Wednesday, June 30, 2010

lots of new pics

http://www2.snapfish.com/snapfish/thumbnailshare/AlbumID=2256447021/a=158961882_158961882/
6/23/10
Today we had the day off. We woke up pretty early and read a little before having breakfast. We spent the majority of the day working on our med school apps and some time after lunch we went to the city to look for trips to take this weekend (turns out we have Monday and Tuesday off next week so we were looking to do an over night trip to some where further away.) Our tourist tickets run out in a few days so we decided we would look for a trip to the Sacred Valley to see more of the ruins that were covered by the ticket. Since we have a long weekend we decided we’d look into a over night lake Titicaca trip. After browsing a few agencies we found one that had the cheapest prices for both trips. We set up a Sacred Valley trip for Saturday and a Lake Titcaca trip for Sunday – Tuesday. Later that night we came home and went to bed pretty early because we had to wake up early Friday morning to stake out a place at the Inti Raymi Festival.

6/24/10
Today we woke up, had a quick breakfast, and headed off the Sacsaywaman (spelling?). We arrived around 9:00 and there were already tons of people there. A lot of Peruvians had gotten there early and “reserved” space that they were selling to tourist. We found a small patch of grass that had an open area, sandwiched in between two Peruvians who were selling their space for 20 soles. We ended up meeting up with Sarah and another girl staying at the same homestay (Whittney) after their family decided last minute that they weren’t going to go to the ceremony. Right before the girls arrived, the police came where we were sitting and told all the Peruvians who had “reserved” space that they couldn’t, and that they had to move all their things (they were taking up the majority of the space at the front of the terraces.) Like the rest of the tourists, we quickly spread out into the previously reserved areas. After the girls arrived we had 4 ish hours before the ceremony started (at 1:30). We spent the time talking, reading, playing cards, and buying food from vendors who did laps around the area like they were selling food at a football game. During this time the area really filled up and people started encroaching on our small space, eventually leaving us almost on top of each other, like the other hundreds of people sitting on the terraces.
The ceremony was pretty cool, although we were kind of far and couldn’t see that much. They came in dancing from all different directions. The Inca Queen and King followed on some cool chairs that were being carried by others. The main event of the ceremony was a Llama sacrifice. We had a booklet in English that was explaining everything to us as it happened, so we knew it was coming. They chose a dark brown lama from a fenced-in area and carried it to the stage. The Inca cut into the llama’s middle and cut out its heart and intestines. They then cooked these on a fire as an offering to the sun god. After the festival we headed back to the Plaza de Armas with Whittney and Sara to drink some Cuzqueña and eat some chicken.

6/25/10
On Friday we went back to work at the clinic. Elijah was working in Pediatrics while I was in Topical. After a slow day of a few injections and cleaning a couple of wounds, the topical department was packed. We had a patient come in who had two dog bites (from his dog) on his calves. He didn’t have a clinical history, so the doctor said he couldn’t treat him. There seemed to be a lot of confusion and frustration before Sara directed them to Triaje to open a new chart. She said that it was some sort of cultural issue where the people at the center wouldn’t tell the patient what he needed to do, but also the patient wasn’t asking how to get a chart. After getting all that figured out, the man was given a couple stitches in eat bite; not enough to fully close the wound because they were worried about him getting a serious infection. While all this was happening, the doctor was also putting an IV in a man who had Soriosis of the Liver. Sara said that during his consultation, the patients daughter asked the doctor to tell him to stop drinking or that he would die. The mans body and skin were very yellow, and the doctor had a hard time finding a vein that would accommodate a sugar IV drip. We stayed a bit longer this day to help clean up and finish with the patients. We then got some delicious carrot juice from the woman downstairs before heading home.

6/26/10
Saturday we woke up early to go to the city to get our tour of the Sacred Valley. The travel agency we had bought our tour through passed us off to a bus with a semi-bilingual guide. The people on the tour had gone through various other agencies. We first went to Pisac. We stopped at a little town to look at and buy ‘handicrafts’, although they were far too overpriced so we just looked before getting back on the bus. At Pisac the guide did a lot of explaining before we were allowed to do some climbing and picture taking. It was apparently used as a food storage place because the climate was good for long-term storage. We got back on the bus and drove to Urubamba where we were to have lunch. We had opted for the tour without lunch, so we went with a girl from California and a guy from Thailand (originally, now living in Canada) to find a place with cheaper food. We got some delicious Quinua soup, chicken and rice, and a drink for 10 soles, just more than 3$. The restaurant also had the USA-Ghana game playing, and we were able to see Ghana’s first goal during the 30 minutes that we were there. The next stop on the tour was Ollantaytombo, a temple of sorts for the Inca. There were some cool ruins built into the side of the mountain across from the ones we were able to climb. The guide showed us a picture that showed the ruins we climbed as looking like a llama from the far mountain. These ruins and town were our favorites. The town was built on and around the ruins, using the Inca irrigation and water systems. Some of the homes were even built on top of/ including the ruins in the town. The temple ruins also had terraces running through them. Some of the walls with the terraces had longer rocks sticking out of them that looked like a kind of stair case from one terrace to the other (where the actual stairs were on the other side- see pictures). Climbing around here was a lot of fun, though some of it was closed off. The last stop on our tour was Chinchero. By the time we got there it was pretty dark and we weren’t able to see much that was outdoors. However, the main attraction here was a large church that the Spaniard had built on top of Inca ruins during colonial times. The inside of the church was painted with a lot of biblical depictions as well as some intricate designs and patterns. Even the ceiling and beams were completely painted, although some quite faded from the test of time.

6/27/10
Sunday morning we woke up early to take a bus to Puno, a town on the outside of Lake Titicaca. The bus ride was smooth, though 7 hours long. We drove a,long a river for much of it, so the scenery was really nice. There were numerous herds of Llama/Alpaca grazing along the road, much like we would see cows in the US. Once we got to Puno, we took a mototaxi (motorcycle with a carriage attached) to find our hotel that we had made a reservation at. The driver got lost and took us in the completely wrong direction before we told him to just take us to the town center and we would walk from there. The hotel was really quiet and out of the way, but we found it and the owner let us in and showed us to our room. They provided us with free Wi-fi (yay) so we were able to skype with Elijah’s family, check our emails, and even watch some US TV (streaming online). We then took HOT showers (again yay) before heading towards the center for dinner. We went to a place called Mojsa, which means ‘delicious’ in Aymara (one of the languages of the indigenous around Puno). Elijah ordered Alpaca, while I had a trout and avocado dish. Both lived up to the name and were reasonably priced. Lij says the Alpaca tasted much like beef, but a little bit ‘game-ier’. I also tried the local alcoholic drink called ‘Pisco Sour’. Pisco is an alcohol made from some sort of fruit (I think?) and the drink tasted a little bit like a margarita.

6/28/10
Monday morning we woke up early for a 7:00 breakfast included with our hotel stay. The owner and her daughter made us fried eggs, warmed bread, and fresh orange juice. We sat with a nice German couple at the end of their 5 month trip to India, Malaysia, and various South American countries. A bus came to pick us up about half an hour later to take us to the port to begin our Lake Titicaca tour. After picking us up, we picked up some more people. A younger guy got on the bus saying ‘hola’ and when he got to us he said ‘hey guys, whats up’. Turns out his name is Bobby, and hes from San Diego but is moving to Boston at the end of August for Americorps. When we got to the port, we got on a boat with a guide named Alex who spoke better English than our Sacred Valley tour guide. We left to first go to the floating island of Uros.
When I first heard “floating island” I thought it was just an expression, but turns out that Uros is literally floating. We got off the boat and had a small explanation of the floating islands. To make them the locals go to a shallow spot where tall reeds grow and they cut the reeds, then with a long saw they cut out cubes of dirt + roots. When dried the dirt + roots float. The people tie the dirt + root cubes together, and lay down reeds on top of it. After repeating this hudredes of times, you have an island (the roots grow back together, forming a pretty stable platform). The guide said the islands can be meters thick, and last about 10-15 years before they need to begin the process again. The people living on this islands spoke Aymara. After the explanation of the island we had a chance to walk around. We noticed that the people had ducks tied to ropes (see pictures), probably for eating later. After hanging out on the small demonstration island we took a boat ride over to a larger one. On the way over to the other island we sat with Bobby, another guy from San Diego, Sterling, a British guy Tom, a Scottish guy named Allen, and a few French girls. We hit it off with the Americans, Brit, and Scott and spent the rest of the tour with them. We spent 5 minutes on the bigger floating island then headed off the the island of Amantani, a 3 hour boat ride. We did a lot of talking on the way over. Turns out our new friends have done some serious traveling in the past few years, and know a lot about world and South American politics (they were all political science or history majors). They spent a lot of time talking politics with an older Spanish couple who live in the states. Kenz and I were able to contribute a little when talking about US/Massachusetts politics, and a little more when they moved to health care. Three hours later we arrived and were assigned a host family. We went back to the host family’s house for lunch, which was fried cheese, a few types of potatoes and some cucumbers (see pictures of house and lunch). Eduardo, our host father, went to herd the sheep when Elijah asked him if he owned any of the grazing sheep. We smelled something delicious on the hills and Eduardo pointed out the Muña plant which we picked for some tea later on. The house was nice, and our bedroom at the house was bigger than our bedroom back in Cusco.
After lunch we met back up with the group to do a little island tour. We climbed to the top of the island and took pictures, then headed back down for dinner. For dinner we had more soup and some rice with pasta and vegetables. At dinner we talked to the host family for a little bit and found out that they and many other families on the island are vegetarians. After dinner we had about an hour to hang out before we went to the “discotec.” When it was time to go, we started to head down the stairs when our host sister caught us and told us we had to put on the traditional clothes before leaving. I was lucky and just had to put on a big red poncho over what I was already wearing, Kenz had to wear a few skirts, shirts, and a big belt. After dressing up we headed to the discotec, which was just a big empty room with benches along the wall and two bands at either end. More and more tourists dressed up in the traditional garb filtered in with a member of their host family, until everyone was there. The bands alternated playing songs and the Peruvians made sure that everyone danced. It was fun to watch host families dance, we could tell our host mom was having a great time which made us feel like they enjoyed having visitors and didn’t just do it to make money. After a hilarious and embarrassing night of dancing and mingling we headed back to the homestay and went to bed.

6/29/2010
The next morning we had pancakes with jelly for breakfast before heading back to the boat. After saying our goodbyes to the host families we took an hour-long boat ride to Taquile island. We hiked up the hill to the island’s main square and took pictures along the way. The guide told us some info about lake Titicaca and then we headed toward the other side of the island for lunch. We had lunch at a small restaurant over-looking the lake. Lunch was delicious. We had some bread with Ahi, quinoa soup, and some grilled trout with potatoes and veggies. After lunch we walked down some 520 steps to our boat.
On the way down the British guy we met was telling us about a prison he visited in La Paz Bolivia. The prisoners run the prison, and although it is one of the largest cocaine producers in the country, it is otherwise a pretty sound place. There are 7 sections of the prison, and each democratically elects a representative, and the whole prison votes on a president. The elected officials manage prison business, including bribing guards so they can go about their lives. Life inside the prison is almost like life on the outside; prisoners have to buy their cells, and once owned they can customize it and sell it as they please (flat screen tv’s, fridges, beds…), there is even a prison “realtor” who manages housing for incoming and exiting inmates. Some prisoners own restaurants, and some offer tours of the prison. There are only police OUTSIDE the prison, and they are bribed to allow the import and export of various things into and out of the prison. Our British friend heard about the tours and decided he’d check it out. He went to the police out front, and after asking if he could go in, one officer gave him a quick look and said to come back tomorrow. From the officer he received some information to contact a prisoner inside. He called the prisoner, who very professionally set up a visit. The next day he met a contact outside the prison and then was guided right past the guards into the main courtyard. He “guides” showed up, he paid them, and they gave him a tour of the prison. He said at first it was strange being surrounded by murders and drug lords but that after a short time he became very comfortable. There is a book written about this prison called ¨Marching Powder¨ I think, if anyone is interested in reading it.
After getting back to Puno, we decided to meet up with our friends at 6:00PM for dinner. We went back to the hotel we had stayed in the Sunday night to ask if they minded if we hung out in the lobby for an hour or so while we waited. They had wireless internet and a bathroom there, so it was definitely a good choice. Elijah got a 31 on his MCAT! Exciting news. They were happy to have us stay and were very friendly and welcoming. We met up and chose a restaurant at 6 that served us a primero, segundo, postre, and a Pisco sour for 15 soles (5$). We also ordered some Cuzqueño Negro which tastes a bit like a light porter, with a hint of coffee. We got on a 9PM bus back to Cuzco. We slept most of the time, and arrived this morning at 4:30AM.

6/30/2010
After sleeping a little bit we went to work this morning. Mati was back, though in a bit of pain from her various injuries. The guy with the dog bites came back today and I got to clean his wounds myself. His bites weren´t infected, and only hurt moderately so that was definite improvement. A few people needed stitches taken out, and the usual injections as well. Elijah watched the doctor today. He seems to be quite interested in our learning, and had Elijah checking peoples noses, throats, and lung sounds after he had already made a diagnosis. Lunch today was a fried plantain (YUM!), sweat potatoes, fish, rice and some salad. We were still really tired from our trip so we napped after lunch. Elijah then worked more on his Med School application while I tried to get into ´Grapes of Wrath´. We´re currently trying to plan a weekend trip to a small jungle town about 5 hours from Cuzco for the upcoming weekend. Then only one more weekend before our Machu Picchu hike, and then home only 3 weeks from today.

Wednesday, June 23, 2010

6/22/10

During Topical today, I gave my first 4 injections. We have learned that most of these injections are birth control shots. Most of the women prefer to have another woman do the injections, so it is good that Sarah and I have been there while Mati is gone. One guy came in with an ingrown toenail (ew!), and another woman came in with a fresh deep cut in her hand from cutting cheese (or her hand as the case may be). When we were folding gauze that morning, a woman from the vaccinations department came in and asked if she could have one of us. Elijah went with her. They ended up patrolling the streets for un-vaccinated babies chasing them down to vaccinate them (which was somewhat unsuccessful sometimes because they thought they had to pay). They did vaccinate 4 or 5 kids, so that was deemed worthy of the efforts. We took some pictures with Sarah and Eduardo, Doris and Jessica, and Sarah took one with the head doctor. We have until now forgotten to mention (not sure how) that the head doctor looks very similar to a pimp. He dresses in all black almost every day, uses a cane, and has a long pony tail down his back. We will also have to take a picture with him before we leave. (the other pictures are on Sarahs camera so we wont be able to post those until she emails them to us).
After a delicious almuerzo (lunch) of spagetti with a cheese/spinach/cream sauce and a stir-fry type ‘ensalada’ with vegetables, Elijah siesta’d while I worked on my Med school app. When he woke up we went into Cuzco to see some of the other sites on our Boleto Turistico. We went to see the monument of Pachakuteq, the 9th Incan king. We had to wait a little while before the Centro de Arte Qosqo opened for the dancing and music performance. We wandered into a tiny café where the woman had some Cerveza Cuzqueña, the local beer we have been meaning to try. We then went to the dance and music performance, which was pretty cool. We took a lot of pictures (without flash, trying to be as minimally touristy as possible), and a couple videos. We will post the best ones. One our way back to the bus stop, we saw a bunch of impromptu dancers in La Plaza Tupac Amaru. There were a bunch of highschool and college aged kids dancing with sound systems and whistles. Some of the guys had some cool boots with bells on them. Almost all of the girls where wearing dangerous looking heals. There seems to be a girls dance and a guys dance, although there were a few who participated in all of them. It was really fun and we stayed to watch for a while (and tried to take some pictures, but the darkness made it difficult). We made it home easily, and Elijah is currently helping Vale by checking her multiplication problems. Yesterday I taught her the 9 times table trick (when 2 digits, the numbers add up to 9 and begin with the number 1 less than the multiplier; ie: 9 X 4 = 36). She is a pretty good math student, although her English grades still leave something to be desired.


*will post pictures later or tomorrow

Monday, June 21, 2010

Ladrones

6/21

Today we went back to work at the clinic. Mati, (her name is not Mimi we learned today) one of the techs in Topical got mugged and beaten over the weekend and is recovering in the hospital. Needless to say, she was not at work today. Elijah and Sarah spent their time in Topical doing the usual wound tending and injections.

I went to the baby place again today. Often when a baby is sick multiple times within a short period of time, Doris will fill out a questionnaire that asks parents questions about their homes and their hygiene. She makes sure to tell people to wash their hands, boil the water, keep the bathroom clean etc. Apparently sometimes people lie to her during these conversations, and we do some house visits to make sure. Sarah said that sometimes house visits are made also when a child seems to be malnourished or is losing weight. Jessica and I went to a patient´s house today to make sure the address was correct and the other information as well. The baby was playing in a walker-toy in the sun at the correct address and everything was in order. Tomorrow we will be changing locations. I think I´m going to Topical to help out (since Mati will probably still be out), while Elijah goes to a new place.

Sunday, June 20, 2010

Ruins

6/20/10
Today we did more touristy things. After breakfast we headed out to the ruins that are close to Cusco (4 of them, the furthest being 5 miles away.) We hopped on a crowded bus and rode to the first ruin Tambomachay. This place had some streams running through it – the book said this ruin’s served as a water source and maybe a place to take bathes for the Incas. The ruin itself was pretty small, but there were paths that went past “the main attraction” that we followed and we hiked around behind the ruin for a while and took some pictures from the top of a small mountain. Next we walked down the road about a half mile to the next ruin, Puka Pukara. This ruin was an outpost, and had a pretty good view of the surrounding area. After walking around Puka Pukara we started to walk down the road towards Q’enqo, which was about a 2 mile walk. About a mile in it started to rain so we waived down a taxi to take the rest of the way. Q’enqo was probably the coolest of the ruins because it had some cave like structures that we could walk through. The Incans used this area for worship and various ceremonies. After seeing Q’enqo we thought about going to Saqsaywaman, but decided not to because we were tired and we are going there this Thursday for the Inti Raymi ceremony anyway.
After the ruins we headed back to Cusco to get lunch. We went to another place recommended by the guidebook. It was a seafood restaurant and it is known for its Ceviche. We weren’t quite sure what type of seafood was on the menu because we haven’t really been practicing our sea animal vocab, so we ordered a “mixed ceviche” and some rice with seafood. Everything was delicious.
Happy Fathers Day Dads and Grandads!

check out the pics

Saturday, June 19, 2010

Cuzco- Boletos Turisticos

6-19
Today we did more exciting stuff than sitting in the house. We left after breakfast this morning and went to the Plaza de Armas. They had another parade going on with a bunch of paper-mache looking floats. There were a bunch of ones that looked like they were documenting Incan and Peruvian history, perhaps as a preview to the Inti Raymi festival happenings of the coming week. There was also a Michael Jackson replica… not sure of the significance of that one. After watching the parade for a bit, we went to find the place where they sell Boletos Turisticos. With a student ID, it is only S/ 70 (~$23). It grants us access to all the major museums in Cuzco and a few other cool tourist attractions. It also allows us to see the ruins in the Sacred Valley as well as those within 5 miles of Cuzco (4 of them). Saqsayhuaman is the closest one and is where Inti Raymi will be held next Thursday.
We took our Boletos and went to three museums where they had some cool art and artifacts. See the pictures for some pictures of the art from the first museum (where they allowed pictures). Many of the artifacts were pieces (some very large) of pottery and tools. There were a few skulls in one of the museums that had holes in them from a surgery they used to do when people had impact injuries to their skulls. Apparently 65% of patients survived (without some brain cover?). Some skulls were also oblong, from a shaping procedure started as babies that gave them some social prestige.
We also then went to one of the restaurants our tour book suggested for their ‘Cuarto de pollo’, a Cuzco favorite (literally, a quarter of a chicken). These were rotisserie cooked, and there was a salad buffet included (vegetables are kind of exciting here, they don’t eat much of them). We got both of our delicious meals for only S/30 (10$!). We tried to go to a couple other museums but they were closed, so we will have to return some day this week after work. In one of the closed museums they were having an artisans market where they had a lot of really pretty woven, embroidered, and painted things. We resisted buying anything here, as it will be cheaper to buy keepsakes and gifts at the Mercado San Pedro. There was a really cool crocodile skull with turquoise eyes and other decorations that they allowed me to take a picture of for free. The man said an indigenous man killed the croc, and then he took the skull and made it pretty. Very cool.
We are feeling much more comfortable these days. Our Spanish vocabulary has improved (although grammar not so much). We also know our way around the city much better (and we have some maps). Eli gave us a list of all the buses that go to the places we might need to go so that has been helpful too. We started planning some weekend trips this morning. There is a very cool rainforest/national park we want to go to, but they say sometimes trips return 3 days late. We only have 3 more weekends before we leave for our Machu Picchu hike, so we have to limit our travels somewhat. There is also a place we can go to ‘sandboard’ with the highest sand dune in the world. Given, this is a very touristy thing to do, it sounds really fun so we might try to do that. We’re also definitely going to see Lake Titicaca at some point. The other option is to visit Arequipa, another city of Peru. They have some pretty impressive canyons there that we can hike without a guide, so that would also be fun.


ps. adding more photos to the same album. use the same links as before.

Friday, June 18, 2010

Boring

6-17
Kenzie forgot to add that yesterday an older man who had come in the day before with a bite on his hand came in again for a cleaning. After we took care of him he left the room to get a bag from his wife, then came back and gave us a bottle of soda and cups, as a thank you for helping him out. He thanked us for saving his hand and said he’d see us for his next cleaning. Nice guy.
Today we had the day off from work because of the protest. Kenzie woke up early and read, I slept in until it was time for breakfast. For breakfast Eli’s aunt joined us, and we had the usually food plus a vegetable omelette. After breakfast we lay around and read for awhile then headed to the internet café. Later we came back and Kenzie taught me to play cribbage. We played cribbage for awhile and didn’t too much else. Right now we’re watching “Los Angeles De Charlie.” We have the day off tomorrow as well, not sure what we’re going to do yet.



6-18
Today was more of the same. No work so I slept in and Kenzie read. After breakfast we played cribbage and worked on our med school applications. Tomorrow we might head into the city to do something that doesn’t involve sitting on the couch in our house. Celtics lost, USA tied.

Wednesday, June 16, 2010

Wednesday

6-16

Not too much exciting stuff happened between yesterday and today. Vale and I watched Anastasia (in Spanish of course, what better way to learn a language than Disney movies?) while Elijah read ´Ham on Rye´ and laughed out loud.
This morning we went to the clinic and saw many of the same types of patients. A baby we both saw had a temperature of 39 centigrade. They gave her an alcohol bath to cool her in Topical, and we gave her antibiotics and fever reducer- which she promptly threw up. Hopefully she will be ok.
We also went into Cuzco today for lunch and to watch a parade/celebration type thing. Pictures later, the costumes were really cool and the dancing was a lot of fun to watch. We ordered taqueños and guac (Lij had bacon too) at an Irish Pub where we watched some of the S. Africa/Uruguay game.
I was feeling hot, so we checked my temperature and apparently I have the baby´s sickness. A fever of about 100 and some congestion. No work tomorrow or Friday because of the riots so I have plenty of time to rest and recoup before next week. We might be changing departments next week. Unsure yet, we have to decide where we´d like to go and then ask the doctor. I´m thinking maybe baby vaccinations. Ciao for now.

Tuesday, June 15, 2010

El Centro de Salud y fotos

6/12/10 cont’d

Tonight we went for dinner at Eli’s dad’s house. It was a pretty big complex, Eli’s family owns a store and her dad and her four sisters all live in house that are attached to the store and to each other. After meeting the family and the dog “bombom” (*said Boomboom) we had a chance to use the internet for a little while to upload the previous post and check on the world cup games. Afterwards we learned how to play a card game called Casino, which we’ll have to teach everyone when we get back. After getting our butts kicked in cards by kids half our age, we had lunch with the family – spaghetti with a ground red pepper-y sauce (the sweet kind, not spicy) and potatoes with a kinda spicy delicious sauce (all sauces are ‘salsa’). After lunch Eli told us that the kids would take us for a walk, and we headed off towards the mountains with Vale, and her cousins Rodrigo and Sami. After we rounded a corner we saw a river sandwiched between two mountains and foot paths along the sides (hopefully we can upload the pictures so you can see.) We walked along the paths, into the valley and across the river to the other side so we could climb on top of a structure that was carved into/made out of the rocks, called “la torta.” From the top we could see almost the entire city of Cusco, take a look at the pictures, it’s hard to describe the view. After we summited la torta we walked back down towards the house, and helped the kids grab some fruit from the trees. They called the fruit ‘Tumbo’. It was a little green pod-like thing with seeds that were surrounded in a sac-like thing that had a citrus juice in them. When we got back to the house Kenzie and I played Casino for a little while, (I got destroyed, Eli’s dad was on Kenzie’s team) then we headed back home.
On the way home we had to pick up paper towels to donate to the health center. Originally they asked us each to buy 80 units of toilet paper when we arrived to donate, but when we met with Jenny she said they were in need of paper towels more than TP. There were a few problems with this. First off, the store had nowhere near 160 rolls of papers towels. Second, the cheapest roll of paper towels was 1.10 Sols or about 35 cents… .35 x 160 is more than we wanted to spend on paper towels, and we had no idea how we would get all of them to the Centro de Salud. We ended up buying 60 rolls total and decided that if they wanted more we’d just go back (after the store had re-stocked) and buy the rest later. We proceeded to check out with our two shopping carts full of paper towels and stuffed all the bags into a taxi to go home. When we got back we had a small meal (bread, granola, yogurt, tea) and hung out until bed. Tomorrow Jenny’s mom will come with a taxi to take us and our paper towels to the health center.



6/13/10

Today we had our very first day at el Centro de Salud San Sebastian. We were very nervous, as Jenny had said that the head doctor might not let us work without our white coats (which we were unable to buy on Sunday). Also, Jenny’s mother was running late this morning so we were worried that we wouldn’t be able to meet with the doctor before he needed to begin seeing patients. However, all these fears were assuaged when we arrived just after 8:30, and the doctor had also not yet arrived. When he arrived almost 45 minutes later, he thanked us for the donations (and didn’t say anything about not having 80 units each..) and gave us direction as to where we will start our volunteering. He said we will have time to rotate through many of the departments during our 5 weeks there. We didn’t see or hear any word of where Sarah (the other volunteer from the US) might be. Elijah was led to the department called “Topical” where they do injections, sutures, cleaning/draining of wounds etc. He will add more detail to this later. I went to the ‘Pulmonary’ department for children.
I worked with a nurse named Doris, who gave me and Elijah a quick tour of the center before we began. She said they have 3 full doctors, 8 nurses, and a few other technicians and administrative people working there. The patients first see the administration for paperwork and clinical history. They are then assigned to one of the doctors, where they are seen and given another destination and often a prescription. The prescription is brought to the department, where they send them back to the pharmacy while they do paperwork and prepare for the patient. The patient returns and is treated in the respective departments. There is an obstetrics department, tuberculosis, preventative care, topical, dental, vaccinations, and baby pulmonary problems. Overall it seems to be pretty well run and efficient, though lacking in sterility and resources.
Most of the children I saw had a respiratory infection or bronchitis. They were treated with ‘Amoxicilina’ for their cough, and ‘Paracetamol’ for the fever (side note- paracetamol is the same stuff they used in Ghana). Most of the babies don’t like it (most are less than 2 yrs), so when we give them 1 cuchara (1 tblsp) of medication, we have to hold their head back, open their mouth, and plug their nose so they swallow. Kind of sad, but if they don’t get treated it could turn into pneumonia and be fatal. Some of them also needed a nebulizer, which they didn’t like much either. During treatment of one of the children, I noticed that I couldn’t understand anything that the nurse and the mother were saying (not even a word in passing). I realized that they were speaking Quechuan, the language of ‘las Indígenas’. Eli had told us that many times health workers, police officers etc. speak both Quechuan and Spanish. She can speak and understand Quechuan herself, but does not write it.

Elijah’s Day at the clinic:
After we arrived and waited 30 minutes the head doctor showed up and we were assigned our positions for the first week or so. I noticed afterwards that his assignments may have been a little sexist… but in my favor. He talked to us at the same time, but directed his question to me first and asked if I wanted to work in “Topical,” where they tend wounds and give shots. After I agreed he asked Kenzie if she wanted to work with babies… to which she also agreed, but later realized he asked her to work with babies because she is a woman.
Anyway, I went to topical and met my two co-workers who I think are named Eduardo and Mimi. We folded gauze into squares for the first 10 minutes until the patients arrived. The first patient was a woman who needed a shot, and I was a little bummed because I thought all I’d be doing was watching/giving shots. The next patient was a women who had a C-section and needed her wound cleaned and stitches removed. After cleaning it with a solution of herb water, they rubbed on some iodine and then removed the stitches (stitches are removed with forceps and a razor blade.) After taking out 3 of the 5 Mimi asked if I wanted to take out the rest. Surprised and nervous I said I needed to watch a few more, to which she replied “you watch everything today and do it tomorrow,” which reminded me of a joke the Lehigh’s health center’s doctor told Kenzie about med school: “Watch one, do one, teach one.” After the women left, another women came in who had a few holes with stitches in her chest that were mostly healed. Mimi took out all the stitches, but noticed that one hole near her belly button hadn’t sealed. She dumped on some herb water, iodine, and soap and told the women to come back if it turned red or purple. We saw 20 or so more patients before I left, probably 10 were just shots and the rest had wounds that needed tending, I’ll highlight a few below, but don’t read on if you’re squeamish… it might gross you out.

Still with me? Bueno. The first really interesting case was a woman who had a C-section that was infected. After doing the normal cleaning, Mimi removed the stitches and then wound up a piece of gauze into a thin column-like piece. She then took the liquid soap and put a few squirts directly into the open wound (a little smaller than a dime in size.) She then took the wound up gauze in a forceps and inserted it into the wound and moved it around to clean it. She repeated this with a new piece of gauze soaked in iodine. Afterwards she squeezed the wound to get out the fluids and pus, and then dressed it with some gauze and tape. She sent the woman on her way and told her to come back if it started to look worse. Later we had a guy who had some type of bite on his shin, and Mimi did a similar procedure, except this time she injected iodine into the wound with a syringe as well as the other things.
Towards the end of the day I had my first chance to do something. A man came in with a bandage on his hand and Mimi told me to take it off and clean the wound. As I took of the bandage I realized that the man had no thumb or ring finer, and had serious cuts on all his other fingers. His hand had healed well except for a small area on the inside of his pointer and index fingers, where the wound was still bleeding. I cleaned off this area with some gauze and herb water/iodine, and then the doctors wrapped his hand back up with a new bandage, and told him to come back in a few days.
Tomorrow should be interesting… the doctors kept telling patients that I was “a doctor from the United States” (they know I’m only pre-med) and I think they actually expect me to do everything that they did today. I’m excited and nervous to work with the patients directly, but the doctors are good teachers so I’m sure everything will work out. We’ll keep you posted.

Side note I – the doctors hardly ever wear gloves.
Side note II – ceilings are low because Peruvians (and Kenzie) are small… I haven’t gotten used to it yet and I hit my head at least twice a day.



6/15

Yesterday after work we hung out at the house for a while, used the internet and the café down the street and had lunch with Eli. Lunches have turned into a sort of language lesson, and we ask Eli a lot of questions about how to say certain things. Yesterday she and Vale were asking us about some English words too and working on the days of the week. After lunch, we went to town again so that we could buy our white coats at el Mercado San Pedro (*Dad and Jen—make a point of coming here. It is full of wonderful things and cheaper than the usual tourist spots, although you still have to bargain!). We found some white coats that were actually made for Chefs, but look very Medical. We also bought some glove/mitten combination hand-wear here for the mornings and evenings when it is very cold. We returned to the house to play cards with Vale, while Eli went out to buy some cheese. After coming home for lunch around 3 PM, Yhomar goes back to school and he didn’t return again until about 8:30PM! A very long day for him.
*note: Peruvian dogs are quite interesting. I have only seen about 2 dogs on leash ever, but many of them are ‘pets’. There are also many strays around. However, in other places where I’ve encountered this many roaming dogs (DR, Ghana), they usually look very similar since they are able to interbreed with whomever they want. It seems that these dogs are almost ‘breeds’. We’ve seen some that look very much like terriers, spaniels, rotweillers, and some little ugly ones that I don’t know the name of.
*note: The air here, besides being thin, is hard to breathe. Out of the city where we are, there is a lot of dust in the air that can hurt our eyes and throats. Closer in the city there is a lot of smog and general air pollution that is even worse.

Today we had our 2nd day at the Clinic. We arrived in time to help clean our respective rooms before the patients began arriving. Initially, we had a lot of patients in the children’s room. Some of them had intestinal infections today, so we had to also give them rehydration salts in water along with their antibiotics and fever reducer. I was glad to have learned a lot yesterday, and was able to help with the paperwork (and find all the information myself in a chart full of Spanish!) and preparing the medications. It was nice to feel that I was helping and not just asking a million questions in broken Spanish. The patients stopped coming around 10:30, so I went to Topical to watch and help Elijah and Eduardo, as Mimi was not in today. The cases I saw were the woman with a hole still healing from her cesearian had returned, the man with a puncture wound in his lower leg, a woman with about 25 stitches in her face and forhead, and another woman with a large open would on her tailbone. Elijah was able to take out a few stitches from the woman’s face, gave an intramuscular injection to another woman, and re-cleaned the puncture wound. The head doctor came in to check on another woman’s cesearian while we were there and was very friendly and encouraging. He told us to jump in and help take out stitches and give injections etc. We met another nurse today, Matilde, who came in to help in Topical near the end of the day who usually works in the Tuberculosis ‘department’. She was very funny and friendly and wanted to learn and show us what English she knew.
We also got to meet Sarah, the other volunteer from California. She was really friendly and told us about her experiences there. She said the head doctor is very funny and willing to allow us to volunteer in any department, we just have to let him know. She has asked him if she can make rounds to many of the departments and also sit in with him and watch him consult with patients. Sounds interesting. She does speak Spanish fluently though, so we need to work on that a bit.



Pictures- I hope this link works, it´s the one they gave me
http://www2.snapfish.com/snapfish/thumbnailshare/AlbumID=2256447021/a=158961882_158961882/otsc=SHR/otsi=SALBlink/COBRAND_NAME=snapfish/

or kenziejoy.snapfish.com/snapfish
I think you can comment on pictures on the 2nd link. I couldn´t figure out how to make it so you don´t have to sign up for snapfish to see the pictures. If you don´t have an account you might have to make (or share) one, but it´s free. Enjoy

Sunday, June 13, 2010

Since We´ve Arrived...

6/12/10
Today was very exciting. After almost no sleep in the Lima airport, we finally got on the plane to Cuzco. We arrived on time at 7 AM, found our bags, and went outside to see our Host Mother and daughter waiting for us with a sign. Our host mother asked us to call her Eli (*sounds like Elly- her name is Elizabeth). Her daughter is 9, and is called Valeria (or Vale for short), and her son is 13 and is called Yhomar (yo-mar). They are both quite friendly and we’ve already learned and taught the kids some card games. They have trouble with Elijah’s name, so he just told them to call him Elias. They say my name pretty well, although the Z sounds more like a C. When we first got to the house, Eli fed us some Coca tea and bread (Coca is supposed to be good for both the breathing and the stomach problems associated with altitude sickness; someone else told us that carbs are also supposed to help). Neither of us have had any trouble with the altitude yet, but we were exhausted after our flight and immediately took a long nap after tea (mate).
Nobody in the family speaks English hardly at all. Eli asked us if we could help Vale and Yhomar with their English homework during the week. Eli is a teacher of young children (not sure how old, she just said pequeño). The house is small but well equipped. We have a color television, and we are currently watching a replay of the US/England World Cup game. There is also a computer here, but no internet. The living room has a large couch, couch-chair and two seats. There is a dining room area with a table where we eat our meals. Our bedroom has two single beds and is accessible through the kids room, and Eli’s room is also connected to the right. It is small, but the blankets are warm!
Eli is very good with our slow Spanish, and she speaks slower for us. We have already taken out our pocket Spanish/English dictionary a few times. Although it seems difficult, we do understand most of what she and the kids say (with a little work). For lunch Eli cooked white rice and chicken. Elijah asked, and she said the chicken was a piece of leg. There was no bone and it was pounded flat to about 1cm thick. She fried this in a pan. We also had a salad of lettuce and tomato with lemon squeezed on it. After lunch we gave them the gifts we brought. They dug in to the Grammie bars right away, and Valeria especially loved them (she’s got quite the sweet tooth). They also liked the Maple Syrup a lot, and have been using it similarly to how they use honey (on bread, in yogurt(?), in tea etc.). Yhomar snatched up the RedSox bottle opener right a way and attached it to his key chain. The kids seem to be sharing the RedSox cards (kind of), and everyone loves the chocolate we bought in NYC. All around success.
The area we are staying in is not in the center of Cuzco. Everywhere around us there are mountains. There are no other tourists around here. By bus, it costs 70 centimos(only about 22 cents) to get to the center of town (where all the turistas are). It is very easy to navigate, as we live only a couple streets off the main Avenida de la Cultura. Almost everything else is easy to find off la avenida. There are signs that say each bus stop, so it is easy to know when to get off. Some of the buses are larger and more like the buses we have in the states, but some of them are much like the Tro-tro’s (large, run-down vans) I used in Ghana. There is one person who takes your money and asks the driver to stop when you need to get off. Our stop is Santa Rosa (the section we live in), and San Sebastian is only a few farther up (where we will be working). Eli said it is only about 15 minutes to walk there, so most likely we will be walking to and from work.
We went to town for a few hours this evening after our large lunch (around 2:30). Eli and the kids showed us where to buy sweaters, hats, etc. that is cheaper than most of the really touristy places. They already had an adaptor that we are borrowing, and I brought a power strip so we didn’t need to buy another one of those. We did go to the supermarket however, to buy some eggs, juice, granola bars, granola, yogurts, apples and a few other items. We were worried about our snack needs, as we will be leaving for the clinic before 8AM and not being able to eat again until 2PM. Elijah also bought a grey hat, as it is quite cold! During the day it is very sunny and nice, but at night and in the morning Eli said it can get below freezing, down to -5˚ centigrade. Our beds are equipped with three thick wool blankets each, although I wish they also came with a nose warmer. I’m definitely glad I thought to bring my slippers for wearing around in the evening.
For dinner, Eli cooked us some more rice with a fried egg on the side (over-easy! Just like I like). We had some more coca tea, while she had cocoa powder in cold milk and some bread. Elijah and I have also been noticing that our fingers are tingling. This is a side effect of the altitude medication. Elijah seems to be feeling it much more, although it was hard to find the words to describe this sensation (or lack of) to our family.

6/13/10
This morning we woke up at 8:30AM. I thought it was 9:30… but apparently I had set the clock an hour early. Woops. Elijah wasn’t very happy. We unpacked our stuff and put them in whatever places we could find before getting ready for breakfast. For breakfast we had bread and yogurt, with hot chocolate. Yhomar also had some Jello. The Peru program coordinator Jenny came over after breakfast to talk with us about our placement and make sure everything is going well. She said she will come in the morning tomorrow to pick us up and bring us to Centro Salud San Sebastian to meet with the head doctor and get project details. Apparently there is another pre-med volunteer named Sarah already working there in her 3rd week. Hopefully she will be a valuable resource and be able to explain to us the ins and outs.
Jenny and Eli then started talking about current events and saying that we should not go to the center on Thursday and Friday. There will be protesters in the streets and all around Cuzco on both of those days. Apparently, in the Southern regions of Peru (Cuzco to Arequipa) there is oil. The president (maybe?) has decided that he wants to sell some of this oil to Mexico for $1 a barrel. Obviously, the people of Peru are pissed off about this because they have to pay $15 a barrel for their own oil. The police will be using tear gas bombs to disperse the crowd, so she said it was best for us to stay at home that day. We agree!
Soon we are leaving to buy white coats (so that we look like Doctors) and to visit Eli’s father. She said he lives further into the mountains, so maybe we will be able to do some walking and take some pictures of views. I’ve taken some pictures from our living room window, and will try to post them soon. We will be stopping by the internet café on our way home this evening, and I will not have time to post them today.
*side note: when answering the phone, Peruvians generally say “alo?”, like Hello in english. When hanging up or leaving, they say ciao much more often than they say adios. Interesting that hello and goodbye aren’t in Spanish.

Saturday, June 12, 2010

The never ending lay over

So... our lay over in Lima was 9 hours long. We arrived in Lima at 8:30 pm and we are going to leave in half an hour or so (5:30 am local time.) We thought we'd try to find a hotel to sleep for a few hours, but it turned out to be too expensive to store our bags and take a taxi etc. so we decided to stay at the airport. I ate 1/4 a chicken and Kenzie fell asleep on the food court floor. I stayed up for awhile guarding our luggage until a security guard came over and I figured it was okay to sleep. A little bit later we woke up and moved to a different spot on the floor because our old spot was getting cleaned, we traded shifts watching our bags until 3:00 am when we could go check our bags. We've seen two huge groups of Americans on church missions, and we met a few people our age who are also traveling to Cusco, two of them are 2nd year med students and are volunteering at another clinic in Cusco.
The flights from JFK to San Salvador and from San Salvador to Lima were fine, we met a gastroenterologist from Uruguay and Kenzie played with his 2 year old daughter. The announcer is saying something about Cusco, got to go.

Friday, June 11, 2010

First Leg

We made it to San Salvador! First leg is over. Free wireless here, so that's nice. We have gone back in time 2 hours, but we are going to be in the same time zone when we make it to Peru. Turns out, we have from 8:30PM to 5:30AM in Lima. We're going to try to see if there is somewhere we can sleep at the airport. Adios!

Thursday, June 10, 2010

Passport Crisis and New Information

6/7 - 4 Days before we take off for Peru, Kenzie can't find her passport or camera. She frantically searches Pam's house,
6/8 - 3 Days before take off, Kenzie still can't find her passport. Grandma and Jim get brought into the search because they have some of Kenzie's things. No one can find the passport. Kenzie contacts the passport agency to see if its possible to get a new one in the next 3 days, its possible but will cost $150. Elijah calls the landlord in Bethlehem to see if he will check the house where Kenzie is storing some things. The landlord called a few hours later, he found Kenzie's things and shipped them to us overnight. (Elijah gets a job a Brown.)
6/9 - Kenzie's things arrive. Yay.
6/10 - We leave for NY to stay at Nick + Gina's. We leave tomorrow morning.

We received more info about our host family, our sister is 9 and our brother is 13, and our mom will pick us up from the airport when we arrive.