How Things Really Work: Lesson One

January 31, 2012 - Had a productive meeting today with Doctor Alfonso where we reviewed my analysis so far and he seemed pretty happy with what I had done and answered some of my lingering questions and guided me in a few areas. It seems like my client satisfaction survey may also be turning into a lifestyles survey (to find out, for example, what our clients eat, how many sexual partners they have, how often they exercise, etc.), which likely means two separate surveys so I have to think about the logistics for that. The good news is that the majority of the women in Puno can read and write Spanish.

Perhaps even more productive was the talk I had with Angie after where she explained how things really work with regards to patient follow up. I have seen how difficult follow up can be in other countries and suspected it was a problem here just from looking at the statistics (for example they have rates of how many positive PAPs but not actual cervical cancer diagnoses). I also know that Pro Mujer is relatively new to Peru (compared to the other countries it works in) and is still ironing out processes. So that is what Angie is focusing on for her internship. But I was shocked to learn that there really isn’t a formal referral process if a woman has a positive PAP or if the obstetriz notices anything in her breast exam. So basically they find out they might have cancer and then they have no idea what to do. If any of you are as shocked as me, don’t worry, we’re working on it. I suggested a “coupon” idea like PSI used for IUDs in India, and Angie has some other great ideas too. Another reality check is that currently Pro Mujer offers no family planning. They “consult” with women about methods, but can’t prescribe, insert, inject, etc. any methods. We’re working on that too, but in the meantime, I’m curious and plan to include in my research where else the woman are getting family planning methods, if anywhere.

On a lighter note, had a great lunch today at a restaurant that is very popular with the staff – Ukuku’s. They have a fixed menu for 10 soles that includes a starter (today a dip similar to guacamole), soup (quinoa of course), main dish (chicken stuffed with spinach, peppers, and cheese in a sweetish sauce with rice and fries) and dessert (a fruit dish – all peeled thanks goodness!). One funny cultural thing I’ve noticed with every group of people I’ve eaten with is that they all want to talk about how much obesity there is in the US. Which is ironic when we are eating a huge, not so healthy lunch. Also ironic because the three Americans who work at Pro Mujer are all skinny. But always interesting to hear how Americans are perceived in other countries.

This weekend is shaping up to be quite fun with one other staff birthday and a going away party!

Back from the dead

January 30, 2012 - After two days of misery I am finally recovering and will definitely be more careful about what I eat. The thing is, I thought I WAS being careful. I guess not. SO, went to the store today and bought lots more water and packaged food I can cook for myself. I will remember not to drink lemonade when the entire table does at lunch and I will boil water for soup longer or, even better, just use bottled. Lesson learned, let’s hope I don’t have to relearn it again! The only good thing about this weekend is I read two books.

So I have not exciting weekend adventures to report. Work is chugging along and going to pick up really soon I think. Spanish skills didn’t make much progress this weekend, but gotta forgive myself for that one. More later this week.

Random Thoughts

January 26, 2012 - Not much to report today so I'll just list some random thoughts I've been meaning to share.

1. People in Puno take their festivals seriously. They have been practicing for more than a month, some people all year. Can't wait for the big festivities.

2. My landlord, Hernan, calls me Kellicita. Love it!

3. I ate Ramen for dinner tonight. Yep, you're jealous.

4. Stats suck, even in Spanish. But I was pretty proud of my skills today, thanks to a little help from my economist sister.

5. A filling on my tooth broke off today, good times, but I don't think I'll be braving the Peruvian dental system anytime soon!

6. I may or may not be getting addicted to a telenovela called Decisiones.

7. Along the same lines with guilty pleasures, I found they have delicious ice cream here for only 2 soles. Another reason I'm going to gain a millions pounds.

Ok seven feels like a weird number but I'm in a weird mood, so that's all for now.

Bienvenida a Pro Mujer

January 25, 2012 – Sorry I’ve been slacking but wanted to update everyone on my first few days of work. First, Sunday night I met the other American intern, Angie, and an American consultant, Mariano, who is working here for another couple weeks, and we had dinner together. It was nice to know them before I walked into the office Monday morning.

I was so nervous I could hardly sleep and I woke up early Monday to study more Spanish. But no cramming really can prepare you for arriving at an office where you are expected to speak another language the entire time. Regardless, I arrived a few minutes before 8:30, hoofed up the three flights of stairs, and quickly met my boss/preceptor Doctor Alfonso Medina Bocanegra, the director of health and human development. He is very nice and welcome me right away with a long “speech” about Pro Mujer, which was great because I understood everything he said but didn’t have to speak other than to nod or say bueno/si/claro every so often. Then the other pasantes arrived and I realized there was not room for us in the office, so me and Angie moved to a conference room for the day, which was nice because we could speak in English. Doctor Alfonso sat down with me for about an hour going over some presentations with background on the organization and then sent me a work plan to start drafting. I had lunch with Angie and Carlos, a Pro Mujer employee who lives in the same building as me, (a great meal of soup and a chicken and rice dish for less than $2) and spent the rest of the day reviewing documents and brushing up on Spanish business and health vocab.

The next day was not quite so smooth. First, Angie was not here so it was a bit lonely in my conference room. In fact, I hardly spoke to anyone all day. Then I had a meeting with my boss about my work plan objectives and he gave me a laundry list of things he wants me to do in three months. As if a qualitative study is not enough, he also suggested a systematic analysis of their processes in their health centers, a review of their communications techniques, an epidemiologic and statistical analysis of their health center results, and a customer satisfaction survey. Gee, no big deal. So I pushed back a bit but overall said I’d think about what I thought was feasible. I ended up eating alone for lunch and dinner, which is no fun, because the internet was out so I couldn’t meet up with a friend. And I couldn’t Skype with anyone back home. So I went to bed feeling a bit lonely. Bleh.

The view from my office window of the main street in Puno, Jiron Lima.

 

But today was back on the upswing. In the morning I helped my boss with an urgent search for any reports on gender violence and micro-credit, which I just so happened to have because of the lit review I’m doing with Dr. Gurman. Then he took me on a tour to the two centros focales in Puno, which is where Pro Mujer clients come to pay their monthly loan payments, receive training, and access health services. All of the staff I met were very nice and while I got some strange looks from the women themselves, I think they will be welcoming once they start to see me there more often. Doctor Alfonso introduced me to the staff and each time either jokingly said that I was from the U.S. so they’d have to speak in English to me (to which they gasped and blushed until he said it was a joke) or honestly said she speaks Spanish but there are some words she doesn’t know so if she gets confused please help her. In particular I enjoyed meeting the obstetrices (basically nurse midwives) who I’ll be working closely with.

After the visits, Doctor Alfonso took me to the market because he wanted to buy some chocolate and I found peanut butter, which I had looked in no less than five other places for, so I bought it even though it was more than $5. When we arrived back at the office, the doctor invited me to lunch and we ended up going with a large group including Mariano and another Peruvian intern, Marita. I was certainly not the most talkative of the bunch but was able to mostly follow the conversation and respond when spoken too. It’s funny how my personality is different in Spanish because I have to think about what I’m going to say and can’t just blurt it out in my usual fast-talking way. Anyways, I split chicharron del mar with Marita, which was basically a bunch of fried seafood and potatoes. A little too much fried stuff for me, but good. We also had chicha, a drink made from purple maiz, and leche de tigre, which is the marinade leftover from ceviche and is apparently great for hangovers. Both were interesting and decent tasting. So far my favorite drink here (besides of course the delicious fresh juices) has been the warm wine they make with pisco in it, so basically warm sangria.

Anyways, back to work, this afternoon I finished my work plan so now I’m waiting for my boss to approve it. I managed to whittle it down to a manageable workload (I think!). Hasta luego…..

Andean Explorer = Once in a lifetime experience

January 22, 2012 - Wow is all I can say about my 10 hour journey yesterday on the Andean Explorer from Cuzco to Puno. Even without contrasting it to my previous train experiences (sure NE USA and Europe have nice trains, Bangkok to Southern Thailand sleeper train was fun with my buddies Josh and Colleen and Mike, India third class train was an experience I will never forget and not in a good way) this train was amazing. From the moment I dropped off my bag and walked into the receiving room where a group was playing traditional Cuzco music, it was a delightfully-touristy experience that was just authentic enough not to be too cheesy.

Stepping into Coach A (the only passenger coach) was like stepping back into the early 1900s. Not that I have ever been on a train from the early 1900s, but it was just like the movies. White tableclothes, dim lamps, comfy chairs that look like they came from my great-grandma's living room, a little vase with a rose. Beautiful. And the service staff was amazing. There was capacity for maybe 50 passengers but were only about 20 on board. By the end of the trip we had all chatted and shared travel advice. I met a very nice and interesting women named Mitey and also some guys who lived in Bethesda.
 

After we exited Cuzco city limits we were invited to the rear coach which is the observation deck with huge windows on the sides and ceiling and an open back. I've posted a few pictures here but there are tons more on Facebook.

 

Shortly after departing we were treated to more music from Cuzco and a fashion show of knitwear.

 Then the landscape really became beautiful as we began climbing to 4,321 meters above sea level, past snow capped mountains, to La Raya. There we stopped at a local market and I bought a sweater that is supposedly alpaca. I don't really care - it is warm!

After getting back on the train I had a delicious lunch of quinoa soup, trout filet with plantain/sweet potato-ish mixture on side, and chocolate mousse, plus a glass of Peruvian wine. (I didn't know they made wine in Peru, it was a decent Malbec.)

As we arrived on the altiplano, the landscape had started to flatten out and get less exciting aside from the random llama or alpaca herd grazing nearby, so I took a short siesta and read for a bit. Then it was back to the lounge for bar tending lessons. After a demonstration, my new friend Mitey made a pisco sour, which is not easy on a rickety train. Then there was more music and traditional dances, this time from Puno.

One of the dancers made everyone get up and dance with her so video of me dancing may be leaked at some point ;) 

Next it was afternoon tea time, which was accompanied with mini sandwiches and chocolates, and a drink similar to a mimosa but with a different kind of juice (maybe mango?). Soon after we passed through Juliaca, which was crowded and rundown. Then the landscape began to change a bit as we neared Puno. First I noticed the terrain became very rocky with mountains in the horizon, not as close to the train like earlier. Then we started seeing small marshes and streams, foretelling of the lake. And finally I got my first glimpse of Lake Titicaca. At first it was just a narrow strip and I thought "that's it?" but then as we continued I saw it was a long but narrow lake worthy of its renown. Arriving into Puno city at dusk was a little bit of a let down compared to the wonderous landscapes of the countryside, but I felt a nervous anticipation as I arrived in my home for the next three months.



I checked into my room on Jiron Azoguine. It is quite large, probably near the size of me and Mike's first apartment minus a kitchen. I have a bed, wardrobe, desk, small couch, TV, private bath, and big window overlooking the city with the lake in the distance. My room is in a building that is basically a long-term inn connected to Hernan's house, with a small restaurant downstairs  (where I can have breakfast for 1 sol). I spoke with the landlord, Hernan, about using the kitchen to cook dinner at night. So I think this place will work out just fine, as long as the shower situation gets better. It was cold last night :( In fact, it is cold in Puno in general. You don't realize how much we take heaters for granted in the US. Last night I slept in two layers of PJ pants (one fleece), wool socks, an under armor shirt and fleece, and a wool hat, plus my bed has four wool blankets. Definitely have to buy some more warm stuff at the market! 


Ok that's all off to explore now.

El Monzon

January 21, 2012 - Had an amazing trip to Puno, will update soon. For now, here is:

January 20, 2012 - Today was my last day in Cuzco and what a day it was! I had my last classes. Just before our lunch break we had a cooking demonstration by Mariela, one of my professors. She made Causa Rellena and it was delicious. It was a “salad” served kind of like a cold casserole and basically consisted of a mixture of mashed yellow potatoes with lemon juice layered with avocado, boiled eggs, and tuna salad, plus a few peppers and olives (the latter of which I of course picked off) for garnish. It had a lot of mayonnaise in it so I would probably tone that down if I made it myself, which I plan to do in Puno.

Then in the afternoon I ran some errands including confirming my train ticket for tomorrow morning (Perurail.com turned out to be real, check) and picking up small gifts for my professors. Then in the afternoon I suggested to my professor Dorian that we go to a nearby festival because my host mom had mentioned the school sometimes takes students. He agreed it was a good idea so we left around 4:30, right as the sky was starting to turn dark. What a shame too because early in the day it had been really cold and then turned into a beautiful afternoon with sunshine and 75+ degrees. But right as we got to the festival it started to rain. It was just a light rain so we walked around and watched numerous traditional dances. They had the brightest, most colorful and detailed (sequined!) costumes I’ve ever seen and the music was infectious. The festival is in honor of San Sebastian, the saint of the village, which is now part of Cuzco municipality. In addition to dances, music, and tons of people, there were street vendors selling everything from balloons and cotton candy to pirated DVDs and food stands serving delicious-smelling-but-probably-completely-unsanitary food that I did not eat. Also saw my first cuy (guinea pig) on a stick.

So right as we were watching the final procession as all the dancers were leaving it started to pour. I’m talking monsoon. I had on my raincoat but not my umbrella and Dorian had neither. So we ran to an awning and stood there for what seemed like an eternity before he finally agreed with me that the rain was not going to let up and we should make a run for a taxi. At this point only my feet were completely dry (thanks Kathy and Jim for the great boots!). Even my trusty raincoat had failed me and water was starting to seep in, plus it was a cold rain – the worst. So finally we made a run for it and got a taxi. When we got in and started driving we realized the streets were rivers. It reminded me of when we were in India during monsoon season. And I truly thought our taxi was going to wash out like so many cars we passed. What on the way seemed like a short drive took forever and I finally arrived at my host family’s house looking like a drowned rat.

Dorian told me on the way home that this is the worst rain he has seen in Cuzco in years. It was even on the news tonight. Lluvia loca! Needless to say I did not go to dinner with some other students from the school as I had planned. (Thankfully my host mom graciously made me dinner – platanos again! – even though I had told her I wouldn’t be home.) I have a feeling the other students may have stayed inside too…it is still raining.

Mujeres en la calle

January 19, 2012 -  Today was one of those days that is so long and varied it feels like three days. I hope I can remember all the stories I wanted to communicate.

First, a sad story, I mentioned the cruise ship that sank to one of my professors today and he told me that he used to work on that ship and knew the girl from Cuzco who disappeared (and presumably is dead). Very sad. Apparently a lot of people from Peru work on cruise ships.

Then, during lunch, I was having a funny conversation with my host mom about men and loyalty and she was telling me about how many men here keep “mujeres en la calle” in other words, girls on the side and that I should be happy that my husband is tranquilo (translation doesn’t run around on me). Then she said her husband had two mujeres en la calle and I looked at her husband assuming she was joking and he didn’t say anything. Later they had an argument while I was siesta-ing. AWKWARD! But also very sad if that is the reality for many women here.

In the afternoon I had more classes in Spanish and in salsa! I learned the first eight steps of salsa and wasn’t too shabby.

Now time to do some homework in preparation for my last day of classes and then, off to Puno Saturday a.m.

Like riding a bike

January 18, 2012 -

Well after three days I can definitely say that a lot of Spanish is coming back to me, but there is still so much to learn! With 8 hours a day and the fact that I’ve had all of the grammar and just need to “repasar” and “fijar bien,” I have been flying through lessons, but still struggling with basic things like those pesky pronouns. Today we started on the subjunctive and after learning it for probably the fourth time (starting in high school) I feel like I can actually use it in conversation. So I left school in the afternoon feeling great and then arrived at my host family’s house to find they had a visitor, a Peruvian girl about my age who now lives in Italy. She was fascinating but she talked so fast, telling these apparently hilarious stories, that I couldn’t keep up! I guess now I understand how people feel when they are talking to me and Kristy at the same time!

I also had a short salsa lesson today because the school offers classes and no one showed up so even though it was during my lesson, my professor suggested I take a quick break and learn some salsa. Which was perfect because my brain was fried. So now I know the four basic steps of salsa. Although I’m not quite sure if the teacher showed me the right way because I swear he kept switching which foot to start with. I guess I’ll find out tomorrow if I go again and actually dance with a partner.

Can’t believe its almost time to head to Puno!

La lluvia hembra

January 16 - Today was my first day of Spanish classes and also the rainiest day so far. The morning was fine but the sky opened up in the afternoon and it was frigid. Luckily I was inside, which I will be for the majority of this week because I am one of only two crazy students at the school taking eight hours a day of classes.

One of my teachers (we switch every two hours which I don’t think I prefer, but it does make the day more interesting) taught me a local saying about the rain. Lluvia macho (masculine) is short but strong and lluvia hembra (feminine) is light but long lasting. You can draw your own meaning from that but basically his interpretation was that when a man bothers a women (like catcalls in the street) it is strong but short and when a women bothers a man it is more sweet but long lasting, I took that to be a Spanish reference for nagging. Ha!

My classes were great but I definitely forgot how tired your brain gets after so many hours thinking and talking in another language. I was also starving at each meal. Today also marked the first appearance of my favorite fruit, platanos! For lunch they were served on the side of the dish and for dinner they were the main course  - rice with platanos and a fried egg. Sounds a little weird but so good!

Also got to chat with Mike and Mom tonight. Love you guys. Time to go to bed. I have to get up in the morning and do my homework. Good thing either the rooster nearby or the cat in the apartment wake me up each day around 5:30.

Coca y Cacao

January 15 -

Today was another interesting day, touring around Cuzco. In the morning there weren’t many people out and about so I had a peaceful walk down past the Santo Domingo convent. Then I walked up to the Plaza de Armas and did a short walking tour of the Incan stones. Not the most thrilling thing I’ve ever seen, but there was a cool 15-sided rock and there’s just something neat about seeing things that are thousands of years old. There is another group of rocks that are supposed to be shaped like a puma, a sacred animal of the Incas, but I guess it was too abstract for my eye.

I also explored San Blas, a cute neighborhood popular with tourists where my school is. Many of the streets are pedestrian only so that was nice. I hiked up a big hill to check out a hotel Kristy and I were looking at for her visit and it was ok but I don’t think we’ll want to make that hike every day!

After some more walking, a quick trip to Starbucks (had to try one of their local flavors of frappachinos!), and the internet café, I came back for lunch and a siesta. Man am I getting lots of time to read and rest here, but I’m sure that will change tomorrow when I start a week of 8 hours of Spanish lessons daily.

After lunch I had quite an afternoon. I visited the Centro de Textiles where they were doing demonstrations of weaving and there was a small museum. It was interesting but the staff wasn’t very talkative so I left after a short while. Then I went to the Museo de Arte Precolombiano where there was a nice collection of pottery, wood carvings, gold and silver carvings, and a few out-of-place Spanish paintings. I especially liked the wood carvings, which are amazingly well preserved for being from sometime between 1 and 800 A.D. Also there were some very detailed carvings of ancient gods and mystical combinations of animals like a serpent with a cat’s head.

After that I stopped in at a café and sat on the balcony overlooking the Plaza and had my first cup of mate de coca. Its made from the leaves of coca plants but unlike cocaine it is not a drug or addictive (well no more than coffee). It tasted like green tea and it definitely helped my headache, which I had been blaming on allergies but was maybe the altitude. At the café a cute little perrito sat by my feet and kept perching one of the stools. I guess he wanted to see the beautiful view too! 

On my way back I took a short detour and ended up running into a guy promoting the Choco Museo. Sounds good to me! The second I walked in I was overwhelmed by the delicious aroma of chocolate and minutes later I was greeted with a lovely cup of chocolate tea, which I later learned is made from the stalks leftover when they remove the beans to make chocolate. They had a nice display all about the history of chocolate across the world and its production in Peru. I didn’t have enough sencillo to buy any chocolate so I’ll just have to go back!

On the way back it was starting to get dark and I ran into this little girl trying to sell hats. Throughout the day I had encountered several people hawking various goods but normally a simple no gracias was enough. But she was persistent. She showed off her English skills and knowledge of the US, reciting for me the president’s name, the colors and design of the flag, and the capital. I complimented her but refused to buy anything. All of a sudden she turned from nice to mean and I couldn’t tell what she said but I pretty sure she swore at me! Oh well, so far that is the only mean person I encountered, so not too bad, and I’m sure her life situation warrants the frustration. Overall all it was a great day. The only thing that would have made it better is if I had a travel companion (hint: visitors welcome!). I’m definitely looking forward to making some friends this week at the Spanish school and of course meeting my colleagues in Puno next week.

Estoy aqui

Well, I am finally here. I can’t believe it. Seems like just yesterday I was hoping I might get to do my practicum abroad and even more recently that I began planning this trip. I experienced a whirlwind of emotions saying goodbye to everyone and then on the long plane ride here last night. Three flights, three trips through security, not much sleep, and two near breakdowns later, and I settled into a nervous anticipation.

Flying into Lima was beautiful, sort of like San Francisco the way the ocean sneaks up all of a sudden. But Cuzco seemed even more amazing to me. The zigzagged patterns of land stretched across jagged mountains – much like Ecuador – are breathtaking and mindboggling at the same time. And today was an unseasonably warm day in both cities, sunshine and more over 70 degrees. My delight with the weather and the beautiful views continued when I walked out and saw my driver holding a sign with my name in big block letters.

I’ll never forget that feeling of relief. I remember when Mike and I booked our Costa Rica honeymoon online we felt that sense of relief when we arrived, glad the whole thing wasn’t a hoax. I felt the same when I landed in Guatemala City, fearing kidnappers and rogue taxis. And in India when I found out the whole group I was traveling with got re-routed except me, but there was Netra to pick me up. The only time my ride ever fell through, also in India when I arrived at Delhi train station late one night, was one of the most terrifying nights of my life. Everything turned out fine but you better believe the hotel manager got a piece of my mind that night.

But anyways, back to Peru, everything went smoothly and my driver, Rene, was a very nice man who gave me an impromptu tour of Cuzco in the short drive to my host family’s house.

Senora Chacon met me at the front door and I was later introduced to her husband, Pancho, and one of their two sons, Dennis, who is about my age. Their apartment is small but cozy with a nice size bedroom where I’ll be staying for the week. They have a tall white cat who like my old Boo kitty (now J-man’s) is very vocal. Senora Chacon immediately began cooking lunch for me while I got settled. I came out to find a steaming bowl of soup with rice and beef. I forced myself to finish it all, not wanting to seem rude, and then she brought out the actual almuerzo – a giant plate of meat, potatoes, rice, and tomato salad. Dios mio. So I sucked it up and made it through nearly the entire plate. I truly might gain 20 pounds while I’m here. Interestingly I found out later that my family does not customarily eat dinner, but Senora Chacon cooked for me (a delicious omelette and more rice). I told her she could feel free to cook a little less for me so as not to waste any food.

My only other homestay experience was in Guatemala where my family hosted several students at one time. This made it a little less awkward to find things to talk about at meals. But I made it through lunch ok and they complimented me on my Spanish (that may be a first!).

In the afternoon I walked around Cuzco. What started as a mission to find an internet café (which was not hard, it’s right across the street) turned into an hour and a half walk because I hadn’t exchanged my soles for small bills at the airport and since it is Saturday no where wants to give you their change. But my hunt was a good excuse to get lost in Cuzco and while it started to rain for about 10 minutes it quickly stopped and ended up being a beautiful day. The city reminds me of Antigua, Guatemala, only bigger and a little dirtier. My eyes hurt a bit from all the dust and exhaust but it certainly is not the dirtiest place I’ve been. The architecture is beautiful and colonial style like Antigua. In fact the Plaza de Armas is nearly identical. Cuzco is also very touristy like Antigua. Every other storefront is a tourist shop offering trips to Machu Picchu and various adventure hikes. There are also lots of cool artisan boutiques like in Antigua, which I will probably wait to check out until Kristy is here (and maybe I can send her home with my purchases!).

I’m sure my updates won’t always be so long but I am staying in tonight, just reading and relaxing, so I figured I’d type this up and try to post it tomorrow. Also the temperature dropped tonight and it is super cold in the apartment without a heater. I’m bundled up in my new PJs from mom plus a fleece. Tomorrow, time to learn my way around and find my school.

Buenas noches.

One Week Countdown

Wow, I can't believe it is January and I'm leaving for Peru in one week! I'm so excited for what I'm sure will be an amazing experience but nervous too. As if traveling to another country by myself, being away from friends and family for four months, and doing my first major research project wasn't enough, I also have to do it all in Spanish! But I set myself up for this challenge and I know it will pay off. I'm so thankful to my supportive family and friends and I hope you all will read my blog and stay in touch!

Oh and in case anyone is wondering about the title of my blog, Puno, where I'll be living, is 12,400+ feet above sea level. That's why next week I'm headed to Cuzco where, at a "mere" 10,000 feet, I hope to acclimatize and brush up on my Spanish before heading to Puno.