MEDLIFE

Today was the day. With sweaty palms and few expectations, I would finally have the opportunity to accompany one of the nurses, Janet, for my first patient follow-up visit in the field.  I excitingly rushed down to the lower floor of the office, greeted her with a customary kiss on the cheek and introduced myself.  While we waited at the bus station, which was about a block or two from the office, I nervously attempted to converse with her in Spanish.  Feeling invigorated,I understood almost everything, the amount of time she had been working with MEDLIFE, the names and ages of her children, and the patients we were going to visit.

It took about an hour and a half to travel to the location of the patients in Villa Maria del Triunfo. We whisked through Lima's infamous traffic on a city bus, transferred to a Combi, a privately owned transportation bus, and finally ended up in a cramped mototaxi chugging our way up the bumpy and uncomfortable dirt road.  When we arrived at the smog-covered community, I was struck by the intriguing beauty of overcrowded houses immersed in the faint smell of burning trash and echoing barks of stray dogs.  Janet and I had spent about an hour walking around one hill to the next. Finally after asking for what seemed like 100 people for directions, we arrived at a tattered and rustic house.  What I first noticed was the almost impossible stairs that we had to traverse just to arrive at their front door.  The uneven stairs were made out of stones and dirt and, when wet, would require the residents to navigate an extremely dangerous thoroughfare.

Every family member in the house politely greeted us when we entered and I finally found myself face to face with the patient, Francisco.  Sitting down on a worn out couch was a 69 year-old man with a ruggedly serene face framed by a smattering of withered grey hair.  He smiled and mumbled a few indistinguishable words to express his gratitude in light of the fact that he had to deal with so much. Before we had entered, Janet mentioned to me that this man suffered from a severe case of Alzheimer's, making it impossible for him to leave the house.  We sat down on another couch just a few feet from Francisco, while his wife patiently stood nearby. Once I handed the evaluation papers to Janet, I was a silent observer.  It was a back and forth communication between Janet and the patient's wife for about 20 minutes. Ultimately, all of Francisco's symptoms became clear.  He had pain in his joints, difficulty swallowing, controlling his bladder, and had a very difficult time conversing with others. He needed a 24/7 caretaker to aid in his daily activities.  I was shocked to learn that this family had limited access to basic resources, which many of us take for granted: running water, electricity, a clean and healthy living space, and easily accessible healthy food.  It quickly became clear that all of these factors contributed to the difficult situation Francisco and his family faced.  It not only is medicine that can provide a stable and healthy recovery, but also the correct environment.  Francisco slowly descended into a vegetative state because of the almost impossible trek to leave his house.  Their lack of running water and electricity made it very difficult to sustain a healthy living space.  On top of that, they had no access to general physicians or medicine.   However, despite all these challenges, they always had big smiles on their faces and laughed as if life was the best that it could be.

MEDLIFE has provided me with many new insights about myself and the world around me. This great organization identifies difficult situations and strives to alleviate the suffering and hardships of many in need.  They listen to the community and act upon what needs to be improved rather than rashly barging in and temporarily fixing a problem.  With Francisco's case, the nurses visit him regularly to ensure that he has sufficient medication and knowledge to sustain a stable lifestyle.  I hold in high regard one of MEDLIFE's core goals: to establish the proactiveness and personal sustainability within these great communities.  Even though Francisco and his family lack many basic resources, they still strive toward a better and brighter future.  After we had finished conversing, I was astonished to learn that he knew some English.  As we were leaving, he shook my hand, looked me in the eye, and said two words that deeply touched me, “My friend.” I feel immensely privileged to have been an advocate for MEDLIFE's mission this summer and hope to return in the near future.

Peru. The country where the Spanish founded their empire and took over the Inca Empire. Having been in Lima for six weeks has put several things into perspective.  First off, the world is so large! The fact that I'm living in a city with over 3 million people is unbelievable. You see different faces everyday, whether on the street or on a bus. What's my point? That everyday in this city has potential. You can decide whether or not you want to make a name for yourself. You can assimilate with the culture, or you can stick to what makes you comfortable. You can enrich your life with positive experiences, or you can sit at home and go on social media. The possibilities are infinite, but it's for you to decide what it is that you want to get out of your stay.

On one of the more recent mobile clinics, I was introduced to a daycare center called “Virgen del Buen Paso”. The UC Davis MEDLIFE chapter sponsored a project to repair the flooring and kitchen of the toddler area. The principal, Blanca, took us class by class to meet the kids. The kids loved seeing us and were in awe when they discovered we were Americans! It just so happened that the lesson of the day was poetry. Not many people know this but writing poetry is a hobby of mine.  A few of the kids recited some of their poems, and then they asked if any of the volunteers wanted to recite. Nobody knew any! So I decided to recite one of my own.

After taking the daycare tour, we walked to the playground. It was ginormous! There were a group of kids playing in a small section of the playground while the rest remained unoccupied. At first I thought it was because the kids enjoyed playing in the smaller section but I was then told that the majority of the playground had been closed due to infrastructural concerns. The main wall surrounding the playground was old and deteriorating. When brushed, the concrete would flake off.

The principal mentioned that it would take lots of money to fix it but it was something that they'd look into in the future. This caught my attention but I didn't think much of it at the moment. That same night I sat down to write in my journal and reminisce on the week's events. I got this sudden rush of anxiety and all my mind could think of was that daycare wall. I wanted to do something I had never done before. I wanted to leave my mark in Peru. I think what pushed me to start my own project was when the principal called me the “angel de los niños” which translates to the angel of the kids. 

This is the part where I talk about my good friend Carlos Benavides. Carlos is the director of all MEDLIFE development projects in Peru so I had to meet with him to discuss my plans. We both concluded that repairing thiswall would be a great idea but we first needed an engineers opinion.

And that's where I'm at today. Making small amounts of progress and getting closer to the bigger picture. If there's one thing I've learned about Peru, or life in general, it's that you can't get anything done on your own. Carlos proved to me that being successful is all about the quality of your network. You save time, money, and resources just by knowing the right people.

Instead of hiring an engineer for a few hundred dollars, Carlos called over a friend to do it for free.  Instead of purchasing thousands of dollars worth of cement, Carlos found a person that can provide it for free. Instead of waiting a month to meet with government officials to discuss our plans, Carlos was able to get an appointment for the same day. Carlos is the perfect example of a leader and team member. Carlos didn't meet this people from behind a desk or computer. He met these people by going out into the city and meeting people. By listening to what they have to say and giving them what they need. What do you get in return? A life with new meaning. So when I say that everyday you have the opportunity of meeting someone that can potentially change your life, I mean it. 

"We won't have water for two days, starting tomorrow at nine o'clock AM."

My finger nearly became a part of the onion that I was cutting, as my knife dropped at the news that I had overheard.

"What? No running water for two whole days?" exclaimed another intern.

A thousand thoughts raced across the forefront of my mind. Since our apartment did not have a water tank for excess water storage, we would have absolutely no water to supply our needs.  How would I shower? How would I clean my growing pile of laundry? How would I live with twelve people, all limited to a single flush for each of the three toilets in the apartment? Because let's be real, we were all on Pepto Bismol.

Precisely how I felt when I heard that I would not have access to running water.My qualms were quickly reassured with another claim of the night:  that there would be running water in the office, as the cut only affected the district that we lived in.  It was going to be alright-- I could have my toothbrush in tow to the office, and have pearly whites after a mysterious bathroom break.

The next morning, I filled up my water bottle with the last remaining bits of filtered water that my apartment would spit out for me for the next 36 hours. As I stepped into the office kitchen later that morning to stow away my lunch, my eyes feasted on an unusual array of colors. The floor was covered with multicolored buckets filled with water. I nervously glanced at the microwave clock. It was 8:04 AM.

I arrived to my desk listening to the fear that was settling into panic-- the district that our office was in, would be affected by the water cut as well. No running water here, either.  To be honest, I freaked out a little bit. How does one survive without running water? What do you do when your back up for running water needs to be backed up?

As the clock approached nine, so did my uneasiness. I had never tackled the issue of water cuts. The closest thing I could relate to was electricity cuts at my parents' childhood homes in India, which was a completely different game. At those routine 9 PM power cuts, I was never worried about being dehydrated or even unclean.

But I began to ponder about my work with MEDLIFE and the communities that we served.  A lot of the homes do not have running water, nonetheless access to it at all. I thought back to the community meeting that I had attended just that previous Friday with Señor Carlos and the rest of the Volunteer Affairs interns. On our trek down to the city center, he pointed out a portion of the area that was cloaked in darkness, as opposed to the gridded lights that illuminated the outskirts of Lima. He explained to us that this area was documented as an illegal settlement, as those who lived there did not have land titles to claim it as their own. Those settlers had moved to Lima nearly a year ago, and had to scavenge for water and pay spiked rates for electricity.

More often than not, the water that the people in pueblos jovenes ("shantytowns") receive are stored in old chemical waste containers because it's a cheaper alternative to the larger water tanks that are clean. This one tank of water is used for a family to cook, do laundry, bathe, and aid in personal hygiene. As the water tanks sit outside of homes with a flimsy tarp as a cover, they become prone to the bacteria that resides in the air. Burning garbage, human excrement, dog excrement, dirty diapers, and dirt all culminate into the air and rise to water-borne illnesses. I bore witness to this fact at a patient follow-up visit during hour 25 in my drought with water.

A look at the water containers that are used to house water in los pueblos jovenes.I accompanied one of our field nurses, Janet, to a women's health clinic in Jesús María. Any patients that had irregular breast exams or pap smear results at the mobile clinic were brought to that clinic for their next round of care. I sat in the room, quietly listening to the initial consultation, trying to understand each patient's condition. After a few minutes of formalities and chatter, a young woman in her mid-twenties stepped into the room. We were told by the doctor that her irregular pap smear results were caused by a parasitic infection near the opening of her cervix, which had caused a large open wound and a source of great discomfort. The likely cause? Some form of water intake, most likely through washing of the body. Though her wound was cauterized and closed, it didn't solve the issue at hand-- access to clean and safe water.

As  I came upon hour thirty of my drought with water, I had already stopped at two bodegas, or convenience stores, to find no bottled water available for purchase. I also learned that the water cut had happened in all of the areas but the extremely wealthy ones. Though it was due to maintenance, we all joked that the Miraflores district paid the water company, Sedapal, from cutting the water in their district. Unfortunately, the role that money plays in accessing privilege is a reality for much of the world, Lima included.

I'm happy to announce that I survived the thirty-six hour run without running water. Looking back at it, I am a little embarrassed at my fears and anxieties about it. Putting your life in perspective to the conditions in the world is humbling, sparking a renewed sense of appreciation. The unknown is always intimidating and a bit scary, but can be morphed into a challenge for bettering yourself. My time in Lima has been incredibly challenging, but working through those hurdles has brought an immeasurable amount of growth and reward. My point: always remember to check your privilege, and keep the thirst for life alive!

Overlooking the hills of Villa Maria del Triunfo, one of the many areas that are a part of los pueblos jovenes.

Yesterday, I tried surfing for the second time here in Lima.  This time was marginally better than the first, thanks to some calmer waves.  For a coordinated person, surfing is a tricky skill to pick up.  For a slightly klutzy person, as many of my friends would classify me, surfing seems near impossible.  The first time I went, my friends and I took a much too quick lesson then struggled barefoot along the rocky beach to the water and into the surf.  The further I paddled out into the water, the stronger the waves got.  It wasn't long before I was bracing myself at the sight of the larger oncoming waves.  They would come, flip me off of my board, and send me tumbling in a whirlwind of  water.  During these more violent waves, I couldn't tell which way was up.  All my senses were assaulted by salt and water and noise and force.  The only thing to do was let the wave take you and wait for it to spit you out, all while hoping your board didn't hit you in the head and you had enough air in your lungs.

Out there in the ocean, struggling to get back on my board before the next wave came, I was struck by a feeling that I do not often have: a lack of control.  I couldn't stop these waves, I couldn't get a break from them, and I was completely at their mercy. It was a scary feeling.  Unfortunately, this lack of control is a feeling that many people experiencing poverty have constantly.

On a patient follow-up visit to a very marginalized area recently, I was confronted with this problem in an unforgettable way.  While waiting outside a small bodega with MEDLIFE staff for a follow-up patient, we encountered a woman who had come to wait for a phone call on the bodega's phone.  Upon closer inspection, this woman's body, especially her eyes, were tinted yellow.  Alarmed by this, the doctor asked if she needed medical care.  She said no, but explained what had led to her appearance.  Years ago, she had problems with her gallbladder, and had gone to the hospital to get it removed.  Shortly after, she began turning yellow.  When she went in for a scan, the medical professional had told her that she was missing a kidney.  The woman was shocked – she had never had problems with her kidneys before.  The MEDLIFE doctor told us that the surgeon for her gallbladder surgery had probably taken a kidney to sell.  I knew organ trafficking was a problem here, but it had never before presented itself to me in such an apparent way.  This woman must have felt so betrayed by the breach of her trust – an unfortunately not uncommon feeling towards medicine here.

Later, we heard more about the woman's story from a neighbor.  She had seven children.  The oldest was 20 years old, while the youngest was 1 year old.  The woman, with jaundice and missing a kidney and gallbladder, was probably not in the best health to be carrying children.  The nurse commented that she needed to be on birth control, or to tell her husband to stop getting her pregnant.  However, family planning is not often a process that most women here are involved in.  Some women try to hide birth control use, or but many simply do not use it and then find themselves with many children, often not by their own choice.  Finally, according to the neighbor, one of her daughters had stopped growing at age 6.  She was now 11, and unable to walk.  The doctor hypothesized that her daughter probably had polio. 

I was speechless after hearing this woman's story.  She had gone through organ trafficking, had many kids in an area that was extremely affected by poverty, and a daughter with polio – all of which could have been prevented.  How little control she must have felt over her situation, when wave after wave of negative circumstances hit her and her family.  These events in her life were effects of a larger, very complicated system.

Working in the pueblos jovenes of Lima has illustrated to me the complexity of poverty.  It doesn't just come down to not having a job.  It's the political issues that lead people to mistrust their government, which has a history of violence and lack of support for its people, whether that's by not providing electricity or denying land rights.  It's the economic issues that force people to leave their farming lifestyles and move to a crowded shantytown.  It's the social issues, like sexism and violence in the home.  More than anything, it's a lack of control over one's situation. 

When I was surfing, I knew I could make the decision to get out of the water whenever I wanted.  Getting out was the only way to avoid the waves.  However people here and marginalized populations around the world can't simply leave their situations.  That's where MEDLIFE comes in.  We're working to help these people get out of their oceans of poverty, and onto more stable ground.  I'm sure the woman we met felt little control over her situation.  I want to change that and in working with MEDLIFE, I feel like I am – little by little and patient by patient.  My experiences here are formative and everlasting.  I know that I will leave this internship at the very least with a slightly better knowledge of surfing, but mainly with the desire to continue helping people affected by poverty leave their oceans of disadvantage and gain some control.