Magic Baby

I have spent the past nine months being humbled.  To not feel so, would be next to impossible.  However, some things are definitely more humbling than others.  One of the strangest things is to realize that life really does go on without you.  People move, get new jobs, get married, etc.  But one of the biggest things that really makes me realize that everything continues as normal at home is the arrival of a brand new family member.  Ann Marie Chappell was born this morning to my sister and her husband.  I like to think of her as a magic baby.  When I left, my sister was not pregnant, she was just my sister.  When I come back, she will not be pregnant, but, she’ll have this new little person.  This is one of those events in life that I always thought I would be there to watch.  To watch her belly grow and then get to meet my little niece right when she was born.  Its humbling (and a little sad) to realize that things go on as normal, even when I’m half a world away.

Is it possible to miss someone you have never met?  Because I miss my goddaughter like crazy.

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.

Peruvian Dreams

When I was sixteen, I was confirmed.  My patron saint was St. Rose of Lima.  I think part of the reason I chose her was due to the fact that my family always jokes about how I was supposed to be named Rose, but when I was born my mom said I just did not look like a Rose.  I have never fully recovered.  I can give you the full sob-story later.  The main reason I chose St. Rose was her love for the poor and her humility.  Last summer, before I knew my placement for this year, my mom had a dream that I would be going to Peru.  I kind of laughed it off and thought, “Yeah, I’d be okay with that” and then moved on without giving it a second thought.  Now, I do not know if I really believe in fate or destiny, but I do know that I am (obviously) in Peru right now.  I also know that over these past eight months I have had a lot of déjà vu.  I take all these things to mean that this is exactly where I am supposed to be.  Why I am supposed to be here, is a question that may never be answered.  So on those days (which have been happening more frequently these past couple weeks) when I realize that I kill an average of eight bugs in my bedroom alone in one day and when the smell of fishmeal wafts into my bedroom from the factories, I start to wonder if it really just was coincidence that I picked St. Rose and that of all the countries in the world, my mom dreamed of Peru. 

Anyone who tells you that volunteer work is not stressful has obviously never worked in Peru.  Throughout the past couple weeks, it has not been uncommon to work five 12 hour days in a row, followed by a Saturday in order to catch up on everything that was not finished throughout the week.  I’m not complaining (ok, maybe a smidge), the project is cool and when I actually take a second while I’m walking around Cambio Puente it really hits me all the great things you can do with public health.  These realizations have not only made me thankful for this opportunity down here, but have also made me thankful that there are people who love public health as much as I love the idea of public health, because I could not do this forever.  With the start of our nutritional workshops about six weeks ago, everyone has been a little stressed out and a little more on edge.  Thankfully, we seem to have finally settled into our schedule and the end of the workshops in July no longer seems so far away.

This week was a nice work break for me.  Early Monday morning, a couple co-workers and I headed up north to Trujillo to help out with their project.  For all my complaining about having too much to do with our project, I am thankful that there are three of us to spread out the workload; the Wiñay project in Trujillo has only two and I admire their work ethic and spirit.  Its amazing how doing something we do every month (weights and heights) can be so different in another environment.  We were able to learn a lot from the Wiñay project and share some of the ideas that have been successful with our project.  On Wednesday, my fellow CMMB volunteer, Amber, came down to Chimbote with a couple of her friends who are also PTs.  We were able to do some home visits with some families in Cambio Puente as well as hold a workshop for teachers about identifying disabilities in children.  In the evening, we had a workshop for the staff at the clinic about proper body mechanics to prevent back injuries.  The whole day was a nice change of pace.

This week I am thankful for fresh bananas straight from the tree in our tree, big, sweet mangos and a host family that (vainly) keeps trying to convince me to stay for just one year longer.

 

Feliz Dia Mama!

A very Happy Mother’s Day to all the moms in my life! Especially, Grandma Daly, Grandma Marilyn, and my Peruvian mom America. An extra special ‘Happy Mother’s Day’ to the strongest, most beautiful woman I know, my mom. You are amazing!

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!