chloe is on vacation

Fieldnotes and fleas (well, I can never put the fleas on hold...) are on vacation. Please check in after the New Year for some resolutions and my near-mid-year reports. I have now been here in Lima for 5 months. It really seems like home to me. I will leave you with some pictures from our wonderful few day trip to Mancora beach where we took surfing lessons, laid in the sun, and drank Cuba Libres.

very close

I am very close to being done with this informe I am writing on my water research. I am trying to write it in a way that gets my advisor more excited about the project since I actually think there is a lot Socios could do with a water project. I do however think that it will involve more than just me wandering through the fields taking pictures of pretty springs.

I am very close to being done with the paseo for MDR TB patients that I am organizing. So many little and big details keep coming up! Can so and so bring his mother because she always comes to therapy? Make sure to get the name and ID of the bus driver because last time someone got on the bus and pretended to be from the bus company and took the money. Make sure to fill the water balloons up with water before getting to the place in case they don't have faucets small enough. Divide up all the responsibilities, the treats for the bus ride, the prizes for the group games. Make gift baskets for a raffle. Pay the bus company. Just to mention a few...

I am very close to seeing Meggie.

I am very close to being home in Belmont for Christmas and New Year's. I will be home from December 23 to January 4. I would love to see you all when I'm home. Those of you who are in the Boston area.

I am very close to being really exhausted and annoyed by little things.

Thankfully come Sunday I will be on a 14 hour bus ride with Meggie up to Mancora, starting what should be a wonderful vacation--both part 1 and part 2.

surfear!

OK, so this is the beginning of Chloe's surfing experience. Collin and I went to a beach right beneath the city of Lima where I had previously sworn to never swim. They say that something like 80% of the sewage from the city goes untreated into the ocean. Yum. I tried not to swallow it, but I definitely came out with salty lips.

I had a lesson from a dude who has given a few lessons to Collin. He was really chill and eased my fears. For one thing, he didn't leave us out of the water for too long so my fears didn't escalate fully. A little stretching, a little practice how to stand up on the board using a bench, and then we jumped right into the waves. Fortunately on the first wave coming towards me I fell off, so I learned quickly that waves are not always scary. In fact, waves are really fun.





OK, so the person actually standing up is not me. But Collin got a nice shot of my hands on the board right before I attempted to stand up. He had his nifty water proof case for his camera and was chilling in the water 25 feet in front of me. Right before I would go over him with my board, he ducked down.

All in prep for my week with Meggie at the beach! A vacation for this hard working volunteer. This is a long week filled with lots of work...

head vs. heart

I was just reading a friend's blog and she had a critical comment from a former coworker who said something like "it sounds like this is all coming from your head, not your heart." Based on my own worries about my blog, I think her coworker was just trying to push her, knowing that she has more inside her that she wanted to read on her blog. Not just her observations and commentary. Those don't show what we all love about Alexa. When I first started writing my blog, I think I was so caught up in worrying about what my readers would want to learn about my Peruvian experience that I lost a lot of "my heart" from what I wrote. I hope that is changing! I am not writing this blog specifically to be a formal report on working in Lima. I am more interested in sharing my experiences, observations, fears, joys, and difficulties with people back at home.

I was really worried about writing a blog that was too formal and elite sounding. For whatever reason it feels like some blogs out there are inaccessible and snobby. Writing on a blog, depending on your readership, is kind of like trying out ideas and processing them. Those ideas might not be always from your heart, nor they might not always be the definitive answer on a subject. Your feelings of the subject might change. In Alexa's blog perhaps she was trying out an idea she had about her recent move to New York City, and in a few weeks, her whole opinion on that subject will change.

In any event, I do hope that I am getting some of my "heart" into my blog. My professors in college always told me that I try to squish too many ideas into too few words. I always assumed people could read my thought process when reading what I wrote. Or maybe I assumed it wasn't necessary or interesting to explain the thought process. Grace Burton, my spanish literature teacher, was the first person to point this out in my writing, and it led to a big change in my perspective of how I think, process, and write. She encouraged me to tease out what I am trying to say. Help the reader along. Show each step my mind took as it jumped from one concept to the next, instead of assuming that those were unnecessary steps to explain.

While I am writing this, I am considering the report I need to write to evaluate the water investigation I have done so far. I have to turn it in before Christmas, which I just realized is quite soon. I have been keeping myself busy at work organizing a fun recreational day for MDR TB patients who are in group therapy in metropolitan Lima. There are about 120 patients in total. Should be a fun day full of soccer games, three-legged race, the egg toss, and swimming. Meggie is coming the day before, and Socios has quite generously invited her to come along. Socios takes a while to trust people, including their employees and volunteers, so it takes a while before the volunteers can work directly with patients or community members. So I am very thankful and slightly surprised they are inviting Meggie along. After the fun day (aka paseo,) Meggie and I are heading up to a beach town on the northern coast. Then I am flying home to Boston for Christmas and New Year's! I would love to see anyone who is around Boston!

fotos...

I just realized that I have a half written blog post waiting to be published. Hard for you all to read my half written posts just like the emails that end up waiting longer than they should in my "draft" folder. I love that Gmail has that option, but sometimes I feel like I wrote an email to someone since I started it, so then I stop thinking about it--but since I never finish, and it remains in my "draft" folder. Anyway, in the meantime before I finish my draft post, I'll post a couple photos.



The above photo kind of catches everyone's faces in odd expressions. It was out in the campo at a workshop for mothers about nutrition for kids under 1. During the workshop we drank (including a nursing baby) orange soda and Frito-like spicy chips. The poor baby after consuming too much, vomited up most of what she took in.



This picture is at a training we held recently to train the public hospital nurses and psychologists in how we run group therapy sessions for MDR TB patients. I am sitting next to a psychiatrist and 2 Socios nurses that I work with. The plan, I think, is for a switchover so that group therapy sessions will be run by the public hospitals and be part of the MDR TB treatment. If it works, it would be a great way to make it more accessible and sustainable.

While we're talking about pictures, I put a link to my fellow volunteer Collin's photo blog. He's the big photographer of the 4 of us.

how does one spend life outside of work?

A topic that goes through my head frequently is how I spend my time outside of work. We are at work (in the office or in the field) a significant period of time: 8-5 Monday through Friday, 8-1 Saturdays, and sometimes Saturday afternoons as well. But that still leaves a lot of time outside of work to recharge, relax, have fun, explore, process, read, and write. Sunday is the big day for all those activities.

When I first got here I think I felt a pressure to get out and explore the city, and not just stay in our comfortable cable/internet outfitted apartment. I have done some exploring, but I admit it's hard to do alone in a big city. One Sunday I went to the Lima art museum, walked around a park, ate at a cafe, all by myself. When my coworkers asked me the next day what I had done the day before, I proudly said, "I went to the art museum!" Everyone was shocked to hear I went alone and encouraged me to next time go with another volunteer. But how can I always just do what I can get someone else excited about doing too? It felt kind of liberating to go to the museum and not worry about who to invite, who I should spend time with, who I should call. I have very few social obligations in my life in Lima, which is sometimes isolating, but also liberating. And while I do love my fellow volunteers (some of whom are reading this,) I also need a break from them from time to time. We work together, eat lunch together, and live together. Fortunately they're buena gente.

Anyway, after a while of resisting the limitless amount of HBO programming and DVDs we can cheaply buy here, I feel like I have folded and have watched more HBO on DVDs than I thought possible. You know, they're great shows, "Six Feet Under," "The Wire," "Arrested Development," and "Entourage." But in moderation I could enjoy them more. I would also probably feel better about my life here if it didn't revolve around work and watching HBO. Anyway, I try to make an effort to do a variety of activities outside of work in order to not fall into an unstimulating routine. For example, going to spinning or pilates classes with Holly (fellow volunteer.) Or going to the movie theatre with César (non-work Peruvian friend of a friend.) Not having lots of other non-work Peruvian friends makes it challenging sometimes. Poco a poco I'm getting there though. Slowly, but surely, I am getting to know this city of 10 million people (more than the entire population of Bolivia.)

Yesterday Holly, Collin and I headed to a town on the southside of the city and came across a rocky beach that didn't smell so good, but offered a great escape from the city. We enjoyed a lunch of ceviche and pisco sours (they served us even though it was election day and alcohol is prohibited the weekend of elections) at a restaurant playing hits from the 1950s in Spanish. The town felt like a town from a different era. Today a coworker told me it was a popular place to go in the 1950s. Here's some pictures including Holly and Collin in one of their many political debates, and a view of Lima from where we were:

más fotos

Sra. Valeria, her son, and her grandson. One of her daughters is trying to find work in Buenos Aires and the other in Spain. So far the one in Argentina has been there for more than a year and hasn't sent home any money. A lot of Bolivians travel to other countries to work for a couple years since there are zero jobs in Bolivia, but it's not always more beneficial than staying.



Our stop at Sipe Sipe at the best house to buy huarapo, sweet fermented grape drink. The woman on the right owns the place and was filling up our yellow jugs with the drink from her barrels of it.

fotos de Bolivia

Raul for diputado! Unfortunately he didn't win. Raul was my advisor for my water research in the Zona Sur of Cochabamba. It was pretty exciting to drive past his name on the walls.



Ruins outside of Cochabamba where until recently the people who live around there played soccer in the ruins.

ah, the sweet smell of cochabamba

When I got off the plane early in the morning I smelled the familiar urine smell of Cochabamba and saw the striking cordillera, the mountain range the surrounds the small valley city. It was really great to be back for a few days. I saw a lot more stray dogs, smooth sidewalks, less clouds, familiar faces, cholitas, political graffiti on the walls, people speaking quechua, and heard less cars honking. Cochabamba has a calm feeling to it. Everyone is doing something, but slowly, with intention.

Fortunately I was able to catch up with almost everyone I know who lives there. The first day Juan Pablo took me along with his classmates on a fieldtrip to see ruins that I had never seen. The bus ride through the wrinkled-sheet mountains reminded me of when I was there before. The ruins were of big buildings and houses, but no one know much about them because there is no funding for a study.

Back in the city I enjoyed a long lunch with a siesta (Peruvians don't take a siesta after lunch like they do in Bolivia) at my former director's new house. I spoke at my program's field studies class about the research I did in Bolivia, giving suggestions and warning about the potential frustrations. I ventured to the Zona Sur, the poor part of Cochabamba, to visit the families I knew when I did my research there. I first went to Valeria's house to find that she had moved. Wandering through the familiar dirt roads, I found Fabiola sitting outside of her house. I actually walked by the house, not sure which one it was, but she yelled out, "la chloe?" It was great to see her and her family. It is so weird to see kids I know grow up. I felt like such an adult remarking on how much they had all grown. They said they thought about me often and had assumed I was for sure married by now.

The next day I found the cell phone number of Raul, my supervisor for my water research, who helped me find Valeria's new house. She moved in to a shared lot, her daughters have both left (one to Spain, one to Argentina) to make money for a couple years, and she is alone with the 2 ten year old boys. Unfortunately it seemed they had not grown as much as the other kids I know. Or they just stretched out. Raul was in charge of buying a ton of huarapo, a fermented grape drink, for a big cholita festival, so we all piled into his rented taxi to head out to Sipe Sipe where they supposedly have the best huarapo. I had lunch with my host family the next day, and my host father said, oh no, they have fake huarapo in Sipe Sipe. So, who knows. I enjoyed catching up with my host sisters who have both now graduated.

It was a great trip and really hard to leave. Everyone talked badly about Peruvians, so I found myself defending my new people. Whereas in Peru, I have to defend Bolivians as well. Bolivians and Peruvians really should be friends, as I understand. Although now they have presidents who are not too fond of each other. Last time I was in Bolivia the conservative gringo Goni was president, so it was pretty great to be there and talk to people about Evo, the coca grower who is making a lot of great reformations. He has already advanced really successfully with a literarization project and an agrarian reform project giving people deeds to land that they live on.

Anyway, on top of all the great people I saw, places I saw, and salteñas I ate, it was also really great for my spanish since I spoke spanish the whole time I was there. Now it's back to work until me next fun break in December when Meggie comes!

Fotos de Arequipa

Before I put any Bolivia pictures up, here are some from the short viaje to Arequipa. The first one is from the convent that I went to. Each nun had her own kitchen and servant to cook for her (that's the kitchen.) The guinea pigs that would soon be lunch lived underneath the stove. I am standing on the roof of a building at the convent. You can kind of see the volcano, El Misti. The other picture of El Misti is taken from the zoo where we had a our outting with the patients.

bolivs!

A little Bolivia story: A couple years ago I studied abroad in Cochabamba, Bolivia. Cochabamba is a quaint quiet city that is located in between the altiplano of the Andes and the lowlands leading to the Amazon. It is kind of off the normal tourist track since there isn't anything especially noteworthy unless you count the Christ statue on top of a hill like the one in Rio de Janeiro. It is pretty small, with narrow roads left over from colonial times. The plaza is really lively especially around lunch time when everyone walks through it to get home for a leisurely lunch and nap. In San Borja, Lima, we see modern Peru. Our streets are wide with green boulevards, people commuting, people walking dogs. There are parts of Lima with beautiful architecture, balconies, narrow streets, typical plazas, but they aren't part of my everday sites.

While I love the feeling of the city and how it looks, what really excites me about Cochabamba are the people that I met when I was there. Since I have a tourist visa of 90 days, I have to cross the border to renew it for another three months. I am happily taking the opportunity to go back to Cochabamba for a few days, despite the fact that it is not near the border. I have really been enjoying reconnecting with people there to let them know I am coming back for a visit. So far I have emailed with one of my host sisters, one of the director's of my program, the administrative assistant of the program, and Juan Pablo.

In Bolivia I did research that turned into my thesis back at Skidmore on the communities in the Zona Sur, which is similar to Carabayllo (and the Zona Norte) in Lima. With the help of a resident who had been elected to serve on the public water committtee which took over after the perserverent Bolivians kicked out the private Bechtel-funded water company, I met a couple really great families. They both welcomed me to their houses, answered all my water questions, and invited me to watch the latest soap operas with them.

I head off tonight on a 2am flight and will wake up in Bolivs!

little trip

I had my first ever business trip this last weekend. It was really awesome. I flew down to Arequipa with a psychiatrist to attend a paseo for patients and their families. The city is located south of Lima, in the mountains, right under a big volcano called El Misti. I didn't ever see the tip of it because it always had a little bit of clouds chilling at the top. Arequipa is nicnamed the white city because many of the buildings are made with sillar, which is a white volcanic rock. The city plaza was small, with lush green plants and trees, and covered walkways surrounding it. The plaza was familiar feeling. It reminded me of the plaza in Cochabamba.

I took an early morning flight back to Lima on Monday. The doctor I work with recommended I try to get a seat on the right side of the plane. The sky was clear, so I could perfectly see all the wrinkled dry mountains of the Andes, a lake, a snow-capped mountain, deep canyons, and finally the Pacific. I was glad to get back to Lima because I was sick and wanted the comforts of home, but it was hard to come back to the loud, polluted, overcast city.

A boring side note: One of the faults I am learning about having a password-protected blog is that everyone has to get a google account, and I have to invite everyone (which means I need their email address.) In no way am I trying to make my blog exclusive, just trying to make it less public, so please let me know if I left anyone out or can help with the google account business (although who wouldn't want a google account, right al?) Thanks for helping me create a safe place to post my opinions! Sorry if it has been a hassle.

mi primer temblor

So I woke up a little before 6am this morning to our apartment shaking! We live on the 2nd floor of a 7 story apartment building. It felt like I was in a jenga tower about to fall. I wasn't actually that scared, which is maybe my "stay calm in emergencies" mechanism working too hard. I couldn't find any reports of the earthquake on the news outside of Lima, but I did get a email from gg asking about it. The Peruvian news report says that it was 6.4 on the Richter scale. There are no deaths reported and just minimal damage near the epicenter, which was hours away from Lima. Anyway, I don't really know any more details than that, but it sure was a surprising way to wake up. The only other earthquake I remember feeling was a few years ago at Skidmore. It's kind of scary to think about being right on an active fault line. The pulses of the earthquake were so even and forceful that I kept thinking maybe it was just the construction next door.

Collin's thoughts during the "tremor:"

Thought 1: Oh, an earthquake.
Thought 2: Wait, they don't have earthquakes here [they do actually, Collin], our neighbors must be having sex.
Thought 3: Wow, they must be big individuals our walls are moving.
Thought 4: OK, good, it stopped.

Collin is one of my roommates/co-volunteers. Also, on CNN tonight the banner at the bottom of the screen reported our little earthquake, which made us proud.

inspiración

Last week I had the great opportunity to meet my hero. I know some people aren't fond of meeting their heroes because they are sure to not meet their expectations and leave them feeling less than inspired. Fortunately for me, it was quite the opposite. Paul Farmer was here for about 5 days to talk at a presentation that we had for a book that showed 20 testimonials of MDR TB patients who have survived and also talk at a conference on health and human rights. He helped us play hookie from work for an afternoon and got us invited to the conference. It felt great to hear him talk to the audience knowing that we were part of the work he was talking about. Fighting structural violence with our little contributions. Mine might be small like organizing the clinical information from psychiatric evaluations, but I have trust in the rest of the organization that I work with.

One of his talks reminded me a lot of the outreach work at the mental health clinic that I worked at last year. The idea that we need to have a paradigm change in terms of how we think about health problems. We all need to work together to fight to make it illegal to NOT have the right and access to health and basic services. Socios has figured out how to treat MDR TB by going into people's houses, helping them take the medicine, getting it to them for free, helping them with the awful side effects, and helping them socioeconomically as well. At 5 Hall Ave (the mental health clinic), we went right into people's houses, made sure they had groceries, they had paid their bills, and assured they got to their medical appointments. Anyway, keep the up the good work, SMHC crew!

It's time we all start demanding some kind of global change of how we look at health care. I loved my medical anthropology classes in college, but I have to say that I am starting to feel that we can no longer just analyze and study--we have to start acting, too. Analyzing is important to cause real global change, but in the mean time, before that change arrives, we need to fill in the gaps of our current social and health services. Anthropologists need to gang up with health workers and economists and epidemiologists. That's where you come in, Meg!

Ok, I think I have proven that my meeting Paul was an inspiration. He took the 4 of us volunteers out for some pisco sours, told stories, and gave advice. Now we are back to "eating shit for the poor." Less worrying about little complaints we might have. And just because I can never thank you enough--thank you again to all my supporters and readers. It is an incredible feeling to have so many people supporting me. I hope this post finds you all well!

international living

As I am entering my third month here in Peru, I am feeling more like a true member of the Young Americans Practicing International Living Club, the unspoken association we all belong to by living abroad. We adjust to different changing of seasons, types of food, amounts of food, language, sides of the road, lack of roads, customs, and of course politics. A friend joked with me that I am not truly experiencing "international living" because I have a 617 phone number for people back in Boston to call my Skype phone for free. I also feel like I should get points taken away because our apartment has cable with news in Spanish, English or Arabic. My easy internet access is a big difference from my own previous international living experience in Bolivia where I had a few favorite internet cafes to do my correspondence. Yesterday as my roommates and I were relaxing watching one of our many pirated HBO series DVDs, I realized that I am finally feeling at home in the apartment I arrived at couple months ago, unable to imagine ever feeling at home in.

I still take pleasure in doing activities that make me feel more at home or comfortable like reading a novel in English, watching "Sex and the City," and of course corresponding with all of you, but more and more I find lots of my new activities fun and fulfilling. This past Saturday the 4 of us volunteers had our monthly meeting in Carabayllo. It was slightly stressful for a couple, not so bad for me, but we were all looking forward to our lunch of ceviche. I never had ceviche before coming to Peru. It is fresh fish, not cooked, soaked in lime juice and herbs. It comes on a plate with choclo (oversized tasty corn) and potatoes. It has a really great savory flavor. Carlos's girlfriend just arrived last week, so we went out to a ceviche restaurant with her and some of our coworkers. It was relaxing, delicious, and fun. A great Saturday afternoon with, finally, some springtime sun and warmth.

weight loss and chicken

Thank you everyone for following me to the new location!

Today I was eating lunch with some of my coworkers who do data collection (I think) and one of them asked me about the U.S.'s obesity problem. I confirmed that, yes, we have an obesity problem. My coworker was perplexed because all the Americans he sees are the volunteers or medical students that come down, and so far all of them have been thin. It was challenging to explain my perspective of how socioeconomic factors cause people to have to work multiple jobs not leaving time to prepare healthy meals, so then they have to buy premade food that is high in fat and calories, leading to obesity problems.

I am actually getting used to the food here and craving certain dishes. I can even name about 5 of their regular plates. Here there isn't the same kind of variety of food I am used to at home. At home I might prepare one type of food for dinner one night, and never prepare it that way again. My parents prepare food differently from each other, and I prepare food differently from them. Here there is a repertoire of maybe 15 dishes that everyone knows how to make. One time I brought my tupperware dinner that the house makes for us over to someone's house. We realized that her family had cooked the exact same meal. It's called "arroz con pollo," one of my favorites. It has the vaguest name though. Almost every dish is some variety of chicken and rice, but this one plate is specifically called "chicken and rice." (Emphasis on the rice part...it's unbelievable how much white rice we are served.)

On the topic of food, and more specifically weight loss, last week I had an unexpected experience at what I thought was a Spa. We know someone who has a friend that works at a spa and got us some free trials. I was really excited and tried to save up all my knots and neck aches, so I could really enjoy a massage. We got there and learned that they don't give relaxing massages, they give weight loss body massages with electric currents and weird wands. Anyway, it was not the relaxing evening at the spa I was hoping for. But maybe it helped me lose a few pounds that I have gained from eating all the white rice.

Here are some non work pictures that are kind of funny. One with me looking really out of place and perplexed and the other one was taken at 4am. Collin and Carlos (2 of the other volunteers) are to the right of me. Carlos is asleep. I think he woke up briefly to pose for the picture, then fell back asleep.

how public are my opinions?

I originally started this blog because I thought it would be a good way to communicate with those who contributed to my fundraising for my year of work here. With a blog, people can see what I am up to at their own leisure. It also seemed like a good way for me to have people at home know what I am doing, so that when I talk to people at home (or when I come home) people will have an idea of what my life has been like. Now that I have the blog, I have also enjoyed using it as a place to process, analyze, and articulate the disorder of my thoughts. I enjoy thinking of ideas to write about that would be interesting to read and fun to write. I also enjoy knowing that people at home doing all different kinds of jobs and activities take time to think about my experiences here. All of that said, I might make some changes. I might change the web address of my blog, but don't want to lose faithful readers. If I do, I will email those who I have email addresses for, but if you think I might not have yours, please email me. My email address is avaiable I think if you go to the "complete profile" page. The blog will look and be just the same, only with a new name. Again, this is just an idea, and depending on what my feelings say after I sit on this for a little I might not follow through.

While I am in announcement mode, let me take this opportunity to say thank you again to everyone who is supporting my work here. Either through your contributions or your emotional support, I appreciate it greatly. It still surprises me to realize that I am down here doing what I have always known I was interested in doing after taking "Medical Anthropology" junior year at Skidmore. Four years later, still interested in the topic of social inequalities and health consequences, I am working hard to make my contribution to the mission explained in the book I read for school. So thank you for the continuous support, helping me get here, and helping stay here!

¡Hasta pronto!

sorry to keep you waiting, pops

Last week was probably my best week at work so far. I helped organize a big meeting with 6 psychiatrists and 5 nurses. There was a lot of photocopying, powerpointing, formatting, and I think it all went relatively smoothly. We held the meeting in a fancy restaurant that served everyone a pisco sour, so that maybe helped the discussion. Many of the nurses told me that they thought I did a great job putting it together after they had seen me scrambling around to make the doctors' last minute requests come true. Since I frequently feel like the nurses around me don't know what I am doing, it was nice to get that recognition. I sat between doctors at a fancy table, eating good food, trying desperately to follow conversation, but mostly just feeling quite content that we all made it, including Mr. Powerpoint. It was a good bonding experience for my superiors and I. The next morning unfortunately it all began to unfold, but it wasn't a big deal. I think it's a sign that I am getting more comfortable here if I can easily admit mistakes knowing that it's okay. I was asked to write a summary of the night and what was discussed, so I had to admit that after we went through what was on the agenda I stopped being able to follow the discussion. We also realized quickly that a disc and the list of people who came had gone missing. Fortunately we have found them all now and have recovered from the late night meeting.

I realized I haven't really explained the project that I am working on yet. Probably because until recently I wasn't quite sure what the project is. While I am still feeling like I don't know exactly what they want me to do, over the last 2 weeks I have gotten a much better grasp of the project. The psychiatrists that I work with treat patients who are on the treatment for MDR TB, which is a really difficult treatment for many reasons. The treatment lasts at least 24 months, involves taking medication (including an injection) multiple times a day, with lots of really awful side effects (physical and psychological). On top of that, patients also have to deal with the stigma of the disease and the fact that it is really contagious (many people's family members die from it, so getting rid of guilt is a frequent theme of discussion). If the medication isn't helping the patient get better, then the last choice is an operation and restarting the 24 month regimen. Years ago Socios started a group therapy program for patients struggling with the psycho-social aspects of the disease. Many people come from outside of Lima for the treatment, so it's a good environment for them to get support. Because the side effects are so extreme, people use the group for support in continuing taking the pills and injections. The group therapy is now happening all across Lima. One hope they have for me, is to help monitor how the groups in different parts of the city are going and uniformize them. Right now a Socios psychiatrist, nurse, and promotora organize and run the groups, but hopefully they will become a part of a clinic's treatment of MDR TB. Anyway, that is a little of what I am doing. It continues to be challenging and interesting, which is why I came here.

Outside of work: We have a new volunteer who came this last weekend. She is an epidemiologist which is pretty awesome. So she is teaching me a little about statistics since I know nothing, but hope to help them organize data for a study on the group therapy program. We have been having a lot of fun with Carlos's coworkers from the Salud Infantil program. Discotecas in Lima are open all night, and it is not unusual for people to be out dancing till 5 am. Last Saturday we celebrated the birthday of one of our friend's from Salud Infantil at a boulevard of discotecas. The night ended at a karaoke bar at 4 am, where half of us were asleep, the other half trying to sing.

I hope everyone is well! Thanks for reading. I am open to any comments or suggestions about the blog.

non-biomedicine services are not far away

I was just taking a break from my morning work to eat an apple and read the NY Times headlines. As I was reading an article about the scene today at ground zero, I was feeling more shaken by it than I expected I would. If I was in the U.S. today I would probably be really aware that today marks 5 years since 9/11, but here the day goes just like any other day. So I finished my apple and started to walk to the kitchen where I could throw it away and wash my hands. To get to the kitchen, you have to walk down a few steps out of the enfermeria, into a little lobby, down a set of stairs that do not have a roof covering, and then into the kitchen. As I was walking down the outside stairs I passed Aurora, a woman who cleans the office. Right as I was passing her, I slipped down the rest of the stairs. In my defense, they were wet, they have slippery linoleum covering, and my shoes don't have much traction. A doctor and Aurora began asking me if I was okay. Although my butt hurt, I knew I was fine, just shaken. Aurora was worried and took me aside and started rubbing where I fell. That sounds like it should feel violating, but it just felt like a mother taking care of her kid without shame. I think she was saying that in order for it not to bruise, she was rubbing it. Or something like that. (I am finishing this on Tuesday, a day after, with a big bruise...sorry Aurura) By the time I got back to my desk, I was feeling pretty vulnerable (reading about 9/11, falling down stairs). Later when Aurora walked by I told her that I was fine, just shocked still from the fall. Really I think I just wanted to go cry for a second. She said that she could use an egg to get rid of the fear. I remember hearing that in Bolivia too. They pass it over your body, then put it in a glass of water. I forget what else. The egg treatment never occurred, but I really loved the presence of traditional medicine in an ostensibly biomedical institution.

Despite the slip, yesterday was a good day.

Hope everyone is well,
Chloe

fotos

Aquí estan unas fotos que he tomado ayer cuando estaba en el campo con Carmen. Ojala que las disfruten!


This was the sunniest and warmest day I have seen so far. It would be good contrast to show a picture of me at work every other day of the week in the office.


This is the public faucet in a town called "Santa Rosa Puquio." Puquio means natural spring in quechua. Unfortunately this town does not see so much water these days. About 5 years ago the city water company put wells in the area, which lowered the water table level, changing a lush town into another dry town with no water.


Our walk behind the sheep back to the highway to take a car back to the city. The bundle leading the flock is a woman with a mountain of hay on her back. We passed one house with dogs that are known to bite strangers, so we used the sheep as guards to sneak by. Good thing I have a guide.

Feliz Cumpleaños Mama!! Que tengas un día feliz.

desorden desorden!

I will leave you with a picture from the other week when we saw a field full of people digging out potatoes. (look how orderly the potatoes are stacked!)

Santa Rosa de Quives

Week of Santa Rose de Quives. Last Wednesday was a national holiday in honor of Santa Rosa de Quives, patron saint of Lima. I will describe our celebration, but first this fellow standing in front of his truck filled with trash. Last Friday on my "Friday fun day of field work" regarding the water project, Carmen took me to a town in the district of Santa Rosa. When we crossed the bridge, this blue truck pulled up, a couple dudes hopped out, and started collecting trash from a public trash barrel. Walking down to the edge of the Rio Chillon, we could see the difference of having a trash collecting system. My past research has been in the district of Carabayllo, which does not have trash collection. In Carabayllo the river and the subsidiaries are all filled with trash. So what will it take for Carabayllo to get a trash collection system that does not require burning it or throwing it in the river? Probably months or years of bureaucratic nonsensical reports that might lead to a trash collecting system. Maybe I am being too pessimistic. It was really interesting though to see a town with a clean river edge and clean paved irrigation canals running through the chakra (Quechua for field). Just down the river is the town of Chocas, where the irrigation canals are filled with trash and the river is considered very contaminated. Chocas is the town where we spent our Dia de Santa Rosa.

There are a couple different ways to celebrate Santa Rosa, as I have collected. For some people I talked to in the office the day after, they took it as a relaxing day off in the middle of the week. Cooked (they work all day with long commutes leaving little time for cooking I imagine), spent time with their family, and relaxed. Another coworker told me she went with her mother to the big church in central Lima for a procession and mass. We joined the masses of people from the outskirts of the city and some from the city on the long trip to the small town of Santa Rosa de Quives. We took a few buses over hills (I were told they were hills, we couldn't see anything) on windy roads that have recently been paved. The town was set up for an all night party. Carnaval rides, stands of food, a huge dancing area, live band, and restaurants. Everywhere we looked there were tents squeezed in between trees. The chapel of Santa Rosa and the big party supposedly started the next day. Everyone wanted to be there for it. People write their wishes (and are encouraged to be specific) on letters addressed to the Saint who is told to make any miracle come true. We stayed til the sun was just starting to come up, then took a bus back to our coworker's house in Chocas. We slept for a couple hours, then she started to cook us a lunch of baby goat. Fortunately I got out of eating it, but poor Carlos and Collin (my fellow volunteers) both got sick the next day. It was lovely to spend the morning walking around the corn fields around her house. The sun rarely shows through the clouds in the city.

Thanks again to everyone who helped me get here. I greatly appreciate all the emotional support and contributions. The work here can sometimes get really frustrating, but when I take a step back I realize I am doing what I have always wanted to do.

in search of agua potable

So Fridays are becoming my favorite days here. All three of us woke up to get on the movilidad that goes to Carabayllo at 7am. Collin spent the morning photographing women at a health center taking part in a breast-feeding competition. Yesterday was "breast feeding day" around the whole city to promote that over using formula. I spent the morning going around with a woman from the Salud Infantil program. It was a simple excursion, but interesting and comforting. Her work reminded me of what I did at SMHC visiting my clients at their houses. We went to the houses of 2 promotores. A promotor is like a health worker that knows their neighborhood well and has been elected by the local community. She divided up medication and prescriptions for different patients, and then the promotor will go out and deliver them, making sure the children are taking the medication properly. Using this method, health workers can manage infections and diseases better and those who are sick feel more comfortable. From what I have heard, because people who live in this district come from outside the city, they are not accustomed to going to doctors for medical concerns. There is a fear of doctors even, that keeps people from taking their children or going themselves. A neighbor coming over to the house and explaining the medications would be a much more comfortable way to receive treatment.



In the afternoon, my guide from the previous Friday took Collin and I to Huarangal, a small town way out of the city that borders a nuclear plant and fields of corn, potatoes, and other vegetables. We drove through hills of pure rocks and dust, without any houses or plants in sight. Crossing over the hills, down into a valley where there was just enough water for farmers to grow crops and just enough for the people to live. One family told us how we could get to a spring that provided the most potable water. Walking through fields of people digging up potatoes and tall corn, we arrived at a place that once had water. It was a dried up spring, which is unfortunate because this is the time where there is supposed to be the most water. Beyond the spring, the Río Chillón provides more water, but is considered very contaminated. An interesting point that we're realizing is there is not one definition or source of potable water. Potable is relative.

take care of your life, don't cross the highway

Signs on the highway in Lima advise pedestrians to use the elevated walkways to get to the other side, instead of crossing through the lanes. It seems obvious, but the sign is necessary. People constantly run across the lanes of the highway, risking lives and scaring passengers (or at least when I'm the passenger). Traffic accidents account for the most deaths in the city. Cars drive here like the people live. Desparately trying to grab hold of the little corner of the blanket or squeeze into a space much too small for them. Lanes, traffic lights, and rotary laws are suggestions.

Last Friday was my favorite day here so far. I got out of the busy city and went to the farmland north of Lima. We took a van, a bus, a taxi, and then walked. Here too I saw signs of not respecting one's health. Like running across a highway. A woman from the area who coordinates health workers for Socios acted as my guide and took me on a tour of the land and people. Her knowledge of the land, history, people, and short cuts was remarkable. After getting out of the squished taxi (the taxi acts like a public bus, so it gets crowded. I think we had 8 people in it at one point, but I'm not sure because I was squeezed in the front next to the clutch), we found ourselves in a small town with steep rocky hills on one side and green lush fields on the other. My mission for the day was to start my investigación exploratoria on the water issues in the area.

My friendly guide took me through the fields of chives, beets, potatoes, lettuce, corn, and of course more potatoes. We arrived to this water where there was a truck, a truck load of beets, and about 10 people. I instantly regretted not taking my camera as we watched the people cleaing the beets in the water. They had set them up to create almost a dam. We followed the water, taking short cuts through the fields, to where it originates at a spring. We stood at the spring and in a short period time watched a woman wash her clothes, a boy shave, a man wash his face before getting on the city bound bus, and a truck come and suck water out to then sell to a nearby neighborhood that has no access to the spring water. The water at the spring is clear and clean, unfortunately it will travel past everyone's houses, through the crops, and be quite contaminated once it's used for cleaning and watering crops. I am eager for this Friday when I will find my guide again, enjoy a break from the office, and ask more questions.

Until then, I will be very careful when crossing the street as I know the cars will not stop.

my mood changes frequently

Good news: The group therapy session that I sat in on was both difficult to hear the testimonies of the patients and exciting to be present for. What I have been reading and what the people shared shows how much of a struggle the treatment for MDR TB is, and how much they need the psycho-social support from the group. Soon I will attend sessions in Lima Norte and Lima Ciudad. In other good news, I talked briefly with the sociologist this morning while waiting for the doctors about my future research with her. As many of you know I have a passion for the political economy of water, and so I am eager for my interviews and research to begin!

no big update

One of my fellow volunteers has a blog that I have put a link to on the right. He is ahead of me in putting pictures up. We can take advantage of that though. I can take longer to take pictures, and you can check out his! He is working primarily in Carabayllo with kids in the Salud Infantil program (or what I call "Discovery Zone." Pictures of where he works are much more interesting than pictures of where I work would be. Cubicles here look like cubicles at home.

Thanks for everyone's emails and thanks for reading.

Una semana!

My thoughts feel too disorganized to write a new post, but I have done and seen so many things I want to share. It is now a week since I left. I think it still hasn't quite set in that I am staying here for a year, since I am feeling rather calm about the whole deal. I also have been busy and around people, which are great ways to not be scared by reality.

This past weekend I went out with a couple of the other volunteers and a couple of their Peruvian friends to a neighborhood right on the Pacific Coast. It was incredible to see the ocean! We drank Pisco Sours on the balcony of a restaurant overlooking the cliffs that lead to the water. My only other experience in South America is in Bolivia. Thanks to Chile and Peru, Bolivia no longer has a coast line which made it more impressive to look out with dusty hills behind me and see water. We went to a peña which is a show in a restaurant setting that demonstrates folkloric dance from all parts of the country. It was really fun. Everyone danced between the performances. We left at 3:30 am, but the show supposedly goes on till 6 am. Lima is known for its nightlife that goes on all night.

Today one of the founders, took the other volunteers, a new communications design person, and I on a tour to the different parts of Lima where Socios operates. Everyone in the office said we were lucky to have Jaime show us around. The trip took about 4 hours, and we didn't see everything. The first stop was a warehouse where they store, organize, and distribute medications. It was well secured, and not like anything I had ever seen. It almost reminded me of something out of "X-Files" with people in white jackets counting little pill boxes and not looking up, with rows and rows of boxes behind them. In some of the data entry I have been doing, I have read about the psychological side effects of some of the MDR TB medications, so it was not shocking to see locked cabinets of psych. meds. Next we went up up up to the part of Carabayllo where Carlos (one of the volunteers) has been working with kids in an after school kind of program. We were lucky also today because it is the first clear sunny day, so we could see the hills and mountains quite clearly. The area kind of reminded me of where I worked in Bolivia, except that it was on a steep dry hill side.

Next stop was the Carabayllo office where the organization began. Our guide's optimism and humble confidence was inspiring to be around. Socios discovered that patients with MDR TB were not being treated correctly, began the treatment plan, but didn't stop there. Now all of the city of Lima and provinces surrounding it are under the Socios treatment plan, but it hasn't stopped there either. From the rooftop of the Carabayllo office, Jaime pointed to a building in a plot near the office that they owned. He wants to turn it into a cultural center for community activities and performances and thought we might have useful ideas for helping design it. I imagined that he meant in the next year or 2 they will start doing that. We walked down to it, the mayor was waiting for him, they had a handshake, and he showed us copies of the potential floor plan.

That's all for today. Soon I will take photos and post them as well. Thank you all for reading!

He llegado a Lima!

Hola todos,

I am writing with goosebumps and layers on, while it seems everyone I know is baking in over 100 degree heat. I remember last week thinking I shouldn't complain about the heat because I was about to enter winter, but I didn't really believe it. The temperature isn't that low, but it's a chilly damp cold that makes it hard to ever be warm. Fortunately my apartment have hot water.

I arrived in Lima yesterday at about 5 am. It felt quite odd to drive through a city that was totally asleep. A city that seems so huge, but soon I will know at least a small corner of it. One of the volunteers woke up to welcome me, which was sweet. In the afternoon I was driven from the Lima office out to the Carabayllo office--it was very exciting. For anyone who has read Mountains Beyond Mountains, you might remember Carabayllo as the part of Lima where Father Jack, Paul, Jim, and Jaime began Socios en Salud. It was almost an hour ride from one part of the city to the other. Passing packed streets, stores, the central plaza, a river, and hills covered in houses recently built by immigrants from the provincia.

Today I met with a nurse and psychiatrist who I will work with. There is a support group for patients who are on MDR-TB medicine, but the data and information isn't organized. So I think that's what I am going to help with. Still not sure though. Today I also met Jaime and the sociologist who hired me. I am eager to work more with her on a project past Carabayllo in the rural area north of Lima.

Dinner is supposed to be lunch in a tupperware left for us to reheat. I was happily surprised by leftovers from another meal that included rice, tomatoes, chicken, and french fries. French fries mixed in with dinner is amazing. I also got to drink coca tea. It's nice to enjoy drinking it, since I never wanted to use the teabags I brought home from Bolivia for fear of finishing them.

A note about the last post: I've been told that maybe 80% of mail will get to me. Just in case anyone was planning on sending jewels or your favorite T-shirt. Thank you for all the welcoming emails! If anyone has Skype or wants to talk for free, download it and let me know!

so close

Hello!

Thank you everyone for the very generous contributions, the good wishes, and the continuous support. I admit I am nervous to go, but with all the support people are giving me I hardly feel scared. My trip was delayed a week because the nurse I am working with was on vacation. So I am off to Lima this Monday, July 31. In case anyone wants to send mail to me, email me for my address.

NOTE: I have heard the postal service between the U.S. and Peru is unreliable and sending packages is very expensive, so while it's sad, I think it's better to stick with emails. Or you could scan a letter and email that.

Packing has been difficult in this heat, but I am trying to enjoy it since it will be cold in Peru. Stay tuned for the next update. I am eager to discover what my life in Lima will be!

welcome!

my first post. thank you m.lady for showing me how to start my new blog! stay tuned for more updates...