countdown . . .

So i'm leaving peru in exactly two weeks. It's been a great ride, but I'm ready to go home, get back to America: my friends, rotations, American junk mail magazines, a sweltering Boston summer, driving my car, hip-hop music, everything.

I got so frustrated on friday that I packed one of my two bags, to calm myself down. Someone tried to break into the research offices on our ward, since the whole ward has been emptied out due to the potential for swine flu. There's no one there at night now, and the hospital security doesn't really go to that corner, so we had to empty out all our valuables and files and they are now sitting in my room. We couldn't get out our scanner though, after 6 weeks waiting to get a permission letter, the people who stamp it are always at lunch when we try to take it out. Frustrating . . . so it's sitting there where it might get stolen but there is zippo I can do about it.

anyhow . . .

In the tradition of Heather and Erica, here is my list of things I will and won't miss, in no particular order.

Will miss

• Cumbia
• Peruvian big-heartedness: invites to dinner, mother's day celebrations, coffee, and help with any kind of situation
• Peruvian work ethic. sincerely hard workers.
  
• Cheap buses that run day and night, on every possible route
• Peruvian food: ceviche, tacu tacu, chupe de camarones, lomo saltado, caldo de gallina, any lucuma dessert, carapulcra, amazing bread, tamales, chifles, anticucho, arroz con mariscos, cremoladas, seemingly endless varieties of fresh spicy sauces (aji). to DIE for.
• Menú lunches: apetizer, main course, and drink for $2-3
• Hierba luisa, muña, and coca teas
  
• Alaska popsicles, maracuya flavor, bought off a beach vendor and eaten fast since they are already melty.
  
• Exotic fruits: maracuya, chirimoya, granadilla, pepino melon, super-fresh figs, tiny sweet bananas, tomate d'arbe, lucuma, camu camu, tuna,
  
• Buying any drink or snack I need right through the bus window
• Polvos azules: peruvian bazaar for shoes, jeans, tees, pirated dvds, everything under the sun
  
• Inca market: amazing gifts for all my dearest friends and family
  
• Sunshine
• Being the sole representative of my nation and how that gets me into strange conversations. Like "Oh, wow - you have a really high arch. Your country must have different shoes. Peruvians don't have high arches like that." "No, it's not all French - just me"
  
• Pisco sours
  
• Men who can not only dance, but lead
• Having " a guy" for everything: money changing, shoe fixing, tailoring, lawyer, etc.
• Living on $10 a day
• The expat community: wonderful, adventurous and open-hearted people who become near-instant friends and are there for you in a pinch
• For occasional pampering: manicures at Toque for less than $3.
  
• My patients and their families - have gotten to know them all very well and I am sad I won't get to see them all hopefully get better
• Not needing to carry ID every time I go out (I swear I finally look over 21)
• Surfing
• Peruvian children: almost without exception extremely well behaved and pleasant to be around
  
• The sincere politeness and generosity of Peruvians. Today on the bus I asked my neighbor if I could borrow his pen for a sec (to write down ideas for this blog). His response: "Please keep it - a gift from me"
• The astonishing amount of valuables women manage to store in their bras: I've seen women pull out wallets, phones, keys, all kinds of things
• The peruvian aversion to swearing, quite charming with quasi-swears such as: "miercoles!" instead of "mierda", "pucha" instead of "puta", "A su" instead of "A su madre". Think I've heard peruvians swearing twice this whole year
  
• Free medical care as a courtesy since I'm in medicine
• Living 200 meters from the Pacific Ocean
• Jeans being appropriate to 100% of occasions
  

Won't miss

• Single-ply napkins
• Having to throw out TP in a trash can instead of the toilet
• Pollution
• Insane herky-jerky driving with eternal games of intersection chicken
  
• Plumbing nightmares
• 1.5-2 hour commutes (each way)
• Paying all my bills at the bank or grocery store
• Electric sparks every time I plug in anything
• Keeping on high-alert every time I go anywhere with my laptop in my backpack
• Getting my phone stolen every 3 months or so
  
• Running out of drinking water on a regular basis
• Peruvian wine. undrinkable.
• That dirty, dirty way some men have of saying "preciosa", "mi reina" or something of the sort under their breath as you walk past (others manage to do it in a flattering way)
  
• Being sick: altitude sickness, flus, mono, diarrhea, and parasites. can do without
• Bargaining 12 times in a row for a cab. (My limit of tolerance is 3)
• Peruvian obsession with receipts and documentation, carbon copied in triplicate and individually signed and stamped (once got a receipt for $0.02 copy)
  

Ok off to see my friend Paty . . . the goodbyes continue.

more photos of hospital

Here's a photo set I found of the hospital (not at its most photogenic) where I work, from back in Sept. when the docs at the hospital were on strike to get the minister of health to resign.

And, the article in peru.21.

escandalo

So yesterday, the news crews and reporters were all over our ID ward at the hospital. My nurse called me to tell me they were filming and interviewing . . . though the chief of our service refused to talk to them.

Last night on the nightly news the story was on the local stations, apparently my nurse was even on tv (I tried to watch but fell asleep early). Today it was in all the papers, including the big national paper, El Comercio. They reported that there was a staff outbreak and that a resident and a psychologist were diagnosed with TB, and that it was the fault of the poorly maintained ventilation system. They asked for the resignation of the hospital director, as well as for a hospital emergency to be declared.

Today some people from the ministry of health came by as well as the chief of internal medicine.

Lots of local politics that I don't want to get involved in . . . wonder when this will be solved. In the meantime the ID service is not accepting any TB patients.

cholitas playing golf

Thanks to my friend Karthik for this fabulous article in the Guardian.

Back from cusco with the fam. Mom and dad are off to Arequipa and a 3 days trek through colca canyon. Rachel is with me in Lima until thursday when she jets to Sao Paolo, and I'll meet mom and dad on friday in Puno to head to Lake Titicaca for a couple of days.

Love this country, but mentally ready to go home. I've pretty much eaten my way around the Peruvian menu and I'm ready to go home to my food, my haunts, etc. I will definitely miss the friendly faces, the surfing, and the sunshine. Luckily I'm heading back just in time for summer . . .

heading back to Boston in just over 1 month.

google maps peru

google maps has finally got a good version of lima going.

so, to celebrate, i live here:


View Larger Map

outbreak?

So a few of the docs at work are sick. One of the residents from last year has confirmed TB. The psychologist has TB. The current senior resident has new nodules on his xray and CT and additionally has fevers.

Obviously, this is kind of a problem. Luckily the chiefs are taking Rahm Emanuel's advice to "never let a crisis go to waste" and are pushing the hospital admin and the government to do something about the barely working mechanical ventilation, upkeeping the UV lights (does a great job at killing TB), and building an outdoor waiting room for the outpatient service so that patients don't all catch TB waiting to see the doc (natural ventilation is actually superior to mechanical in dissipating TB).

Aside from my concern for the patients and their families, nurses, doctors, volunteers - it's a tough spot for the study since we won't be able to start any new patients anytime soon.

And mom, don't worry, I'm wearing my N95 mask.

must-see pelicula

La teta asustada. ("The milk of sorrow")

A lovely Peruvian film, has won the Golden Bear at the Berlin film festival. If you do anything I recommend this year, check it out. Trailer (sorry, sans subtitles). A great glimpse into life in Peru.

hit and runs, and policia de transito

great peruvian saying:

choque y fuga = literally means hit and run,
but colloquially, also used to mean "one night stand".

Which reminds me, Lima is a giant, gridlocked city. To combat this, the government seems to employ inordinate amounts of traffic cops at every major intersection. They wear these sort of equestrian outfits and white helmets and wave people around with hands and whistles. They are also, noticeably almost always young, hot women.

I thought it was just me - and I formed a theory that macho men are more likely to pay attention to these traffic cops than other specimens doing the same job. Asked around a bit, though, and it seems a few other people have noticed the female bias. I must admit that those ladies look quite authoritative and sexy in their knee high boots, helmets, and hair nets. Weird, i know, for hairnets to be attractive. You'll just have to come visit to see for yourself.

However, I looked into it and it turns out it is a big sexist scam, though they claim not for the reasons that I describe above (mind in the gutter).

"A partir de mañana, la Policía de Tránsito peruana sacará de sus filas en forma paulatina a 500 agentes varones de esa unidad policial, los que serán reemplazados por policías mujeres bajo la premisa de que las agentes son más drásticas a la hora de aplicar las papeletas, muy estrictas y difíciles de sobornar."

translation: As of March 2009, the peruvian Transit Police removed 500 male officers, to be replaced with female oficers based on the premise that the females are tougher when it comes to giving out tickets, very strict, and more difficult to corrupt.

I asked around and this was generally thought to be true. "The women, if you try to bribe them say 'What, do you think I am for sale? Am I a prostitute???'" -said my friend V.

I like this very practical approach to getting the job done. Sometimes, it seems, equal opportunity isn't as good:)

beach vendors

Went to the beach yesterday in Punta Hermosa (Playa Caballos) with Vicky, JoAnn, Sural, and my friend Chris who is visiting. Here's a list of things we bought off the beach from various beach
vendors . . .


-2 CDs (really JoAnn, Backstreet Boys?), $1 each
-3 or 4 pairs of earrings ($1.30)
-5 Alaska maracuya popsicles
-1 anklet ($0.60)
-1 necklace
-2 books (pirated just like the CDs and DVDs), $5 each

other things we could have bought:
chicken sandwiches
corn on the cob (the kernels are HUGE here)
DVDs ($1)
giant wraps from india (expensive, at $20)
dresses
hippie knee-length pants

like chris said, it's hard to relax at the beach with all that shopping going on!

a surfer's perspective.

surfers have an amazing worldview . . .

Rathika: Yes, my parents are from Sri Lanka. It's near India.
Alberto: Sri Lanka? Really?!? That's niiiiice. That's great. Wow.
Rathika: Yeah! . . . uh, why?
Alberto: amazing surfing there!

pretty much, if you can surf it, they've heard of it.

location, location, location.

i'll get back to that thread on ethnicity and stuff shortly.

but, first, a funny little thing about peruvian hospitals it they seem to attract a conspicuous nearby conglomeration of pharmacies (logical), orthopedics and radiology providers (ok), and coffins retailers. yup, you read that right. I know of at least one outside Dos de Mayo. And on the road by Hospital Nacional Cayetano Heredia (where our labs are located), there are at least seven, SEVEN coffin stores just across the street from the hospital. And their window displays are all coffins, in various elaborate styles.

I guess the first rule of sales is to know your market, eh?

mejor una chola . . .

So i've been spotting a sticker lately on buses and mototaxis:

"Mejor una chola conocida que una gringa con sida".

First, a translation:
"Better a known chola than a gringa with AIDS" . . . if that rhymed, anyhow.

Where chola refers to peruvians that are ethnically . . . peruvian. like the guy in the hat in the previous post. The ethnic groups here, as denoted by Peruvians, are:

cholos: indigenous incan/mayan descendant peoples (mostly from the sierras or mountain ranges . . . the jungle indigenous peoples are just referred as "de la selva").

--From what I can tell, "cholo" can be quite derogatory. But the newspaper publishes the word every day, so it's it seems to be also just descriptive. Mostly it's derogatory in that some peruvians are racist, and darker-skinned "cholos" get prejudiced against, i.e. can't get into nice clubs, etc. - so the way these people get treated is derogatory rather than the word itself being un-pc.

chinos: asians (yes, no matter where from).
negros: blacks
gringos: depending on who you ask, may or not include europeans.
blancos: whiteys.

----

Anyone know where this new public-transport-sticker idea comes from? Not so sensible, or, well, productive.

----
which brings up another point, about addressing people by their appearance alone. that, and the reaction to anti-cholo-ism. that is, bricheros (spelling, anyone?). in this space soon . . .

Chullo and friends

Of all the Peruvian hats (including one that Matt calls the "tiny sombrero on top of the head", below), one of the most symbolic of Peru is the Chullo (pronounced choo-yo), seen at left in traditional model and below, its urban cousin. I just gave my little cousin Kate a hot pink model with llamas and Peru inscribed on it.

Apparently, this is somehow all the rage in New York, as the Times recently reported. Although the NYT did call them ugly, they also mentioned they are darn warm. Not to mention, they are "muy barato".

In Peru hat is "gorro" and cap is "gafa". Below I bring to you a variety of pictures of peruvian hats, from the tiny sombrero to the late 19th century bowlers, to the cowboy hats, to the mini tablecloth-with-fringe sort of variety. Enjoy - and if you find a good resource that explains all of them, please let me know.

Peruvian soy milk

Thanks to Lucha, our lovely housekeeper. Hopefully this will keep me drinking more drinks at home and less from street vendors (see, Dami, I'm trying), and hopefully I'll get sick less often.

:)

Makes: about 2 L.

Take about a cup of dried soybeans (you can buy in bulk).
Soak overnight with plenty of water (2-3 times volume of soybeans).
In the morning, rinse out soybeans.
Put in blender, picking out any stones or skins.
Add a little water and blend
Put in a big pot with about 2-3 liters water.
Boil for at least 30 min, adding a bit of cinnamon stick and a few cloves..
Strain and drink (recommend adding a little brown sugar).
Swoon.

Keeps for a couple of days in the fridge, just microwave when you want to reheat.

Apparently, you can use the residual soy bits to make soy meat-subsitute type products which Lucha's sister seems to know how to do. Can't help you there . . .