Chancho Marino

This story really starts on Saturday, although, I did not realize it at the time.  Please don’t judge me too much for what you are about to read.  I wouldn’t say it exactly has a happy ending, but here goes….

Saturday morning, I walked into the kitchen to find a big market bag full of bloody meat.  In my house, this really is not all that uncommon; we fairly often have freshly killed chickens in our sink, just waiting to be plucked and cleaned.  This market bag was left by my host dad who has been working out on a fishing boat since February.  Every couple weeks he stops by (usually in the middle of the night) when the ship is in port, to drop off some fish and say ‘hi’ to the family.  The bag of meat in the kitchen was his gift to the family for this trip.  The meat was eventually rinsed off and put in the refrigerator.

Yesterday, I got home for lunch and saw a heaping plate of meat waiting at my place at the table.  I thought to myself, “Beef!  We haven’t had beef in a long time!” and sat down to dig in.  Before asking what it was, my host mom told me I was being served the former contents of the bloody market bag, chancho marino.  I looked at her and said, “Is it a fish?”.  She said that yes, it was fish, so I took a couple more bites.  Up until this point, I have liked everything I have been served in Peru.  This was the first dish of which I was not fond.  After seeing me struggle through a couple more bites, my host mom told me that I did not have to eat it if I did not like it, phew!

That afternoon, I went into the clinic and told my co-workers that my host family finally found something I don’t like.  I told them what it was and then innocently asked, “What is chancho marino?”  My co-worker replied that it may be better not to know.  That comment always troubles me.  After a little more nudging, she pulled some pictures up on Google and said, “Well, at least you didn’t like it!”.  The pictures she pulled up were of large marine mammals.

I went home last night for dinner and saw Johannes (the German volunteer) sitting at the table with my host sister, Milagros, eating chancho marino.  Milagros made a comment about how much Johannes liked it and I asked if he knew what it was.  The following conversations still makes me scratch my head:

Johannes: Well, it’s fish, right?

Milagros: It lives in the ocean, yes.

Cathleen: But it isn’t really fish, is it?

Milagros: Well, I guess not technically, no.  But it does live in the ocean, so kind of.

Johannes: Well then, what is it?

Cathleen: My co-worker told me it was related to sea lion, is that right, Milagros?

Milagros: Some people say it is related to dolphin.

Johannes: …………

Cathleen: So, it isn’t fish, then….

Johannes happily finished his plate of porpoise and I dug into my bowl of cereal.  Trust me, I feel terrible enough as it is about this situation, so no guilt trips please.

Elecciones

Last Sunday the primary presidential elections were held.  Out of the five leading candidates, one of the two with the highest number of votes will go on to be elected president in June.  Ollanta Humala and Keiko Fujimori were the two candidates with the highest votes.  Ollanta Humala is a leftist, former military man who is friends with Venezuela’s Hugo Chavez.  Ollanta says that he will implement a curfew in order to help cut down on violence and delinquency.  Keiko Fujimori is daughter of former president Alberto Fujimori who is currently serving multiple, concurrent prison sentences for human rights abuses and corruption.  The fear is that Keiko will pardon her father if elected president.  If you want to read a little more about Keiko, check out this article.  How did these two candidates end up on top?  Well, it is at least partially due to the bribery that is used by the candidates throughout their campaign.  In Chimbote alone, families were given pots and pans, rice cookers, bread and money for pledging their support.  Candidates have also been known to pay to have roads paved, street signs installed and other public works carried out.  One thing I can say with 100% certainty: the next couple months will be interesting.

For the past two weeks, we have been holding workshops in Cambio Puente.  For each workshop, we invited ten moms from the sector we had selected for that week.  The goal is to eventually have all the moms attend a workshop.  The focus of these workshops was nutrition, but we also included early childhood stimulation, education on safe drinking water, family planning information, anemia education and a discussion about respiratory infections and diarrhea.  It would be an understatement to say that I was overwhelmed the first week.  I was thrown into the workshop with little knowledge of what was going on and still halfway in vacation-mode.  The first workshop felt unorganized and chaotic.  This past week, however, was about a million times better.  We sat down as a team at the beginning of the week to talk about the whole plan for the workshop—something that should have been done in the beginning, but better late than never, I suppose.  I also had another nurse to work with who helped translate from ‘Cathleen Spanish’ into ‘normal Spanish’ when the moms gave me that look that said “whaaat??”.  The confidence I had lost in the first week of workshops came back as I realized that I really had not lost any of my Spanish in my two weeks of vacation and that I still do know what I am talking about when it comes to health topics.  I think we all have those moments when we doubt our skills and during that first workshop, I forgot how to cover up my own doubts. 

Along with the workshops, we also brought in an agricultural engineer to talk to our families and some of the staff of the local schools about starting their own vegetable gardens.  We are starting this project in just one sector and then hoping to spread it out through the rest of the community.  Our goal with the engineer is that he will help these families to find nutritive, inexpensive crops with a year-round harvest. 

A big thanks goes out to the Sprangers family this week.  Thank you for all the sugar cookies, pool parties, giggles and continued support throughout the years.  I feel very blessed to have you all in my life!

Pros and Cons

There are lots and lots of good things about having family come visit.  There is also one down side.  Having family visit means that eventually, they leave and you get left alone in a country that is still not quite home, no matter how hard you try.  However, the pros definitely outweigh the cons. 

Back in September, I never thought March would be here.  Before I knew it, my family’s visit was a month away and there was a point when I actually thought to myself, “but wait, I just saw them!”.  Two weeks passed much too quickly and I now find myself wondering if the next six months will go as quickly as the first six. 

One of the great things about travelling with my parents is that we stayed in hotels that had hot water, clean sheets and private bathrooms.  Long, hot showers meant I felt clean for the first time since September.  I will spare you all the details and just give you the highlights of the trip.  (If you feel like you are missing out on something, you can always shoot me an email.)  I like to think that after these past couple weeks, my parents, brother and I are now amateur archeologists.  Not only did we hit Machu Picchu, we also saw Caral, Chan Chan, Huaca de la Luna, Qorikancha and a well-hidden site in the heart of the Colca Canyon.  We started out the trip with a trip to Caral, the oldest city in the Americas.  After surviving what was the most nerve-wrecking taxi ride of my life, we got to enjoy the only partially excavated ruins that lie about three hours north of Lima.  After Lima, it was a quick trip up to Trujillo to see the ruins of Chan Chan and Huaca de la Luna in one day.  We made friends with a taxi driver who asked whether I was from Chimbote or Trujillo; one of the highlights of the trip.

From Trujillo, we headed down to Chimbote for a very short trip.  I was able to take my family out to Cambio Puente and they got to meet some of the community agents that work with us on the project.  These women are incredible.  Every single one welcomed us into their homes and were genuinely excited to meet my family.  I know how much I appreciate these women and how hard it will be for me to leave them in just a couple more months, but hearing them say the exact same thing to my family brought tears to my eyes.  It is an amazing thing to be welcomed into somebody’s home to share food, stories, laughs and broken Spanish when you know how little they have.  Peruvians give a new meaning to hospitality.

From Chimbote, we fought the altitude and headed up to Cuzco.  After trying to use, what PeruRail told us were nonexistent tickets, we spent the next couple hours trying to navigate our way through the system.  After lots of phone calls (the first time I have really been thankful for my cell phone down here) and talking to what seemed like everyone in the train station, we finally made it to Aguas Calientes and Machu Picchu.  I do not have the words to describe how beautiful Machu Picchu is, you will just have to come down and see it for yourself.  Our second day at the ruins, we were there from when the gates opened at 6am and had to be chased out by the guards at 5pm.  We got to see the fog clear over the ruins from the top of Huaynapicchu and caught a double rainbow from the Caretaker’s Hut in the afternoon.

We shipped Patrick back to the States in Cuzco and my parents and I headed down to Puno to see Lake Titicaca and the manmade islands of Los Uros.  Then it was on to Arequipa.  Arequipa is Peruvian Disney World.  Everything was clean and bright and the garbage trucks sounded like ice cream trucks.  We spent a day exploring the Santa Catalina monastery which takes up an entire city block and is a city in itself.  There are still about thirty cloistered nuns that live in the monastery, but the majority of the building is open for touring.  It is gorgeous and maze-like with hidden passages and dozens of rooms.  Arequipa is the starting point for any sort of tour or trek of the Colca Canyon.  The Colca Canyon is twice as deep as the Grand Canyon and has countless ruins inside.  We headed out to the canyon for a quick, two day tour and got to do some hiking, some more exploring of ruins and some hotspringing.  We got front row seats to see condors fly over the canyon and were stopped in the road due to a llama crossing. 

Unfortunately, Arequipa was our last stop on our quick Peruvian tour.  It was really hard to watch my parents leave, but it was a really wonderful couple weeks.  I am very blessed to have such a great family and that they had the opportunity to get a little taste of what my life is like down here. 

A couple things my family got to check off their bucket list on this trip (some of them had to be added first):

1. Having our bus stopped by the policia.
2. Having front rows seats to watch a grown man wet himself on the bus from Chimbote to Trujillo.  Gotta love Latin American transport.
3. Eating alpaca.
4. Eating guinea pig.
5. Watching the fog clear over Machu Picchu.
6. Watching sunrise over the Colca Canyon.

Thank you for a fantastic trip.  I miss you guys already!

¡Feliz Cumpleaños Mama!

A very happy birthday to my wonderful mom, Kris!

Carnaval

Things in Peru are not all work and no play.  Actually, judging by how much I love my work down here, I would say it is mostly all play. This past weekend was particularly fun.  Let me start by saying that in the month of February, Carnaval is celebrated in Peru.  This meant that the scariest sight in Chimbote was a group of kids with buckets and water balloons.  It is fairly common for people to get hit by water balloons or have buckets of water dumped on them from second floor windows by complete strangers.  Gringos make a great target.  So most of my month of February was spent peeking around street corners or high-tailing it in the other direction to avoid being hit.  Thankfully in Chimbote, only water is used.  Some cities throw paint, flour or talcum powder on innocent passersby.  The city of Cajamarca has a reputation of having one of the wildest Carnaval celebrations in all of Peru.  Friday night I went to sleep in Chimbote and woke up Saturday morning in Cajamarca.  I met up with some friends in Cajamarca and we walked to the plaza to get painted.  Innocently thinking that we would get some face painting, I was very surprised when the first handful of paint was chucked at me.  Within a matter of an hour, we were covered head to toe in paint.  Not wanting to feel left out, we bought our own bucket of paint and left our mark on everyone else (especially those who lacked any color).  The day was spent walking around the streets of Cajamarca, throwing water balloons, splattering paint on perfect strangers, banging on buckets, singing songs about Carnaval and dancing.  It took three days to get all the paint out of my hair and I am still finding spots of paint on my skin.  Not a bad way to ring in the season of Lent.

A little taste of Carnaval

Finger-Pricking Fun

Sometimes it is the tiniest successes that make everything worthwhile. Josefa and her family are one of those successes. I love handwashing, which is probably why this particular event was all the more exciting for me. Over the past couple weeks, we have been conducting home visits (among other things). Our goal is to visit all our families in Cambio Puente on a monthly basis to see how they are doing and what kind of improvements can be made to their living situations in terms of safety and sanitation. At the end of a long day, we had one more home visit before we were going to call it a day. We knocked on Josefa’s door and she opened it with a big grin on her face and welcomed us inside. We started chatting about their drinking water and told her about the SODIS system which is a method of purifying water by putting it in plastic bottles and leaving it in the sun for six to eight hours. The UV rays purify the water, making it safe to drink. (My SteriPen does the same thing, but a lot faster and was a little more costly.) She was very excited to learn about this because it means she will no longer have to use gas or wood to boil water when it could be used to cook food. Part of the home visits is evaluating the bathrooms of our families. By US standards, the term bathroom is used very loosely. Nobody in Cambio Puente has sewage pipes so most of what we saw were pit toilets and latrines. Many had no walls or doors and were little more than a hole in the ground. There were quite a few families that do not have a bathroom and just do their duty out in the open fields. Walking back to Josefa’s bathroom, we noticed her hand-made faucet that our community agents had taught their neighbors how to make. This gives the families a clean place to wash their hands with “running” water. Josefa had taken everything to heart and not only had her soap and water tap but had put a bucket on the post with all the toothbrushes, toothpaste and other toiletries. We were beside ourselves. It is such a silly little thing, but is so nice to see our families actually implementing what they have been learning.

Besides rejoicing about Josefa, I have spent the majority of my days poking kids’ fingers. Last week we started (and finished) all of our hemoglobin testing for our kids. Only about 45% of our kids are considered to have a normal hemoglobin level. There was some frustration on my part because the ranges we are using seem much lower than what should be considered normal. This gives the ministry of health the impression that anemia is not that prevalent in Peru. (On a slightly different note, the same situation can be seen with heights and weights for kids. The tables used have been shifted to the left by 0.5 or 1 standard deviation making it seem like malnourishment is no longer a problem.) Due to all of this, we have decided that even for our “normal” kids, we are going to provide prophylactic treatment. Raising their hemoglobin levels a smidge will not do them any harm and it makes us feel a lot better about using these ranges. Win-win.

A huge congratulations to Krista Horejsi and Tony Linn who are tying the knot this weekend! I wish you both the best and could not be happier for the two of you. I will be celebrating with you in spirit!

Pinworms and Giardia and H. Nana, Oh My!

The final results are in: 49% of the kids in Cambio Puente who are enrolled in our project, have some sort of parasite.  Normally, to get a good diagnosis, three…umm…samples… need to be collected.  Due to the size of the group we were testing we only had the time and resources to collect one sample from each kid.  The problem with this is that often, the parasites will not show up in the first sample or the second sample, but will stubbornly show up in the third sample.  Therefore, we can only assume that more of our kiddos actually have parasites.  This is what the breakdown looks like:

Rather than just providing treatment to the kids that we were absolutely sure had parasites, we decided to make medication available to all our kids in Cambio Puente because of the fact that we cannot be sure that the 51% that showed up negative are actually parasite free.  The tricky part is that we had two different medications we were using because unfortunately one type of medication does not cover both giardia and oxiuros (pinworms).  This is where our sectors came in handy.  Rather than just treating the whole population with one blanket medication, we looked at the parasite prevalence in each sector and treated the kids that came back with a negative diagnosis for the parasite that was the most prevalent in their area.  When it came to actual treatment, we had a complete range of reactions from the kids.  There were some that could not wait to take their medicine while others were climbing over their mom’s shoulders trying to get away from us and spraying the medicine back out as soon as it was in their mouths.

One of the (many) things I love about our project in Cambio Puente is the way it is designed.  In total, the project will be present in Cambio Puente for just a couple years.  After those years, we will leave the community to care for themselves.  In those few years, it is our goal to provide the people of Cambio Puente with the tools they will need after we are gone.  The main way we are doing this is through our community agents.  Every couple months we hold workshops that last for a day or two and talk about different health conditions in kids and what can be done about them.  My co-workers apparently think my Spanish has improved to such a level that I can now more actively participate in these workshops.  Read: lead discussions and give presentations.  There was still a little giggling at my Spanish as we worked our way through talking about infant warning signs, but at the end I think (hope?) everyone understood.  There may be one benefit to my stumbling through the language, though—there was more participation from our group of women than normal.  I think they just felt sorry for me.  Whatever the reason, I had to pat myself on the back for leading a discussion when just six months ago I could barely carry on a decent conversation about the weather.  It is an unbelievable experience to be a part of something that is much much bigger than myself and I count myself lucky and blessed every day I am down here to be a part of it.