Friday, May 16, 2008

Peru Part Four: In which we rough it on a beautiful island and I get ready to return home

At times during the past couple of weeks, I´ve thought wistfully of what must be the pleasant early-May weather back home. But I have never yearned for May flowers quite as much as in the past few evenings spent on the coast of Lake Titicaca. It´s bone-chillingly cold up there, and alpaca mittens and leg warmers can only go so far to warm one up. Despite this, we had a great trip out to visit three islands in the lake. The first was actually a group of man-made islands formed from reeds. The islands are soft and squishy and the inhabitants (when not selling trinkets to boatloads of tourists) live a very traditional life.

From there we moved on to Isla Amantaní, where we spent the night at the home of a local family. Theirs is a very rustic home: although we did have actual beds to sleep on, there was only an outhouse, no running water that we could detect, and no electricity. No electricity means no heat and no heat means sleeping all bundled up in full winter regalia including aforementioned alpaca goods, plus winter hat and ski coat, covered with two alpaca wool blankets. But add to that the stillness of a vehicle-free and tranquil island, the contented exhaustion at the end of a day of hiking to explore its scenic hilltop temples, the sound of gentle waves lapping at the shore, and overall it was a beautiful place to spend the night. The next day we visited Isla Taquile, another beautiful spot, but one whose lasting impression will always be the 500 steps leading up from the port to the town. The other night, we went to a bar and Marco and I wanted to dance, but felt winded after just one song. These are the effects at 12,000 feet of altitude, so imagine what 500 steps can do!

Now I´m back in Cusco, wandering its pretty streets and killing time until my flight tomorrow. Marco and Edward are in Arequipa, but they arrive in Lima tomorrow, at the same time as I arrive for my seven-hour layover, so we plan to meet up and explore the city together, at least for a little while.

It´s been a great trip, full of challenges and lots of fun, but I´m definitely ready to go home again.

Here are some photo highlights of the last few days:

Playing house with a couple of local girls on the floating islands, and (as usual) having some fun with my flip-screen camera:

Our house and outhouses on Amantaní (the green one is a squatter toilet--just a hole in the ground with two places to put your feet--and given the state of the actual toilet, I´ve never been so happy to see one of those.)

Group picture at the top of Isla Taquile´s 500 killer steps:

Oh, and did I mention I ate guinea pig?

Tuesday, May 13, 2008

Peru Part Three: In which an adventure begins and the three travelers experience some of the local culture

I´m happy to report that I´m feeling much less stressed now, having had my last meeting with the hospital staff yesterday morning. Sunday was also a great day--Marco and Edward and I went to the market at Pisac, a town about 45 minutes from Cusco. The town is surrounded by hills lined with Inca terraces, and although the market happens every day, Sunday is the biggest. There´s an artisans market, where you can buy all the textiles (Marco), jewelery (me) and bells to hang around llamas´necks (Edward--really!) that your heart desires. But the best part was the food market, where I could spend all day just watching the people. In this area, many people, especially the women, still wear traditional dress, which includes multilayered skirts, embroidered shirts, a great variety of styles of hats, and colorful cloths slung across their backs, containing merchandise, food, or children. Fruits and vegetables are stacked in neat piles, chunks of meat or piles of fish or sometimes entire animal carcasses are on tables ready to be sold, bags of spices and grains and other staple foods are available for purchase.

Yesterday we took a bus from Cusco to Puno, opting for the cheapest ticket we could find, about $5 each for what turned out to be an 8-hour ride. During the trip, passengers loaded and unloaded, carrying boxes and bags of food, blankets and all kinds of things, sometimes sitting in the aisles when all the seats were taken. Occasionally, we would pick up a woman or two selling food--fruit drinks in plastic bags, ears of corn with slices of cheese, loaves of bread, jello cups, and once even a fully cooked meat and potatoes meal. We´d drive along with them while they made their way through the bus, stopping off to let them off when they were done. Presumably they picked up another bus later to sell more of their wares and find their way back home. About 6 hours in, an earnest young man addressed the passengers with a sales pitch for herbal supplements guaranteed to improve your mental, respiratory, cardiac, sexual, and general health. We watched three DVDs: The Green Berets starring John Wayne, dubbed in Spanish, and two compilations of music videos from Peruvian artists. These last two were simultaneously annoying, fascinating, interesting, and ridiculously irritating. Take a look at Katty Portella singing of her love for gringo tourists, and you may understand why we decided to take a break today, hanging around Puno before our trip out to several of Lake Titicaca´s islands tomorrow:

Friday, May 09, 2008

Peru Part Two: in which things get better, then worse, then better, then just plain frustrating, and Jess becomes a godmother

After Monday´s success, we were pretty excited to get to the hospital on Tuesday to start our work. That excitement was soon deflated when the first two patients (out of four) didn´t show up. Add to that continued confusion with the Ministry of Health and, aggravatingly, Peruvian customs agents, and I was ready to throw in the towel by lunchtime. In the early afternoon, things reached crisis phase when our third patient didn´t arrive, and we began doubting that we should even continue the mission. Thinking back, it´s pretty unbelievable that I didn´t break down in tears at any point during the day. However, the hospital administration assured us that the paperwork was just a formality, and the third patient appeared a bit late with his family, and we got to work. Never mind that during the last operation of the day, someone plugged in a machine without using a voltage converter and blew a fuse and fried the machine, rendering it unusable and canceling two procedures for the following day. We were badly beaten but not KO´d.

On Tuesday afternoon we saw more potential patients. One girl´s parents came in with her one-year-old brother in tow, a boy we all thought was a girl because of his very long hair. The parents explained that normally, a child´s godfather is the first person to cut his hair, but they didn´t have a godfather for their child. So, they proposed that we all cut his hair, thereby becoming his godparents! (Attention party poopers: please do not point out to me that there are errors in this logic; I will ignore you. Also, this is obviously a symbolic title, since religiously speaking I am totally unfit to be anybody´s godmother.) So we all took turns cutting off locks of his beautiful hair, chopping away with a pair of extremely dull safety scissors. Tuesday evening, I made my second Peruvian TV appearance on a show called ¨Variedades¨ which is broadcast live. It was a talk-show kind of setting, with couches and very enthusiastic (him) and surgically enhanced (her) hosts.

Wednesday, things began to look up. We put surgical work on hold until we discovered exactly what official paperwork was missing and completed it. All our patients showed up at the appointed time, and we even added a few new ones to our schedule. Many questions remained but for the first time, I could see the light at the end of the tunnel. Thankfully, yesterday, our last day of surgery, was completely successful! Actually, one patient didn´t appear until the end of the day, to apologize for not coming earlier, and explaining that their priest had advised against medical intervention! The surgeons finished up around 5, while I spent several tedious afternoon hours carefully counting all of the leftover medical equipment we would donate to the hospital. We were in a great mood last night, and I was thrilled to meet up with my friends Marco and Edward, who will be my travel companions for the next week. The whole team went out to dinner, and we all drank too much Chilean wine at dinner and made a ruckus in a fancy restaurant, but were so glad that it had all worked out well that we didn´t care.

Today, the rest of the team went to Machu Picchu, and I spent the day at the hospital, meeting with the head administrator. (Frustratingly, the hospital director seems to have disappeared and I haven´t seen her since Wednesday morning.) The purpose of the meeting was to discuss the fees that we owe them for use of their facilities, beds, x-ray machines, lights, electricity, space, air, etc. Amazingly, the huge pile of medicines and equipment doesn´t seem to count for much (¨acetaminophen? that´s no use to us, we use ibuprofen here.¨) I am completely fed up with these hospital people, their long lunches, mysterious disappearances, and most of all with their assumption that we rich Americans owe them thousands of dollars. In the end we are paying for the x-rays, and to ensure that our patients get the attention they need we are paying for all follow-up procedures. When I left them they were still in the process of taking inventory of our materials, separating out what they can use from what they can´t, and being unbelievably irritating. I don´t want to assume that they should just be so grateful to us, because after all, we did take them by surprise, and disrupted their week. But really, they should be a bit grateful, shouldn´t they?

Anyway, apart from what should be a quick visit on Monday morning, and some patient care instructions I have to e-mail to the head osteopod, I am now done with the medical portion of this trip. I´m going to celebrate with a Pisco Sour or three.

Here are some photos to highlight the week. Unfortunately, I don´t seem to have any photos of the haircutting ceremony; I´ll have to get them from somebody else´s camera.

Little Fiorella draws a family portrait while waiting her turn with the doctors:

My second shot at television stardom:

An amazing experience at the end of the day: twins are born by emergency C-section, and who better to hand them off to (just 15 minutes or so old, before meeting their own family, even) than the nearest gringa? The youngest babies I´ve ever held (look closely, I´m holding both of them):

Monday, May 05, 2008

Peru Part One: In which the trip gets off to a rocky start and Jess becomes a TV and radio star.

I am writing from an internet cafe in Cusco, surrounded by backpackers living the life I had three years ago, and feeling a very strange disconnected sensation. I envy their freedom but at the same time I am enjoying some of the benefits of being here for only two weeks. I don´t count all my pennies, for instance, and I can buy souvenirs and gifts without worrying how much weight it will add to my backpack. And in most ways I am looking forward to getting back to my real life. But I can´t seem to fall easily into the role of tourist in this place. Despite this confusion, I am enjoying being back in Cusco. It´s an absolutely gorgeous city with beautiful surprises around every corner. I am also pleased to announce that the altitude (approx 13,000 feet) hasn´t affected me badly and as long as I take it easy on the uphill walks I am not having any trouble at all.

Unfortunately, in these first few days, the same cannot be said for our trip. I found myself feeling ecstatic when we arrived at the Cusco airport, and also somewhat incredulous. After all the trouble we had organizing this trip over the past year, and all the setbacks we encountered, and all of the problems we had en route (my bus to New York was running 4 hours late so at the last minute I drove, we spent hours negotiating with baggage checkers, customs agents and Ministry of Health officials in New York and Lima) we had finally arrived! It seemed that we were on our way to a successful trip. When we arrived at the hospital to drop off the 18 suitcases full of medical equipment we had brought, and no one seemed to know who we were, we attributed it to the fact that it was Saturday and the people in charge were not at work.

Then we showed up yesterday, Sunday, expecting to screen a whole bunch of kids with foot problems, and schedule them for surgery. I was completely dismayed, and words cannot describe my disappointment when upon arrival we found not one single child waiting to be seen. We began asking around and found out that no one working at the hospital had any idea that we were coming, and what´s more, they had no plans or preparations for our visit. I felt sick. As I mentioned, I had communicated with the hospital director who assured me that everything would be fine, and we had made contacts with several local organizations who promised to bring us children to treat. Suddenly, the entire plan for the week was in jeopardy. Although rationally I knew that I had done everything I could do in preparation, I began doubting my efforts and wondering where we had gone wrong.

Luckily, our team, and our local liaison Silvia, sprung into action. I found a sympathetic doctor, who commiserated, saying yes, the hospital director is ¨muy informal¨ and he gave me the names of all the other department heads, encouraging me to meet with them first thing today. Several team members went back to the hotel, printed up flyers about our visit, made a hundred photocopies and spent the afternoon walking around the main squares and markets telling people about the visiting surgical mission team. Silvia, whose brother had just passed away and who had to attend his funeral later in the day, accompanied me and two others around town to two radio stations and two TV stations, asking them to let us make on-air pleas for patients. Can you imagine doing this in your hometown? We walked in off the street to two different radio stations, explained who we were, and minutes later found ourselves behind the microphone for on-air interviews. In the process, we got a glimpse into the very interesting and often hilarious world of Peruvian broadcast journalism. On the second ratio station, the announcer was reading all of the news with a very emphatic and enthusiastic tone, completely unsuited to the words he was saying. Imagine a DJ reading items such as ¨a 52 year old woman in Quillabamba committed suicide after receiving a diagnosis of AIDS!¨and ¨a convenience store in Pisac was robbed last week, and $4,000 was stolen!¨ in the tone of a used-car or discount appliance salesman, and you might begin to get the picture.

At any rate, the point of the story is that yesterday I was interviewed twice on the radio, and this morning I left the hotel with two doctors at 6:30 AM to do a live TV interview on a local news program. It was really fun, and a great test of my Spanish, and at the same time, a completely surreal experience.

We joked about being famous and dodging paparazzi, but to our great pleasure, our efforts paid off. Not even a half an hour after arriving at the hospital this morning we had already met three people who had seen us on TV, one of which was a woman who had left her house immediately to bring her child down to the hospital. The hospital directors came to meet us and agreed to host us, and in total, 87 patients turned up at the hospital for evaluations! This turn of events was all the more exciting because we could see the direct effects of our hard work.

It has been an incredibly long and exhausting day. We still have many challenges to overcome. Much of the hospital staff is still uninformed, and even if informed, sometimes resistant to the idea of a team of gringos coming in to take over their OR. The hospital wants to negotiate with us the fees we will pay them for using their facilities. And of those 87 patients, we only have 12 currently scheduled for surgery (the rest were mild cases where surgery was unnecessary). I swear, we have seen every case of flat feet in Cusco, and if ever I or anyone I know has a child with flat feet or mild hip displacia, I know exactly how to treat them non-surgically. So we still have some obstacles in our path, but after the events in the last two days I feel fairly confident that we are going to make this trip happen, even if we have to ruffle some feathers along the way.

Here´s a photo of me impersonating a doctor, along with two real doctors, being interviewed on Channel 2 News:

Thursday, May 01, 2008

Off to Peru

After nearly a year of planning, it's hard to believe that this trip to Peru is finally happening. We've hit so many snags in the planning for this trip that I have barely let myself get excited about the fact that in a day and a half I'll be in South America again!!

Tomorrow I catch a bus to New York at 1 PM and meet the rest of my group at the airport at 7:30 for an 11:30 flight. Yes, that's four hours early. In those four hours, my job will be to become best friends with the staff of LAN Chile airlines and try to sweet-talk them out of charging us fees for our overweight luggage. We'll be carrying all kinds of medical equipment, machines and supplies, and even with the ample luggage allowance we'll be significantly overweight. I haven't yet finished my own packing, but I'm reaching back into my memory to recreate my backpacker wardrobe of approximately two pairs of pants and three shirts for my two-week trip. Average daytime temperature at this time of year in Cusco is 70 degrees F, but at 12,000 feet, there's potential for some bone-chilling nights, so I'm packing a fleece and my winter jacket, too.

For the first week, though, I'll mainly be wearing scrubs. (Words can barely express how excited I am about that--scrubs are the most comfortable articles of clothing in the world). For the first 6 days of the trip, we'll be working at the Hospital Regional de Cusco, and I'll be doing my best to keep track of the patients and translate medical terms for foot deformities and treatments. Since we're the first surgical team to visit this hospital, we'll be paving new ground, and I am trying to prepare myself for the likelihood that it's going to be a week full of challenges. I have spoken with the hospital director several times by phone, but her constant reassurances of "don't worry, we're ready for you, no problem, everything will be fine" and noticeable lack of concrete details leave me a little bit concerned. There may be some cloudy details at this point, but I am finally convinced that the doors will indeed be open to us when we arrive on Saturday, and there will be children awaiting treatment on Sunday morning.

After the week-long medical trip, I'm staying for another week, and will be joined by my two EF friends Marco and Edward. This will be a totally different travel experience for me. I'll be traveling with two male friends, an Italian and a Frenchman (who will blend in much better in Peru than light-haired little me) and one of them is completely fluent in Spanish. We have absolutely no specific plans yet, and that suits me just fine. I'm a fly-by-the-seat-of-my-pants kind of gal.

I should have frequent internet access in Peru, so hopefully I'll get the chance to post a few times and let you know how the trip is going. At any rate, when I get back I'll have lots of photos and stories to tell.

Thanks to all of you who have sent your good wishes and support for my trip!