pisac! & cusco! :)

Today we went to a town called pisac, about 15 minutes past Lamay! On sunday's there's a market there, con muchisimos turistas, incluyendo nosotros :) Pero fue bueno! they had tons of joyas y ropa y comida y todo! habia unos tiendas con cosas super original tambien que es bueno porque much of the mercados artisanos have the same thing over and over again - which can also be nice :)

We wandered around the market for a while and then started the hike up the mountain to the ruins - fue mas or menos 1.5 horas y .5 horas para bajar! fue un buen hike :) y yo estabba sudando cuando llegamos en el cumbre!

Cuando llegamos en Pisac otra vez, fuimos a un resaurant tan bella que se llamo "the blue llama" they had amazing looking deserts and their food was superrico!! :)

coming back on the bus was como una experiencia de transportacion publico tipico de sur america! :) muchos personas uno encima de otro! haha :) pero bueno! llegemos seguros a nuestro pequenito pedazo de cielo! y todo es bueno!

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Ok - so this a a little late b/c we actually went to cusco yesterday :) but it was super fun and we went to see the salt flats and wondered around the city, which btw was way bigger than i thought and reminded me of ecuador which i miss!! :)

fuimos a un monostario que fue tan bella! y tuvo jardines maravillosos! despues a un mercado artisano que no fue tan original, pero tuvo tantos cosas con arcoiris!! yay!! y despues a un restuarante that was receommended in the lonely planet cusco guide that was super! and the waitress there was a super cute!!

por fin fuimos a recojer los medicinas, pero tuvimos muchos dificultades tratando a sacar dinero de la cuenta de clinica lamay y despues encontrando la faramacia y despues comprando los medicinas!! they had 1000 count box of condoms but no kids vitamins :-P ha! oh well!

The ride back was beautiful with view sof the city and the stars that were hermosas!!!

y por fin llegamos en nuestro little piece of heaven - hot and cold showers and BED!!!!!!!!!!!! :)

Primero Dia de Clinica!!

ya terminamos nuestro primero dia!! y fue beunisimo!!

vimos mas o menos 40 pacientes - y tuvieron todos los problemas... muchos problemas infeciosas, muchos problemas de piel, muchos problems de musculos...

the first patient i saw was so sad... ella fue golepeado en su cabeza, de su esposo, y tuvo un cornea deslocado, y probablemente un hematoma subdural cronica :( ella vino de su casa de fue un viaje de 1 dia y media! y vino con su hija y su madre! her mom only spoke quetchua, but she spoke spanish as a second language and her daughter spoke almost perfect spanish!

Her daughter had what we thought was possibly sporiasis, and her mom had osteoarthritis. In the end we referred her to a nearby hospital to get a CT and see a neurologist and an opthomologist. I felt so useless. :( we also referred her to a domestic violence group, pero no estoy tan segura como esto va a salir...

Patients started coming almost as soon as we walked in, even though they told us they wouldn't until noon! we had about 5 mintues to set up - eep! but we did it and in the end our system tunred out to be pretty effiicient and we got into a good flow by the end.

Maureen was doing glasses, which was so amazing! She even fit a pair for Mario, the go to man of the clinic :)

The last patient was rache's and she had a huge ulcerated sore on her lip... since the lab closes at 3 and we go til 4 we were unable to run any tests for her and i think they ended up telling her to return tomorrow...

Satoko lost part of her opthalascope ... pero pienso que en total fue un buen dia primero :)

Dia de Huelga y Dia a descansar

today we woke up and had the most amazing breakfast - edwin el dueno del hotel tiene abejas!! and he makes his own honey (miel) que es TAN rico!!!

we spent the rest of the morning sorting medications and having impromptu infectious disease and derm lectures cuales eran tan buenos! Gracias a los doctores quien estan aqui!

Despues de esto, we set out to explore the town and find the pequenito restaurante que recomendieron nuestro host.

when we arrived at the restaurant 14 pisco sours and a table for 14 plus baby had been set up for us!! all thanks to our wonderful host Edwin who in his wonderfulness and forsight called ahead to let them know we were coming! wow!

so.... depues de un almuerzo maravillosa, incluyendo tantos platos con quinua y muchos opciones para los 4 vegetarionos en nuestro grupo! we wondered around the town and bought some granadilla! mmmmmmmmmmmmmmmm delicioso!!

we then proceeded to take a "hike" which was a walk around the town and gettting lost and one of us spraining an ankle... and eventually making it back to our, as rachel says, our little piece of heaven!

now - todos sentidos arededor del la sala del hotel chequeando email y probando los frutas nuevos que compramos!

manana, empezamos a trabajar en la clinica lamay!

Lamay Clinic Hoy

Fuimos a la clinica hoy y fueron tan diferente que pensabamos!

habia cuartos de todos tipos, an OR, a gyn room, 2 internal medicine rooms, pediatrics, dental, rayos equis, opthomologia, inpatient rooms! woah.... pero todavia necesitan un microscopio y un echografia.... ahhhh! the lady told us, quote - the microscope works de vez en cuando! so much for having a working microscope!

still no sleep since sat night.... 7 hours sleep + 41 hours awake + elevation of 10,000 feet = tan loopy!

pero beuno, tal vez manana vamos a tener un paro (huelga) - there's gonna be a strike, where the entire countries transportation workers are striking tomorrow, which means we will probably not be going to clinic which means, tal vez un dia mas para descansar!!

and to sort pills into baggies!

everyone on this trip is totally awesome - and everyone who has been helping us, lo mismo, teniamos tanto suerte! ooo tal ez es algo otro :)

nos vemos...

Dia Numero UNO en Peru :)

Woah - ESOTY EN PERU!!!!

30 hours sin dormido pero estoy en peru!!! ... no puedo describirlo aqui es TAN hermosa! llegamos en lima a noche a las 11 de la noche, y pasabamos el noche alli, despues de unos luchas con customs... pero todo salio bien! no tuvimos mucho dormido, pero, bueno, por lo menos estamos aqui!

we arrived in cuzco at 6:45 and took 3 vans with luggage piled HIGH on top and with all of us loaded inside. we drove for over an hour through the city, over a mountain up to 11,000 feet and back down to 9,000 to arrive in the village of urabamba where we are staying in the most amazing hotel i have ever seen in south america...

We will start to bring supplies over this evening and were planning to start running clinic tomorrow, but because of a country wide strike, we will be unable to go ANYwhere tomorrow, so will plan to start on Thursday :) yay!

currently can't find my camera cord, but have un mil de fotos para mostrar, ojala puedo encontralo y cargar los fotos!! :)

ciao bellos!

visitas domicilarios

This will be my last post talking about the DR - all f the following (most recent ones) will be about Peru. (I was in the DR May 2009, and Peru, July 2009).

Entonces, visitas domiciliarios - one of the amazing things about the HIV program at Cabral y Baez is the home visits that they do. Aside from the handful of incredible and devoted physicians who treat the HIV patients there, the social worker who runs the HIV program visits the patients in their homes. Assessing the home environments is so important, but more than anything it just reinforced the extreme poverty that many of the patients lived in.

The picture to the right is a photo of one of the living rooms of a patient we visited on the last day of home visits. No habia un bano a dentro, no habia una neverra y todo la gente en esta barrio se limpiaron sus comida y ropa en el rio which ran along beside the one road that all of their houses lined the opposite side.

Other houses we visited were one room seperated by a curtain with one bed to sleep 5 people and a tv on one side of the curtain and a stove and tiny table on the other side of the curtain. The bathroom a small ceramic toilet with no lid surrounded by only three walls with a shower head on one of the walls. Fungus growing underneath. Con los pacientes que tuvieron SIDA, fue tan peligroso a tener condiciones tan sucios en respecto a sus systemas tan supressadas....

It was sad, and I felt especially during these visits so lucky to have what i have and so helpless to do anythign about their conditions. Pero una cosa beuna fue que one week after leaving the DR we found out that the governement had decided to give ten more bags of food per month to the program to hand out to the patients. So.. one step at a time I guess.

We are still working on putting up a website, finding funding and other ways to help with this little piece of amazing that struggles along in the bigger broken system of health in the DR :(...

argh

another tradgedy on my the one day of ob/gyn....

of the 15 patients who filled the sheet-less beds of the all but open air maternity ward, at least half of the girls were under 20

this one in particular was a hatian girl, probably about 16 years old, if i had to guess. the resident was using her as a teaching example - she was evidently in Lots of pain...

the students and interns gatehred around the bed as the resident pointed to the girls vagina. blood clots were coming out from around the foley that had been placed earlier...

taking the end that was sticking out, the resident says to no one in particular "this is a good example of a foley put in incrrectly" he then prcoeeds to yank the foley out... without disenflating the balloon - the young girl about to give birth yells out in pain as the foley with the inflated balloon comes out through the tiny opening of the urethra bringing with it even more blood...

the only thing i can think of is how this 16 year old is going to be incontinent for the rest of her life....

it made me shudder to think about it, and as i described the scene to the senior resident I am working with on night float today, i realized just how terrible it had been, the ful impact of the incident didn't really hit me until i retold the story 2 weeks later... here in the comfort of our rich, clean american hospital, with private rooms, plentiful nurses and salaries that are paid on time every month without fail...

i can understand how there is such a divide between the medical care given in a public hospital in santiago, puedo ver porque... pero en el otro lado, no lo tiene que ser como asi no? realmente, no estoy tan segura