Living in the Third World

While living in what is sometimes called a "Third World" country (though that is now becoming a very antiquated term), I have had to readjust to many realities of daily life here. To name a few of the trickier scenarios I have had to get used to, I have learned to: take cold 2-minute showers when the electrically-run hot water gives out; sleep in long underwear, scarves, and wool socks at night to bare the 30 degree weather with the lack of a heating system; watch my step while walking through the streets to avoid running into piles of accumulated trash; wash my laundry by hand and hang-dry it on our roof; stand quietly by as a Peruvian toddler relieves herself in front of my clinic to avoid using the dirty public bathroom provided in the health center itself. And the list goes on.

One day during my rotation in pediatrics, I went with two nurses to an elementary school near the clinic to weigh and measure the students in addition to checking their vision and general hygiene. I was astounded to discover that almost 100% of the children did not have dental care and thus had horribly advanced cavities. Most of the kids did not maintain what a U.S. doctor would consider "adequate hygiene," subjecting themselves to our examinations with unwashed bodies, sunburnt faces, and uncut fingernails.What impacted me most perhaps was the mere fact that the nurses and doctors here have to go to the schools to give these kids regular checkups and integral vaccinations. Although that particular day we were not giving any injections, I have on several occasions traveled with a nurse to vaccinate young children in the communities inhabiting the hills above our clinic. What I soon learned (and what the nurse lamented openly to me as we trekked up the trash-ridden dirt paths) was that many parents wont bring their children to school the day of a vaccination, in order to avoid short-term side effects such as crying, screaming, and temporary fever. Because of these common absences, the nurse has to regularly travel from door to door, practically harrassing the families until they consent to vaccinating their children (which is often done in the middle of the dusty roads with no more than a soapy cotton ball to clean the injection site).I have talked with several nurses and doctors in my clinic, and nearly all agree that the root problem in these communities is a lack of information, education, and consistent communication about the importance of vaccines like those that fight influenza, polio, measles, mumps, and rubeola.

One slow morning in the clinic, as I was waiting in general medicine for patients to arrive, I borrowed one of the nurses medical books and began reading about main health problems in the area. Many prominent health issues in Peru, such as respiratory infections and malnutrition, are systemic, due to lack of education or extreme poverty, etc. In addition to the resistence to vaccinate described above, family planning is a huge issue that is often avoided among the more impoverished communities in the campo. The doctor explained to me that is not because of Catholic doctrine that these families end up having 8 or 9 kids they cant feed, but rather, a lack of resources and a failure to communicate information on methods of family planning. For example, most Peruvian women believe that birth control pills cause cancer. In fact, in my lesson on Family Planning during my 1-on-1 Spanish class last month, nearly all the scenarios presented in sample conversations between patients and doctors involved the patient asking the doctor for other methods of birth control, "since the pill causes cancer"; in none of these scenarios did the doctor ever correct the patient or hint that the pill is a "safe" method of contraception.

As these same systemic issues come up again and again, I got to thinking: what is the best way to communicate with the Peruvian populations? In the US we can send mail, insert informational pamphlets in the newspapers, make announcements on TV or the radio, etc. Here, where a huge percentage of the population does not have running water, electricity, or a mailbox, the most effective way to reach these communities is to go door to door, to hold charlas (or information sessions), and give demonstrations. But even this isnt easy. The doctor at my clinic explained that the only way to incentivize people to show up for the charlas or socio-dramas is to provide some sort of giveaway, which can get expensive for small clinics and health centers. Since coming here, I think I know now that I dont want to be a doctor, but that I am fascinated by the medical industry. Maybe I can pursue a degree in Public Health somewhere down the road, and help discover a better solution to reach the people of Peru.

One last thing I do want to mention is that I have been amazed and perplexed by the perception many Peruvians have of the US. One day I was talking with Jaqueli about "The Pursuit of Happiness," a movie starring Will Smith in which he loses his job and ends up living on the streets while trying to provide for his young son. Jaqueli told me how much she loved the movie and then assured me that she knew it was just made-up, a fantasy. I thought at first I had misunderstood her, so I asked for clarification. But no, my host mother explained that this situation doesnt actually happen in the US. People arent poor, everyone has a home and a job. This movie was purely fiction. Obviously this turned into a much longer conversation, in which I explained to Jaqueli that YES, this was real, that there are many people in my country without jobs or homes or family. However, I was very much taken aback that this was her perception of the US. I have run across several other Peruvian people who have held similar beliefs, some convinced that there is no crime in the US as well. Though I feel somewhat bad being the one to shatter their visions of the American Dream, Ive felt its only right to paint an accurate, unpolished picture of our country. Because being here, I have come to realize that the poverty, illiteracy, and hunger that I see every day here is also very much present in the US, though assuredly on a smaller scale. It has become so important to me to remember the difficulty and suffering that exists within the borders of our own nation, especially while we try to help others overcome similar issues in other corners of the world.

Puno and Lake Titicaca

Much unlike my usual hyper-organized self, I hopped on the bandwagon with 17 other ProWorlders to plan a last-minute trip to Puno (home of Lake Titicaca) over the weekend. Friday day we decided to go, and bought tickets to catch the 11 pm bus out that night, hurrying to our nearest La Canasta supermarkets to pick up snacks for the 7 hour ride. Luckily, I was able to sleep off and on most of the way there, so when we arrived just after 6:30 am I was ready to explore. And good thing I was, too. After dropping our bags off in the hostel and scarfing down a quick breakfast, we were off to start our tour of the Lake just an hour and a half later.

The first stop on our soon-to-be 8 hour boat tour was Los Uros: The Floating Islands. These small islands are made of a reed called totora that grows in the lake, using blocks of the roots as a base flotation for what become little villages in just several weeks of criss-crossing construction. Every week, the villagers put down a layer of totora on top of the last until 2 meters of totora, including the roots, floats on the surface of the water. And ta-dah: thus we create a floating island. While on one of the islands, we learned that the people of Los Uros not only make their homes of totora but also eat it almost constantly. I was not greatly enthusiastic about the watery, semi-sweet taste of the celery-like root, but very much enjoyed watching the islanders peel the roots like bananas every few minutes, munching away as we continued our tour. We split up into smaller groups as the islanders showed us their homes, and as we entered the hut smaller than my kitchen at home I struggled to imagine this family of 5 sleeping together in the single bed by candlelight during the cold Puñenan winters. Alicia, the mother of the house we had entered, told me that her eldest daughter had completed high school in Puno (the kids travel in totora-based boats from island to island for elementary school, but have to venture back to the mainland for further education) but that they did not have enough money to send her to University. After our small heart-to-heart, Alicia took us outside to show us her amazingly intricate weavings, literally begging us to buy something to support their family (basically 100% of these families’ income is based on tourism). I realized that us getting a sneak peak into such a different lifestyle was not possible without great hope and trust from the islanders that the many tourists marching through their homes would reciprocate with the purchase of a wall hanging, or at least a pillowcase.

After visiting a few of the floating islands, our boat made the almost 3-hour trip over to Taquile, a natural (and much bigger) island near the border with Bolivia. As we trekked 40 minutes up the mountainous island to the center plaza, our guide told us that the people of Taquile lived in an independent commune that was governed not by police but by 3 rules: don’t be lazy, don’t lie, and don’t steal. The people of Taquile are almost all trilingual in Quechua, Aymara, and Spanish, and wear traditional dress that is not only beautiful but can signify marital status from a single glance. There are no cars or other motor vehicles, and no dogs (which are regarded in the rest of Cusco as a good security system for the house). The most interesting part of the Taquile lifestyle was that the population continues to live in a highly machista, chauvinistic society. Women, who have their hair covered with long black cloth, must walk at least 3 meters behind their husbands in the streets and are never allowed to touch a man in public. If a husband and wife have a civil dispute they want brought to court, the husband goes to represent both sides of the argument- a woman is under no circumstances allowed to represent herself. Perhaps in the hopes of solving the island’s long history of incest, Peruvian ex-president Fujimori tried to build up travel to the island by establishing a hotel there, but the people rejected the idea and the project failed within less than a year of its commencement. There is, however, a market held in the plaza every few weeks that draws traders from neighboring islands to encourage some sort of local economy and to bring in outsiders to mix with the Taquileñans. We enjoyed a delicious lunch of trout (or omlette), fresh French fries, and rice before descending off the beautiful island into the lake once more as the sun set.

Machu Picchu

Although we missed joining Jim Carrey by just a day, my 5 friends and I who adventured to Machu Picchu this weekend came back feeling we'd had an incredible experience and a lot of good stories to share. On the 3 hour train ride up, 2 friends and I sat next to a middle-aged man who seemed to have traveled to nearly every country in the world. After discussing North Korea and where we would go on a Watson Fellowship (a friend of mine is planning to apply after graduation), we all agreed that this trip would be one we'd never forget. As the train pulled into the station at Aguas Calientes, I knew that our conclusion was true- already we were surrounded by lush Peruvian jungle, the green mountains towering over us majestically among the clouds. My friends and I marveled at the beauty as we made our way to the hostel, consenting that we felt like ants walking through the expansive scenery surrounding us.

After buying our tickets to get into Machu Picchu the following day, we wandered around the tourist town where we found restaurants fighting over us for business. A woman with a menu would offer us 20 soles for a "menú" (a 3-course meal consisting of a soup or salad, an entree, and a dessert) when a woman from the restaurant next-door would return by offering us a 20 soles menú plus a free drink! The restaurants carried on like this until we became too overwhelmed and just chose one (where we enjoyed 20 soles menús with our free Pisco Sours, chips, and guacamole). Throughout the whole trip I couldnt help but feel so independent and, well, old. Here I was in a foreign country with my friends, planning a trip to one of the worlds most famous sites by ourselves; we booked our train tickets, found the hostel, budgeted meals, figured out transportation to and from train stations as well as the ruins themselves...all on our own. It was something I had seen before only in movies, this exploring the world with a handful of other college students. Never before was it something I had actually found myself doing, and being able to travel that way now was both liberating and exciting.

We woke up at 4am to walk up the mountain to Machu Picchu in the hopes that we would beat the first bus up (and save money) and make it early to climb Wayna Picchu, Machus sister peak that allows entry to no more than 400 people per day. However, our plans were doomed from the start. The first set-back was that the restaurant connected the hostel, which had offered to open early for us that morning, was not ready at 4 as we had discussed. After shoveling our Continental and American (Continental plus eggs) breakfasts down our throats, we set off on our journey a good 15 minutes later that we had planned. Walking in total darkness lit only by 2 small flashlights, we began to follow the directions we had received from a guard the day before, following the sound of the river to keep ourselves on the right track. Once we found the trail, however, our travels were not made much easier. We ended up hiking an hour and a half up 2300 feet- and I mean it when I say up. The hike was more or less like doing large lunges up endless flights of stairs that had been cut right into the side of the mountain. And after about a half hour of this, we actually lost the stairs and had to hike for a while following the looping switchbacks, jumping off the road, disheartened, when the first tourist-packed buses passed us.

As we tiredly continued to make our way up the mountain, Lena stopped and realized her backpack was open; to her dismay and ours, her jacket and the second cell phone she had bought since coming to Peru were missing. We spent about 10 minutes waiting as she re-traced our steps in search of her things, but pressed onwards when we realized they had likely fallen out at the beginning of our trek. But the excitement didnt stop there. About halfway up the mountain, my friend Gabrielle had her first real wheezing asthma attack in years. As the rest of us stood watching petrified, Natalie (a basketball player at Vassar and an asthmatic herself) expertly held Gabrielle from behind, pulled her arms back to stand her up straight, and led her through slow, deep breaths in order to calm her screaming lungs. As we forged ahead, panting and sweating in the rain, I found myself struggling to breathe through my congested nose at such high altitude, and had to stop periodically to rest so that I wouldnt faint. But when the sun slowly rose to reveal the gorgeous mountains and clouds all around us, I started to regain a bit of hope that I would make it to the top. As I struggled to carry all the layers I had worn out into the cold that morning, pressing ahead with no end in sight, I found that I had started to play the final music from the Lion King in my head (you know, the sort of rebirth theme after the storm?), motivating me to keep moving onward through the rain.

When we finally arrived at the top around 6:45 am, everyone was exhausted and absolutely delirious. To everyones surprise, Lena (who had been grumbling "I hate Machu Picchu!" the entire way up) cried instantly upon seeing the ruins from above, overcome with emotion at seeing such splendor. My friend Meredith and I were to break into fits of giggles for the next hour, unable to control ourselves and our emotions after such physical exhaustion. The ruins themselves were absolutely amazing, but really un-capturable on camera or with words. I could not believe how expansive the site was, and was astounded that it really had remained untouched by the Spanish. For those of you who dont know, Machu Picchu was undiscovered by the conquistadors, and though its presence was known by the local population, it was kept a secret from the outside world until Yale archaeologist Hiram Bingham discovered it 100 years ago. (Side note: Bingham and the "discovery" of Machu Picchu was supposedly the inspiration for my favorite adventuring anthropologist, Indiana Jones).

The "lost city of the Incas" was picture-perfect among the clouds and towering mountains of Peru, complete with llamas roaming the green terraces below. The architecture was even more impressive than other sites we had visited, as the Incas had literally built the city into the mountain, using the mountain itself as the foundations of buildings or the central altars of the temples. However, I would be lying if I portrayed the experience itself as wholly perfect. We took a 2 hour tour with a woman named Olga who refused to speak to us in Spanish (which would have been much more comprehensible than the English tour she gave) and by the end of the tour we were all wet, freezing and pretty miserable in general from the days excursions.

Under normal circumstances, we would have left the ruins to change our clothes and warm up back in Aguas Calientes before catching the train back to Cusco. But unfortunately, one of the boys in my group had bought his train tickets before coming to Peru and was not coming in until 1pm to see the ruins. Since he had no one else to go with, we had told him weeks ago that we would wait for him, and didnt realize until after finishing our tour that we had several hours to kill before his arrival. We ventured to a small restaurant nearby, recommended by Olga as somewhere the Machu Picchu workers ate (enticingly advertised as having sandwiches cheaper than the ones offered for 20 soles at the site of the ruins), and found to our delight that we were the only tourists who had discovered the damp building that day. We spent over 2 hours at the restaurant trying to warm up and dry off (to no avail), periodically taking turns to order fried egg sandwiches (served with a delicious salsa of onions and hot peppers) and loose leaf coca tea, one at a time. By the time we got back to Aguas Calientes to eat lunch and catch the train, we were all wiped out and looking forward to getting back into bed in Cusco. The weekend had been packed with fun, adventure, wonder, and lots of rain, but by the time it was over we were excited to be heading back to what we have come to know as "home."

Shadowing at the Regional Hospital

On Monday I got to spend a few hours shadowing a relative of Jaquelis who is a gynecologist at the regional hospital in Cusco. Before I left Jaqueli told me that last year, the American staying with them had brought a friend to do the same, and that he had ended up fainting while watching a woman give birth! So, excited as I was to get to follow Jorge around for the afternoon, I was also pretty nervous about how I would react to what I was about to see.

And of course, the first place Jorge took me was the heart- and gut-wrenching scene of a woman having a miscarriage. Her 2-and-a-half-month-old baby had died inside her, and when I arrived on scene the doctor was cleaning her uterus and removing the dead fetus. I had never in my life seen so much blood (besides in my favorite medical shows, of course), nor did I anticipate that the woman would be fully conscious and moaning in the bed above me. Whether it was the rigorous scraping, the amount of blood, or the though of seeing a dead fetus, I felt myself getting dizzy within 5 minutes of entering the room. While I have never fainted in my life, I felt that that day might be my first time, so to avoid creating a scene and an unnecessary distraction for the doctors, I left the room to sit on a bench outside. After a few minutes, one of the nurses came out to bring me a cotton ball soaked in rubbing alcohol to help keep me conscious if I was bordering that line. Jorge came out a bit later, once I was feeling better, and told me we had to go see a patient in an emergency situation. I was a bit embarrassed about my reaction to the miscarriage, so I was eager to follow him to the next adventure waiting. It turned out that the emergency was a pregnant woman needing and appendectomy (as determined by Doctor Jorge), so while it was hard to watch her crying in pain, the lack of blood on the scene of the diagnosis was a million times easier on my nerves.

Before his scheduled Cesarian sections at 4pm, Jorge walked around the hospital with me (and also bought me my favorite candy here, a Sublime, which is basically like a Mr. Goodbar but thicker and ten times more delicious). As we wandered through the hallways (that were much cleaner than those of the little clinic Im working at), Jorge informed me that not only was he a doctor but also an architect and an artist who had studied at the Universidad de Bellas Artes, a very prestigious university in Peru. He proceeded to show me 2 beautiful murals he had painted in the hospital, along with a gorgeous Greek-goddess-esque statue he had made, and then told me that he was currently studying law to get the ball rolling on his 4th career. Needless to say, I was exceptionally impressed and inspired; this man was not only very skilled in each of his professions, but continued to return to school to study and push himself further. I told him this, and like the wise man he is, he returned by saying that the most important vocation, and the hardest, is that of being a parent; no one can teach you how to be one, you must simply learn with practice, instinct, luck, trial, and error.

At 4, Jorge took me to scrub in for the Cesarian and, like in all my fantasies from watching House and Greys Anatomy, I found myself entering an operating room in full green scrubs, with my hair, shoes, and face covered. This time, I was ready for what lay ahead (although the sight of a 15 year old girl giving birth is never something you are really ready for). Standing just a few feet away from the surgery, I was awestruck by what I saw. I was fascinated by how diverse the layers of skin are, and how many were cut through to get to the uterus! Surprisingly, during all the cutting, and didnt actually feel faint at all but was loving every minute of it. I couldnt believe how rough the doctors seemed to be with the human body- they would make a small incision in a layer of skin and then the two of them, one on each side, would pull the skin open to stretch out the opening. When the baby was finally visible, they had to push on the womans upper abdomen while pulling the baby out by its head to get it out. The baby came out with the umbilical cord wrapped around its neck, and once on a separate table, you could see that something was wrong; his skin was bluish-green, he wasnt crying and was clearly having difficulty breathing. However, after several minutes of removing liquid from his throat and presumably his lungs, he began to breathe regularly and cry. Though I believe the mother may have been conscious (I think she only had an epidural for anesthesia), she was not able to hold her baby even after the surgery because he was taken to another room for immediate attention.

Throughout the entire procedure, I found myself fascinated by what I saw. The placenta, for example, is so much bigger than I had ever imagined; it was so big, in fact, that I thought it was the womans liver at first! I was amazed to see how Jorge expertly sewed up the uterus as it sat outside the womans body, and then moments later even more amazing as he smoothly popped it back inside (as if returning a water balloon to a bucket). The experience absolutely exceeded all my expectations, but didnt particularly make me want to be a doctor. I was, however, most definitely blown out of the water by the whole experience.

Desfilando, Corpus Cristi, and Inti Raymi

The past week leading up to the holidays of Corpus Cristi and Inti Raymi had the streets of Cusco packed with people, food, music, vendors, and so many vibrant colors. On Tuesday I participated in a desfile with my clinic; we dressed in red ponchos and sombreros and joined hoards of other organizations and groups from Cusco in marching up the Avenida del Sol through the main Plaza de Armas. The experience was, in a word, unique. I arrived with a nurse to the Avenida del Sol at 8:30 am and, as is pretty typical of Cusqueñan style, we ended up waiting around for hours before being able to march in the parade at 1 pm. While standing around, however, I got to see tons of other groups go by in elaborate traditional dress, dancing and playing live music as they passed us. One of my favorites was the group behind us: though I think the message was somehow promoting regular gynecological exams, the women were dressed as middle-aged pot-bellied men waving beer around in a silly sort of synchronized choreography.

As the groups slowly made their way through the cobblestone streets of Cuscos center, you couldnt help but be hit with Cuzqueñan pride. Vendors everywhere were selling traditional food, dress, and (along with packets of sunscreen) rainbow ribbons, pins, and flags so everyone could show his pride for the city. What inflated my pride even more than these colorful gestures was just getting to be IN the parade itself. Marching through the Plaza while crowds of Cuzqueñans and tourists lined the route made me feel like I was really getting to be a part of a tradition, as opposed to just standing on the sidelines and watching one.

Corpus Cristi, brought to Peru by the Spanish, is likely one of the most important Catholic holidays celebrated in this country.

On Thursday, the holiday began in the Plaza de Armas as huge effigies of 14 saints were carried out through crowds of people. The procession began with some of the most beautiful organ-accompanied choral music Ive ever heard being projected out from the cathedral, in a way so clear that it felt more like a soundtrack to the moment than anything else. Before the saints are carried out into the streets, an elaborately adorned metal altar carrying what is believed to be the blood of Christ, la carroza, is brought out through the crowds as everyone stands and removes their hats in respect.

What was most interesting to me was that, despite this being quite clearly a Catholic holiday, Cuzqueñans only eat Chiriuchu, a traditional Incan meal meaning "cold food," on this day. I went with some friends to the Plaza San Francisco nearby to discover vendor after vendor selling plates of Chiriuchu for 18 soles- a pretty expensive meal by Peruvian standards. Chiriuchu consists of a serving each of cuy (guinea pig), chicken, sausage, corn, seaweed, a native grain similar to quinua, and toreja- a savory sort of corn bread made with onions. The meal is eaten cold, as the Incas used to travel long distances through the Andes with their food. To eat the dish in the traditional way, you take a little of each component and chew them all together, combining the flavors and textures in your mouth. Although I didn't get to try the whole dish (and am still avoiding cuy like the plague) I did get to eat some toreja and dried corn, both of which I found extremely satisfying.

And then Friday was Inti Raymi, the Incan celebration of the Sun and the winter solstice. The celebrations began at Qoricancha, in the center of Cusco, with music, dancing, and the bringing out of the Inca- a man dressed as the king of the Cusqueñans who addressed the crowds in booming Quechua. It was so crowded that it was hard to see the ornate attire and dances of each group in the ceremony, but we pushed over one another in order to see the splendor. What made the moment just that much more Cuzqueñan was the presence of a dog in the middle of the ceremonial lawn; as dogs are allowed outside during the day, you can find them almost everywhere they "shouldn't be," from inside the medical clinics to, apparently, the center of a sacred Incan ritual. After starting in Qoricancha, the procession made its way to the Plaza de Armas, but 9 friends and I bypassed this step in order to beat the crowds to the final and most important location for Inti Raymi- the ruins of Sacsayhuamán. My friends and I tiredly weaved our way up steep streets and stairs, finally joining the massive pilgrimage up to Sacsayhuamán, which overlooks the city of Cusco (see my last entry). Once at the ruins, we hurriedly found a spot to sit among the high boulders overlooking the amphitheater below. You see, what most tourists do is just pay $80 for seats in the amphitheater to watch what has now become more show than ritual. My group decided to opt for the local-preferred, free option of staking out a spot above the site to watch from above. We arrived at around 10:30 in the morning, and, to our dismay, discovered that the ceremony itself didnt begin until 1:30. While we were glad that we got there early enough to get decent seats among the hoards of people, being under the strong Cuzqueñan sun (even at the day it was furthest from the earth) was not exactly a pleasant or comfortable experience.

Luckily, vendors were EVERYWHERE selling everything from ice cream to popcorn to chicha morada (a drink made of purple corn), keeping us cool, full, and busy. When the ceremony finally began, not only was it nearly impossible to see (due to the vast amount of people sitting on the angled ground in front of us) but the people around us drew more of our attention than the activities below. People were throwing rocks and bottles at each other for blocking the view or for standing up in the front, all while people behind us chanted "sientense! sientense!"- "sit down!" The most anticipated moment of the ceremony was the llama sacrifice, and while we still don't know if the beautifully dressed black llama was actually killed or not, the heart and lungs that the Inca held up were most definitely real (so cool).

In case anyone is interested, below is a link to The Lonely Planet's suggestions on planning your Inti Raymi experience. It might give you an even better idea of what this day was like!

http://www.lonelyplanet.com/travelblogs/1113/64522/Surviving+Inti+Raymi%3A+What+Not+to+Do?destId=363401

Sacsayhuamán

This weekend my group went to Sacsayhuamán (pronounced like "sexy woman" with a strange accent), a site of Inca ruins just outside of Cusco (actually, "just above" would be more accurate- we had the best view down to the city). Luckily, we were placed with a FANTASTIC guide who showed us around the site and gave us what might possibly have been the most exciting and interactive tour Ive ever taken. Before embarking on our journey, our guide discussed the meaning of the Incan cross, shaped like a cross with several steps in it (google chakana for pictures). He explained that the Incan cross represented the 3 worlds (the upper world of the gods, the world of human existence, and the underworld of the ancestors) and was also used as a calendar, with each corner representing one of the 12 months. As we walked up the hillside, he then began to point out several native plants (in Spanish and in Quechua) and their uses; the Incans had plants to combat soroche, altitude sickness, as well as flowers to rival our modern Viagra! He then proceeded to amaze us by bringing us into what used to be an old aqueduct but what was now an extremely dark and compact tunnel- through which we blindly snaked our way (holding the shoulders of the person in front of us for guidance) to the site of a manmade lagoon. By the now empty lagoon was an area for Inca mummification and a tall chair that was used as an area to communicate with nature. Our guide explained that the high level of magnetism located within the rocks is relaxing to whoever sits there- so of course we all did.

After showing us several other amazing sites (an Incan cemetery, a staircase that had been overturned by the Spanish, a huge boulder shaped like an Inca, a sacrificial table!!), our guide took us to my favorite part of the tour- the glacial ruins. We, as likely did Inca children, got to slide down these beautifully shaped, colorful rocks! No description could do the experience justice- Ill let the pictures do the talking here.

Sacsayhuaman, which houses Cuscos celebration of Inti Raymi- the celebration of the sun (this Friday!)- was yet again a place that did not fail to take my breath away. The history of the land itself, and of the stones, was so old that it was just magical to be there. We got to see the masterful way in which the Incans cut boulders to fit together perfectly without cement, and the areas where the Spanish opened up the cracks between them in search of silver and gold. We saw where Incan children played and where nobles were buried. Being there was like being in the presence of this grand civilization, by going through the motions of what life would have been like almost 9 centuries ago.

Cuzqueña Cuisine

Now that I'm settled into my routine here I can give you a little peek into some of the finer details of daily life here, starting with one of my favorite topics- food! Cusco boasts some of the freshest and healthiest cuisine in the world and, in addition to housing my new favorite grain- quinua, Peru is home to over 2000 species of potato. Needless to say, potatoes are of huge importance to the Peruvian diet. I personally think that Jaqueli's breaded and fried yucca are the best thing I've had since landing in Perú, but I have probably tried only 4 species of potato since arriving, so I guess I've got a long way to go before I can make such a claim.

A typical almuerzo (lunch- the largest meal of the day) includes some sort of meat, usually chicken or beef, a serving of rice, and a side of potatoes (so far I've had everything from fresh french fries to fried and breaded yucca). Jaqueli, being the loving and caring mother that she is, always serves huge portions of her delicious cooking and makes extra dishes, like a salad of salted avocados, tomatoes, and onions, to ensure that everyone leaves the table full and happy. As it is the largest meal of the day, everyone comes home from work or school around 1 to eat and rest before returning to the day's duties for a second shift that starts around 3.

Breakfast, el desayuno, and dinner, la cena, are typically much smaller meals and often consist of a simple serving of tea or mate and bread with butter, jam, or dulce de leche. However, due to Jaqueli's endless generosity (and my botomless stomach), I have gotten to explore several other versions of my first and last meals of the day. She has made me jam- or dulce de leche-filled crepes, yogurt and granola, toasted bread with cheese, omlettes, scrambles, and fried eggs in the mornings, cooking up hamburgers, meat sandwiches, soups, and endless french fries for me to eat at night.

As I mentioned above, mate is a central part of Cuzqueñan meals; I've been drinking at least 5 cups a day, especially at night to stay warm in the cold cement buildings. Cuzqueñans differentiate mate from normal tea in that it contains no caffeine or added sugars and is a 100% natural herbal tea. Some of my favorite mates have been coca (yes- from the plant that makes cocaine, but here the leaves are used not as a drug but as an herbal aid for the altitude adjustment), hierba luisa, and manzanilla (for the stomach).

Mate, as is the case with every drink here, is taken with sugar- and LOTS of it. In fact, sugar is such an integral part of Peruvian food that it has replaced artificial sweeteners like corn syrup in almost all processed food (making the Coca Cola and ketchup here SO much more delicious, and naturally sweet!).

I'm including a few pictures so you can get a better idea of the delicious food I have been eating here. Though adjusting to the large amount of meat Cuzqueñans eat has been tricky, I have had no problem at all getting used to the fulfilling starches and delicious sweets that I have been able to enjoy during my time here.

La Clinica

This week I began my work at the health clinic in Santa Rosa, about a 20 minute combi ride from my house in Cusco. I cant begin to talk about my work at the clinic without first explaining the combi system. The combis are small- to medium-sized vans that run on bus routes around Cusco and the surrounding neighborhoods, and cost only 60 cents (in soles, mind you) per ride. The tricky part about the combis is getting on and off; they stop only briefly at a bus stop to open the door while someone manning the door yells out upcoming stops auctioneer-style, while telling you hurriedly to "Sube! Sube!"-get on! Often the combi will start to drive off before the door closes behind you, and you have to wrentch yourself up into another passenger's lap to stay on board. Getting off is just as tricky: you yell "Baja!" when you want to stop and pay the person manning the door as you are hurried off the combi, making sure to get your change before the rickety vehicle starts to move again.

The clinic I am working at is very small, containing one room each for an obstetrics unit, a pediatrics area, a dentist, a psychologist, a general doctor, and a laboratory (some of which are located in an outdoor area behind the building itself). After lining up in front of the clinic before the doors open in the morning, patients wait in the crowded hallway for what can sometimes be hours until they are seen. My first day I was placed in the obstetricia to work with the obstetrician and a nurse for my first rotation. While I spent a lot of my time sitting quietly and observing the doctor-patient interactions, I actually got to examine a patient and extract secretion samples on my first day! So far I have also helped to examine many pregnant women, locating their babies heads and listening to their hearts, and have helped update lots of hand-written medical histories. Today I got to spend some time working by myself with the general doctor in the clinic as well, which was great because he let me examine all the patients with him as he explained not only what he was doing but why. I got to observe several ultrasounds and learned the formula they use to ascertain whether a woman's belly is the size it should be for her weeks of pregnancy.

Throughout the course of a morning we see around 20 patients, so I've already been exposed to a variety of medical issues and patient scenarios. What first impacted me the most was noting that the average age of the pregnant women coming in (many already with toddlers) was 23. I saw a 16 year old and two 20 year old girls my first day working, all of whom were due to give birth before the end of the year. After talking with the médico today I learned that many women coming into the clinic, which draws mostly quechua-speaking patients from rural areas, actually started having children around the age of 15! What was further hard-hitting was the fact that many of the women coming in for prenatal checkups were malnourished, anemic, and underweight. While the obstetrician (whose demeanor is much like that of Christina from "Grey's Anatomy") scolded them and told them what they needed to be eating, I couldn't help b

ut wonder if some of these women had control over their dietary intake. Many came in without any sort of seguro, or insurance, and confessed that they ate mostly soup, potatoes, and bread- common sources of sustenance in poor, rural areas of Cusco. It was sad to watch these women get reprimanded; you could tell from their eyes that they worried just as much for the health of their babies as did the obstetrician.

Andahuaylíllas and Tipón

Today my group got to travel to some areas outside of Cusco, beginning with a bumpy van ride to Andahuaylíllas, the site of a church built in the 1500s. Although we werent allowed to take pictures inside, trust me when I say that this church deserves its nickname as the Sistine of the Andes. Despite its humble, colonial-looking outside, the inside was filled with hand-painted frescos, elaborate murals, and 6 huge oil paintings artfully done in a very museum-worthy European style. However, what was most interesting about the church was that it was built and decorated entirely by indigenous Peruvians. So what stuck out the most during our private tour were the hidden remnants of Inca religion that the artists had snuck into the creation of this masterpiece: the giant gold sun placed at the top of the altar, to help the indigenous Peruvians feel comfortable when praying towards the large statue of Jesus right below, and the countless mirrors lining the curves of the metalwork, reminding the Peruvians of the reflective glory of the sun, even while standing inside the dark church. What our tour guide neglected to tell us, but of which I was reminded by Jaquelis brother during dinner, was that the church itself was actually built on top of the ruins of an Inca temple- an explicit message from the Spanish that they were here to dominate everything about Inca civilization.

After stopping in a town filled with only families who owned bakeries (and getting our 5 soles worth of delicious freshly made bread), we headed up a treacherously thin and windy road to Tipón, the site of an Inca agricultural center. The site was full of open grassy terraces, and there were canals of water flowing down the mountainside that have been running from a natural spring since the height of the Inca empire. Several members of my group and I split off during our lunch break to hike high above the terraces to see more ruins and get an even better look at the already gorgeous view from 11,200 feet. Though hiking was extremely difficult, and we were all winded by the time we reached the top, the trek was worth it. And realizing that we were standing in what was once a bustling, integral part of Inca civilization made the moment just that much more breathtaking.

Exploring

After seeing what became of that first blog post, I've decided to make future entries much shorter if possible. This one will be a much more brief discussion of my latest adventures, I promise!

Now that I've been here for almost two whole days, I have gotten the chance to start to explore much further beyond the walls of my house. Last night I went with Cydni to a café in the Plaza de Armas, where I ate pizza with cuy (guinea pig!), a delicacy here in Peru. Though the experience was fun and a must-do on my list of adventures this summer, I don't think I'll be eating cuy, prepared somewhat like bacon on the pizza, again any time soon. Today, in fact, I went to a rural village 40 minutes outside of Cusco to build stoves with my ProWorld group and in exchange, the grateful villagers prepared us a feast of cuy, potatoes, and cheese. While I was blown away by the generosity of the villagers and enjoyed my cheese and potatoes, I happily gave my leg of cuy to our cuy-loving bus driver David.

Our work in the village was one of the greatest experiences I've had in my life. Never before have I done any sort of community service involving manual labor, but today, I (with many new friends interning here this summer!) spent 6 hours building adobe stoves in the hot Peruvian sun- and I LOVED it. I think the most enjoyable part was getting to interact with the villagers and knowing that we were helping them create a healthier and much safer set-up for their kitchens. Without the cleaner burning stoves we were constructing, many of the women develop severe respiratory issues due to fume inhalation and also often catch on fire when working over the stoves. After the community president came to our ProWorld representative, Lalo, ProWorld began sending volunteers to build new stoves with long chimneys to direct the smoke out of the houses- a much safer alternative for these women who often spend the majority of their days in the kitchen. Not only was the work rewarding, but the village itself was eye-opening and beautiful. This was likely the greatest level of poverty I have ever witnessed first-hand; the children played in mud filled with animal hair and bugs, trash was everywhere, and livestock (cows, sheep, pigs, guinea pigs, chickens, dogs, cats, donkeys, goats) ran more or less free throughout the village. But despite these conditions that to an outsider might seem unlivable, the villagers seemed happy, the children were adorable and full of joy, and the daily routine seemed as normal to them as to anyone else I've ever met.

CUSCO!

Wow, okay, my first blog post from Peru! So much has already happened in my first 48 hours here that I want to share with everyone! Though I know I cant share everything during the next few weeks, I do hope to give you a good idea of the experiences I have and some of my reflections on what I encounter. Here goes...

First of all, for those of you who are wondering what it is that Im doing here, heres a little introduction to my plans (also, please forgive the fact that I have not yet figured out how to type an apostrophe using a Peruvian keyboard!). Im here in Cusco for the next 6 weeks and living with a host family, thanks to ProWorld, an NGO that organizes study, internship, and volunteer opportunities around the world. Every morning Ill be working at a health clinic outside of the city, and in the afternoons Ill be taking Spanish classes, for at least the first month Im here. I start my internship and Spanish classes Monday, so Ill have much more information on what Im doing then! I do know that Ill be doing some sort of rotation in the clinic- they have an obstetrics unit, a lab, pediatricians, as well as general physicians who I will hopefully get to work with! On Saturdays ProWorld asks us to participate in a variety of service projects they have established in the area, and on Sundays they organize excursions for us, such as to Incan ruins and various communities. Tomorrow Ill be working on a project all day to build cleaner burning stoves out of adobe with other interns and semester students studying in Cusco.

During my longest flight from LA to Lima, I decided to watch The Motorcycle Diaries, which details the journey that Che Guevara took around Latin America with a friend before he became the leader of the Cuban revolution for which we remember him. It was such a perfect choice for a film during my flight, as Guevara had his most life-changing revelations while in Peru, interacting with its indigenous populations. This made me really excited for my adventure this summer, because, even if I dont have any life-changing revelations, I know that I will learn so much from the people I interact with here. Also- just wanted to share a great moment in the movie: Guevara is talking to a young boy in Cusco, who is showing him the walls the Spanish built on top of Incan walls that had existed prior to the conquest. The boy tells Guevara, pointing to the wall of the Incas, "este es el muro de los Inca," and then, pointing to the Spanish bricks says, "y este es el muro de los incapaces." To translate, "this is the wall of the Inca, and this is the wall of the incapable {the Spanish}."

After the very long journey here (involving a 9 hour layover in LA, some turbulent descents, and a missed flight into Cusco), my first impression of the city was the dust. The dry season is well under way in Peru, and it was immediately evident as my taxi from the airport took me along the citys winding roads to the ProWorld office. The sun is hot and strong during the day, and the nights are very, VERY cold (last night I slept in wool socks, long underwear, sweatpants, and 4 layers below my sweatshirt and the 5 blankets on my bed). Cusco is a relatively smaller city, with a population under 400,000, but already seems to have a lot of character. The people seem friendly and laid back, and my host family has been nothing but extremely welcoming from the get-go.

In fact, my first night here really gave me some insight into the welcoming culture that exists in Cusco. Before sitting down to eat la cena, we were joined by 4 boys who are here as Mormon missionaries. The boys had recently befriended my host family after making their calls door-to-door, but what was most surprising to me was that their interactions with my host family were those of close friends or even family. As my host mother, Jaqueli, prepared dinner, the boys, Yackeli (Jaquelis oldest daughter), Cydni (the other ProWorld volunteer staying with me), and myself sat around the living room discussing religion, God, music, and our life goals- as if this was just normal light conversation to be having with near strangers. Not only did I find our discussions fascinating, but I was impressed to have found such a mix of cultures and backgrounds interacting this way so soon into my journey. The boys were all from the United States except one, who was from Guatemala, but all were perfectly fluent in Spanish- something they had picked up just from living here and doing their missionary work. The wide representation of religion in the house was also refreshing, as the Mormon boys were joined by Jaqueli, a Catholic, Cydni, a non-denominational Christian who comes from a long line of priests, and myself, a Jew. The conversation was enthralling and the company was exciting and welcoming. As we all sat and ate I found myself moved by the fact that, despite the vast differences of religion, ideology, cultural background, and language, everyone was laughing and enjoying the same meal together like one family.

This morning, after taking a "placement exam" for my Spanish classes that was more like a 15 minute conversation with the professor, I spent some time sitting in the back patio of the house to journal in the sun. Jaqueli left the house for a bit and I was joined only by Matias, the familys adorable dog, whose gender is somewhat unclear to me as Jaqueli had two big pink bows out in his hair like pigtails. As I sat outside, entirely alone, I realized that I had been talking to Matias in Spanish, despite the fact that I could very well have just spoken English and it wouldnt have made a difference to him. I think that my interaction with Matias is a very good sign that I am in a mindset that bodes well for the experiences that lay ahead.