Lynn's Travels: Peru, Day Six

As usual, I will quote the text and then comment on it.

We were all out of bed and downstairs in the "dining room" by 6:30 AM.

By use of quotes, Lynn takes another shot at the hotel, with a dining room that is not really a dining room. Slowly, but surely, Lynn moves closer to agreeing with the taxi cab driver’s assessment of the hotel.

Morning prayer and some songs from the MMI hymnbook began the day and we were on the bus by 8. Our first session was set up in a tidy little Mennonite clinic, not far from the church we had attended on Sunday. The supplies had been sent on a separate bus and we all pitched in to carry everything inside.

Already this is not like those trips we are used to with Lynn and Rod and bunch of tents set up in some wilderness. This is a pre-established clinic and it appears the Mennonites must do this kind of mission year-round.

This time there were no dentists, so we were spared from having to load and unload the heavy chairs and other equipment they'd need.

“This time there were no dentists” is a statement which implies that there were other times when there were dentists. And yet, this is the first day of this, so clearly Lynn is writing this after having done the whole trip and is not bothering to maintain any sense that this is a day-by-day journal. That aside, this is a confusing statement. If they are operating in a clinic, then why couldn’t they unload the dental equipment one time and be done with it until they were finished? What are the dentists doing?

Already a long line up of patients was there to welcome us at the entrance.

If they didn’t leave for the area until 8 am, then this is not very much of a surprise.

It was a clear day. A brief rainfall in the evening had made the grass moist and green. Kids tumbled about in the small courtyard as volunteers put up tent shelters and rows of chairs. For some patients, a check up and a referral would be an all day process. Many of the ladies there wore traditional garments; multi layered skirts, several sweaters and blouses and knee high woolen socks. Tall white hats and long braids, often tied together at the bottom or finished with long tassels of black wool, made them stand out from the crowd.

Lynn is very descriptive and in the picture you can see there are a few women dressed this way, while the majority are not.

These were Quechua and spoke little Spanish.

For Quechua in Cuzco, I found this information from this website:

Quechua had already expanded across wide ranges of the central Andes long even before the Incas, who were just one among many groups who already spoke forms of Quechua across much of Peru. Quechua arrived at Cuzco and was influenced by languages like Aymara. This fact explains that the Cuzco variety was not the more spread. In similar way, a diverse group of dialects appeared meanwhile the Inca Empire ruled and imposed Quechua.

It was important to find translators who could speak to them and translate for us, so that we could then translate the Spanish into English for the doctors. We soon found several young women, nurses and volunteers who still spoke this ancient language and were eager to help.

“still spoke this ancient language”. Oh, Lynn, you do not disappoint. You are right about it being ancient, but “still spoke” implies this is a dying language. Not so. From this website:

Quechua has official language status in Peru. In Peru, a quarter of the population speaks Quechua, and about a third of the Quechua speakers speak no Spanish.

I can’t believe Medical Ministries International really walked into Cuzco without being prepared to deal with ¼ of the population. I find the idea of Lynn Johnston running about trying to find people to translate Quechua into Spanish for her very amusing. Ultimately, you find that Lynn will not mention these Quechua translators again in this day's writeup.

Inside the neat little clinic, I was paired up with Dr. Pam Bradford from Maryland.

You can see a picture of her here. Her specialty is Internal Medicine.

She and her husband, Norman, were given a small room, divided into two by a set of hospital screens.

Dr. Norman Bradford from Maryland. His specialty is Anesthesiology

We would have about 4'x5' of space each. Plastic bags were being applied to an adjoining window to create some privacy and to darken a room that the optometrist would work in. The staff had given us an examining table and Pam was pleased to see that we had a sink with running water.

I presume by this reference to a staff, Lynn means the staff of the clinic.

In the hall outside our room, two other cubicles had been created with pipes and curtains. Examining tables had been set up there, too. It was a clean and very well organized space, even if it was tiny! Down the hall was a room for pharmacy, to the left of the pharmacy was a long bench for waiting patients and around the corner to the left again, was triage where patients would be lead first to have their weight and blood pressure taken and their charts prepared.

All past tense as if someone else set all this stuff up before they arrived.

It took some time to set ourselves up. The first day is always a fluster of where to put things, how to arrange the flow of patients and which volunteer is best suited to what job. By 10:00 am, we had a system and by noon, we were a team!

2 hours to get there and set up. 2 hours to get a system and become a team. After all this, and Lynn has failed to mention one single thing that she has done.

Liuba had been assigned to Erin Hannigan, a young (and very pretty) pediatrician.

That probably Erin A. Hannagan, M.D. You can see her picture in this website and she does appear to be pretty. Too bad, Dr. Pam Bradford. I am sure if Lynn thought you were pretty, she would have mentioned it. However, the important message is that someone had the wisdom not to assign Lynn to someone dealing with kids.

Their space was in one of the administration buildings across the courtyard from us. Many complexes and private homes are arranged like this, around a central square or rectangular garden which serves as a living or gathering space. The building is hidden by a high wall. The outer doors then open to reveal a courtyard around which the residence is formed. The rooms all open to face the garden in the center; a tiny replica of the public square downtown. We saw this in Pompeii, so this ancient, Latin- style of architecture remains popular today.

So Lynn is saying that the Mennonites occupy a clinic where the architecture is Latin because it is similar to something she saw in the ruins of Pompeii. Pompeii is 1st century Italy. Cuzco was the historic capital of the Inca Empire in the 13th century. That's really a popular style if it carried from Italy to the Incans after 12 centuries.

Liuba's and Erin's space was next to Nora Porter, also from Maryland. Nora, a family physician, spoke fluent Spanish so she was on her own for most of the time, calling on Liuba only when someone's speech was too difficult to decipher!

I can’t find a Dr. Nora Porter from Maryland. However, I did find a website with this Dr. Nora Porter, in St. Louis who has this on her resume:

She has also worked as a volunteer physician for several organizations in Haiti, Bolivia, Costa Rica and Thailand.

There is also a Dr. Nora Porter who practices family practice in Pennsylvania, but I have a feeling that Dr. Nora Porter from St. Louis is the one. I would go on about Lynn getting the place wrong, but if Dr. Nora Porter is really from St. Louis, that explains the whole thing. Lynn thinks, "She's from St. Louis, Missouri. But wait, Missouri? Isn't that actually in Kansas? Oh, I am getting confused again. I'll just say she's from Maryland like Pam is."

Liu was in her element with the children, but her memories of growing up in Russia with little to eat and hand-me-down clothing would come back to haunt her time and again. It was hard for her at first to separate herself from the families who were in dire need, but her experience made her all the more compassionate, kind and understanding. I soon heard her laughing and teasing the little ones while she did the translation.

What? Is she saying Liuba was in tears when she was translating before she was able to separate herself from these families and her own personal history with poverty?

We all established an easy pace, wanting to be as thorough with examinations as possible and still see as many people as we could. Pam and I were a compatible pair. I loved her gentle, understanding style and so respected her abilities.

This statement is loaded with Lynn's patented "read between the lines". While Liuba was described as a translator, Lynn does not mention doing that. Lynn’s respect for Pam’s abilities is based on her “style” and not on what she was actually doing for the patients. Instead of saying she loved working with Pam, she calls her “compatible”.

Patients in these areas tend to suffer from the same things. Hard work and carrying heavy loads on poorly supported feet cause backaches, calluses and sore legs. Dry air - filled with sand the consistency of talcum powder - irritates eyes and throats. Vendors in the streets get up at 5 and work until sundown. Construction workers and farmers work without the proper equipment or adequate food. Women abandoned with children complain of headaches they can't stand and this is often from stress. Just telling another woman about her difficult life was what they needed more than anything.

After the laundry list of things, Lynn works her way around to the thing she was doing, i.e. listening to someone else complain about their hard life. And is that better or worse than getting medical treatment? Why yes it is. They needed it more than anything. By her own affirmation, Lynn is better than the doctor. That pretty much tells you all you need to know about Lynn's relationship with Pam.

At first, when Pam asked if a patient wished to pray, I felt uneasy. I knew my medical terminology, but religious phrases were embarrassingly foreign to me.

Here you go Lynn, “Shall we pray” in Spanish is “vamos a orar”. This is very odd for Lynn to say. Doesn’t she know this is Medical Ministries International? I thought she had worked for them before. If not, the hymnbook and praying should have been a giveaway. Of course, this is a woman who thought prayer and prairie were related and that was in English.

Pam would hold the patients' hands, bow her head and ask God to take the pain away. "Heal your daughter's aching muscles, calm the pain in her head, give her rest from all her duties and make her husband realize that he must support his children. Let her know that she is loved and cared for and that you are listening..." Words like this don't come from the Bible. They come from the heart.

Actually, Lynn, all those ideas (giving rest, calming pain, fathers supporting children, being loved and cared for, etc.) are in the Bible, believe it or not.

What Pam would say could not be given as advice or in conversation. We were, after all, strangers; foreigners. But, her comforting acknowledgement and sage advice, if given in a prayer, was gratefully accepted and would last far beyond the small bottles of meds we could give her.

I like this idea. You can say things in prayer with someone that you would never say to them in person. I can imagine Lynn praying, "Oh God. I pray that she will take a bath because she stinks so bad, not that I would ever tell her that in advice or in conversation."

I soon became part of an intimate trio; Pam holding the patients' hands, my hands on Pam's and the patients' shoulders. I wanted to be a translator, but this was a private exchange beyond words, beyond borders, beyond looks and lives, possessions and beliefs. It was an experience I can't even begin to explain, which is rare for a talker like me!!

Lynn has had a good experience witnessing someone else ministering to someone else and apparently does little else. “I wanted to be a translator” says it all.

Outside our little cube, patients were waiting patiently for their names to be called. "Runners" would put their charts into the docket on the wall, then lead patients to the next station after their appointment. Treatment continued with a "charla".

Charla = Conversation / Chat En = In Español just so you know. It is not the name of a medical practice, which is what the next text would lead you to believe:

This is an opportunity for nurses, therapists and ministers to help people understand how parasites and other diseases are transmitted and how to avoid them. Plastic models showed how the back works and how lifting in certain positions can put too much stress on the spine. Exercises to improve back and leg strength were demonstrated. People could learn about nutrition and infant health, and there were two psychiatrists as well who would talk to people about their lives, their fears and their faith. Fear is a serious problem- for everyone. In a country where services which house and protect the elderly are either too expensive or non-existent, the fear of having a terrible disease or a chronic ailment is constant. In a modern city in 2010, it's hard to believe that such services are so underfunded. Even hardy young people fear a health problem, as work cannot stop because of an aching back. Somebody has to feed the family and pay the bills.

Although Lynn is slamming the Peruvian health care system, the Health care system in Peru is universal, and financed by government though a system of national health insurance. In fact, this website shows that Cuzco has 1 public hospital and 7 private hospitals. In fact, after reading Lynn's description, I enjoyed this story talking about how Peruvian health care shames the USA health care system.

On the first day, Pam and I saw more women than men. This meant that we dealt with a lot of intimate problems and one in particular made us laugh for the rest of the week. Our patient was a woman of about 50, well into menopause and trying to cope with the crazy ups and downs of hormone change. One of her concerns was that she peed when she laughed. Pam smiled and said there was an exercise she could do to strengthen the muscle that controls the opening of the bladder. "The next time you urinate" she said, "stop before you're finished and hold on for the count of ten. This exercise can be done anywhere, once you know how to do it, and you should do it at least 10 times a day.". Even though Pam made it clear that you didn't have to run to a washroom, the lady was confused. "Look" I said. "you practice on the toilet, but you can do the exercise anywhere! Nobody has to know what you're doing- you just do it. For example," I went on, "you can do it on the bus!" I held an invisible stanchion and lifted my eyebrows as if counting to ten. "You can do it in the kitchen!" I whisked invisible eggs and grimaced up to ten. "You can do it while you're buying groceries!" I pretended I had a bag of grocs and was paying the cashier as I flexed my privates secretly. Both Pam and the patient laughed until they cried. This is the kind of audience a comic adores....and is far too encouraging.

This comment is far too easy. This is the kind of audience Lynn adores…audiences that love pee jokes.

We saw the dear Quechua ladies who complained of varicose veins. Their stockings, held up with strong elastics formed ligatures behind their knees and we asked the local nurses to find a solution if they could.

What? The stocking elastics form ligatures and this causes varicose veins says Dr. Lynn. This article on varicose veins suggests different sources: Pregnance, prolonged standing, obesity, straining, or trauma to the leg. Maybe Lynn means that the stockings fall into the "trauma to the leg" category.

They complained of aching backs, arthritis and dizziness. Pam listened and administered without letting on that she had seen and heard the same story from almost every patient.

What is Lynn suggesting here? It is a trial to the doctor to have a series of patients with the same symptoms?

One of the things everyone seemed to overlook was their need for water. In a climate as dry as this, Pam recommended at least 8 tall glasses a day; something we hear often enough as well. It's amazing what happens to your body if you don't get enough water.

Lynn. You take getting clean water for granted in Canada. It’s not as easy in Peru.

There weren't enough otoscopes to go around, so the few we had were in great demand. Blood pressure instruments break with the change in altitude, so we needed those as well and the one little knee-knocking hammer made the rounds, too making us a lot more aware of what was going on in the other operatories around us. It was clear to everyone that bringing all your tools with you was a good thing to do!

Well, Lynn. It sounds like the tool you needed was a Spanish – English dictionary, so you could look up the word “pray” in Spanish.

Around 4 in the afternoon, the line was halted and we were able to able to clean up and head for the hotel. Little was said on the bus. We were all more tired than we realized, having worked non stop all day with just a short lunch break in which to catch your breath.

Basically 10 am to 4 pm for patients. That's not a lot of time.

Liuba decided to try and use the miserable hotel computer and I crashed on the bed in our room.

Another slam to the hotel about its computer (as if Lynn would actually use such a thing).

I was starting to catch a cold and hoped it wouldn't tie me down at all.

Lynn suffers. Oh how she suffers.

Dinner began with grace and after we had all been fed, we dissected the day's events. Everyone had a story to tell about an unforgettable patient or a system we could try. Good suggestions and good laughs always followed dinner and after dinner, bed felt wonderful - cold mattress and all.

Another hotel slam. I guess Lynn must have a heated mattress up in Corbeil. I don’t think I have ever been in a hotel that had anything but unheated mattresses.