DIARRHEA

It’s inevitable.  If you live in Peru, you are almost guaranteed to suffer through diarrhea.  Almost every volunteer has had diarrhea severe enough to have pooped in their pants.  (I will refrain from sharing those personal details and let you ponder that statement).

 

A lot of people arrive here with the strategy of eating everything served to them, and then they suffer the consequences until their stomachs are accustomed to the bacteria and parasites flourishing in the food.  I (more or less) took that tactic when I arrived in my site, and after being ill for 5 weeks, I had enough.  Ever since, I have been preparing my own food and I’ve had very few tummy troubles, which, by the way, makes me a much nicer person.  J

  

It has been 4 months since I have been preparing my own food, and for the most part, I’ve had few issues….until today.  Something infected me during the past few days, and it is certainly having its way with me.  My host mom noticed that I hadn’t left the house today and she came to check on me.  She asked me if I had taken medicine, and I explained that it’s better to let the diarrhea run its course and let the bacteria work its way out of my system.  But if it doesn’t clear up in a couple of days, I will need to get antibiotics.

 

Curiously, she kept trying to confirm which symptoms I have, and I noticed that she repeatedly asked me if I had “pain in my belly.”  I responded several times that I had pain in my stomach and lower intestines.  It wasn’t until later that it dawned on me why she was asking about a “pain in my belly.”  Unfortunately, people here cannot afford to see specialists, so usually if a patient goes to the local health clinic and presents with something vague and potentially more complicated than a routine illness (like a nagging pain in the belly), the clinic has no way to diagnose it.  People here often don’t get it checked out further by a specialist and never find out what’s wrong.  There is a long history of residents of my pueblo ending up deceased with no further explanation beyond “he complained of pain in his belly before he died.”  The pain was never diagnosed, so nobody knows exactly what killed him.  Naturally, they associate the pain his belly with whatever killed him.

 

So, back to my stomach cramps.  Nothing unusual about them; I am highly confident they will subside soon.  (And if not, I have a team of doctors to provide assistance).  But now my host mom is on high alert because she fears that I might suddenly drop dead from the pain in my belly.  I’m sure that at this point she has notified half of the pueblo who will start rushing over here to ask me questions (or pay their final respects).

 

Hoping to feel better tomorrow....

Of Robbers and Rapists

The agency I work for offered to provide bicycles to volunteers in remote locations (such as mine) to make transportation easier to outlying areas.  I was very much looking forward to receiving my bike because I prepare my own meals and there is no market in my town.  The closest market is a 15 minute ride in a mototaxi that costs 3 soles roundtrip (about $1).  When you factor in very short shelf life of food, requiring frequent visits to the market, having a bicycle is a huge cost savings to me – and great exercise, too.

 

While I waited for the several weeks it took for the bike to be delivered, I went on a low-key campaign to prepare my host family and neighbors.  The key ingredients of the campaign were to let them know that I did not pay for the bicycle myself (reinforcing the fact that I do not have the money to buy a bicycle), and because the bicycle does not belong to me I have to follow the rules of the owner who has lent it to me (which means I cannot lend the bike to anyone else).

 

Another important factor in my campaign to prepare people for the impending delivery of my bike was to reassure them that nothing bad is going to happen to me when I’m riding it.  The initial reaction of my host dad was that he believes it is dangerous to ride a bike on the country roads and that I should restrict myself to only riding it in front of the house.  I explained that I am accustomed to riding my bike in New York City, and that I think I can handle the country roads.  And, of course, I promised not to ride my bike on the Panamerican Highway.

 

I wanted to make sure that people who are concerned about me would have an opportunity to voice their concerns and then eventually they’d get over it when they realized that I am going to ride my bike wherever I choose.

 

And then I had a disturbing conversation with a woman who told me that I shouldn’t ride my bike into the farmland areas because there are robbers out there who will steal my bike.  I half-joked that I can ride my bike faster than robbers can run, so that won’t be a problem.  “No, you don’t understand,” she said.  “They will ride up on horseback and steal your bike and then rape you.”  It was such a horrifying scenario that I couldn’t even imagine.

 

But guess what?  That doesn’t happen around here.  And I’m not sure that it ever has, as I cannot get anyone else to validate her story.  And I have spent plenty of time in the farmland, among the lovely older farmers (with their even older donkeys) who clearly enjoy saying “good afternoon” to the resident gringa.  So, why would she give me such a horrible scenario?

 

I have realized that there is a tradition of telling women and girls stories that will strike paralyzing fear in them as a way to control their behavior and movements.  I imagine that the woman who told me about the rapist robbers was told the exact same story the first time she expressed interest in venturing beyond the town’s borders.  And I have heard other women and girls express concern for whatever plan I have declared to do is just plain “dangerous.”  Are they able to explain why it’s dangerous?  No. 

 

I think that it must be highly unusual for a woman to make decisions for herself because of the constant fear of being maimed or killed.  Hopefully I can serve as a role model and show women and girls here that we are capable of making decisions for ourselves and it's okay to take calculated risks to do things that will improve our lives.

 

Rushhour on Main Street

What Projects??

I gave a big presentation to the Health Committee at the municipal government recently, which was well received. It was the first step to getting a project launched in the community.

During my first 3-4 months in the community, my main job was to collect primary and secondary health data, in addition to building relationships with key influencers and getting a sense for what's working and what could be improved.  To collect primary data on the health needs of children under 3 years of age, a nurse from the health post and I trained 9 volunteer community health workers to conduct surveys.  They bravely went from house-to-house and asked invasive questions of 135 mothers with young children and collected a ton of first-hand information on hygiene, food preparation, illnesses and early childhood development.  There was another survey done for adolescents on the topics of sexual knowledge/behavior and pregnancy prevention. 

I combined the primary data with secondary statistics from the local census and from the health post to create an overall picture of the health needs of the community.  Here's a quick glimpse:

• 28% of children in my district are suffering from chronic malnutrition or are at high risk for malnutrition.
• 85% of children tested for parasites had them.  (This contributes to malnutrition because parasites steal nutrients before the body can absorb them).
• Respiratory illnesses are the most common maladies because most people cook over a campfire.
• 7 teen pregnancies were reported last year.

I had made some recommendations as part of my presentation for the types of projects that would address these health issues, which include:

1. Reducing respiratory illnesses by building improved cookstoves for people who cook over a campfire and get smoke filling their homes.
2. For the families selected to have new cookstoves (with fancy chimneys to filter smoke outside), they will be required to participate in an integrated health and hygeine program that addresses handwashing and clean preparation of meals, nutrition, treating parasites and avoiding diarrea diseases, brain stimulating activities to nuture infants, proper treatment and safekeeping of water, etc.
3. Reducing teen pregnancy by offering sex ed classes in the local high school, and training youth leaders to be peer educators.
4. Training parents to communicate better with their kids -- and we'll teach them the birds-n-the-bees, too. We are calling it "Parent School".

Plus, I included a project not related specifically to health issues, but focusing on childhood brain development in a response to requests from parents to teach their kids English.  I think that it is a complete waste of my time to teach kids English (that they will never use, so instead I want to get English language-learning books and dual-language books donated to the library. It would be really fun to host reading sessions each week to get kids involved in reading out loud and hearing stories read in both Spanish and English.

 

 

It looks like I have a lot of work on my hands, I feel like I need to get started on a timeline and documenting resources and responsibilities...sounds a lot like project management! I think that's the one huge benefit they will get from having me here -- is learning from my mad project management skillz. :-)

 

 

Here is a photo of the volunteer community health workers who conducted the surveys: