A health care lecture ~ A spider ~ A flooded office ~ A birthday party & A trip to the Jungle!
It was rainy week in Huancayo. We were joined by Katarina at Senora Elena’s house! Katarina is an aspiring PA student from Maryland. We loved having someone our age in the house this week and she was an amazing addition to our team! She challenged us to try to go to a new place every day to soak in as much of Huancayo as we could in a week. We bonded over our immigrant families, although all from different countries (Guyana, Romania and Nigeria), there seems to be something that are just so familiar in first generation American households, we also had a little bit of a spider incident that really brought us together… more on that later. Overall, it was a great week even though the weather wasn’t quite on our side.
Day 1:
In the morning we went to el Mercado Modelo with Lucero and Marcia, to buy snacks for the celebration for the new Portawawa group the following day. Helen and I were shocked to find out that although we had gone to the market this weekend, we hadn’t realized just how close it was to other places we had gone last week. I guess walking really does make everything seem farther away. We probably also took the long way since we were just following our location on maps. We bought ingredients for fruit kabobs as well as guacamole, to dip with carrots and celery. As you can probably tell, we were trying to be as healthy as possible. While at the market I tried my first Granadilla...it was interesting.
In the afternoon we got started on categorizing the donations that we had received and brought to the clinic. We brought 3 whole suitcases worth, about 150lbs of supplies. We made a list for the clinic and then got started or organizing the supply closet. Manouche told us that they had recently moved to this new location and really hadn’t been able to arrange the material as much as they would have wanted, so we were excited to be doing something helpful. This was going to be an ongoing task we quickly realized… there's a lot of stuff in there!
Day 2:
In the morning we went to Portawawa (I forgot if I explained but this is the name of the action of carrying your baby in a cloth fabric on your back) group. Marcia had invited the people from health center, but only one new mom showed up along with three of the moms who were previously in the program. While we waited for more women to show up, I enjoyed playing with the kids that came with their mother’s. The kids loved walking around the building and having me search for them, there was even a small corn field in the back that they would hide in. I wish I had my camera, so you could see their smiling faces through the corn husks! It was so cute!
The women said that they liked our guacamole, but Helen said that it probably needed more salt… whoops! I know it’s probably an unpopular opinion but I don’t really like avocado so I didn’t try the guacamole! Altogether we had a great time of conversation and getting to know each other, but no other new moms showed up. It wasn’t what we had expected so we are hoping to get more women to come next week. We spoke to the Obstetrician at the clinic and she gave Marcia a list of mothers who would potentially be interested in the program, so Marcia was tasked with calling each one to ask if they were willing to come. Fingers crossed next week goes better!
In the afternoon we were joined by three local medical students who told us about the health care system in Peru. Sami, Marden, and Elisabeth were a fourth year, a third year and a first year respectively. As I described last week, they gave us much more details about the five forms of insurance and how each are accessed here in Peru. I think I’ll make a separate post with all the details, because I have a feeling this week’s post is going to be long already! It was great being able to hear from other medical students, it was easy to relate and share stories about our different experiences. They were interested to know what “a gap year” meant and how that fit into our medical education. Helen and I both did a gap year before starting medical school, so we had personal experiences to tell them about. They were very sweet and willing to be patient at we tried out best to use our ever-improving Spanish skills (thanks to Duolingo and Drop)!
After our health care lecture, we were planning on going to Torre Torre a natural land formation a few minutes from Huancayo, but since it had been raining all day Pedrito (our driver for the week) suggested we postpone our trip until tomorrow with hopes that it would be a little less wet. Instead of Torre Torre, we took Katarina to visit the Identity Park that we went to last week, the Parque de la Identidad was greatly influenced by Parque Guell in Barcelona, Spain and Katarina had visited it in Spain and said some things looked similar.
We got home, we ate dinner and were just hanging out in our room, when down the hall Helen and I hear Katarina say “hey guys come here” in a concerned tone. My mind automatically jumped to “There’s a spider.” I grabbed a book that was sitting on the dresser and headed over to Katarina’s room, only to see a GIGANTIC spider on the curtain by her bed. Ok… I thought to myself it’s not that big but how was I going to hit it without knocking it off the curtain and losing it in the room. I walked closer to it but in the background, Katarina kept saying “that’s a big spider”, “I don’t think you can kill it”, “wait, don’t do it.” I think her words psyched me out more than the spider did, so I called Helen over. She comes in with a shoe and air freshener. While we are contemplating what our plan of attack would be the spider moves, and we all scream and run out the door. Let’s call Mateo (Senora Elena’s brother who lives across the courtyard from us) we all say in unison. So, I walk outside knock on the door, but no one responds. I call out… “Help! There’s a spider”, but no one is there. As I walk back inside Helen and Katarina say that they lost the spider and can’t see it anymore. So, we go in again and look on the ground for where it might be, as I lift up the side of the blanket that is on the ground and look under the bed, I see something move. Now, I don’t know if it was a spider or a shadow, but I scream again, Helen runs out of the room and I stumble over the shoe she dropped as I try to escape. Outside the room we are both on the ground laughing! Guess it’s Spider 1, Girls 0. At this point, Katarina had already decided that she was just going to move her stuff upstairs, and we decided to just close the door, write a note and tape the spider inside. We would just have to deal with it later.
The next day I think Señora Elena and Mateo had a laugh as they read our note, but they were so kind to spray the whole room with bug spray and the next day we found the spider on a napkin by the door. Thanks, Señora Elena! ;)
Day 3
Today we went to a health post in Unas. Where we were able to help the nurse with developmental checks for a few children. We basically took heights and weights and played with the kids while the parent’s waited to have their paper work filled out. Each child in Peru gets a booklet with growth curves for height and weight, as well as a checklist of developmental milestones, and vaccinations. Each parent must keep these records for their children whenever they go to a checkup, but they are also logged in a larger book, that is for the clinic’s database.
We had one little boy who refused to step onto the scale, I’m not sure if he thought it would hurt or he just didn’t want to, but it took 3 of us to get him to finally step onto the scale and to check his height. We used a toy car and a stacking toy to get him to do it. He was able to name some animals throughout the room but didn’t know his colors at 4 years old. He was just guessing them when we would ask him. His mom got scolded by the nurse, because she should have been teaching him at home, I thought it was a little harsh. I debated asking if he had a vision test, because he could be color blind and be having this issue, especially since the mom was adamant that the child knew his colors at home. I wondered if it was possible that he just memorized which toy at home was what color.
I saw a five-year-old girl, who knew how to count and knew her colors in English. She was shy at first, but her mom encouraged her and as we kept talking, she warmed up to me. Towards the end her mom asked me to teach her a song in English. Well I used my skills from last week and was able to sing it “Estrellita” to her in Spanish and “Twinkle Twinkle Little Star in English. I even wrote it down for her so she could have something to practice off of. I also taught her how to say, “My name is ______.” She was so sweet and gave me a hug when she left.
As I was doing a developmental milestone evaluation, I asked a little boy to draw me a picture in my notebook, well he drew a lot more than one… as you can see! A fish, and alligator, hearts, a hippopotamus. His mom was a little worried that his pronunciation was lacking and the nurse I was working with suggested that they continue going to lessons to help him develop his language skills. The mom stated that when she had gone to the lessons the teacher told her that she only taught kids that were much worse off than him, and that the lessons wouldn’t help him. The nurse suggested getting a referral for a different teacher so that he could get the specialized attention he needed. I thought that was really important and great that these kids even though they were getting the government funded health insurance had the opportunity to participate in these services that will surely help them become successful. As we were driving around town the day before, I saw a wall that was painted and said “Education is the most powerful weapon” which is something Helen and I were talking about earlier in the week. Education really is a tool that helps people out of poverty, and I think it’s so important to emphasize it all over the world, but especially in developing nations.
Pedrito agreed to take us up to Torre Torre (Torre Tower) before lunch. Torre Torre is a natural rock formation. It has been formed over the years due to the erosive action of wind and rain, some of them reach up to 30 meters! On our way up to Torre Torre however, our van got stuck in the mud! We had to push it back down a few meters so that Pedrito could find a place to park. He secured the tires in place with a few large rocks and we were off. Pedrito was the best tour guide, he was patient with us as we were panting up the hills that he had just run up with ease (it was the altitude I promise). He laughed at us when we told him that we wouldn’t jump across a small ledge to get to a different area because we were scared, as he jumped right back over like it was nothing. The ground was wet from the past few days of rain and it was even sprinkling while we were climbing so there were a few times when our feet would slip in the mud. Maybe you could say we saw our lives flash before our eyes…maybe. It was a great afternoon adventure and we were so glad we went even though we got a little wet.
After lunch we headed to Aco! We had 62 kids lined up and ready to go (just kidding they were being dragged in by their moms) to get their hemoglobin checked. For some reason I found that the kids this week were much less willing to smile and talk to me while I was poking them, I think it’s because they were watching all the kids before them in line also get poked, at least last week we had our own room and they didn’t really know what to expect. Last week we had seen a few kids with anemia but today we had quite a few more. I had one mom with her 9-month-old son, who told me she had checked his hemoglobin 6 months ago and It was 15 but when I check it today it was 9.3. The doctor in Aco reassured her that he would also check the baby’s hemoglobin in a few days just in case there was an error, but he still suggested joining the program to learn about anemia and how to ensure that your child is getting all the nutrients that he needed.
Day 4:
We headed to Daniel Alides Carion Hospital today for rotations. Yuli was a great tour guide as she showed us around the new hospital building that was just across the street from the older one that we had seen surgeries in last week. We walked through the Emergency Department, where they have an observation wing, that Pablo told us people can stay in for up to a week when the hospital is full. From there we went up to the trauma floor, where we were able to talk to and take vitals of all the patients on the floor. I was nervous about using a mercury thermometer because you had to shake it pretty briskly to get the mercury below 35 degrees before you could take any temperatures, what if it slipped out of my hand, cracked and mercury spilled everywhere? We would probably have to evacuate the room and call a special clean up team, and then watch for any symptoms of mercury poisoning, right? These were just some of the things passing through my head every time I would pick up the patient’s thermometer. The patients actually had to buy their own thermometer that they stored in the bed side table, with the medications that they also had to buy from the pharmacy before it could be administered to them. It reminded me a little of the hospitals in Romania.
One side of the floor was just men, the other side was just women and there was one room of 2 little boys with broken legs. Most of the patients on the floor had lower extremity fractures, some had deep cuts that they were just being observed for, others had forearm fractures. Yuli pointed out the traction devices hanging off of one of the patient’s bed. It was just a 3L bottle of Fanta filled with water, but it did the job! There was a patient who had just gotten a below the knee amputation and was asking us about prosthetics in the United States. How long it would take for him to get one if he was there? How much it cost? If there were any people that we knew who could get him one? I felt terrible because I didn’t have any answers to his questions, and yet he still wanted to take a picture with us before we walked out of the room. Another patient I remember clearly was an older woman who had her finger bit off by a dog, 3 days ago she came to the hospital and the trauma team had placed a metal rod through her thumb right under the nail to try to reattach the finger, however over the past 3 days the finger had become necrotic and the patient stated that she had no sensation in it. The doctors were planning on amputating it tomorrow. She was so calm, and kind to me as I took her temperature, and blood pressure, she called me sweetheart and wished me luck in the future as I walked out of the room, and I couldn’t help but think how I would be reacting if I was in her situation.
After we finished taking vitals on the floor, we headed home for lunch, where Senora Elena had made us Papa a la Huancaina, a traditional food in Huancayo, which is potatoes topped with a rich cheesy topping and a boiled egg. It was delicious!
After lunch, we headed to the teen mom shelter where we were going to learn about the human body, the organs and what they do. I was so happy to see the girls again and was completely surprised when they remembered my name! To start off the lesson, we prepared a True or False game for the ladies. Here are a few examples? Do you know the answers?
True or False? You have no sense of smell when you’re sleeping?
True or False? You have 206 bones in your body?
True or False? Babies have more bones than adults?
True or False? It takes 45 minutes to digest the food you eat?
True or False? The smallest bones in your body are in your ears?
After the game Marcia had each of the girls stand up and talk about a specific part of the body, what it did and why it was important. We then got to cut out little human bodies, with a nervous system, circulatory system, digestive system, muscular system, skeletal system. And we used a clasp to pin them all together so each of the girls could have all the body systems together, so they could look through them. It was a great activity, that was simple but still educational. As we were saying goodbye, it started raining outside (typical rainy season in Huancayo), and we noticed that the panels that they had as a roof were leaking, as we drove home, how hard it must be that they can’t stay in their own living room while it’s raining.
Day 5:
On Friday, Pedrito picked us up as usual at 8:15am and we were all excited about the health campaign this morning. However, as we pulled up to the FIMRC office, we saw Marcia sweeping water out the front door, from there we knew something was wrong. As we walked in, we discovered that overnight the office had flooded! We all got to work sweeping water out of the building and picking up the cardboard boxes that were getting soaked on the floor. Pedrito and Pablo had to prop up the couches, so they wouldn’t soak in more water than they already had. It was a mess! The good thing was that the majority of stuff on the floor hadn’t been destroyed and the supply closet only had a few wet boxes, that were filled with things that were packaged in plastic. By the time we finished in the office, it was 10:30am and we decided that the rain would probably keep people away from the city center where we were going to be doing our health campaign so instead, we went out to do some home visits, to two new mothers in a neighboring village.
The first visit was to a mother who delivered on January 1st but had just spent 4 days in the hospital for pre-eclampsia. She was not able to remember what her blood pressure was at the initial nurse check that sent her to the hospital on Monday, but she said that she wasn’t having any symptoms. While in the hospital she was also unsure of what they gave her to control her blood pressure, but she said they initially gave her 4 pills then 2 pills for the following 3 days. So we were here to just see how she was doing after her hospital visit. Helen took her blood pressure and it was high, 155/100 on the left and 148/85 on the right arm. I was really concerned and asked her if she had a headache, any changes in vision, hearing problems, any pain anywhere, and she denied it all, stating that she felt well, but had a headache last night that resolved on its own. I was still worried however, so I checked her reflexes, and eye movements, and did a quick neurological exam. Everything came out fine, but I couldn’t believe that her blood pressure was still so high and that the doctors hadn’t given her anything to take at home for it. We asked her if she was taking any medications, and she said they had given her some pills that she didn’t know what they did, her older son, probably 6 years old, brought them downstairs for us and they were just antibiotics for preventing infection, at that point we also asked her for a thermometer just to check and make sure she didn’t have a fever… she didn’t. As we were preparing to leave, I told her to just be aware of any other headaches, or vision changes and if she at all felt uneasy to please go see her doctor. As I was saying it though I felt uneasy, knowing that it would take so much effort to get her to a doctor. She told us that it had taken her husband a few days to get her to visit the nurse for her regular visit, where they found her blood pressure to be so elevated.
The second visit was even harder. We walked into a courtyard, that was wet and muddy to see a house without complete walls, there were three walls on the first level, and three on the second level, you could see inside the entire house from the entrance gate. The woman we were visiting had 4 children and home, and one older son out working. She is 30 years old, just two years older than me, but looked so much older. The stress and hardship of her life was written on her face and in her tired arms as she held her 3-month-old. Watching this mom and her 4 kids in the cold, really struck me. Her older daughter was maybe 8 years old and had only a short sleeve dress, while the 3-year-old girl was sucking on a green lollipop as she played with a ball in the mud, with her little pink boots on. We listened to her story, and took her vitals, but as we packed up to leave, I couldn’t help but wonder what else we could do for this family that had so little. It was hard walking away, knowing that I hadn’t done anything but listen.
After the home visits, we made it back to the office, and worked on organizing some more supplies until everyone was ready for lunch! We planned an outing to celebrate Helen’s birthday and to get Katarina some ceviche that she had been planning to try while she was here. We went to the cutest restaurant, it was all an aqua blue color. The food was great! Manouche even surprised us with a beautiful cake for Helen’s birthday, the whole restaurant joined us in singing Happy Birthday as the restaurant played it over the loud speakers. The cutest waitress even went out of her way to buy us coffee from around the corner so we could enjoy it with our cake (it was decaf though… coffee isn’t really a big thing in Peru from what I noticed everything is instant).
After lunch, we headed to do home visits at an orphanage that FIMRC has been working with for a few years. The orphanage had nine homes on the property each with a house mother and 6-8 children. We wanted to assess the needs of the mothers and children so we could come up with useful lessons and activities regarding healthy habits and lifestyle for the families. This will be one of the big projects we take on during our time in Huancayo so I’m sure I’ll write more about it later.
Day 6:
Today was Helen’s Birthday!! We took a day trip to la Selva Central (the central jungle). We woke up at 5 am to get to the constitution plaza by 5:40 so we could buy tickets before the 6am departure. We had a great tour guide named Edgar, who explained to us that all the tour companies in the plaza kind of work together and divide up their clients into a few vans, so all the people on the bus had come from a different tour company. Tricky, tricky! We headed north with 15 other native Peruvians, although Edgar was sometimes hard to understand I think I did an ok job trying to quickly translate what he was saying. Our fellow travelers included a family of four, and their aunt and uncle, another family of 4 and their grandparents, two middle aged men, and another family of 3 (a grandma, mother and son). These people really became our own family as the day went on, we would swap pictures of each other and even take a few together. Helen and I stuck out like sour thumbs, but they treated us like family, asked us about our lives and how long we were going to be in Peru. One of the girls traveling with her family was also a medical student, so even though we didn’t talk too much about school it was a funny coincidence!
Our first stop was Santa Ana Cathedral in Tarma. Edgar was eagerly taking everyone’s picture before he rushed us back into the van. As we drove through Tarma, Edgar told us that Tarma is boasted as “La perla de los Andes” (The Peal of the Andes). He also told us that the 34th president of Peru, Manuel Odria who famously said “ Por mi patria doy mi vida y por Tarma mi Corazon” (For my homeland I give my life and for Tarma my heart). The remains of this president are actually in the Cathedral we visited.
We also stopped and visited a Sanctuary of the Lord of Muruhuay also in Tarma. Edgar stated that people had been leaving the city in the 1830’s due to numerous plagues and diseases in the area, but one night there appeared a cross engraved on a rock near the town, that community members believed would be the miracle that saved them from smallpox, they painted a crucified Christ on the stone and called him “The Lord of Muruhuay.” There is water running along a wall behind the sanctuary that is also thought to have healing powers. Many people from our tour filled up water bottles and rubbed the water on their hurting backs and knees.
As we continued our drive to the jungle, Edgar told us about some historical battles. I really wished I knew more about Peruvian history before I went on the tour because things would have just made more sense, but it was interesting to hear about the numerous battles between the Chilean and Peruvians, and the internal conflict in Peru starting in the 1980’s.
We drove along some very narrow and winding roads, Edgar called on of the curves the “curva del diablo” (don’t google it because it comes up with a different one with lots of tragic accidents closer to Lima, the one we were at was not that bad). We also passed through a series of six tunnels, the 5th tunnel called the “Tunel de la Virgen” that we were not allowed to breath in (not sure why… that part got lost in translation). The last tunnel we went through Edgar reported as the longest tunnel in Peru (it didn’t seem that long to me but we’ll go with it).
Around noon, we finally made it to the jungle! As we entered the jungle, there was a stop where people were able to get a Yellow Fever Vaccine for free, most of the people on the bus= lined up to get the shot, I was grateful that I had gotten it before I came to Peru. I thought it was interesting that they were giving it out specifically since you don’t get immunity for 10 days after the vaccine, but again I just went with it. From there our next stop was “Catarata el Tirol” a gorgeous 30-meter waterfall! We had to hike about 40 minutes before we got to it and were frightened by a tiny mouse that ran in front of us on the way, but it was definitely worth it. We were also just happy to escape to some heat and sunshine in the jungle!
After the waterfall, we had a delicious dinner, before we headed to a native tribal reservation and a coffee roasters. It was a very long day, we didn’t make it back to Huancayo until 1:30 am, because our van had some tire issues and the driver was driving what seemed like 10 miles per hour the whole way home! But we made it back safe and sound!
Day 7:
A much-needed lazy Sunday at home after a busy tour of the Jungle!
I bet you weren’t expecting that long of a post when you first clicked on it did you? Neither did I, but I feel like a lot of things happened this week, both big and small that will have an impact on how I look at the rest of my time in Huancayo. I hope you enjoyed reading and won’t give up if the posts continue to get longer! ;)
Chau,
~Maria