Wednesday, January 05, 2011

Lynn's Travels: Peru, The Last Day

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

Some people had to return right away to their clinics, homes or hospitals. The rest of us arranged a tour of the countryside with a trip by train to Aguas Calientes and Machu Picchu.

From this website:

Aguas Calientes is the colloquial name for Machupicchu Pueblo, a town in Peru on the Urubamba (Vilcanota) River. It is best known as the closest access point to the sacred Incan city of Machu Picchu (in Quechua: old mountain), which is 6 kilometres (3.7 mi) away, about 1.5 hours walk. Aguas Calientes serves as a terminal for the PeruRail passenger train service from Cusco. Trains serve locals and tourists arriving from Cusco and Ollantaytambo to visit Machu Picchu.

Farewells took place before a large, comfortable tourist bus came to collect the travelers. We hugged and waved and genuinely hoped we'd see each other again. It had been another emotional and memorable experience.

However it was not emotional or memorable enough for Lynn to mention any particular person by name. This farewell is emotionally distant compared to the heartfelt farewell to Nilda and her friends Ana Maria and Rosa from Day 3 in Lima. There is no promise of continued contact or how much she misses them. Throughout the course of the 5 days of her medical clinic description, Lynn hammered away at her theme of “what the people really needed was someone to talk to” versus the actual medical treatment offered by her partner Dr. Pamela Bradford, whom Lynn consistently and continually referred to without calling her “doctor”, in stark contrast to the male doctors on the mission. This stream of self-complimentary dialogue tells me that perhaps Lynn was not getting enough positive feedback from others on the mission. When you get right down to it, it would be difficult for her to get any. She’s not a medical professional and she admitted on several occasions to being an inadequate translator. She takes long shopping lunch breaks and she takes a lot of pictures. I can only imagine the reaction she got from the medical professionals on the mission with her.

When she took these kinds of trips with her ex-husband Dr. Rod Johnston, she expressed a frustration in her inability to contribute much to what was going on. To her credit, she seems to be doing more than she used do when she was traveling with Rod. Nevertheless, I think she would be better served to participate in mission trips which do not require medical expertise, instead of continuing to try to outplay or outlast her ex-husband. Lynn has very deep pockets, and there is a great potential there.

I thought about writing more. There is just so much to say about the wonders and the mysteries of Peru. To continue would have made this diary far too long. Besides, the mission itself was the most important thing to share.

This is a nice thought, but certainly does not match Lynn travelogues in Thailand or Oaxaca, Mexico or even the first 3 days of this trip. Lynn originally described this as a 10 day mission. Lynn posted Days One – Five back-to-back on December 6-10 and Days Six-Eight back-to-back on December 13-15. Then she skipped a day and posted Day Nine on December 17. Clearly Day Nine was intended for December 16 and Day Ten was intended for December 17, just before Lynn left for the holidays. I don’t think Lynn had any plan to write a Day Eleven originally. Her final line on Day Ten was very Christmasy and very “end”-like:

As we ate and enjoyed, I couldn't help thinking about our last patient and all of the others out there who were hungry. Just a few more days until the gift-giving and gluttony of Christmas and here I was seeing the "other side of life". Perhaps this is the gift I gave to myself; something to put my life into perspective and to make me thankful, once again for all that I have.

On the way home, I read through my notes and tried to add anything more that came to mind. I thought about the young mother at the church who didn't want her baby and I wondered what had happened to her. I thought about the farmer who survived the murder attempt and the dear little lady to whom we gave the waist pouch. I thought about how different my life would be if I had been born in another place at another time and that I was going home to a reality the patients in our clinics could never imagine.

Lynn has had such good fortune in her life, it’s good for her to get some perspective. If she had been born in Cusco, Peru, her life would have been very different from the life she has now. For one thing, she would know how to speak Spanish.

There are a bunch of pictures here which I presume are of the town Aguas Calientes followed by the ruins in Machu Picchu. The Machu Picchu pictures match others I can find on-line of the area. Aguas Calientes is less certain for me. I found this website from someone else who made the same trip and Aguas Calientes looks different. There was plenty else to tell about a PeruRail trip, the sights on the way there, and the river for which Aguas Calientes was named.

Christmas 2010 has come and gone. I've tidied up and changed my calendar.

2011 For Better or For Worse calendars are still on sale. Hint! Hint!

For me things are almost back to normal. I'm grateful for having had another opportunity to see what's normal for others and my sense of privilege and gratitude has been reinforced once more.

What an interesting way to phrase it. Her sense of privilege has been reinforced. Her sense of gratitude has been reinforced. I find that I have to agree with this sentence whole-heartedly as a very accurate summation of her travelogues.

I sincerely hope that everyone who has "come along with me" on this mission in Peru has enjoyed the experience. Thanks for reading. May good health, good news and good friends be part of your new year. All the best!

I certainly have enjoyed the experience. Lynn did not disappoint. Bathroom stories abounded. Women doctors were disparaged. Peruvian health care was vilified. Peruvian men were slandered. Names of people and places were misspelled. The only thing missing was Lynn’s description of her alcohol consumption, which I blame on the Christian aspect of the Medical Missions International. All in all, it was a very fine travelogue. I look forward to the next one.

Tuesday, January 04, 2011

Lynn's Travels: Peru, Day Ten

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

Christmas was busier than I thought it would be...but I say that every year. Here are the final two installments in the Peru Diary. Happy New Year... and I hope my memory serves me well!!

This is an interesting way to start out, since she has pictures and this was only 2 months ago.

On the last day of our Mission, we set up in a community center in a very run down neighborhood. This long cinderblock building was attached to a private home- a small, adobe flat with two large, vacant chicken coops at one end. The owner was inside the house watching television. He appeared briefly in his pajamas to use the latrine outside then got dressed and left for the day, giving us access to the property, the latrine and the chicken coops.

Pajamas? What happened to “pyjamas”? As for finding where Lynn is this time, it is difficult. Internet searches show there are many community centers in Cusco. One possible clue is the second picture, which shows a picture featuring the words “Apv. Villa Jardin”, which is probably a reference to The Garden House hotel. It is located in Larapa, Cusco, Peru, which is a spot further west in Cusco that the prior place where she had been working. However, the hotel is not located in a run-down neighborhood, so I can only guess is that each mission has been working more west in the city.

Inside the center, volunteers had created cubicles for the doctors with wire, string, blue plastic sheets and black garbage bags put together with clothes pins and masking tape. Triage was in the first cubicle, Pam and I were given the second, Liuba and Erin the third. Pam's husband was across from us, optical was in the back of the hall, pharmacy at the front. Outside, a tent was erected for integrated health and the psychiatrists found privacy in the chicken coops into which were placed a table and two small chairs. Seeing psychiatry being taken seriously within the shade of a chicken coop was the highlight of the day and we took turns going out to take photographs!

I can only guess that this is photo six of set since it just shows people talking in an outdoor area with a broken wall. There are no pictures with chickens or coops, so this description is iffy for me. Photo five is very interesting to me, who matches the picture I had found on-line for Dr. Pam Bradford. I had mistaken the picture of the tall, thin female doctor with glasses in prior travelogues as Pam, since Lynn had taken several pictures of her. However, it seems that this picture today is the first picture Lynn has put of the woman with whom she worked for most all the mission. It makes me wonder (a) Who is the glasses doctor and (b) Why didn’t Lynn have more pictures of Dr. Pam Bradford?

Pam and I saw the usual assortment of complaints and then a young man came to us with an older gentleman who had trouble walking. The young man was attractive, well dressed and well educated. His companion was about 55, dressed in the traditional garb of the agricultural worker; loose pants, white blouse and at his waist a colourful woven sash. The young man explained that this was his father's best friend. He had survived an attempted murder and was suffering from numbness down his arms, dizziness and depression. The story was right out of "The Sopranos". He had been a successful farmer - well respected and well liked. His wife, however, had a lover. She and her lover attempted to kill him, but failed. It was an amazing story. After his release from hospital this man continued to suffer but doctors blamed his numbness and dizziness on his pent up rage. Pam examined his neck and back and concluded that he had a pinched nerve - that his symptoms were not psychosomatic, but caused by the beating he endured. This news was such a relief that he nearly cried. After all that had happened to him, to be told that he was making up his symptoms was unendurable. We saw this so many times. When people actually know what their problem is, they feel better. To not know is as painful as the injury itself.

I don't remember any farmers in "The Sopranos", but I know what Lynn means. Lynn casts no judgment on the quality of Peruvian health care, which is contrary to the direction she had been going with this travelogue. My wife has had the same kind of problem with some doctors in the United States who couldn’t be bothered to figure out problems that she had and I will admit it is very gratifying to have someone figure out what is wrong with you instead of being told it is in your head.

Next door, Liuba and Erin were working with moms and babies. Occasionally a stray youngster would crawl under the plastic divider into our space. Older kids would peer in through the masking tape, but we were all too busy to worry about it. Privacy wasn't as important as seeing as many patients as possible.

Initially my thought is, “the kids want to see an old man’s neck?” Then Lynn leads into the prostate exam, and it becomes a lot clearer.

Our next patient of note was a man in his eighties who was worried he had prostate cancer. He had no teeth, mixed Quechua with Spanish and I had a really hard time understanding him. Liuba was busy shooing toddlers from under the dividers, so for a moment I could ask her to help with translation.

As if Liuba knows Quechua. I am not sure if the reason Lynn mentioned the kids is just to give herself an excuse for asking Liuba to help with the translation. Not to worry, Lynn. We know that your primary purpose here is to hold sheets and strip clothes off multi-layered women.

Pam had to do a prostate exam, so with me holding the sheeting together for privacy and both Liu and I looking the other way, our patient braced his hands against the wall and the exam took place. Pam told him he had an enlarged prostate but it was very unlikely to be cancerous. He sighed with relief. He had been worried for so long, he was almost in shock.

There’s something missing here. Most times people are not aware they have an enlarged prostate unless it is severe. The man probably had other symptoms. My experience with this is that next step is to consult a urologist to make sure that it is really “very unlikely”.

"Now what do I do?" he asked. "Are you married?" Liuba replied "Yes" he said. " You're over eighty years old, you're a healthy man - go home and enjoy!" said Liu. The patient started to laugh and so did we. Once again, to be told you were going to be OK was the best medicine... and a good laugh comes second.

Liuba makes a sex joke and judging from Lynn’s reaction, I wonder if Lynn understood it.

After awhile, it was necessary for me to go outside and use the latrine. It was a single toilet in a small, dirty space between the house and the community center. With all the people using it for urine samples, some local authority had put a padlock on it.

This is a mysterious statement. There is a local authority who, given that the community center is being used for free medical care, has decided to protect the single toilet in that community center by padlocking it?

This was our only nearby facility. Dr. Paul, having finished in the psychiatry unit for awhile was walking with one of the local volunteers down to the bus stop. I threaded myself past the waiting line of patients, through the chain link fence and ran after them. Desperate for a washroom, I asked the woman volunteer where I could go.

Another mysterious statement. Lynn can’t ask any of the other people around where to use the washroom, but she has to speak to a woman volunteer who apparently is not local (i.e. is leaving via the bus). Is Lynn too embarrassed to ask a doctor or nurse or Liuba where the washroom is?

She led me to a small, steamy restaurant and said for a small fee I could use use the washroom there. To digress slightly. I once met a man who was a health inspector - his specialty was restaurants. His advice was: "If you go to a new place to eat and you're not sure about the cleanliness, check out the bathroom. If the bathroom is spotless, then so is the kitchen. It never fails!" As I squatted to avoid touching any surface in the filthiest place I have ever been, I thought about his advice and thanked my lucky stars that I wasn't there for lunch.

Not to worry Lynn. I’m sure the beer was still safe to drink. Nevertheless, I am glad that Lynn had at least one bathroom reference in here. It wouldn’t be a Lynn Johnston travelogue without one.

Back at the community center, the sun had passed its peak. The patients outside were much more comfortable. They conversed with friends, sat passively and hoped to be seen before we had to close up shop. Dr. Norm, who had seen one too many back complaints and could speak Spanish quite well, decided to give a demonstration on how to avoid some back problems and set up a table outside. How do you explain core strengthening exercises and proper lifting techniques to a lot of people at once - especially if you're not sure they even understand you?!

Lynn doesn’t answer this question in words, but instead in pictures. It appears that you get someone to volunteer to help you do the demonstration while lying on a portable medical table. Looking at the environment around Dr. Norm, it appears that the community center is somewhere near some kind of government office since there is a reference to a lawyer written on the wall which also has the Joint Command Emblem of Peru, which joins the sword of the Army, the cross anchors of the Navy, wings for the Air Force and the national coat of arms. In case you missed it, Dr. Norm is Dr. Pamela Bradford’s husband, he speaks Spanish quite well, and he has been consistently located near Dr. Pam in every mission location. If Dr. Pam doesn't already know Spanish, I have a certain feeling that Dr. Norm was her choice for translation. Lynn is still consistent with her reference to men only as doctor. Oddly enough, Dr. Norm’s back demonstration gets him 2 pictures to 1 picture for Dr. Pam.

Our last few patients were elderly ladies. The one Liu and I will always remember was a tiny, sweet natured woman who had a bad heart and breathing problems. In order to listen to her chest, we once again, had to peel away many layers of clothing before we could find her inside. It was a surprise to see that she was wearing a brassiere over the top of one of her sweaters. No matter - it was not our business to ask. She had trouble walking. Arthritis had reduced her hips to bone on bone. She was hungry, emaciated and alone. Pam gave her as much of a check up as possible with our limited resources. She called Tanya, the MMI representative over to our space and arranged to have a walker delivered to the woman's home - along with some food. It was good to know that walkers wheelchairs and crutches are kept in a warehouse in Cuzco and given to those most in need.

The joys of Peruvian universal health care. I suppose there was no possibility of getting the woman any kind of arthritis medicine. Looking at the Medical Missions International website, the MMI representative is named Tania Catacora, not Tanya. She’s on facebook and her picture there looks a lot like the young woman sitting in the chicken coop with the doctor in picture 6.

We wanted to give her more. Since she was our last patient, Liuba, Pam and I wanted to give her a little money. We rolled together a few bills- maybe $30.00 Canadian in total, and she immediately reached inside her blouse and tucked it into her brassiere! It was not being worn as underwear, it was her purse. Not wanting to see her lose her money, Liuba took off her waist pouch and put it on our patient. She then retied her apron to cover the pouch. Our little lady was delighted with the pouch, the money and the news that she was soon going to have the aid of a walker.

Since Dr. Pam is not from Canada and Liuba is the one handing over the waist pouch, I have the feeling that this is more a gift from Liuba than anyone else.

Around us, people were beginning to take down the plastic dividers. The folks in the pharmacy were packing up and Tanya was telling anyone who had not been seen when the next mission would take place.

That’s November 5 – 12, 2011, according to the Medical Missions International website.

Our sweet patient sat on a bench near the door and watched. She didn't want to leave us. I gave her a banana and a granola bar that I had in my backpack. She smiled and put them away in the pocket of her apron. The bus had come to take us back to the hotel and still she wouldn't go. One of the volunteers took her by the hand and led her outside, telling her it was time for us all to leave and that she should return home. She sat down and watched as we loaded the bus and drove away.

One of the volunteers and not Lynn. Of course it was probably one of the volunteers who could speak her language. After giving her money and a pouch, Lynn makes her contribution of a banana and a granola bar, so it’s no wonder she’s not leaving. She probably thought the longer she stuck around, the more she would get.

Seems to me that every time you see a public service announcement asking for donations to support a child, there should be another announcement as well, asking us to help the countless, ailing and vulnerable seniors who have nobody to care for them, too. Poverty. It never ends.

Although this is a nice idea, the PSA folks know that sad-looking kids can get people to give money, whereas ailing old people have a harder time.

Back at the hotel, there was a jubilant atmosphere. We were finished the mission and looking forward to a farewell dinner at a nice restaurant and a couple of days to explore. Liuba and I had a shower (mouths closed) and dressed for the Inca Wall.

It’s so nice to know that Lynn keeps her mouth closed when taking a shower with Liuba. That makes it seem a lot more innocent. "A couple of days to explore" means that Lynn may have a few more days in this travelogue, which is kind of odd since she started out saying there was only one more.

As for the Inka Wall, here is its web site. I find it very amusing that Lynn insists on spelling it “Inca” even though her picture clearly indicates the business has a different spelling. On the other hand, Lynn has insisted on spelling it “Cuzco”, instead of the way it is spelled in the country of Peru as “Cusco”.

This lovely, upscale Cuzco eatery has incorporated a small piece of an original Inca stone wall into the decor behind their long and splendid buffet table. The table was laden with every local delicacy including "cuy"- or guinea pig. There were meats and salads and soups and pastries and as we gorged ourselves, an ample stage offered a variety of performances: singers, dancers - both modern and traditional. It was an absolute feast

How did that cuy taste Lynn? I have the feeling she didn’t try it. If you look at the picture, I only see beverages on that table. If you want to see an interesting picture of some cuy, take a look at this painting by Marcos Zapata.

As we ate and enjoyed, I couldn't help thinking about our last patient and all of the others out there who were hungry. Just a few more days until the gift-giving and gluttony of Christmas and here I was seeing the "other side of life". Perhaps this is the gift I gave to myself; something to put my life into perspective and to make me thankful, once again for all that I have.

Clearly this writing was geared towards a “just before Christmas” release on the website, since Lynn took the trip back in early November and it really wasn't just a few days until Christmas.