Monday, June 13, 2011

This is Deborah Shefler writing from San Salvador, having just completed our third visit to Medisol, a well organized clinic in Lima that is a big fan of PINCC. We were able to certify 3 gynecologists in VIA, cryotherapy and LEEP, and 2 midwives in VIA and cryo, so the trip was a success just from that perspective. We screened 220 women!

The Medisol clinic is in a stand alone building in a poor, run down section of the huge city of Lima (I heard variously 8 to 10 million). We stayed in a very safe touristed area full of glittery shops and outdoor restaurants called Miraflores, in a simple but beautiful little flower bedecked hotel, Hostal El Patio, PINCC discovered a couple of trips ago. It´s a budget gem.

It´s about a 40 minute drive from Miraflores to the area where we worked. The contrast between Miraflores and the clinic area is stark. Nothing glitters, the shops are tiny and basic, the building construction is one to two story brick and concrete, and the streets are full of little microtaxies rather than buses and cars. I quickly realized that the microtaxies are essential because they are the only vehicles that can make it up the steep streets of the neighborhood. This area is filled with seemingly ad hoc slums that ascend the hills in switch back fashion. There seems to be at least some electricity, but the plumbing is unclear. By the time you get to the top of the hill the housing is more like camping out. The city is full of these ascending slums. I´m told that in recent years the government has invested in infrastructure in these areas.

I spent a few days in Lima before the group arrived. I stayed in 3B Barranco, a fine small and inexpensive hotel with a friendly staff. The best experience I had was the world class Larco Museum. Check out the beautiful objects, particularly the ceramics, which are extraordinary. Also check out the restaurant, which is quite posh but not expensive. It was filled with French tourists while I was there. I had a pisco sour and a peruvian sampler. Delicious all. It is a private museum with exquisite, well maintained grounds, colorful flowers abounding, quiet ambiance. Some of the art is astounding, particularly the ancient Moche pottery, which was mostly found in perfect condition in tombs. The pre-Colombians in Peru practiced a cult of the dead, something like in Egypt. The pottery therefore depicts all aspects of ancient life, including the pornographic.

I also went to the national cultural archaeological museum, Very extensive museum of everything about Peru. Again, the Moche ceramics from the north are worth the visit in themselves. It's among the most inventive, beautiful and entertaining art work I've ever seen. It's the vessels with the curved handle and spout coming out of the top of the handle. But what we've seen in the states is nothing compared to the work on display here and in the Larco. Unlike Museo Larco, little of this museum was in English, but I got along fine. Finished with a delicious grilled fish with sauteed veggies in a big, open air restaurant.

There was (supposedly) no alcohol served in Peru for several days leading up to last Sunday´s run off election. Also, it is compulsory to vote in Peru. Some people predicted the election would be very close and the results not available for some time, given the remote rural situation of many voters. But that turned out not to be the case and one candidate conceded within a day. It seemed most people in Lima preferred the more conservative candidate, the daughter of a former president now in prison, but she was defeated by someone who has sometimes identified himself with Hugo Chavez.

I drove through some of the nicer parts of town in taxis, particularly San Isidro and Miraflores, which is next to Barranco, where I'm staying. Lots of attractive stucco housing, some colonial buildings, Spanish churches, flowers everywhere, lots of walls and attendants, low buildings and luxury high rise towers with expansive views of the ocean. These parts of town look well taken care of and very clean. There was some graffiti, but few signs of poverty.

I walked alone down the main drag in Barranco several times, feeling very safe. This area used to be a town in itself, but has been absorbed into greater Lima. It's a middle class neighborhood. No international chains, only local businesses. Not even Starbucks, and nothing even close to Benetton. Some shops are quite small and simple, like in Morocco or Turkey. The nicest businesses are white table cloth restaurants, and some look nice indeed. It is safe for me to walk here after dark, and indeed you see lots of police and guards, certainly around all the banks. If you eat before 8 or so, you'll be eating alone. Street food looks good but not sufficiently tempting to take a chance. Streets are relatively clean, much better than India but there is some litter. Traffic is relatively courteous, with lights, sidewalk slots for persons with disabilities, and pedestrian crossings. Sidewalks are normal and walkable, much better than in India, at least in these areas. No hassles whatsoever on the street. In fact, it felt like not a single person bothered, or even looked at me. People are conservatively and simply dressed, with young women almost universally in tight jeans. ATM worked perfectly. Super market well stocked.

I spent a day with a prearranged guide named Arturo, visiting downtown Lima. There are two squares in particular that are world class. The buildings are consistent in size, period and color, and exquisite, clean and well maintained, mostly from late 19th century. The oldest church is 17th century. Lima is a relatively new city. Someone from Spain would be right at home with the civic and ecclesiastical architecture. The weirdest thing is the catacombs under St. Francis church, which is now a museum. It's really an ossuary, full of piles of bones separated by type, femurs, tibias, etc. It's completely anonymous, just bones, all looking exactly alike and undifferentiated in any way.

We took public transportation, a first for me, so I got to see more parts of the city, for better or worse. We took a bus with a dedicated lane, a massive public works project that is only a couple of years old. I'm told it's like a system in Mexico City. It goes above and below ground and was a big deal project here that took several years to complete. On the other extreme, I got my first look, from afar, of one of Lima's infamous slums, little houses built up a steep hill.

Had ceviche, sliced raw fish in a lemon, yellow pepper sauce about the consistency of lemon juice. It was served with corn and sweet potato, and delicious. This was my third fish dish in a row. Fish is the thing to have here. Chinese food is big here too, on virtually every block, but it is made with Peruvian ingredients so should be a little special. Peruvian ingredients generally means potatoes (there are hundreds of types here, in all colors and sizes), rice, and corn (also all colors and sizes). Cooked veggies are a little hard to come by.

Arturo is a nice, 34 year old single man who is thinking about getting married (or not) and having children, or not, or moving to the US, or not. His father lives in NYC, but he seems more attracted to Miami or San Diego, where he'd like to have a travel agency. He says that Peruvian young people generally do not get married, they just live together and have children. His brother did get married, but that's because he's a Jehovah's Witness. This is strange because although people tend not to get married, they are religious, overwhelmingly Catholic. There's a real dichotomy in my experience here. The museums are all about pre-Colombian pagan polytheists, and the architecture is all about Spanish colonialism. It's interesting to compare how the ancient civilizations imposed order, and how the Catholic church and its secular political/military arms did something similar. Two different ways of accomplishing oppression.

On Sunday I took my last walk in Barranco. It is an up and coming neighborhood with small luxury high rises that I didn't see on my prior evening walks. Everything, however, is behind formidable doors, gates, bars and walls. I transferred by taxi to the Miraflores neighborhood around noon and checked into Hostel El Patio. There are big markets or bazaars nearby that are full of little shops, like the souks in Istanbul or Morocco. Some of the stuff is really nice, particularly the alpaca items, which are highly recommended.

Once the whole group of 8 had arrived, we met for 2 hours to go over what we'll be doing for the next week. Carol is very well organized and has seemingly thought of everything. Indeed, the week went smoothly, showing what planning and experience can accomplish.

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