New Home

I am mostly settled in my apartment in Cusco. I’m living with another Fulbright scholar, Carrie in an apartment close to the center of the neighborhood named San Blas.

Below are pictures of our place!

Bedroom-Yes that's my sleeping bag. It's so cold at night I
often end up sleeping inside my sleeping bag and three
wool blankets.

Living room

Kitchen

Dinning room/Living room

Within the first few days of staying in the apartment there was a big storm, as there often are these days. This one included lots of thunder and lighting and heavy hail. Luckily we were bundled in blankets with hot wine and dinner for comfort. Once the stormed passed I jokingly wondered what the damage was to our top floor apartment. I walked in to the kitchen to find a large puddle of water. We proceeded to find water dripping in from the ceiling in two spots in my room and one large leak in Carries. After a quick attempted to mop up the water we went downstairs to tell our landlady to find a half an inch of hail on the ground. Her response to our concern about water in the house was “Oh, it’s in mine too. Do you want buckets?” Luckily this scene hasn’t repeated it’s self in the following rainstorms. Apparently it is common when it hails, because the hail prevents the water from draining off the roofs. Adventures of renting an apartment in Peru!

I would also like to introduce Mikey! He is an friendly little dog that live in the apartment next door. His real owner leaves hime in the courtyard during the day when she is at work. So we let him in to hang out with us when we are home. He love to cuddle and curl up under blankets. It's perfect. All the benefits of having a dog, but none of the responsibilities.

I love finally having my own kitchen. It is really nice to be able to cook. My proudest accomplishment is these cookies from last weekend. High altitude baking is not joke and to make it even trickier our oven has three temperatures, high medium and low (non of which are very hot), we only could find baking powder and not baking soda, and we had no measuring cups or spoons. Quartering a high altitude cookie recipe and eye balling measurements ended in a delicious success!

Anta

My second day at the Cusco office I got to take a field trip just outside of Cusco city to a rural field site in Anta. The group is setting up a 5 year cohort study to look at the burden of fasciolosis in children. Fasciola is a fluke that grows in the liver when the eggs are ingested, typically from water greens or other water plants. It is generally associated with poor sanitation.

The group has been working from the top down to get community buy in for the project. First the regional and community officials, then community health workers, school principals and finally parents of the children. That morning there was discussion about when they were going to be able to meet with the school principals one on one to discuss the study. When the Anta community nurse didn’t answer here phone, the head doctor, my boss, decided we would just get in the car and go to Anta right there and get it done.

Now I have a love hate relationship about this process of getting things done here. I’ve found that one needs to be in person to effectively facilitate communication and accomplish any goal that require cooperation. On one hand I love the approach that if I want to get something done, I go and bug someone until it’s finished. On the other hand, it goes against my nature of having a plan. The system work for us that day though. Everyone got in the car, we showed up at the Anta clinic and somehow convinced the nurse to leave the clinic for the day to introduce us to the principles at each of the schools. Whatever she had planned for the day went right out the window to take care of our needs. I will get more and more use to this I am sure. Or perhaps I won't.

One elementary school

Anta

Overall it was a successful day. I got to get out of town and see a bit more of the beautiful valley. It was really interesting to learn about this project. Hopefully I will be able to continue to be involved while I am in Cusco. This is really the first time I have been on the ground involved with the set up of a study and data collection. All of the information from school about the right and wrong way to conduct a study is running through my head. 
I know cognitively that it’s extremely difficult for every aspect of the study to go perfectly by the books, but I am still the eager grad student, fresh out of school holding impossibly high ideals. This team is doing everything in the right way, but on the ground it doesn’t go quite as smoothly one would hope. The principles don’t attend the district meeting where you originally present the project, or maybe the community health workers don’t pass on any information to parents about the study. Welcome to the real world of research. The take home message for me is the value, as an epidemiologist, of really understanding how the data was collected and not just what the data set looks like. As frustrating as it can be, this will be a great learning experience so that in the future I am more prepared to problem solve and have hands on experience to reference. Yeah for the complexity of research!!

Below are some picture form Anta, one of the schools and some kids playing on stilts. One the way back we stopped to get fresh cheese. Two pounds of cheese for a little more than $3. FANTASTIC!!

Cusco

I made it to Cusco! This city is beautiful and has so much character. The weather is either intense 80 degree sun or pouring rain, often only 15 min apart from each other. I rested for the first few days after arriving to adjust to the altitude. Cusco sites at 3400 m (about 11,000 feet) above sea level. That is not an altitude to balk about. I still get winding walking up hills and stairs, but I have been able to, somewhat successfully, exercise, so I would say I have adjusted.

I have been keeping myself busy with work and finding a place to live. I’ve changed hotels three times in the last week and a half. Each time to cut the price in half. It’s a bigger feat than you might think will all of my luggage. Unfortunately I don’t pack light. Here is the view from the last place, where I am now. I am on the 5^th floor and have a fantastic view. Better yet the place only cost S./35 a night (about $13).

I have had a chance to wonder a bit, but there is still a lot of the city to see and plenty of tourist activities to keep me better. My first impressions are that is this going to be a fun place to live. There is a lot of Italian food and plenty of good coffee. The city set in a valley and so it pretty hilly, but the mountains make for beautiful views. Cusco has an interesting history as a pre-Inca, Inca, and then Spanish European city. The architecture in the center definitely reflects the blend of Inca and Spanish history.

Eating out alone. Book and Pizza

I found a place to live in the center, in a neighborhood called San Blas. I move in tomorrow, so pictures to come soon! Also more on work and Cusco adventures!

Cusco at night

Quick Update from Lima

I am headed to Cusco on Monday November 4^th! I am looking forward to getting settled and exploring a new city and region of Peru. Everyone has good things to say about this city. However, I have been in Lima long enough to get a feel for the culture and rhythm of the city. I don’t know how daily life will compare in Cusco, but here are things that so far

I love about Peru/Lima and things that I have started missing from home.

First of all the food here is fantastic! At almost all price levels there is something delicious. A big thing here is the lunch special, el menú. It’s a prepared menu, usually including an appetizer, main plate, drink and sometimes even dessert. The best part is the price, typically less than 12 soles (about $4.50). There certainly have the other spectrum, fancy creative culinary arts. I had the chance to join a few friends at Astrid and Gustón, supposedly the best restaurant in South America. There are some pictures below of the food. It was a whole evening culinary experience starting with a rice cracker served on a rock and finishing with coffee and pastry bites.

Going to the market and buying something you have never seen before is part of the fun. There are over 3,000 types of potatoes in Peru, potatoes of all shapes, colors and sizes. The tropical fruits are also abundant and tasty. My staples are mini bananas, mangos and avocados. Also the bread is delicious and very inexpensive. The variety is also amazing. Bread rolls make out of sweet potato, potato, rye, ones including onions, anis or raisins. Unfortunately the bread is too good and cheap and vegetables are harder to find and take more work to clean or cool. You throw in empanadas and delicious coffee and you get a sample of my diet.

Tubers! Oca on the left and Ulluco on the right

I do miss peanut butter. Good peanut butter, one without lots of sugar. I was craving it so much I barely thought twice about spending $7 on a jar once I found it. A lot of money considering lunch usually costs my half that. I must have been telling everyone who would listen because a friend gifted me a jar of crunchy peanut butter after a quick trip back to the US. I haven’t opened it yet, mostly because I am not ready to share.

Ok that was all about food. I also love where I where I have been staying in Lima. I love the ocean view and the running path that overlooks the ocean.  I like walking all over the place, although I hate the traffic. I definitely don’t miss driving. 

I am slightly ashamed to admit that I REALLY miss streaming TV.  I didn’t realize how much TV shows were my relaxing outlet. The benefit is that I am reading much more which I enjoy.

I am enjoying learning Spanish, reading it and listening to it everywhere. I hope I do more speaking once I move to Cusco too. The whole learning speaking another language is fun. I’m sure some of these things will change over time and maybe once I move, but here is a little update from Lima!

La Selva

Another vacation! Work hasn’t quite picked up yet so a friend and fellow Fogarty Scholar, Devora, and I took advantage of the down time, and Peruvian holidays, to take another trip to see more of the country. We booked a quick flight to Iquitos, the Peru entry to the Amazon jungle.

 As soon as we got off of the plane we felt more like tourists in a foreign country than we do in our daily lives in Lima. The typical mode of transportation in Iquitos is a mototaxi (pictured to the right). It's a small two-person cab hooked onto the back of a motorbike. So even before we stepped out of the airport we were surrounded by mototaxi drivers vying for our business to take us into town. I should mention, that I was towering over all them as they questioned us yelled out prices in a mix of English and Spanish. I'm not sure what the uncomfortable part was, the towering or the decision-making or all the attention, but this was a common scene over the week that I never got use to. 

 We spent the first day exploring Iquitos and also a butterfly rehabilitation center in the area. During this trip I was reading Barbara Kingsolver’s Flight Behavior, which is about migration of butterflies. Her imagery of the butterflies is so beautiful and mesmerizing, I had to see it for myself. The Mariposaria provides a habitat for the butterflies to mate and for the next generation to grow. Then they release them back into the jungle. The rest of the trip we were stopping to watch butterflies dance around. 

 The second day we were off for our Amazon jungle adventure. An Italian woman joined, Devora and me, to make up our tour group. We first took a four hour boat ride up the Amazon, seeing many fresh water dolphins and birds. We stopped to chat with a group of carachama fisherman. Five or six guys live on raft for about a week, floating down the Amazon from Pucallpa to Iquitos fishing for carachama, a popular and ugly Amazon catfish. They find the catch the fish and keep them in large water cages attached to the raft (see pictures below). They then arrive in Iquitos to sell thousands of fresh fish. The guys strangely happy to show off their loot and explain to us how it is done.

Jungle Downpour 

We arrived to our lodge just in time to miss a thunder and lightening storm, which I enjoyed watching from our room. This was the introduction to our four day jungle experience. Meaning, it rained everyday, I was constantly dripping sweat and fighting off bugs, and it was beautiful and green! 

Blender

Our guide, Alberto, was from a neighboring pueblo. He fit in with us well, joking around, making fun of our Spanish and indulging our constant stream of questions. We spent the next four days exploring the jungle by boat and by foot. We saw lots of animals, pink dolphins, monkeys, an alligator and lots of birds. Alberto taught us about the medical properties and household purposes of many plants (see the picture of the blender he made on the left). 

Las Renas de La Selva (Jungle Queens) and Alberto

We ate delicious food, fresh fish, plantains, sugary fruit juice; even the instant Nescafé was tasty. We fished for piranhas, swam in the Amazon, and watched the sunset. It was a typical tourist experience and I loved it! I think I will just let the pictures tell rest of the story. 










On one hike Alberto made Devora and I crowns. That machete is his lifeline, trail blazer, eating utensil, blender maker, and much much more.

In Alberto's village

Alberto took us to his village. This woman was trying to give her hen some sort of medicine.

Swimming in the Amazon

We went swimming in the Amazon. It was disturbingly warm, like bath water. But there were pink dolphins swimming in the background!

Piranha fishing.  

Unhooking the Piranha 

Fishing for piranhas. We used expensive chicken meat to fish for small barely edible piranhas, and by fish I mean feed them lunch. It was the easiest fishing I have ever done. It took seconds to get a bite, but you had to be quick to get them out of the water. It was surprisingly entertaining, although I was the least successful in our group.








We ended up throwing most of them back. Unhooking them was part of the fun.

Post Jungle Lunch- Street Food

Baby Ocelot in a Iquitos Hotel

Sunset over the Amazon River

 The primary goal of this experience in Peru is to gain global health research experience, but the secondary one is to get to know a new country and culture. AKA my excuse to travel. Peru is such a diverse country and has so much to offer. I’m so glad I get to explore some of it!