1. Ronald McDonald gets around. I saw the fast food clown the other day giving a presentation to children on the importance of living a healthy lifestyle. Right after handing out Happy Meals to the crowd, he said,¨and remember children, we are not defined by what we eat. We´re defined by what we do.¨ In addition to this poignant insight I also learned that Ronald MacDonald only speaks Spanish and has the voice of a heavy smoker. Maybe that´s why he never talks in the US.
2. The look people often give me when I try to speak to them in Spanish is remarkably similar to the look Jeopardy contestants give when they don´t know the Daily Double question (complete with eyebrow scrunching and head shaking).
3. Saint Judas in Spanish actually refers to Saint Jude, not the disciple who betrayed Christ. In light of this new information, the massive procession in his honor last Friday seems a lot less creepy.
4. I´m not very good at soccer. I sometimes play with guys from work on Thursday afternoons and there´s a father-son duo that joins us. The son is 11 years old and schools me pretty much every time. For a while people thought I was being gracious by letting him score a few goals and steal the ball from me, but I think they´re catching on.
5. Military time can make for long afternoons. I got back from lunch the other day a little past one and to my horror realized that I had to work until 17 o´clock. I can handle an 8-5 no problem, but with this 8-17 stuff, I gotta be in bed by 23 at the latest.
6. There is a subtle but very important difference between a tomato and a Peruvian hot red pepper. Also, embarrassing stories travel around the office incredibly quickly.
7. I´m taller than most Peruvians. I discovered this when trying to sit down on a bus and discovering I am in fact capable of touching my knees to my shoulders. When I enter houses with small children, the mothers often tell their children that I must have drank a lot of milk growing up. Because I don´t know how to say ¨lactose intolerant¨ in Spanish and because I want to counteract the troubling public health message propogated by Ronald McDonald, I go along with it.
Wednesday, October 29, 2008
Saturday, October 11, 2008
Some Observations from the Field
After two weeks of accompanying Socios health promoters in visiting patients homes ("Socios en Salud" is the Spanish equivalent of Partners in Health), I've made a few observations. The first is that if you made a topographical map of Lima by using household income instead of meters to measure altitude, that map would be almost a direct inverse of the actual topographical layout of Lima. That is to say the poorest people seem to live in the hills, and the higher up you go in the hills, the poorer people are. As it was explained to me, during Lima's population explosion in the last generation, droves of people moved from the country into the city (again, often a trip downhill from the Andes but seeking higher socio-economic ground) and began these squatter settlements or "pueblos jovenes" in the unclaimed, unaccommodating hillsides. As new families move in, they simply build higher and higher up the hills. The cruel irony of this arrangement is that the people with the best views of the grandeur of the city have the least access to its resources.
I have also been made aware of the important distinctions that define the different levels of poverty here. The health promoters I have traveled with (who often play a case management role) assess socio-economic status not primarily by asking about family income, but by noting whether the walls are made of wood or metal, whether the roof was plastic or waterproof, whether the floors are dirt or cement, whether a patient has three meals or fewer, whether there is running water or electricity, etc. These factors not only define one's level of poverty, but also one's chances of responding well to treatment, so Socios provides things like cement floors, waterproof roofs, windows, food and other resources to support the patients and their families. These modest improvements (with even the most costly intervention, the wooden housing units, costing well below $1000) can literally mean the difference between life and death for the patients and their family members. (And in seeing all this I have to remind myself that Peru is not a poor country by world standards: it's 116 out of 229 countries in GDP per capita).
I've also learned a few things about tuberculosis treatment. A central focus of Socios' work is to support patients being treated for Multiple Drug-Resistant Tuberculosis (MDR-TB). Due to the complexity and cost of treating this disease, MDR-TB used to be considered "untreatable" in resource-poor settings like the "pueblos jovenes" of Lima. It wasn't until Partners in Health started treating poor patients in Lima in the mid-90's with "first-world" success rates that the international health community started taking seriously the option of treatment. It's crazy realizing that every patient I see would have been deemed terminal just 10-15 years ago and now the vast majority are completely cured.
On a more personal note, I have also discovered that while there is no word in Spanish for "awkward," I have made sure that the experience is still alive and well in Lima. My non-use of Spanish over the past 2 years has forced me to confront a steep re-learning curve. The good news is that I have been able to pick up a lot of Spanish from the health promoters I travel with. The bad news is that the phrases I've learned from them largely consist of things like "is there blood in your flem?" and "do you have diarrhea?". So when I meet new people I usually lead with the latter in hopes that I'll immediately find something we have in common.
So in spite of a few gastro-intestinal glitches (thanks MHAPers for the Maalox) and the harsh reality of the poverty here, I have to say that Lima has been treating me well. The Socios employees are inspiring people and their impact is really tangible. I live an in apartment with 4 other volunteers and they have all been really great about helping me get acquainted to Lima and making me feel at home. I'm also slowly getting acquainted with some of the Catholic social justice communities here that I've heard so much about. One of the van drivers I met has been directly involved with the work of Gustavo Gutierrez, one of the fathers of liberation theology and the subject of my senior thesis, and he's going to get me information about when and where the groups meet for Scripture reflection and retreats. So things are in the works.
I guess I'll leave it at that for now, but I'll try to update soon. Que le vaya bien.
I have also been made aware of the important distinctions that define the different levels of poverty here. The health promoters I have traveled with (who often play a case management role) assess socio-economic status not primarily by asking about family income, but by noting whether the walls are made of wood or metal, whether the roof was plastic or waterproof, whether the floors are dirt or cement, whether a patient has three meals or fewer, whether there is running water or electricity, etc. These factors not only define one's level of poverty, but also one's chances of responding well to treatment, so Socios provides things like cement floors, waterproof roofs, windows, food and other resources to support the patients and their families. These modest improvements (with even the most costly intervention, the wooden housing units, costing well below $1000) can literally mean the difference between life and death for the patients and their family members. (And in seeing all this I have to remind myself that Peru is not a poor country by world standards: it's 116 out of 229 countries in GDP per capita).
I've also learned a few things about tuberculosis treatment. A central focus of Socios' work is to support patients being treated for Multiple Drug-Resistant Tuberculosis (MDR-TB). Due to the complexity and cost of treating this disease, MDR-TB used to be considered "untreatable" in resource-poor settings like the "pueblos jovenes" of Lima. It wasn't until Partners in Health started treating poor patients in Lima in the mid-90's with "first-world" success rates that the international health community started taking seriously the option of treatment. It's crazy realizing that every patient I see would have been deemed terminal just 10-15 years ago and now the vast majority are completely cured.
On a more personal note, I have also discovered that while there is no word in Spanish for "awkward," I have made sure that the experience is still alive and well in Lima. My non-use of Spanish over the past 2 years has forced me to confront a steep re-learning curve. The good news is that I have been able to pick up a lot of Spanish from the health promoters I travel with. The bad news is that the phrases I've learned from them largely consist of things like "is there blood in your flem?" and "do you have diarrhea?". So when I meet new people I usually lead with the latter in hopes that I'll immediately find something we have in common.
So in spite of a few gastro-intestinal glitches (thanks MHAPers for the Maalox) and the harsh reality of the poverty here, I have to say that Lima has been treating me well. The Socios employees are inspiring people and their impact is really tangible. I live an in apartment with 4 other volunteers and they have all been really great about helping me get acquainted to Lima and making me feel at home. I'm also slowly getting acquainted with some of the Catholic social justice communities here that I've heard so much about. One of the van drivers I met has been directly involved with the work of Gustavo Gutierrez, one of the fathers of liberation theology and the subject of my senior thesis, and he's going to get me information about when and where the groups meet for Scripture reflection and retreats. So things are in the works.
I guess I'll leave it at that for now, but I'll try to update soon. Que le vaya bien.
Monday, September 29, 2008
A Deal's a Deal
In return for Kat setting up a blog detailing her Med School experiences, I agreed to make one about my time in Peru. After resisting Facebook and MySpace for years, I've finally entered the world of internet self-presentation. I guess it's all downhill from here.
After only two days in Lima, I'm not sure what to say, except that I'm working with Partners in Health , whose mission is to bring the fruits of scientific innovation in medicine to the poorest of the poor. I also wanted to attach this poem I read recently in Pathologies of Power, a book written by Paul Farmer, one of the founders of PIH. It highlights the troubling priorities that PIH seeks to correct.
Hasta luego...
The Earth is a Satellite of the Moon
Leonel Rugama (1949-1970)
Apollo 2 cost more than Apollo I
Apollo 1 cost plenty.
Apollo 3 cost more than Apollo 2
Apollo 2 cost more than Apollo I
Apollo I cost plenty.
Apollo 4 cost more than Apollo 3
Apollo 3 cost more than Apollo 2
Apollo 2 cost more than Apollo I
Apollo I cost plenty.
Apollo 8 cost a fortune, but no one minded
because the astronauts were Protestant
they read the Bible from the moon
astounding and delighting every Christian
and on their return Pope Paul VI gave them his blessing.
Apollo 9 cost more than all these put together
including Apollo 1 which cost plenty.
The great-grandparents of the people of Acahaulinca were less hungry than the grandparents.
The great-grandparents died of hunger.
The grandparents of the people of Acahaulinca were less hungry than the parents.
The grandparents died of hunger.
The parents of the people of Acahaulinca were less hungry than the children of the people there.
The parents died of hunger.
The people of Acahaulinca are less hungry than the children of the people there.
The children of the people of Acahaulinca, because of hunger, are not born
they hunger to be born, only to die of hunger.
Blessed are the poor for they shall inherit the moon.
After only two days in Lima, I'm not sure what to say, except that I'm working with Partners in Health , whose mission is to bring the fruits of scientific innovation in medicine to the poorest of the poor. I also wanted to attach this poem I read recently in Pathologies of Power, a book written by Paul Farmer, one of the founders of PIH. It highlights the troubling priorities that PIH seeks to correct.
Hasta luego...
The Earth is a Satellite of the Moon
Leonel Rugama (1949-1970)
Apollo 2 cost more than Apollo I
Apollo 1 cost plenty.
Apollo 3 cost more than Apollo 2
Apollo 2 cost more than Apollo I
Apollo I cost plenty.
Apollo 4 cost more than Apollo 3
Apollo 3 cost more than Apollo 2
Apollo 2 cost more than Apollo I
Apollo I cost plenty.
Apollo 8 cost a fortune, but no one minded
because the astronauts were Protestant
they read the Bible from the moon
astounding and delighting every Christian
and on their return Pope Paul VI gave them his blessing.
Apollo 9 cost more than all these put together
including Apollo 1 which cost plenty.
The great-grandparents of the people of Acahaulinca were less hungry than the grandparents.
The great-grandparents died of hunger.
The grandparents of the people of Acahaulinca were less hungry than the parents.
The grandparents died of hunger.
The parents of the people of Acahaulinca were less hungry than the children of the people there.
The parents died of hunger.
The people of Acahaulinca are less hungry than the children of the people there.
The children of the people of Acahaulinca, because of hunger, are not born
they hunger to be born, only to die of hunger.
Blessed are the poor for they shall inherit the moon.
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