Our first week in Huancayo we were able to experience the schedule of short term volunteers, with our fellow undergrad volunteers.
Day 1:
Monday morning, we were picked up to head to the OR in a little hospital called Daniel Alcides Carrion, while the other students got to go to rotations where they: took vitals, talked to patients and and interacted with physicians. At the surgical center, I was able to watch a Radical Hysterectomy with pelvic lymphadenectomy. It was slightly awkward because a nurse just told us to walk into an OR room. After that there was no direction on what to do. I didn't want to interrupt everyone getting ready for surgery, especially because the patient was awake sitting up on the table, however I also thought about my times in the OR at home where I was scolded for not introducing myself to the patient as well as the surgeon before the surgery started. So what did I do? I stood in the corner, until about 2.5 hours into the surgery when the surgeon acknowledged my presence and asked me if I wanted to come closer to see. He proceeded to ask me where I was from, and whether or not a certain type of suture is as hard to cut in the US as in Peru. I didn't know what to say I had heard about the material but was definitely not versed in the majority opinion on the ease of cutting it, so I just stated "No se." (I don't know). After that he didn't seem as interested in asking me questions. Whoops! There were two surgeons in the room one was a little younger and tried to explain things to me as they were doing it, he had some sympathy for the American student standing in the background which was much appreciated. I unfortunately had to leave the surgery early and thanked the surgeons and staff for allowing me to observe, so I felt a little better about the earlier awkwardness and vowed that the next surgery I went into I would do better. Hopefully by then my rusty Spanish will be a little less well.. rusty.
In the afternoon Lucero gave us a quick orientation to Huancayo. We learned that Hola is only used to address people who are younger than you(basically little kids) and that instead buenos dias, buenos tardes, or buenos noches was used for basically everyone else. She also reiterated the point that toilet paper must be thrown in the trash can and not in the toilet because the sewage system here isn't set up the same. Waving down a taxi should not look like an American wave but instead a flapping of the wrist with your arm extended and parallel to the ground, and the price of the ride should be set before you walk in or they will change it on you. We still aren't sure if Lucero was joking or not but she did tell us that sometimes dogs just come up and bite you. Scary right? There are a lot of dogs just roaming the streets so this is a real source of concern. Another fact we learned, is that if you are offered anything you have to take it, you can give it to someone or throw it out later but you can't refuse anything... even if you don't eat meat ("My Big Fat Greek Wedding" reference anyone?) Anyway... I'm sure we will be learning a lot more fun facts but those are just few!
Day 2:
The next morning we headed to el Centro de Salud Sapallanga (Sapallanga Health Center) for the Portawawa project, where we helped with a mother- baby class. However, before class even started we noticed a leak coming from under the sink and spreading throughout the room, so there was some commotion as we tried to figure out what to do. We were able to set up blankets and yoga mats for the mom's but there wasn't much space for everyone so it felt a little crowded. Marcia, taught the mothers about developmental milestones that their child should be meeting and how to engage their babies in constructive play. There were about 6 mothers and 9 children at the session. After the short lecture, we were able to interact with a child individually and show the parents how to play with their children in an educational and interactive manner. We even got to teach them Twinkle-Twinkle Little Star in Spanish! Here are the lyrics in case you're interested.
Estrellita
Estrellita, ¿dónde estás? Me pregunto qué serás. En el cielo y en el mar, Un diamante de verdad. Estrellita, ¿dónde estás? Me pregunto qué serás.
I worked with a mom named Miriam and her daughter Angela who was 14 months old. The baby was so sweet and smart and energetic. She was shy at first but warmed up to us slowly. She was able to stack six blocks together, clap her hands, walk, hop, dance, and throw balls. She could say what the cow sounds like “mooo” and what the sheep sounds like “baaa.” I think she was nervous to truly speak to us, but she had a lot of fun throughout our time together. It was great to see the other students interact with the children and watch the smiles on everyone’s faces!
During our time at the clinic Manouche the FIMRC Field Operations Manager told us about health insurance in Peru. Peru has 5 main health care entities: 1) the Ministry of Health program called Seguro Integral de Salud (SIS) (60% of population), 2)EsSalud which is funded by employers (30%), 3) Armed Forces (FFAA), 4) National Police (PNP) and 5) the private sector making up the remaining 10% of coverage. There are an estimated 11.7 Physicians per 10,000, with 6.7 Nurses/ midwifes (https://www.who.int/workforcealliance/countries/per/en/). I think I'll talk more about health care in Peru as I see more, but that was a quick introduction.
In the afternoon Yuli one of the FIMRC nurses, taught us all some suturing techniques on pig's feet. Although Helen and I had sutured before, you can never get enough practice in, so we joined the girls as we all struggled to pierce the skin of the pig's feet. Poor Elisa somehow managed to get her suture in what seemed like bone on the underside of the foot. While Olivia bent two needles during the whole process. It was fun being able to teach the girls how to hold a needle with a needle driver, and being able to encourage them as they worked diligently on their feet. My sutures were definitely not as neat and tidy as Helen's but I guess that can be the difference between an aspiring pediatrician and a soon to be OB/GYN resident! :) When we finished suturing Joanne goes "High foot" instead of "High five" as she held up the foot!
Day 3:
The Cuy Project, Cuy stands for Guinea Pig in Spanish. FIMRC in Huancayo is focused on partnering with community organizations to create self-sustainable programs that can persist even when FIMRC is not involved. Today Helen and I were able to check hemoglobin levels in children. We both vaguely recalled that Hemoglobin levels need to be corrected for based on the altitude, but were more than willing to listen as Yuli explained this to us! In Aco, the village we were in, the correction for Hgb (3,480m) was -2.4, in Huancayo (3,259 m) the correction is -2, while in Lima (154 m) there is no correction. We ended up having 5 children who were from Lima of 22 children that we checked, so their hgb levels needed to be uncorrected. Out of the 22 children we tested 7 were found to have anemia. Which was a pleasant surprises since we were told that about 50% of Peruvian children have anemia. During the morning there were 2 other health stations, one that checked the weight and height of the children (Faustina and Aaron) and another that took blood pressure and checked blood glucose (Oliva, Elisa, Rachel and Joanne).
Over lunch, which was provided by one of the mothers in the Aco community, we spoke to the Doctor of the clinic, who is completing a one year service year at the clinic. Helen and I spoke to him about medical school, and how it is different the process is in Peru compared to the United States. In Peru, high school students take a test to enter into medical school which is a seven year program, following their seventh year they are required to work in a rural community, which the doctor explained as more of a health prevention and education position rather than medical care, but he does do both. After finishing this year of service, students then apply for "specialization" where they choose a field of medicine.
After lunch, we set out to talk to the families that had children who tested positive for anemia, we broke up into groups. Helen and I joined Yuli, Lucero, and the clinic doctor as we visited the home of a 6 month old we checked this morning with a Hemoglobin level of 6.8. Prior to visiting the family we stopped to do a home visit for a 92 year old who wasn't acting like herself and was not able to get out of bed, the family was concerned. The doctor suggested transportation to the nearest hospital in Huancayo which was about a 40 minute drive, but the family stated that they were unable to go at this point, so instead the doctor prescribed an antibiotics and stated that he would follow up in a few days to check and see if she was improving.
The mother of the 6 month old, made clay pots and children's toys for a living. We were able to ask her about what she knew about anemia, iron, and what foods are good sources of iron. After the survey we asked the mother if she would be willing to participate in the Cuy Project, where she would be able to improve her knowledge of anemia and obtain resources to help treat the anemia. I'm looking forward to seeing how the program goes forward in the next few weeks. I feel like we came at a great time, because a lot of the programs are restarting a new session or relaunching with new goals and we get to be a part of that.
Day 4:
Today we did a Health Campaign in the Huancan district. I was assigned to do Blood Glucose level tests and HIV/ Syphillis rapid blood testing. I tried to use the same finger poke for both blood samples but sometimes there just wasn't enough blood, so I had to poke the patient again. I felt terrible, but they all took it so well! I'm just grateful that they were all adults! I meet a really nice older man who shook my hand not only when I was introducing myself but also as he was leaving after he spoke to the FIMRC Nurse Yuli. His smile just made me smile. We may not have had a deep conversation, but just the fact that I took the time to introduce myself and ask him how he was doing in Spanish seemed to have such an impact, I don't think he was expecting it.
In the afternoon we went to a teen mom's home where we reviewed the female reproductive tract. These girls ranged from age 13-17, each either currently pregnant or already having a child, although we didn't get the details of what brought them to the home, the deep hurt that these girls endured was written on their faces. However, through the sadness we were still able to see them smile as we played games pretending to be sperm (with long balloons) trying to get into a hula hoop ova. Marcia, another FIMRC nurse did a phenomenal job describing the female reproductive tract from internal and external organs, to the menstrual cycle and conception. It was incredible to see how much clear and concise information she could describe in such little time. After the lesson the girls had worksheets to complete which was a great time for me to practice my Spanish as I worked with the girls to answer the questions. It was great being able to hold a conversation with them and then test them about the information they learned and seeing that they were actually able to answer the questions on their own. I was so proud!
I was sad to leave, but hopeful and almost relieved that I would be coming back next week. I think that this teen mom shelter is going to be one of my favorite parts of this trip. I'm so excited to learn more about the shelter and the women there.
That evening we went for a final dinner with the girls and the other two volunteers who were living at the other home stay in
Huancayo. We went to a restaurant called Detras de la Catedral which is directly behind the Plaza de la Constitucion. We shared some laughs and lots of great food.
Day 5:
Today we said goodbye to the girls in the morning and were picked up to go to the FIMRC office, where we discovered that it was Pedrito's (one of our drivers) birthday. Manouche had bought him a cake and we sang him a song, but it was a birthday song I have never heard before. Still haven't figured out what it was but when I do I'll write about it!
After our celebration we were given the task to read over a new project that FIMRC will be starting this year, it is a program to help children develop healthy habits and improved lifestyle. Manouche and the FIMRC staff came up with a great idea to include parents in developing healthy lifestyles in their children by reinforcing lessons that the children learn on a weekly basis on a monthly basis with the parents, as well as incorporating home visits to support families and check on the development of the healthy habits. We were able to go with the team to pitch the idea to two community organizations, one that was hesitant about the impact and another that was excited about the opportunity. As we work out the kinks I will definitely be posting more about it here.
After our meetings for the day, Pablo took us to the Parque de la Identidad Wanka (Identity Park) in Huancayo, since we passed by it on our way. The park was opened in 1996. There is a large "mate burilado" statue at the entrance of the park, which is traditionally made from a squash and has carved out stories, this one specifically has the Huancayo chest on it. It is filled with statues of famous people and other symbols that identify the region. Some of the famous people in the statues include Angelica Quintana "La Chaparrita", Leonor Chavez Rojas "Flor Pucarina", Victor Alberto Gil "Picaflor de los Andes", Emilio Alanya "Moticha", Nestor Chavez Calderon, Zenobio Dagha Sapaico, Sergio Quijada Jara, Francisco Rivera Jimenez, Francisco Leitth Navarro and Amadeo Ugarte Rios. I don't know who the majority of these people are but I'm curious to find out. The cobblestone paths were gorgeously decorated with flowers, everything in the park was so clean and fit so beautifully in there. As we walked through the park, Pablo told us about a snake with a sheep head that was known in these parts to protect the land. A statue depicting the animal was used as the hand rails on some of the gates in the park.
Day 6:
Our first Saturday in Huancayo, we didn't have any scheduled activities so Helen and I decided to do some laundry. Definitely haven't hand washed so many clothes is a while, but it took me back to the summer days in Romania when we would stand by the fountain in my grandma's courtyard doing laundry. After laundry we had breakfast and set out to find some traditional polleras (these really pretty colorful skirts) at the Mercado Modelo. On our way there we found a shopping mall that was just like the ones you would find the the US- it was called Real Plaza. Their food court was filled with American chains like Pizza Hut, Burger Kings, and Popeye's.
From Real Plaza we walked down toward Mercado Modelo, we weren't exactly sure where we were going, so I stopped to ask what appeared like a native shop keeper, but she had no idea what I was referring to, at that point I was a little worried that we had gone in the opposite direction of where we had to go OR that my Spanish was so bad no one understood what I was trying to say. However, I think she just didn't know where it was because we found it about two blocks away. We were warned before going that we needed to watch out for pick-pockets, so we made sure to hold on to our belonging pretty tightly. That's also why I don't have any pictures...sorry! The first floor of the market was crowded with vendors selling fresh meat, fruits, vegetables even live animals (parrots and rabbits), the second floor had more of a clothing selection. We found multiple stores with polleras ranging from 350-1200 soles, for the exact same skirt, talk about price variability. As we walked around we were constantly asked where we were from, we concluded that people assumed we were from Brazil, until they heard us speak, then they knew we were Americans. I ended up letting go of my dream of owning a traditional pollera and settled on a lavender skirt with embroidery. On our way home we saw a woman on the street selling similar skirts to the one I had gotten from el Mercado Modelo, but she didn't have the color Helen wanted available but she told us to come back tomorrow and she would be there...more on this later.
We rushed home to be back in time for lunch at 1pm, ate and grabbed our clothes off the clothes line because it was starting to rain. We waited for the rain to pass before we attempted to go out again to exchange a sweater Helen bought at Casa del Artesano. Unfortunately by the time we got there the ladies shop was closed! Instead Helen and I stopped in at a different store and Helen bought a "earth toned" maroon sweater.
Day 7:
Helen and I have gotten into the habit of waking up at around 6:45, so even though we didn't have anything scheduled and breakfast wasn't until 9am, we were up. We planned to go back towards Mercado Modelo to find the lady we talked to yesterday, but she wasn't there. We were disappointed but knew we wanted get to mass at the Plaza de Constitucion at 11am, so we rushed over there. I had a coughing fit during mass and had to walk out. After mass, we went back to Mercado Modelo, the lady was still not there, so we walked around some more and found another market. It was surprising just how many shops, there were! Just as we were about to leave, Helen saw a skirt that she liked and we asked how much it cost and around the corner came this Peruvian man, who walked us to his other store front to show us the skirts. He asked us where we were from, when we said the United States, he told us he had worked in Idaho for a few years and that he wanted to go back to the US. He asked me if I was married, and how old was.. I sarcastically told him I didn't know. He then proceeded tell us that it was hard to get back to the US and that he would pay us to help him get there. Helen responded with... "I wouldn't even know how." and he goes "Get married!" We both laughed, and after paying 10 soles less for the skirt then he initially asked we both told him good luck and walked away!
We were late getting back for lunch, and felt terrible because Senora Elena was waiting for us. After lunch, we just relaxed at home. We sat on the roof talking to family and friends, reading and soaking up the sun, before it started raining again. It was a great way to end the week.
Hope you enjoyed reading!
Chau,
~Maria
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