If it hasn’t already been mentioned within the first two minutes, I usually start the interview off with a joke about how tall and awkward I am. A joke that has been well received wherever I have traveled. Nothing like good physical humor to make up for my inadequate language abilities.
Most of my day-to-day work in the field involves doing a socioeconomic assessment of incoming TB patients. This involves about 45 minute interview in which I insert myself into their living situation, their education, their family members, alcohol abuse, monthly income, and health history. Their personal life is my interest, and I need them to want to share it with me.
The newly diagnosed TB patients are usually in a state of disbelief that this could happen to them–that is, if they don’t already know someone with TB. Most don’t know what to expect during their treatment or if what they are feeling is normal. That’s when I show up to explain that I’m from the health post and want to do an interview with them to see if we can support them in addition to the medication they already receive (with extra food or an extra room with good ventilation perhaps). This explanation and their fragile desire to learn more about their disease is enough to get me in the door. But that’s the easiest part. Getting the information is the challenge.

An example of house people now live in after the earthquake

An example of house people now live in after the earthquake

I’ll understand that they don’t completely trust me right away.  After all, when’s the last time I willing answered the questions of  people who have appeared at my door and stated their good intentions?  That’s where the joke comes in.  Maybe it’s about my height.  If there is a little girl in the room, I’ll ask her what her age is and then claim to be five-years-old as well–always good for a shy smile.  And there’s no better way to get mother to open up than to show your care for her kid(s).  All I really want to do is show the patients that I care about them; that I’m not just there to fill out some stupid form and leave as fast as possible; that I’m interested in what they have to say.

If I’m successful in getting a person to open up, instead of hearing that she’s bored all day at home (because TB patients can’t work because of treatment), I get her to tell me that she hates being alone for three days at a time, waiting for her husband to come home from a fishing expedition, only to have him mistreat her.  I get her to give me the details of how she wishes her family, who lives ten hours away, could come see her but they can’t because she might give them tuberculosis.   I get her to tell me that she cried the entire first week after she found out she had tuberculosis.  Then I can recommend her to the women’s advocacy center in town.  Then I can use her family as motivation for her to continue with treatment.  Then I can recommend her to a psychologist and to group therapy.  Then I can do what I came there to do: provide support for her outside of the medication which she receives in the health post.

This approach is one which I take on an individual level, but it also can be extrapolated to a community level.  Do you care about the people of the community?  Or just the disease which you are trying to treat?  Why should the community welcome an organization whose goal is not centered around its people, but instead centered around appearing to good?  PIH uses TB treatment as a method for entering into the lives of the community, but from there, once we’ve gotten through the door, we direct our efforts and care toward the entire community.

When I think of rural poverty, I imagine lush,  mountainous countrysides with windy dirt roads.  And that’s pretty much what things looked like along the coast of Peru.  Except there was nothing lush, and the mountains were made sand instead of rock.

Laguna Grande is a small fisherman’s town 2.5 hours drive from Pisco, its nearest city.  Its population varies according to the fishing season, but around 500 people are permanent residents.  The directions to get out there are as follows: stay as close to the ocean as you can, past the rock that looks like a turtle (Land Before Time, anyone?),try to find sticks  jutting out of the sand.  Sometimes we had to stop completely to just spot the next marker in the desert.  Twice we had to back track because we had gotten lost.  It was a pretty hard place to navigate, but we finally made it.

Fishing town, Laguna Grande

Fishing town, Laguna Grande

The purpose of our visit was to visit the government health post in Laguna Grande.  We greeted the nurse–one of only two that worked there.  We chatted for a while about how things were going.  Most of her patients are seasonal migrants, only living in Laguna Grande for part of the year.  They hadn’t seen a TB patient in ten years.  But they can’t really do tests for TB because they don’t have a fridge.  They also have no way to do tests for HIV, but she said she has seen symptoms of the disease in some of here patients.    They also have to import all of their water from Pisco.  A 2.5 hour journey, just for water.  The government gives the health post a monthly ration of water, but it is hardly sufficient.

Laguna Grande's Health Post

Laguna Grande's Health Post

Laguna Grande is a geographically isolated community.  Many questions come to mind in this situation.  How can a health care facility not have enough water?  And no fridge?  Well, part of our goal in the next coming months will be to work with the  government to see that a fridge arrives, sufficient water is supplied, and HIV tests become available.  Our commitment is to providing the community with  sustainable sustainable structural development.  We will work  with the fishermen, with the nurses, and with–not around–the government.

As you may know, it was Easter this weekend. Which means everyone in Latin America takes Thursday and Friday off. The other volunteers and I decided to go to Arequipa, a 15 hour bus ride to the south. It’s known as Canyon country. I spent Friday and Saturday hiking, climbing ruins, seeing condors, and seeing the second deepest canyon in the world. It was a lovely extended weekend.
Then came the fifteen hour bus ride back. We made seven hours of the journey. We stopped at two in the morning, and did not move for the rest of the night. I saw lines of cars around us, so I knew we were not in trouble. If we had been reading every piece of Peruvian news, we would have known that the miners were planning on striking; however, we had not been up to date on the current events. We woke up in the morning to find ourselves in a line of buses, filled with people like us, trying to get back to Lima after the holiday.
We were in Chala, a small finishing/mining town. We learned why we had stopped. The government wanted to legitimize an illegitimate mining industry, meaning creating environmental restrictions, and, presumably, taxes. It was seven in the morning, the word on the street was that we might get through the blockade by 1pm. And by blockade I mean 8,000 miners blocking the road, with only 500 policemen.

I heard shots being fired. I saw a helicopter arrive on the beach (at least we were at the beach). I saw tear gas fired. I saw tires burning. I saw 5 buses pass through that had been at the front of the strikes, their windows smashed as concerned Peruvians looked through the broken glass. Thankfully, I was not near the front. Then we heard rumor that some miners had died. The protests had just been moved up a notch. I could see armed military men standing on top of the police station. We would have turned around, but around 100 km behind us, there was another blockade. So we were kinda stuck. The miners never wanted to hurt us, but they did want to make their voices heard. I was never in trouble, just uncomfortable and on edge.
We decided to move 5 km back to a what I would call a trucker stop. Along with about 20 other coach buses (1000 people) we cleaned out the restaurant, the food, and desanitarized the toilets so you couldn’t go to the bathroom without holding your breath. We were in the desert, next to the ocean. I went to bed having eaten one meal that day, but having stocked up on plenty of water. I went to bed calmly, knowing the miners would not come to where we were. I went to bed almost positive that in the morning, we would be on the way to Lima.
The next morning, things started getting ugly, people were screaming at each other about what to do. The bus company wanted to just wait it out. There was not food. Only a small portion of cheese for children. Our bus collectively decided to go back to Arequipa. Some people couldn’t afford to go back and pay for another ticket, so they decided to wait it out. The place was a disaster–no clean toilets, no food, hardly any water. Unfortunate that people were forced to stay there (voluntarily or not). There was no news as to when the blockade at Chala would stop, but it was rumored that things were ugly there. On the other had, it wasn’t clear that we would actually be able to make it past the blockade that was behind us, but we had heard that other buses had made it through the less severe blockade of only 3,000 miners, and no deaths.
We made it back, with only a 45 min stop at the other blockade, and relatively peaceful passing.  Seven hours later we, were in Arequipa. And thus ended my over 48 hours on a bus. We went to the airport, where the government was giving out free military flights back to Lima for those who had been on buses. Why was the government was investing their money in that, rather than in quelling the protests? Well, they didn’t want to give into the miners demands. And they decided to just wait it out. So Monday night, at 12 in the morning, I got on a Peruvian air force plane and flew home. The main reason I got a flight so rapidly, was because I was American. I felt bad.  So did the other volunteers, and two of them stayed behind, to wait there turn in line. I felt it was a situation that did not have a correct response. Any Peruvian would have lambasted me for giving up my opportunity to go home. Yet I didn’t feel it was right. I wanted to stay. Then I started thinking about what would happened if I stayed. Well, I would probably just be getting on a flight the next morning, in front of some other Peruvians, and still feel bad. Really, there was no right answer. I got my house at 3 in the morning, and crashed.

I am the visitor. I am from Kiva. I am Jeremias. This has been my introduction for my first days in Guatemala.

Tueseday, we went to San Martin. It is a two hour drive from Guatemala City: thankfully it was Marco and not me who was driving so I could observe the scenery as we passed through beautiful rolling hills covered in forests. In the distance we could see small peaks, and each one was covered in trees.

Once we arrived, we were greeted by Bertha Carmelina Tohon, who just finished fundraising on Kiva.  She gave us a warm weBertha with her typewriters lcome and insisted that we have tea before we leave her comedor (eatery).  She was not shy to share her life story.  I quickly learned that her kids attending college, one studying psychology and the other chemistry.  I learned that she thought the Guatemalan school system did not teach the children anything practical, and that she has a typing school where kids learn using typewriters.  I learned that she was hard working: “There is time to rest when you die,” she said.

But not all of our visits on this day would be this happy. Read the rest of this entry »

I have arrived, and am continuously amazed by the friendliness and hospitality of everyone here. I am staying with the director of FAPE for this week, after which I will be moving to the seminary. He has a wife, who he only refers to as his amor, and a two year old son.  You  know how sometimes kids are hard to understand while they are learning to talk?  Well, it’s near impossible to hear anything other than jibberish when they are learning to talk in another language.

Today, I went to the organization’s office, and was intorduced to loads of people, from the loan officers, to the accountants, the secretaries, and everyone else.  Except for the people who get loans.  Tomorrow, I am going to San Martin to see this and collect some payments.  Also today, I discussed how to better use Kiva, and how everything works in the office.  On the way home, I drove a diesel pick-up truck through the streets of Guatemala City.  In order to change lanes, the turn signal and hand wave out the window are both requirements.  It was a little nerve racking, but all things considered not too bad.  Sorry I don’t have any pictures or video, the day was too packed.  Hopefully later this week I will have them.

At the end of every meal we say, “gracias,” to which someone responds “buen provecho.”  To you all, I say gracias and good night.