of whistles and horns and sporadic, erupting chats of “Ole’!”

During the game there was The Wave undulating around the park. Of course there was. All that joy gotta go someplace.

Before the game I met a “house divided” couple. Ken Oliver, a South Florida attorney, wore Team USA colors and his friend, Josie Pichardo, those of the Dominican team. By arrangement I texted them during the game to get a sense of the atmosphere in the middle of it. They sat in Section 206, among far more fans who agreed with Josie’s team preference. I asked what it was like down there.

“Banging drums!” Oliver texted back.

Edison Cruz, 28, of Miami, had arrived with a handful of buddies — all wearing Dominican shirts.

“It is because baseball is our true national pastime,” he said. “In American there are all sports to love.”

Team USA and the Dominican both are favored to be the two teams of four in this Pool C to advance to the WBC’s next round, each fielding lineups filled with major-league stars. How good were these batting orders Saturday? The Marlins’ Giancarlo Stanton, a threat to lead the majors in home runs, hit seventh for the United States.

There is a reason Miami attracts global sporting events like the WBC. It isn’t just our weather. It’s our welcome. It’s all the colors in our quilt. If sport truly is an international language, we are fluent.

It is why this same ballpark was reconfigured recently into a racetrack for a major annual auto race involving stars from NASCAR, Formula One and IndyCar — an international event choosing Miami for its first-ever U.S. appearance.

This week it was announced two of the most famous, celebrated club teams in global soccer, Real Madrid and Barcelona, would bring their El Clasico rivalry to Hard Rock Stadium this July. The place will be filled in a way the Dolphins rarely manage.

So Saturday it was Team USA and the Dominican Republic filling MarlinsPark with passion and fans.

Who won? You didn’t need a scoreboard to tell you.

Miami did.

This blog-submission is not just relating a newspaper article and commenting about events from a far. This writer was at the game, Section 32 – Left Field bleachers.

The purpose of the book Go Lean…Caribbean (GLC) is NOT to celebrate Diaspora life in American cities; rather it is to champion the causes of retaining Caribbean citizens in the Caribbean, and inviting the Diaspora back to their homelands. These intentions were pronounced early in the book with these statements in the Declaration of Interdependence (Pages 13):

xix. Whereas our legacy in recent times is one of societal abandonment, it is imperative that incentives and encouragement be put in place to first dissuade the human flight, and then entice and welcome the return of our Diaspora back to our shores. This repatriation should be effected with the appropriate guards so as not to imperil the lives and securities of the repatriated citizens or the communities they inhabit. The right of repatriation is to be extended to any natural born citizens despite any previous naturalization to foreign sovereignties.

xx. Whereas the results of our decades of migration created a vibrant Diaspora in foreign lands, the Federation must organize interactions with this population into structured markets. Thus allowing foreign consumption of domestic products, services and media, which is a positive trade impact. These economic activities must not be exploited by others’ profiteering but rather harnessed by Federation resources for efficient repatriations.

This quest – reversing the propensity for Dominican people to abandon their island home – is a “tall order”, heavy-lifting task. This was expressed by one fan at the WBC Baseball game on Saturday March 11. He – first name Pablo – explained the following:

Pablo: I completed high school in the DR and knew that I was to leave immediately at the end of high school. This was not just my scenario, but the majority of the students in my graduating class. I look back now and I personally know that at least 50 percent of the class is in the US, through legal or illegal means.

GLC: You are celebrating your love for the DR homeland by being here at this baseball game, so I assume your plan now is to just work in the US during your active years and then retire back in the DR. Is this correct?

Pablo: No. I would not want to retire in the DR. It is too costly a lifestyle. You spend a lot of money in the homeland but get very little to show for it. I simply wish to visit, but I would not live there again … ever.

GLC: We recognize that even with some success from our roadmap, repatriating to the DR may never appeal to Diaspora members like you; so our focus is on the next generation, we must dissuade future classes from leaving in the first place.

Pablo: Good luck…

The Go Lean book serves as a roadmap for the introduction and implementation of the technocratic Caribbean Union Trade Federation (CU) to bring positive change. The CU‘s prime directives are identified with the following 3 statements:

Optimization of the economic engines in order to grow the regional economy to $800 Billion & create 2.2 million new jobs.
Establishment of a security apparatus to protect the resultant economic engines.
Improve Caribbean governance to support these engines.

The Go Lean book posits that with the empowerments that come with this roadmap, the region will be a better place to live, work and play. But this quest is heavy-lifting. The book thusly details the community ethos, strategies, tactics, implementations and advocacies to finally re-boot Caribbean society. Consider this sample:

Community Ethos – Ways to Impact Turn-Arounds	Page 33
Advocacy – Ways to Grow the Economy	Page 151
Advocacy – Ways to Impact the Diaspora	Page 217
Advocacy – Ways to Preserve Caribbean Heritage	Page 218
Advocacy – Ways to Impact the Dominican Republic	Page 237

This commentary previously featured subjects related to the DR; consider this sample:

DR President Medina on the economy: ‘God will provide’

Low-cost Dominican surgeries spark warnings by US

As related previously, Miami is a better place to live, work and play … due to the contributions of the Caribbean Diaspora, including Dominicans. The new Marlins Park had never seen such a baseball fandom before the Dominicans made their impact on Saturday. (The stadium and Marlins owner is extremely disliked in the Miami community).

Dominicans are good for Miami and Miami is good for Dominicans. See the related VIDEO here:

VIDEO – http://www.miamiherald.com/sports/mlb/article137986623.html

Dominican fans dance to the music before Saturday’s World Baseball Classic game between the United States and the Dominican Republic at Marlins Park on Saturday, March 11, 2017. Pedro Portal The Miami Herald

Now, the purpose of the Go Lean roadmap is to foster that exact same prosperous spirit among Dominicans, but to prosper where planted in their Caribbean homeland, not in this foreign city (Miami). We urge all Dominican stakeholders to lean-in to this roadmap, those residing in the region and those in the Diaspora. 🙂

Download the book Go Lean … Caribbean – now!

Sign the petition to lean-in for the roadmap for the Caribbean Union Trade Federation.

————

Appendix A – Dominican Americans

Dominican Americans are Americans who have full or partial origin from the Dominican Republic.^[5] Although their emigration began in the sixteenth century,^[6] thousands of Dominicans passed through the gates of Ellis Island in the 19th and early 20th centuries.^[7]The most recent movement of emigration to the United States began in the 1960s, after the fall of the Trujillo regime. In 2010, there were approximately 1.41 million people of Dominican descent in the US, including both native and foreign-born.^[8] Dominican Americans are the fifth-largest Hispanic group in the United States.

…

The absolute latest number in terms of size of this Diaspora is an estimate from 2015: 1,873,097^[1][2]; this is 0.6% of the U.S. population (2015).^[3]

As of the 2010 census, the top 10 US states with the largest Dominican populations are the following:^[24]

New York – 674,787 (3.5% of statal population)
New Jersey – 197,922 (2.3% of statal population)
Florida – 172,451 (0.9% of statal population)
Massachusetts – 103,292 (1.6% of statal population)
Pennsylvania – 62,348 (0.5% of statal population)
Rhode Island – 35,008 (3.3% of statal population)
Connecticut – 26,093 (0.7% of statal population)
North Carolina – 15,225 (0.2% of statal population)
Georgia – 14,941 (0.2% of statal population)
Maryland – 14,873 (0.3% of statal population)

Source: Retrieved March 12, 2017 from: https://en.wikipedia.org/wiki/Dominican_Americans_(Dominican_Republic)

————

Appendix B – Allapattah

Allapattah is a neighborhood mostly in the city of Miami, Florida, and partly in metropolitan Miami, United States. As of May 2011, the county-owned portion of Allapattah, from State Road 9 to LeJeune Road, is being annexed by the city proper.^[1]

The neighborhood was nicknamed Little Santo Domingo in 2003 … to honor the sizable Dominican American population in the community.^[2]

History
The name is derived from the Seminole Indian language word meaning alligator. The initial settlement of the Allapattah community began in 1856 when William P. Wagner, the earliest documented white American permanent settler, arrived from Charleston, South Carolina and established a homestead on a hammock along the Miami Rock Ridge, where Miami Jackson High School presently stands. Development ensued from 1896 and into the 20th century in the area with the completion of the Florida East Coast Railroad (FEC).^[3]

Allapattah was predominantly populated by whites from early in the 20th century until the late 1950s, when there was a large influx of black Americans displaced by the construction of I-95 (then, the North-South Expressway) in the 1950s and 1960s, leading to white flight to suburban Miami-Dade County and Broward County. Cubans migrated to Miami neighborhoods like Allapattah in large numbers following the Cuban Revolution of 1959, hosting one of Miami’s largest Cuban American populations. The 1980s brought influxes of Dominican Americans, Nicaraguans, Hondurans, and Haitians in the aftermath of various refugee crises in those nations. Now, a melting pot of residents from all across the Caribbean, Central America, and Latin America reside in the area.

Demographics
As of 2000,^[5] Allapattah had a population between 40,406 and 43,860^[6] residents, with 12,508 households, and 8,224 families residing in the neighborhood. The median household income was $19,141.53. The racial makeup of the neighborhood was 72.23% Hispanic or Latino of any race, 18.33% Black or African American, 6.89% White (non-Hispanic), and 2.55% Other races (non-Hispanic).

The zip codes for Allapattah include 33136, 33125, 33127, and 33142. The area covers 4.653 square miles (12.05 km²). As of 2000, there were 23,967 males and 19,894 females. The median age for males was 33.9 years old, while the median age for females was 36.0 years old. The average household size had 2.8 people, while the average family size had 3.4 members. The percentage of married-couple families (among all households) was 36.4%, while the percentage of married-couple families with children (among all households) was 16.6%, and the percentage of single-mother households (among all households) was 14.5%. 8.0% of the population were in correctional institutions, 1.0% of the population were in nursing homes, and 1.2% of the population were in other group homes. The percentage of never-married males 15 years old and over was 24.5%, while the percentage of never-married females 15 years old and over was 12.4%.^[6]

As of 2000, the percentage of people that speak English not well or not at all made up 33.0% of the population. The percentage of residents born in Florida was 30.5%, the percentage of people born in another US state was 9.2%, and the percentage of native residents but born outside the US was 4.3%, while the percentage of foreign born residents was 56.1%^[6]

Source: Retrieved March 12, 2017 from: https://en.wikipedia.org/wiki/Allapattah

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DR President Medina on the economy: ‘God will provide’

Posted on November 8, 2014 in Economics, Locations

Go Lean Commentary

The Caribbean is in crisis!

For many, “success is measured by the successful exodus from their Caribbean homeland”. So declares the foreword of the book Go Lean … Caribbean (Page 3).

The Dominican Republic is in crisis! According to the foregoing news article, the island nation have lots of issues, stemming primarily from economic dysfunctions, and the solution, according to the President of the Republic is only “Faith, Hope and Prayer”:

Santo Domingo – President Danilo Medina says that the Dominican state has a very high level of debt, because it is dragging a vital execution deficit with the income it receives and has to spend, which has prevented the economy from recovery over the past few years.

“When a country does not receive enough resources to fund its spending, the only way of financing it is to use state money. In all these years the country’s average fiscal deficit since 2000 to date has been 4.5% of the annual Gross Domestic Product,” said Medina

He said that the state will have to pay US$11 billion in debt between 2013 and 2015, and for the deficit to be reduced an effort must be made to reduce its essence, in order to take it to 2.8% of GDP.

The President warned that this reduction is behind the importance of building coal-fired plants to supply the country with energy, and that he does not understand why “there is a conspiracy against these plants that should be defended by the whole country, if we want sustainability in public finances.” He said that these plants, which will come into operation in 2017, would mean the state would save 1.7% of the GDP, by paying the Dominican Corporation of State Electricity Companies (CDEEE) debt, thus putting the national economy on a good path within a few years.

When he was asked where he would obtain the resources for governing over the next years, Medina answered, “God will provide.” He said that the budgetary spending restructuring meant the government was investing where people needed it and that this was being reflected in economic development.
Dominican Today – Online Community – Posted 08-20-2014; Retrieved 11-08-2014:
http://www.dominicantoday.com/dr/economy/2014/8/20/52502/President-Medina-on-the-economy-God-will-provide

The publishers of the Go Lean book recognize and respect religious faith and devotion. In fact, the book examines the Bible’s record on economic empowerment, listing 10 Lessons from the Bible (Page 144). For the consideration of this commentary and the President’s “easy” secession in the foregoing article, a fitting lesson is derived from the Bible Book of James Chapter 2:14 – 26; (see Appendix*):

James 2:26 – “Faith without works is dead”.

The required “works” is described in the Go Lean book as heavy-lifting.

The publishers of the Go Lean book humbly submit a plan for heavy-lifting, one so comprehensive that it is considered a roadmap, turn-by-turn directions to move the Dominican Republic from Point A (status quo), to Point B (destination of societal elevation). This roadmap is set to re-boot the island’s economy, security and governing engines, highlighting 144 different advocacies designed to impact society. The book asserts that the problems of the Dominican Republic (and by extension, the entire Caribbean) are too big for any one member-state to solve alone. Rather, the focus of the roadmap is the region-wide professionally-managed, deputized technocracy of the Caribbean Union Trade Federation (CU).

The Dominican Republic needs the strategies, tactics, implementations and advocacies of the CU.

The CU needs the Dominican Republic!

The CU requires the full participation of all 30 member-states in the region, including all 4 language groups (Dutch, English, French and Spanish). With this approach, the CU benefits from the economies-of-scale of 42 million people.

The CU expects NO MONEY from the Dominican Republic. This is good as the country’s treasuries are strained, maintaining the national debt of US$11 billion, plus a budget deficit reflecting 4.5% of GDP. To cure a deficit a government needs combinations of two things: more revenues and/or fewer expenses.

The Go Lean roadmap features both. The roadmap is a complete re-boot: new revenue streams and a separation-of-powers, thereby delegating some governance to CU agencies.

The Go Lean … Caribbean book introduces the CU to take oversight of’ much of the Caribbean economic, security and governing functionality. In summary, this plan’s execution makes the Dominican Republic, and the Caribbean, a better place to live, work and play.

This Go Lean roadmap assesses the Dominican Republic human flight/brain drain crisis, where large percentages of the island’s populations have fled to American shores, with estimates of up to 1.3 million in the Diaspora as of 2006 (Page 237 & 306). This plight makes the task of building a functioning society difficult, as often the brightest and best talents are the ones that flee; plus entitlement programs simply need populace retention.

The CU will fix the Dominican Republic! Look here at the solutions; (sorted by Economic/Security/Governance). The book Go Lean … Caribbean details these specific curative measures (advocacies, strategies, tactics, and implementations):

Economic:

Community Ethos – Money Multiplier	Page 22
Help Entrepreneurship	Page 28
Impact Turn-Around Strategies/Tactics	Page 33
Tactics to Forge an $800 Billion Economy	Page 67
New Ways to Pay for Change	Page 101
Improve Energy Usage	Page 113
Better Manage Debt	Page 114
Foster International Aid	Page 115
Improve Trade	Page 128
Improve Interstate Commerce	Page 129
New Ways to Grow the Economy	Page 151
Create Jobs	Page 152
Control Inflation	Page 153
Improve Credit Ratings	Page 155
Improve Education	Page 159
Mitigate Black Markets	Page 165
Enhance Tourism	Page 190
Impact Wall Street	Page 200

Security:

Separation of Powers – Homeland Security	Page 75
Security Initiatives [stemming from the Start-up]	Page 103
Impact Justice	Page 177
Mitigate & Reduce Crime	Page 178
Improve Intelligence [Gathering & Analysis]	Page 182
Impact the Prison-Industrial Complex	Page 211

Governance:

Community Ethos – Deferred Gratification	Page 21
Improve Negotiations	Page 32
Impact the Greater Good	Page 37
Tactics to Foster a Technocracy	Page 64
Implement Self-Governing Entities	Page 105
Strong Reasons to Repatriate	Page 118
Promote Independence	Page 120
Improve Healthcare	Page 156
Impact Entitlements	Page 158
New [Governmental] Revenue Sources	Page 172
Impact Public Works	Page 175
Better Manage Natural Resources	Page 183
Improve for Natural Disasters	Page 184
Improve Emergency Management	Page 196

The people of the Dominican Republic are calling for change, for help, for some mitigations. They need prayer, yes, but they need workable solutions too. See the VIDEO below, produced by young students in line with a “poverty” theme; this assessment is “from the mouth of babes” – Bible Quote (Matthew 21:16).

With the Go Lean roadmap, change has come to the Caribbean. The people and institutions of the Dominican Republic are all urged to “lean-in” to this roadmap.

In fact, now is the time for the whole Caribbean region to lean-in for this change, described in the book Go Lean … Caribbean. The benefits of this roadmap are too alluring to ignore: emergence of an $800 Billion regional economy, 2.2 million new jobs and an end to the economic dysfunction. This will result in Dominicans repatriating from the US, not fleeing to the US. 🙂

Download the book Go Lean … Caribbean – now!

————-

Appendix – Bible Reading – James Chapter 2:14 – 26 (New International Version)

*Faith and Deeds

14 What good is it, my brothers and sisters, if someone claims to have faith but has no deeds? Can such faith save them? 15 Suppose a brother or a sister is without clothes and daily food. 16 If one of you says to them, “Go in peace; keep warm and well fed,” but does nothing about their physical needs, what good is it? 17 In the same way, faith by itself, if it is not accompanied by action, is dead.
18 But someone will say, “You have faith; I have deeds.”
Show me your faith without deeds, and I will show you my faith by my deeds. 19 You believe that there is one God. Good! Even the demons believe that—and shudder.
20 You foolish person, do you want evidence that faith without deeds is useless ? 21 Was not our father Abraham considered righteous for what he did when he offered his son Isaac on the altar? 22 You see that his faith and his actions were working together, and his faith was made complete by what he did. 23 And the scripture was fulfilled that says, “Abraham believed God, and it was credited to him as righteousness, and he was called God’s friend. 24 You see that a person is considered righteous by what they do and not by faith alone.
25 In the same way, was not even Rahab the prostitute considered righteous for what she did when she gave lodging to the spies and sent them off in a different direction? 26 As the body without the spirit is dead, so faith without deeds is dead.

————-

Appendix – Video: Why the Dominican Republic is poor? http://youtu.be/pCVR-kdc0ss

Published on May 15, 2013 By YouTube Contributor: “camilalovescupcakes” (Sharen Sosa)
The prologue included this verbiage: “In my school, as final exam in English classes, told us to do a video of ‘Why the Dominican Republic is poor?’ We had to make groups and make a video, talking about it, and also focus on the cause, which was the “Corruption”, we made a documentary and here is the whole video, hope you love it”.

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Low-cost Dominican surgeries spark warnings by US

Posted on April 1, 2014 in Economics, Ethos, Industries, Strategy, Tactical

Go Lean Commentary

By: Ben Fox and Ezequiel Abiu Lopez
Beverly Brignoni was a young New Yorker seeking a less expensive way to enhance her appearance and she did what many other people are now doing: travel to the Dominican Republic for cosmetic surgery; (see undated “selfie” photo posted to her Instagram account, courtesy of the Brignoni family).

It went horribly wrong. The 28-year-old died Feb. 20 from what the doctor told her family was a massive pulmonary embolism while getting a tummy tuck and liposuction at a clinic in the Dominican capital recommended by friends. Family members want local authorities to investigate.

“We want to know exactly what happened,” said Bernadette Lamboy, Brignoni’s godmother. “We want to know if there was negligence.”

The district attorney’s office for Santo Domingo says it has not yet begun an investigation because it has not received a formal complaint from Brignoni’s relatives. Family members say they plan to make one.

Shortly after Brignoni’s death, the Health Ministry inspected the Vista del Jardin Medical Center where she was treated and ordered the operating room temporarily closed, citing the presence of bacteria and violations of bio-sanitary regulations. The doctor who performed the procedure and the clinic have not responded to requests for comment.

Brignoni’s death is unusual, but it is not isolated. Concerns about the booming cosmetic surgery business in the Dominican Republic are enough of an issue that the State Department has posted a warning on its page for travel to that country, noting that in several cases U.S. citizens have suffered serious complications or died.

The U.S. Centers for Disease Control issued an alert March 7 after health authorities in the United States reported that at least 19 women in five states had developed serious mycobacterial wound infections over the previous 12 months following cosmetic procedures in the Dominican Republic such as liposuction, tummy tucks and breast implants.

There were no reported deaths in those cases, but treatment for these types of infections, which have been caused in the past by contaminated medical equipment, tend to involve long courses of antibiotics and can require new surgery to remove infected tissue and drain fluid, said Dr. Douglas Esposito, a CDC medical officer.

“Some of these patients end up going through one or more surgeries and various travels through the medical system,” Esposito said. “They take a long time typically to get better.”

The Dominican Republic, like countries such as Mexico, Costa Rica and Thailand, has promoted itself as a destination for medical tourism, so-called because people will often tack on a few days at a resort after undergoing surgery. The main allure is much lower costs along with the promise that conditions will be on par with what a patient

would encounter at home.

In 2013, there were more than 1,000 cosmetic procedures performed in the Dominican Republic, 60 percent of them on foreigners, according to the country’s Plastic Surgery Society.

The Internet is flooded with advertisements and testimonials from people who say they have had successful procedures in the Dominican Republic, and an industry of “recovery houses” has sprung up to serve clients, along with promoters who canvass for clients in the United States. The price is often about a third of the cost in the United States.

Dr. Braun Graham, a plastic surgeon in Sarasota, Florida, says he done corrective surgery on people for what he says were inferior procedures abroad. He warns that even if a foreign doctor is talented, nurses and support staff may lack adequate training.

“Clearly, the cost savings is certainly not worth the increased risk of a fatal complication,” said Graham, past president for Florida Society of Plastic Surgeons.

Brignoni was referred to the Vista del Jardin Medical Center by several acquaintances in the New York borough of the Bronx where she lived, said Lamboy and Lenny Ulloa, the father of the 4-year-old daughter she left behind.

“Supposedly, it was a high-end clinic, one of the best in the city,” Ulloa said.

The doctor who performed Brignoni’s procedure, Guillermo Lorenzo, is certified by the Plastic Surgery Society, but there

are at least 300 surgeons performing cosmetic procedures who are not, said Dr. Severo Mercedes, the organization’s director. He said the government knows about the problem but has not taken any action. “We complain but we can’t go after anyone because we’re not law enforcement,” Mercedes said.

The number of people pursuing treatment in the Dominican Republic doesn’t seem to have been affected by negative reports, including a previous CDC warning about a cluster of 12 infections in 2003-04.

In one recent case, the Dominican government in February closed a widely advertised clinic known as “Efecto Brush,” for operating without a license. Prosecutors opened a criminal case after at least six women accused the clinic of fraud and negligence. The director, Franklin Polanco, is free while awaiting trial. He denies wrongdoing.

There was also the case of Dr. Hector Cabral. New York prosecutors accused him of conducting examinations of women in health spas and beauty parlors in that state in 2006-09 without a license, then operating on them in the Dominican Republic, leaving some disfigured. Cabral pleaded guilty to one count of unauthorized practice of medicine in October 2011 and returned to the Dominican Republic, where he still practices.

In 2009, Dominican authorities charged Dr. Johan Tapia Bueno with illegally practicing plastic surgery at his apartment after several women, including a local television personality, accused him of malpractice that left them with infections. Awaiting trial, he has pleaded innocent to charges that include fraud.

Juan Linares, a lawyer hired by Brignoni’s boyfriend, said he is still awaiting an autopsy report.

Because she arrived in the country late at night on a delayed flight and was on the operating table early the next morning, a main concern is whether she received an adequate medical evaluation before the procedure. Graham, the Florida surgeon, said sitting on a plane for several hours can cause blood to stagnate in the legs and increase the risk of an embolism.

Brignoni paid the Dominican clinic $6,300 for a combination of liposuction, tummy tuck and breast surgery. Lamboy said she had decided not to have the work done on her breasts and was expecting a partial refund. The woman, who worked as a property manager, had lost about 80 pounds about a year earlier after gastric bypass surgery.

Brignoni was clearly excited about the procedure. Her final post on Facebook was a photo she took of her hands holding her passport and boarding pass for the flight from New York to Santo Domingo.

“She wanted it so bad,” her godmother said. “It felt like she was going to have a better outlook on life, getting this done.”

Associated Press writer Ben Fox reported this story from Miami and Ezequiel Abiu Lopez reported in Santo Domingo.

Source: Associated Press (AP); retrieved 03/31/2014 from: http://news.yahoo.com/low-cost-dominican-surgeries-spark-warnings-us-042418398.html

There are also peripheral issues associated with this news story, many of which are examined, as missions, in great details in the Go Lean book. The issues/missions are:

Image: Confidence in the competence of service providers is sometimes based on reputation and branding. This is para-mount in medical fields. While the Caribbean is home to many excellent medical schools, facilities and practitioners, there is no regional “sentinel” role-player. The CU mandate is to zealously protect and promote the image and branding for industrial developments. So now when the media portrays “negative” depiction of Caribbean life, culture and people, there is no formal response mechanism. But with the CU’s implementation, there will be an entity to effectuate an anti-defamation response and better manage the region’s image.
Health Administration: The Go Lean roadmap recognizes healthcare as a basic need for the people of the Caribbean. As such, there is the acknowledgement that health delivery systems generate excessive costs and risks for a community. As a planning tool, the roadmap commences with a Declaration of Interdependence, pronouncing regional integration (Page 11) as the strategy for optimized benefits:

Self-Government Entities: The foregoing news story involves a clinic regulated by a Caribbean member-state, the Dominican Republic. The Go Lean roadmap institutes an arrangement for medical/research campuses as SGE’s (Self-Governing Entities) that are only regulated by the CU federal authorities. Had this tragedy occurred on such a facility, the response would have been immediate and comprehensive, employing best-practices of trauma medicine arts and sciences, thusly requiring a post-mortem lessons-learned process that would be fully transparent and accountable.
Lean Government: The Go Lean roadmap also extends optimizations to the member-states governments, requiring a separation-of-powers dictum to transfer oversight and administration of certain state functions to federal authorities. This includes standards, licensing and administration of healthcare facilities. The application of best-practices would most assuredly minimize the risk of medical negligence.
US Exceptionalism: The Go Lean roadmap maintains that other countries have their own version of the American Dream. The quest for life, liberty and the pursuit of happiness is not exclusively American. Whereas there are millions of negligent deaths in the US hospitals/clinics every year, one American dying in a Caribbean facility does not constitute an exceptional event; bad things do happen to good people … everywhere, in the US, in the Caribbean and in the Dominican Republic. Having a tourism-based regional economy means we always want to extend hospitality to our American guests, but embarking on medical tourism, also means assuming some degree of risks, for the facilities, the doctors and most importantly the patients.

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