Lynn's Travels: Peru, Day Nine
I dragged myself out of bed to discover that my voice had become a whisper. It was my turn to say the morning prayer and I happily passed the honor to Dr. Jim who eloquently filled the bill. I have no trouble with public speaking, but for some reason I find it hard to speak to God in front of an audience.
There is a little bit of a disconnect here. Initially it looks like Lynn has bowed out of doing the morning prayer because she is losing her voice; but then she says it is because she finds it hard to lead a public prayer. Considering Lynn’s difficulty with religion she has expressed many times during these travelogues, this is not surprising. It does not come naturally to many and for a woman who told us 2 days ago she had not attended a church in years, it would be quite hard. As for Dr. Jim, if you guessed this is the first time he has been mentioned, you would be right.
The day was cool and windy, but the line outside the church was long and welcoming. We went to work without the usual bumbling about, having now created a system that took advantage of everyone's skills.
And now for a description of what that system is:
Docs and Spanish-English translators went straight to their stations. Runners guided patients through triage to the waiting areas and placed their papers in a docket on the wall. Quechua translators went from one clinic space to another, on call- and seemed to appear exactly when we needed them.
Do you notice the difference between the set up at the La Fuente clinic and what I presume is their setup for the second day at Iglesia Evangelica Peruana (Consistorio Cusco)? Quechua translators. At La Fuente clinic, Lynn was running about trying to find people to volunteer to be Quechua translators. At Iglesia Evangelica Peruana, they are already there.
Downstairs, the pharmacy- in a constant state of motion - received prescriptions and carefully prepared packages for patients who went to Integrated Health before receiving their meds. Integrated Health is a classroom of sorts where patients learn how to deal with their personal concerns, how parasites are transferred and how to stop the cycle, how to strengthen one's back to prevent strain, healthy ways to eat, child care, birth control and psychiatric help.
Oh, it’s called Integrated Health now. Back on Day Six, Lynn called it a "charla". Like on Day 6, Lynn said they talked about back care, parasites, nutrition and infant health care, plus the 2 psychiatrists. New for this time is birth control. Missing this time is the discussion about their faith. Later on in this entry, we will find out why.
I wondered at first how our two psychiatrists would handle emotional concerns when we were there for such a short time. The answer was soon evident. Alcoholism, thoughts of suicide, spousal abuse and endless poverty were things people wanted, needed to talk about. It didn't take long for Drs. Jim and Paul to find themselves quite busy.
For the obvious comparison. Dr. Pam Bradford was called “Dr.” only once on Day 6 and never since and the other female doctors did not get that title from Lynn. Jim and Paul are a different story. Jim has been “Dr.”ed all 3 times he was mentioned and Paul the one time he was mentioned.
Pam and I spent a long time with two young women who really needed to talk. Both had chronic illnesses and I saw for the first time how devastating this can be to people who would normally be enjoying their youth, their friends and their education.
The first time? It’s hard to believe that Lynn Johnston, who suffered with her dystonia for 10 years, would say this. Of course, for those of us who doubt whether or not Lynn Johnston actually had dystonia, this comment is not a surprise.
Both felt left out, worthless, betrayed by their bodies. They wanted a cure or a way out! Suggesting antidepressants wasn't enough. Pam sent them to see the professionals downstairs and arrangements were made for them to have follow up care.
Lynn doesn’t say what these chronic illnesses were, and it is possible she didn’t know. I wonder if they really did say that they wanted the doctor to cure them or kill them, as Lynn implies.
Most of the patients Pam and I saw were women - and one I will always remember is the beautiful young mother who, after her appointment, agreed to show us how she wrapped her baby so that he could be carried on her back. So many women carry their babies this way and it amazed me to see how they maneuvered around corners, or in and out of buses and cars without bumping the infant's head or feet. They are so intimately aware of the size and position of their bundle that accidents don't seem to happen. Her baby boy was a beauty and sound asleep when she began to unwrap him. He awoke as she showed us the shape and size of the shawl. She told us where to buy the same shawl and said that she would now have to show us the "awake" way of wrapping. She placed him in the richly coloured fabric, turned the edges this way and that, bent over and slung the little one over her shoulder all in one fluid movement. He was suddenly peeking over her shoulder, his dark eyes shining and eager to go. Pam and I were as enchanted with the lesson as we were with her and we wished we didn't have to hustle to the next patient and let her go.
Lynn expresses regret about letting the woman go because:
a. She told Lynn where to buy then same shawl she had, and Lynn wanted her to take her shopping.
b. She wants to learn how to wrap a baby in preparation for getting grandchildren from Kate.
c. She is excited about having a patient who isn’t depressed and looks beautiful.
d. She knows her next story about a mother and a baby is not going to be as happy.
This day went by more quickly than the last. Now a cohesive unit, we took apart in short order the clinic we had so neatly put together, packed the bags and were preparing to leave when something stopped us all. Near the side entrance to the church, a small and earnest group had formed a semicircle around a young mother of three. She was perhaps 25. She had two little girls and a newborn. The baby, 7 days old, lay on the bench beside her. It had not been fed. It was thin, listless, quiet. One of the nurses was explaining to the mother that she had to feed her baby or it would die. The translator had tired of waiting for the nurse and was admonishing the woman saying, "Do you want to be responsible for your baby's death? Don't you want to save this baby?"
This is a little confusing here. The translator is waiting for a nurse, when a nurse is already there explaining to the mother basically the same thing the translator is saying. The mother is near the side entrance to the church and has a group around her after they have taken apart the clinic. Is she there to be treated and got there late? Is she just a person who happens to be sitting on a bench near the church who is being admonished by the translator? Lynn has none of these details.
The woman's eyes were open, but she looked at nothing. Her eyes were without expression; completely blank... Her body was still rounded from having given birth, but her breasts were flat, her face gaunt and colourless. Her other daughters, ages perhaps 4 and 7, were being hugged by two of the volunteers. They watched but also with little expression. It was as if they were deaf to all that was going on around them. The nurses became frantic. The baby's condition was grave. Any decision involving the baby would have to be taken away from the mother. The baby would go to the hospital where it would have a feeding tube, where it would get treatment and hopefully survive.
More confusion for me. Why are the nurses frantic? Haven’t they been dealing with sick kids and babies for 4 days now? After all that, why are they losing their composure now? Don’t they have access to the pediatrician who has been working with Liuba? Don’t they have access to the doctors in the Integrated Health who have been teaching child health? Don’t they have the Cusco hospital just down the road? Why would any decision involving the baby mean taking the baby away from the child? Mothers don’t get to go to Peruvian hospitals with their kids? Why do the volunteers have to hug the other daughters? If the baby’s condition is grave and they are afraid it is going to die, then what makes them think the baby is in a condition where it can take food from its mother? As you can see in the text coming up, Lynn doesn’t stick around to find out what happened or what the actual situation is.
Liuba and I continued to help pack up the pharmacy and carry the supplies outside. We could do nothing and the fewer people in the area, the better. Outside at the bus, Liu was distraught. The scene we had just witnessed had been awful. It occurred to me that we had seen so many women left with children they had to raise alone, with no money and no support and this one had just given up. What was there to celebrate in this new birth? More responsibility, more need, more hunger. What I saw in her eyes was beyond desperation. She had lost the will to care.
Lynn’s description goes to the eyes for the 3rd time now. The mother’s eyes are without expression, the mother’s children’s eyes watch with little expression, and the mother’s eyes are beyond desperation. My guess is that Liuba is not reacting to the mother’s eyes, but the really sick-looking baby. That’s what would get me upset. It’s not too surprising Lynn’s focus is on the mother who was left alone, because that is her own experience; however this does not mean her concern is not real. According to this website for the Mantay Shelter in Cusco, “In Peru, one in four mothers is under the age of 18.” That is a very high percentage compared to the 5.4% in the United States, 3.1% in the United Kingdom and 2.8% in Canada; but small compared to Niger, where the percentage of women who had given birth before 18 is 53%. Now we see why Lynn added birth control to her list.
The small, cluttered shops passed by under the windows of the bus, now recognized - a landmark here, a sign there. We were becoming familiar with the way back to the hotel and glad to retreat to our rooms, wash up, and reassemble downstairs. After dinner, we again went through the events of the day. A tally was made of the number of patients we had seen, how much medication had been given out. We were low now on certain antibiotics, arthritis meds and nose spray.
I can understand antibiotic and arthritis medication, but nose spray? Lynn has not really mentioned anything nose-related about Cusco.
We still had plenty of eye drops, cough medications cortisone shots and antacids.
In an unusual moment, Lynn seems to have run out of commas. You will notice that for a person who has a cold, Lynn’s use of those supplies will not affect the MMI medical stores.
Some supplies could be replenished from a storehouse maintained by MMI in Peru, but was there time to get it? For those of us who were simply there to help, it was an easy few days of work. The organizers however were constantly busy, handling everything from dietary preferences to the loss of a passport to the recuperation of medical supplies. We were constantly amazed by their efficiency and consistent good humor.
In other words, Lynn is not concerned in the slightest about the low medical supplies or how to get them, because she is not an organizer. In fact, she describes herself now as “simply there to help”, and those easy few days of work, and has stopped talking about that hard translation stuff.
Those of us 45 and older usually went to bed around 9, but the younger people sang, talked or went off into town for some fun. Even the evenings were routine - and it took less than a week to make us all a bit "predictable".
"Predictable" for someone who goes to bed at the first opportunity.
As I waited for the cold medication to ease my stuffed head into sleep, I thought about how close we'd all become and how quickly we'd be leaving. Tomorrow, the last clinic.
Lynn talks about the closeness and yet, she mentions so few names. Compare this travelogue for Day 9 to the ones in the first few days in Lima, where her attitude towards naming people seems very different. If I were to go from Lynn’s description of the people working, I would get the impression that they are almost all women except for Dr. Pam Bradford’s husband and the 2 psychiatrists. Looking at the picture of the people on the bus, I get a very different impression about the ratio of men to women on this trip. I have the feeling Lynn only really talked to the over-45, female crowd, and there are not many of those on this bus.
Tomorrow, the last clinic.
Looking at the Medical Ministries International website, I realize what is going on here. The bulk of the mission trips are shown to last 14 days and so when Lynn said she was on a 10-day mission, I presumed she meant that 4 of the days of the mission were involved in travel and the setup, while the other 10 were on the mission. There are some missions that are 7 days only and this appears to be the type of one Lynn is working – probably 5 days of clinic, 1 day to start and 1 day to stop. Add to that a few days of vacationing in Lima, and you have Lynn’s 10 days.