Bienvenidos a Peru!

And I'm off again! This time to Peru with Sarah Hilton, my good friend from MCG. The plan is to work in a clinic for 10 days then travel around and see what Peru has to offer.

We left Atlanta around 6am on Tuesday, July 5th after an awesome, but tiring July 4th weekend. Alex dropped us off at the airport, and we embarked on a 24 hour journey of airplanes and layovers (on a record 3 hours of sleep, mind you). Only a 2 hour flight to Miami, 6 hour flight to Lima, then 2 hours to Cuzco, but a whole lot of downtime between. We arrived in Lima around 9pm with plenty of time till our next departure, so we decided to check out Miraflores, according to most, the only part of Lima worth seeing. With my broken Spanish, we got a ~20 min cab ride to the center plaza. There were a surprising number of people out for a Tuesday night, just hanging, eating, drinking, sitting. There was a little market in the center of the park that I had to resist strong urges to buy earrings and cute alpaca stuffed animals. We took a stroll down the main avenue to the bay, where there was even more going on, but much more tourist-based. TGIF, Ruby Tuesday, etc. I'm sure the view from the dock is incredible during the day, but unfortunately, we only had a vast blankness in front of us, with a massive white lit cross on a hill off in the distance. We got a quick bite to eat back in the center from a place that offered us free drinks. Sarah, a vegetarian bless her heart, ate potatoes with a mustard-based sauce. I had a quarter chicken with a huge helping of fries and a salad, which I left most of for fear of getting sick on my first day. Complete with two pisco sours, the national drink, our meal was only 25 soles. Less than ten bucks. Oh, how I love South America. :)

When we made it back to the airport, we found a few fellow MCG kids, Scott, Amanda, and Meggie. We attempted to crash until our 7am flight, but relatively unsuccessfully. We should have been more prepared like the 15+ people we saw curled up in sleeping bags in a random corner. I slept a little on the plane and opened my eyes just as we were approaching Cuzco to see the snow capped mountains on the outskirts of the city. The runway lies in a valley surrounded by the city. Two strings of small mountains line the sides, with densely packed houses rising up the hillsides.

As soon as we got off the plane in Cuzco, about 20 Peruvians dressed in traditional wear busted out in song with their instruments. Quite a welcome greeting! We gathered up the MCG crew plus Derrick, and hopped on a van cab to the clinic, which we had to ask directions for about 5 times. When we arrived, the clinic was dark and appeared empty. We hit some random buttons on the gate outside until finally Lynn came down and rescued us. Dr. Ferris, the founder of CerviCusco and the man in charge, didn't arrive for another couple of days, so we took it easy the first day. Sarah and I are staying with two others in the "casita" on the roof.



Clay and Mack showed the newcomers the Batman, the van that makes a circuitous route around the city for 60 centimos, and dropped us off at the grocery store. We decided to grab a bite to eat first and found a small Peruvian restaurant with a set menu for 5 soles. That included chamomile tea, barley soup, a piece of potato in Huancaina (a cheese/mustard sauce, as far as we can tell), a fried chicken filet (milanesa de pollo), rice, and a salad. In retrospect, I should have perhaps tried a different entree than chicken, because chicken is hard to escape in this country, as I soon found out. We grabbed some groceries and took a cab back. After a short nap, Lynn took all the ladies shopping down near the Plaza de Armas, where hundreds of vendors have little shops that essentially all sell the same stuff, just different colors and shapes and sizes. I just did some scouting for future shopping.

view across the Plaza de Armas:


I am sad to report that my first real dinner in Peru was spicy ramen noodles, but you really can't beat a 30 cent dinner. We played some Cranium back at the clinic and called it a night due to our 5am wake up call.

Thursday, July 7th

CerviCusco takes trips out to other towns, called campaigns, to do paps and breast exams. This campaign was in Huayaccocha about 2 bumpy hours away. The bus was supposed to pick us up at 6am, but of course was at least 30 min late. The towns usually arrange for transportation there and back, as well as feed us breakfast and lunch. (Dr. Ferris later told us that they sometimes work with the mayors, who use the event to get re-elected.) We usually get a few rooms to set up shop in where we do pap smears, prepare the slide, and do breast exams. Anything more complicated requires a referral to the CerviCusco clinic in Cuzco.

15 of us piled into the sketchy bus that amazingly made it there and back without problems:


This clinic served us bread and jam, tea, and hot chocolate for breakfast. There were 15 of us including Lynn, the students, and the few CerviCusco workers and translators. There were three exam rooms with about four students per room, paired with someone who actually knew what they were doing. This clinic didn't have real exam tables, let alone stirrups for their feet to go in. This caused complications with almost every single patient, only made worse by the fact that none of us really spoke Spanish. Lynn and I spoke the most Spanish out of the 5 of us, but that's not saying much. We could basically say the commands that we wanted, but any attempt at understanding the patient was futile. Most of the women out there speak Quechua anyway, so we brought in a translator when we really needed to.

Lynn & our "exam table"


We put a fitted sheet on the table, folded a couple of pillowcases to make some semblance of a "pillow," and used the same table cloth and gown with every woman. Totally would not fly in the States, but here, it almost seems normal, albeit disgusting.

I was in a room with Sarah, Derrick, Scott, and Lynn, who did the first pap, then let us do the rest. The four of us got our system down by the end of the day. One person, the "assistant," prepped the plastic speculum with lubricant and prepared the slide; another strapped on a headlamp and did the "papanicolaou"; a third did the examen de mamas (breast exam); and the fourth filled out the paperwork. Once, I got to be "baby holder," a job that I loved. Unfortunately, the feelings were not reciprocated; that thing literally screamed throughout the entire exam.



The women in the rural areas and many in Cuzco all look the exact same. Anywhere from 1-10 brightly colored, layered skirts down to their knees (depending on the weather), leg warmers, shirts and cardigans, 2 long braids, and a top hat. Some younger ladies wore pants, but not many. They also have colorful blankets that they use to carry babies or loads of things on their backs. Maybe because they live in more rural towns, but maybe not, most of them were covered in dirt; not just their shoes, but also under their clothes and shirts, as I found out when doing breast exams. These women work so hard doing manual labor all the time, I guess it shouldn't be so surprising. Many complained of pains, which Lynn attributed to arthritis and told them to take ibuprofen.



We saw about 150 patients, and the four of us did about 60 of those. We are basically pros at paps now. I still haven't figured out the best way to do the breast exam, but I'm workin on it... We pretty much worked non-stop, but I did take a couple breaks to eat my granola bar and wander around outside, watching kids run around and women sitting on the ground, knitting various clothes.

"Lunch" came around 3pm when the line finally ran out of people. We ate outside on the grass eating our chicken, rice, and beets (!) for a change. We got back around 6pm and later went out to dinner at caller batata (sp) with everyone, then out for a night on the town. It was the night before the 100th anniversary of Machu Picchu, so there was a band set up in the Plaza de Armas. David, Mack, Sarah, and I braved the cold to get a beer and catch a few songs, but the rest headed to a bar that we were supposed to meet them at. Of course they were nowhere to be found when we arrived, so we headed to another bar that had a Doors cover band (although it was actually a classic rock cover band that probably only knew three Doors songs). Lastly, we made it to Inkateam, a ridiculously crowded dance club playing the usual US hits. We ran into Carolyn and Andrew, danced awhile, then caught a cab back.