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!