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.