Float Down To Peru


Start at bottom (DAY ONE) and scroll up for
a proper chronologically correct day-by-day

Wednesday, June 16, 2010

Day Seven, 31 May, Tuesday


PRIMER IMPACTO

Wake up -- don't read my watch correctly without my glasses on and think I have ten minutes to dress, collect all my supplies, and get on bus (to say nothing of a possible shower or
breakfast) ... I panic --know I need to bring everything for the entire day (small wad of toilet paper -- very small supply in my hotel room, water, my own meds ... sunblock and hat for walks into and from town (from bus), "soles," glasses and Quechua dictionary, Spanish/English dictionary, various Applied Medical Spanish Books, note pad, pens, etc.
Bus is slow in coming, and I actually have 40 mins ... we take off and then have to
stop along the way for people from town who are partnering with us ... we arrive and are walking to Clinic -- word is out that we are here -- a few people see us dressed in scrubs and come up asking if we can help them.
Everybody from town is dressed the same -- everybody being women (few men come to the Clinic -- and then it's usually for our free prescription glasses).
Dress: even though it's 65-70 degrees F., knit leggings ( Alpaca or wool), several layers of wide skirts, layers of shirts and wool sweater and the famous bombín (Bowler hats).
Babies are carried in "manteles" slung over the mothers' backs and shoulders papoose-style.
We see lots of patients with worms -- one very old woman (who was actually 63 yrs.
old-- chronologically they all look older) says she hears worms "scream at night" in her stomach.
We see a lot who have bad vision (the climate is very dry and severe, so no small wonder)... we dispense eyedrops and give eye exams and give donated prescription glasses.
My first in-take patient is a small baby boy, nearly delirious in his mother's arms. We get him to our (really sharp-- amazing) Chilean-born pediatrician who sends him immediately to a hospital in the 'nearby' town of Cusco.
There are complaints of ringing in the ears and dizziness -- irrigations of ears reveal incredible, impacted wax and dusty debris ..
Some come with back pain from the heavy lifting and weight they carry in their manteles. They say they have pain in their "riñones" (kidneys), but I think it's the location of
the pain in their back they are describing ... they speak in terms of organs because they
butcher their own dinners ...so they know the body "parts" ...
There are several women who won't reveal to our male doctors that they are victims of
domestic violence but it's obvious ... I talk to a few privately and then to a female doctor at the Clinic who will follow up with them (there is a social agency in Cusco). The cycle is: they come with complaints of vaginal pain, STDs and UTIs caused by their husbands' wanderings --so they come,
are treated today, and then will come back with the same symptoms -- with no end in sight (the men refuse to use condoms, I'm told by the women). The women cry ...
One woman is 76 years old and has walked alone well over an hour on bumpy, dusty
roads to the Clinic -- she has to take the same route back over streets covered with stones, potholes, and the strong smell of urine. She waits for hours; I bring her water.
As a contrast, our hotel manager/owner brings us a hot lunch (little veggie "frittatas," rice, fried
yucca -- complete with real plates, water !!!, bread, and he ceremoniously serves us donning a
white toque. He's incredibly supportive of us as we are helping his people. He attends to us
as if we were family members.
Scenario for rest of afternoon: same routine -- we see patients, translate like crazy, and give out
prescriptions filled at the pharmacy we set up by our own pharmacist.
All the students get incredible hands-on practice and training. They also connect to the natives using
their Spanish skills.
One young man is seen for eye strain he says is caused by the glare of his computer (!)
screen and receives his eye drops and sees we are having enormous trouble understanding an
Andean woman speaking Quechua. He patiently stays and offers to translate as he is bilingual
(Castellano (which is Spanish)/Quechua). Turns out he works as an intern at times in this Clinic, and
is studying IT which explains the computer comment.
So, the translating goes like this: the old woman who has chest pain and eye problems speaks to him (in
Quechua). He then speaks to me and one of our students in Spanish. We then speak Spanish
back to him and he to her in Quechua. Ultimately, I speak English to the doc who tells me what
to say. I speak Spanish, explaining the doc's recommendations, to the Quechua/Castellano
translator who tells the patient in Quechua what the doc has determined. However, it bounces
around sometimes back and forth and not always in one direction of the "circle" we create.

We come back to our EcoHotel, have a meeting and dinner and I dance with Jorge (the owner)
at our dinner to the great surprise ands amusement of our team. If I hear music, I gotta dance.
As I do each night, I brush my teeth with bottled water, get into heavy sweatpants and a fleece
jacket (it's really cold) and get into bed with all these layers on. Can't take a shower ... too tired.
I pray for Marisa .. one of our patients I made a promise to ... she's separated from
her husband, came in for gyne problem and I attended her pelvic exam and she cried when we were
in private as she told me her story of her husband's abandonment of herself and her two children.
She told me of his new "woman" and child. I pray.

Day Six, Monday, 30 May



Go to Clinic -- unpack and organize our supplies from the U.S. and set up "Consultorios"
(Dr.'s Offices) for tomorrow. Discover there's no toilet paper (anywhere) in the Clinic. We
pee in a toilet and share small pieces of paper from one another.
We spend all day setting up, head home to Urubamba Eco Hotel and have dinner, then another group meeting -- suggestions from all and "assignments" -- who will work with which
doctor and we also discuss the meds we brought.
I'm to do in-take and be on tap to be pulled wherever necessary. Since I'm not an MD but rather a translator, I'll do, of course, whatever is useful. I'm nervous -- will I be of help? Will what I see move me too deeply? ... after all, they are all trained as doctors and accustomed to seeing this type of hardship ...
Tonight, I have one of my academic anxiety dreams -- you know, I'm at the front of the class and supposed to be teaching Physics, only I haven't ever studied Physics.
With the meds for nasal and eye dryness which our pharmacist gives me, I at least
can sleep through the night ... first time in days!

Tuesday, June 15, 2010

Day Five, Sunday, 29 May (Day Four is Actually Included in Day Three)



Leave Puno and drive -- Latino music -- Spanish chatter--majestic Andes-- snow-capped/glacier peaks ...
Stop to see condors (Pepe has promised me --didn't mention they were part of a very, very humble animal hospice and so they are within a reserve. But, still, they are impressive as they
swoop down for the carrion provided by their caretaker). We give small donations as we leave.

Everything, mind you, is always dry and dusty and the dry dust/dirt kicks up into the air
as you walk (I think I'm sucking up the DNA of pre-Incan bones...). It's getting increasingly hard to breathe through my nose and my throat feels dry as the desert (weird to think it's a desert climate, since it's not hot and there's no sand -- I keep reminding myself to stay hydrated).
Drive several hours more and arrive Pisac market -- incredible open-air/partially covered
market of artisan wares. It's just closing due to the time and the downpour--frankly, not to my dismay, don't feel like "shopping"-- I manage, however, to buy a cool, gorgeous high quality sterling silver pillbox with designs of the Nazca Lines on it (Kathy buys a gorgeous bracelet with insets of Lapiz). These are both from an enterprise that (of course) Pepe has connections with ...

We wander deeper still within the market and find several textile stalls still open but the
vendors are disheartened by the rain and lack of business ... I also buy a long hand-woven
runner for my dining room table -- and another "tapete" (cloth)/runner for the top of my kitchen table at home .... (I cook for friends "en casa)"

Onward finally to our destination -- the next EcoHotel which will be our home base for
the Medical Mission. The entire group who had come from Cleveland Clinic and Case Western
Reserve Schools of Medicine are out on the street in the dark cheering and greeting us.
Pepe sounds his loud, long siren horn of the minivan and you would think we were celebrities.

Enormous welling up of love and strong embraces. I had actually been counting minutes
to seeing them all, but especially my two students, Pedro (class name) and Bill. I hug and kiss
them and go into the EcoHotel while they go out to dinner (they've been up since yesterday morning).
They return and we all discuss details -- our student leader (this is a student initiative and the students are given the reins) has a well-organized agenda. We discuss and set up a system of triage (in-take interviews, coding system for rooms and patients, etc.).

Tomorrow we'll go to the clinic to set up meds (we brought a dozens of suitcases filled with supplies, and a Pharmacist) and "stations" or consulting rooms. The clinic is in Lamay (small village in Urubamba about an hour from our EcoHotel).

Day Three, 28 May

Awake and leave 8 am to see Lake (Titicaca) and visit the reed people -- "los Huros" are sweet and seem to love us.
We dress up and dance while they sing their Quechuan songs. What a riot.
Back to hotel to rest (I'm hitting the wall with fatigue, and the altitude sickness has me taking Diomox 2x/day ) and then back in car again to view perimeter of lake at night --
view is gorgeous with lights dotting the Andes ...
Return to hotel for the night -- we finagle our hotel charges and very complicated personal debts with one another and what we'll owe our driver in the morning so that tomorrow might be less complicated.
We also have to take into account dollars vs. "soles." (three soles/American dollar). Nerves
are short from trips down and tourista stops ... we settle finances. We crash.

Sunday, June 13, 2010

The Reed People

So, these are the Huros (Indians) who live
on the highest navegable lake in the Western
Hemisphere (Lake Titicaca). Yes, the people
actually live ON these floating reed platforms
and live in theses huts made out of reeds; and,
as you can see by the little girl, peel back the
outer part and chew on the white fiber and eat it
(kind of like what you would do with sugar cane...).
They speak their own Indian language, Aymará.

Day Two, Thursday, 27 May

Arrive Cusco -- our pick-up, Pepe (little Joe), arranged by me through Jorge (hotel owner of three Eco(logical) hotels we end up staying in/ social activist/helper) is not here.
Oh, no. Lucky for the rental phone the young woman pushed on me at the Lima airport
last night -- could have sold me anything at that point, of course ... our resistance was way down as fatigue set in ...
We call the driver -- no luck. try. try. try. nada ...
Then we think to call Jorge himself -- yes! the protector of our endeavor scold/calls one of his guys -- within minutes we're greeted by not only his guy but Jorge himself who wants to see with his own eyes that we have transportation and are secure.
Cusco Hotel -- upscale digs, ( we've just come from our Lima stay). Seems weird, in a way, lots of hot coca tea, (yes it's legal and which we need for the altitude sickness we now know we are fighting --shortness of breath, hard to breathe, kind of dizzy, really, really tired). We take a walk to the Plaza -- it's dark -- we end up buying Alpacan Indian hats and gloves and scarves from some street market stalls . My bartering skills, not practiced in the Latin style
for a while, aren't at all bad ...
Back to the hotel -- dinner, laughs, and we decide "What happens in Peru stays in Peru" ...
for some reason we really laugh, it's not that funny, but we are in hysterics.
Then, at 9:30 pm we decide to take them up on 1/2 hour massages for $20 American money. I'm in Wonderland, I also tack on a manicure for around $9 American money ...
my hands are a mess -- nails torn and jagged due to the trip prep and travel ..the delay, though
pleasant, has exhausted me. We sleep, arise and leave the hotel at 8 am to go to Puno --port of Lake Titicaca where the reed people live. Arrive in the dark -- stop along the way to
see some small, pretty unexciting 'ruins' -- some shored up by old boards -- but a good place for
drivers to stop with tourists so locals can sell wares --. So, o.k., we do buy. Little tchatkes
like Andean wood flute (quena) for my music-major son. My companions deliberate on
some textiles and ceramics and end up with little ceramic birds that whistle with one tone when you blow into them and then a different tone when filled with water. ¡Preciosos!
Back in the car, the ride with Pepe is a blast -- great conversations in Spanish .. great Incan
music on his CD player and finally Louis Armstrong (he wants to surprise his American friends) with "What a Wonderful World."
Arrive Lake Titicaca (Puno) in the dark ... check into another Eco Hotel. Crash.

Saturday, June 12, 2010

First Day, Wed., 26 May 2010

I'm heading down to Peru to help with a Medical Mission. Not a member of a religious group doing mission work in South America ... I'm a female professor who's going along with docs, a pharmacist and around two dozen medical students from the Cleveland Clinic School of Medicine and Case Western Reserve School of Medicine to a small town situated between Cuzco and Machu Picchu to help out for a few weeks.

I meet my colleagues/friends, Kathy and Federica (both doctors) at Hopkins Airport (Cleveland) and we fly to Newark and board to Lima. Arrive 10 pm and are met by Oscar, a driver known to the family of one of our Peruvian docs whose family lives here.

We have brought extra suitcases (very little personal supplies for ourselves) filled with
donated medical supplies (antibiotics, parasite meds, meds for dry eyes, prescription eyeglasses, pain meds, etc.) and oh, no -- one is missing. The authorities at the airport want
more and more info and documentation (we have documents in each suitcase, copies back in the States, medical licenses, are registered with the State Department and the Peruvian Embassy, and yet we're held up for an hour explaining ...) Our driver, as we come to see with
most Peruvians, is abundantly patient. Big delay. Photocopying of passports, much papelejo ...
Prep for trip had been a sin fin flow of photocopies of passports and credit cards, even just
to make train reservations ... yet we're still held up ....

We are allowed to leave and feel we might actually see the suitcase tomorrow and are told
to return to the special office again in the morning. We are led to the Cuban-style 40 year old
clunker. Oscar is humble and solicitous, but once installed in the car and our suitcases loaded,
the car sputters and stalls out -- won't start -- "no arranca" -- he says -- "arranca, coche, buen
coche, buen coche" he cajoles the car he wants to curse. The problem, he explains to me, is
the ratio of the mixture of gas and alcohol in the lines and we sit for an hour while we hear the engine make its pathetic and recalcitrant attempts -- choke, sputter -- "¡qué bestia!" .. he finally admits.
Why, in God's name, are we not taking other transportation, but "qué insulto sería..."
so, we wait ... incredibly "he" (el coche/bestia) starts and we go into Lima itself at 11 pm --and as we round the corners my eyes become round -- there are metal grates from street level to roof of every single side -by- side house and building. The car stops in front of one and we are greeted by a lovely man with a huge smile and he treats us like family (I had never met him before -- his brother-in-law is the evaluator of my course at the university. His wife approaches, pretty and sweet, in a wheelchair. They offer us anything we want -- food, water... we can't accept, we're zombies.

Actually, I do want water, but can't ask for it since we had a family two year episode with Giardia and I'm skittish (I opt for hot water that had been prepared for tea) . We ascend to two rooms and a bathroom that is quite different from US standards. I unthinkingly brush my teeth with the water coming out of the old spicket. oh, no ... pero, ¿qué hacer?

Across the hall is an old woman (96 yrs old) asleep and breathing heavily. After seeing
the body under the covers, I was actually glad for the loud sounds ...
Next morning, we rise, I brush my teeth with water from the airplane bottle, and use the tiolet, we can't put the paper into it, though. We have to use a waste can to the side ...

Funny feeling, abuelita is the same configuration of bumps I had seen the night before -- oh, no, no sounds.

Suddenly on the scene: two lovely senoritas who are her caretakers -- gracias a Dios, she's
rising for the day ...

We have a super -pleasant breakfast -- these people are simply good, generous, and warm ...
we are embraced by their kindness. Oscar has come back for us and we return to Lima airport to take the flight to Cusco.