Bits and pieces

It’s been a pretty good week. I’m not sure exactly why (although it could have something to do with a double scoop ice cream cone Wednesday), but I looked up and it was Friday, and I realized I had enjoyed the week. That’s always a blessing, right? I’ve rotated to pharmacy in the clinic for the next couple weeks (although still stepping in to triage or give a shot if they need an extra pair of hands), and it’s a little like stepping back to square one. I’ve never really worked in a pharmacy before, so instead of being helpful right now I’m back to the learning stage – and I’ll say props to all the doctors and pharmacists out there because to me it’s still pretty intimidating looking at the shelves and shelves of medicines and wondering how anyone can remember where they all go and what they do. But again…poco a poco. And it’s a little easier now, because I know Nila and she’s very patient and helpful teaching me. I think I also realize I have to be patient and let myself learn…I suppose that’s a good lesson to remember, huh?

Last week, for some reason, was a little more difficult. Not really in a conscious way or even in a way I could put my finger on, but I guess you go through your ups and downs. I’ve been here two months now (how about that?!) and I guess, whether I’m aware of it or not, I’m hitting the first hump of “I’m in a new culture, a new job, a new environment. And it’s here to stay.” Plus, I think last week my brain and heart got hit with a lot of questions, frustrations, and realities that have been gathering in light of the poverty and disparity I see on a daily basis, and I’m beginning to try to process them. (Emphasis on “beginning” and “trying to” :) ). Not an easy task, but an important one, I think. But you know what? In spite of all that, I am extremely blessed, and there’s nowhere I’d rather be.

Last week there was also a group here from Georgia. It was a small team, but they brought a doctor and a pharmacist, and their presence allowed us to do a couple of campañas – where we set up in more impoverished areas with less access and offer free consults and medicines. One day we went to Los Pinos (near Wichanzao) and another we drove to Magdalena de Cao, a quiet town about an hour away. It was nice to get a little change in scenery and responsibility and to get my first glimpse at how the campañas work.

In other news, yesterday was the first day of spring here. (Happy Spring!) The occasion provided an acceptable excuse for a rather lively party at the institute next door (although catchy to listen to, the music delayed sleep for awhile), and apparently there will be a parade Sunday afternoon, so it’s fun to see those celebrations. And you’ll never guess – last week, not one, but two mornings we awoke to actual sunshine streaming in through the windows. Sunshine in the morning…would you believe it? Novel concept. But I think as spring continues to blossom, we’ll get more than just our few hours of afternoon winter sunshine. Ojalá… And I have to say I’m looking forward to it. Bring on the sunshine!

Consultorio Medico Pastoral

CMP – this is where I work in Wichanzao every morning from 8 to about 12:30. You get off the colectivo at Corli (which has been paved within the past year), take a left, a right, another left, and then you’re there. It’s across from the Wichanzao Presbyterian Church and next to Sinergia, Peru Mission’s microfinance program. The clinic used to be in the church, and they built this building about 3 years ago.

The clinic is open from 8 to 5 Monday through Thursday, and until 2 on Fridays and 12 on Saturdays. It’s a primary care clinic where people from Wichanzao (or any of the surrounding areas: Trujillo, Arevalo, Clementina, Los Pinos, Las Palmeras…) can come for quality care and medications at an affordable price. Most patients can see a doctor for about 7 soles ($2.50), and the medications, from what I’ve heard, are much cheaper than at most other clinics. I think the price of everything is pretty comparable to the government postas, but the care is much better and you don’t have to get there as early or wait as long.

One of the things I’ve enjoyed most is working with the staff. Dr. Julton sees patients every day. He’s a young doctor who just began working in the clinic in March. While I think he’s still learning a lot, he is gaining people’s trust and loyalty, and his humble, reassuring manner with patients is inspiring and reflective of his faith. There are also other doctors who come in during the mornings: Dr. Alfonso on Mondays, Dr. Mario Tuesday through Thursday, and Dr. Raúl on Fridays. They work part time to supplement their other jobs and are a little more popular since they’ve been around longer, but I think Dr. Julton is becoming more known and trusted by patients.

We also have Dr. Angel, the dentist. Daniel, the other intern working at the clinic, is helping him, and the two of them together are a mess. Lots of personality and dry humor flying around, and Dr. Angel is fluent in rudimentary Spanglish. That to say he tries to throw out English words and sentences all the time, with varying degrees of success. It’s certainly entertaining, though, and when he found out my last night was Rice (arroz in Spanish), he immediately started calling me “Lydia Rice…rice with chicken!” harkening to the typical Peruvian dish arroz con pollo.

Sonia is the obstetrician, but she only sees patients three days a week as she is also the clinic manager. So she does double duty and coordinates a lot with Dale Ellison, the missionary who is administrator over the clinic (and completes the current gringo trio at CMP). Sonia’s really good, though, and I’ve enjoyed getting to talk with her a little and see how well she does her job. I hope I get to know her better as the year goes on.

Nila is a nurse who is usually in charge of the pharmacy and most days comes and grabs me to come get a cup of coffee and a little snack of conchitas or empanada. She’s kind of like a favorite grandmother-figure. Jenny signs people in and takes out their medical histories, Kelvin is the lab tech, and Marina is a sweet, quiet lady who keeps everything looking clean and great. Noemí and Cynthia are the nurses (I work a lot with them, at least so far), and we triage patients, give shots, administer nebulizations, cut gauze, sterilize instruments, etc. Of course, they have some more qualified responsibilities as well that I can often watch or help with, and they’re very generous and patient to explain things to me.

There are a wide variety of patients who come through, and I enjoy getting to see most of them in triage, even if but for a moment. Some people are well off and don’t have problems paying, but the hard part is when you know they do. The clinic has a fund that helps cover treatment and medicines for people who can’t afford it, but even so I’m sure there are people who struggle to meet the costs. And I’m sure there are people who don’t come at all for fear that they can’t afford it. Honestly (and unfortunately), even if they did all come, we probably couldn’t fully cover the costs of everyone who couldn’t pay. Because, even though Peru Mission makes up for what the clinic loses each month, it seems like there’s always an end to the funds. As much as I would love to believe otherwise, frustratingly everything still comes down to dollars and cents…or soles y céntimos. I guess there’s a balance between looking at how to improve what needs fixing and being encouraged and joyful at each victory. Because, in truth, there are plenty of both.

Trujillo Traffic and Transportation

Traffic in Trujillo is an adventure. Sometimes there are lanes dividing traffic, but often these are just a formality. It’s quite expected for cars, buses, and taxis to weave in and out of one another to squeeze to the front of the pack or get to the curb quickly to drop off or pick up a passenger. And cutting in front of someone is no reason to get offended – that guy’s just doing what the next guy will do to him in 12 seconds, and no one seems to mind. The fun part is the intersections that don’t have traffic lights…but somehow the big jam of cars in the middle all seem to get across, with some well-practiced combination of taking turns and forcing their way through. The amazing part is, there are probably fewer wrecks with all this would-be bedlam than there are in the States. At any rate, traffic moves a lot more reliably than on I-65 in Birmingham, that’s for sure.

Transportation is also pretty exciting. Taxis are cheap, and you can take a car full of people between most places in the city for 3 or 4 soles (just over $1). For destinations along one of the set routes, there are a number of options, including (in descending order of size) micros (normal-sized buses), combis (big vans, similar to the VW variety), and colectivos (a 5-seated sedan). Most of these have seen better days and have lots of character, and all of them will squeeze in as many people as possible.

Colectivos are my transportation of choice on the way to and from the clinic each day. I take the “B” route, and for 1.20 soles (about 40 cents) one way, you can get out to Wichanzao on the Panamerican highway in about 15 minutes. Well, maybe 20 if traffic is heavy or if your driver stops at every person standing on the curb to see if they want “la B” heading out of town. It’s kind of like a big game of Chinese fire drill, with the driving pulling over to let people out or pick people up at their desired stop. It’s not at all uncommon for the colectivo to reach its full capacity of seven people (4 passengers in the back, 2 up front with the driver), and as you extract yourself from the pile, you have to smile as you realize you’ve been closer to these strangers than you have been to many of your closest friends. Gotta love Perú. J

Patience, not Complacence

Each month when SALI classes end, we have Thursday and Friday off before the next month’s cycle begins. Last weekend was our first long weekend, but I decided to stay around Trujillo to relax, spend time with people, and see a few things around town. There were also a couple of people I wanted to see who were supposed to come into the clinic on Thursday, and I didn’t want to miss our Friday home visits to patients.

However, I was a little disappointed. On Thursday, Jenny didn’t bring in Ana, her 22-month-old who needs therapy to correct a misaligned hip in order to be able to walk. Neither did we see César, the 3-year-old whose family Noemí and I visited in Clementina last week. He had a fungus on his hand, and although he was taking some medicine from the government posta de salud, we wanted him to come in when he’d finished it to see how he was doing. Fridays are usually a little slower, but last Friday kept a steady pace, and Noemí couldn’t get away to go out on visits.

So I didn’t get to see most of the people I was hoping to. That’s my favorite part of the clinic so far, or at least the thing I really want to start focusing on: keeping up with patients we see on a regular basis, building relationships with them, and making sure they are getting what they need. I’ve loved getting to go out a couple of times, too, and see them in their homes, where they actually live.

Now that I’ve been working here a month and feel a little more settled, I hope I can do more of that. Although I was a little frustrated not getting to do some of that last week, I realized that I need to be patient. I think I’m learning the need for that with a lot of things here. I don’t need to force things to happen – sometimes I think the best opportunities come when we’re not expecting them, or trying too hard. And I need to be patient, too, because although I am anxious to be active and useful, I have only been working at the clinic four weeks.

At the same time, though, I don’t want to be complacent. It could be tempting to passively go about my work and responsibilities and ya está – that’s it, that’s done, move on to the next thing. But that wouldn’t be very beneficial to the patients, to the clinic’s ministry, or to me. I think I’m at the point where I hopefully can start deciding ways to be more actively involved, and I’m praying to be open to seeing what those opportunities are. Maybe that means, when the line of triage patients slows down, going out to a couple of houses and checking on people we haven’t heard from, or who could just do with a visitor. I kind of hope so.

Today, I went back and saw Cesar and his mother Neida in Clementina. His hand is improving but he now has something on his eye. She said she would bring him into the clinic this afternoon. Poco a poco...

César and his mischievous smile.