Lessons Learned in Huaraz

In Peru, as in other developing countries, about half of childhood deaths are caused by pneumonia, diarrheal diseases, malaria and measles.  The prevalence of malnutrition in these countries makes the children even more susceptible to these preventable diseases.  In Peru, 25% of children are classified as being chronically malnourished, in rural areas like Cambio Puente, this statistic rises to 36.1%.  Chronic malnutrition is seen in the height of children.  If not given enough protein, children do not grow.  This is why, if you look across a room full of Peruvians, the majority are almost exactly the same height.  Chile, on the other hand, has a childhood chronic malnutrition rate of only 2%.  To put this into perspective, in the United States, fewer than 1% of children have chronic malnutrition.  Chile has done a fantastic job trying to reduce the incidence of chronic malnutrition which helps protect children from other childhood diseases.  Peru is trying to do the same.  That is what this past week was all about for me.

Along with other nurses and a couple doctors from Chimbote, Nuevo Chimbote and Cambio Puente, I headed up to the city of Huaraz to participate in a training workshop.  This weeklong workshop—“Curso Clinico de Atencion Integrada a las Enfermedades Prevalentes de la Infancia con Enfoque de Derechos (AIEPI)” or “Clinical Course on the Integrated Attention of the Prevalent Childhood Diseases with a focus on Human Rights”—helped train us on how to recognize and treat the major childhood diseases seen in Peru.  Many of the nurses that attended the workshop work in clinics without a doctor, which made this training even more important.  I would say that about 90% of the material presented to me this week was brand new because most of the diseases discussed are ones that we simply do not have to worry about much in the US anymore.  New information all in Spanish made for a stressful, albeit interesting, week.  It was great to be back in a hospital setting and really interesting to see the vast differences between hospitals in the states and here in Peru.  One of the things I found most interesting in this course was the focus on basic human rights; mainly that every human (even the tiniest of us) has the right to to quality healthcare.  I love that this was so strongly emphasized as this is a culture where children often get overlooked.  There is a practice that the best food is saved for the adults, when in fact, we should be giving the most nutrient rich food to the kids that are still growing.  A couple months ago I saw a poster in Cambio Puente encouraging parents to give their child a name.  This seems so silly to those of us from the US.  My (very pregnant) sister and brother-in-law had a name picked out for their soon to be born child months ago.  It is not uncommon for children here to not have a name until they are a couple months old.  This means they do not have the equivalent of a social security number which prevents them from receiving their vaccines and eventually going to school.  This week really showed me that there is some exciting stuff going on down here that can have a huge impact.  All the people in attendance are required to hold a similar workshop for all of their co-workers as part of their evaluation.  Not only did this workshop show me the things we can do with a little bit of education, but it also opened the door for me to possibly get some more experience in a clinic in Chimbote.  If things ever slow down with the project, I have been invited over to the clinic Magdalena Nueva to work with the pediatric population.

Now, one cannot go to Huaraz without experiencing the Cordillera Blanca.  The Seattleite in me was seriously missing the mountains and a week in Huaraz was the perfect cure.  I went on a great hike with some friends, spent a couple wonderfully relaxing days in a mountain town that taught me a few, very important, lessons.

1. At altitude, I have the lung capacity of a mouse.
2. Nine months of a carbohydrate-rich Peruvian diet DOES NOT mean that you have carbo-loaded for a 18km hike.
3. While my parents taught me what to do if you encounter a bear or a mountain lion on a hike, they never told me what to do when you encounter an angry bull.  Spending 20 minutes on the side of a hill after being chased by said bull is pretty laughable once you know you will not get gored by one of his horns.
4. Two days of playing in the mountains is not nearly enough.  I cannot wait until September.
5. Peru does have good beer.  It is all in Huaraz. (It also has decent Mexican and Thai food.)

A very happy (early) Father’s day to the Grand Poobah himself, my pops, from whom I inherited my love for the mountains, beer and corny jokes.  Happy Father’s Day to Grandpa Lars, Grandpa Daly and my brother-in-law/soon to be poppa, too.  I feel pretty darn blessed to have all of you in my life.