PandoraPeru

3.31.10 – Semana Santa

2010-04-04T16:23:00.002-07:00

This week should be a short week for Anita and I as all of Peru will celebrate Semana Santa Thursday and Friday. However, Cherlita, the 16 year-old gestante and her man Riker are utilizing the casa de espera. She hasn’t shown much sign of labor yet, but we will see!

Earlier today it rained HARD and we spent the morning sweeping the rain out of the clinic and our home. Sweeping rain is part of the routine as I have mentioned. Rising early is another part of the routine and I am slowly adjusting. You all know that I am a lady of the night, a night nurse at heart, a morning soul sleeper. In contrast, at the heart of Peruvian Pucallpiño and carretera culture is early rising (even after dancing the night away – another part of the culture, but a part that I LOVE and I dance most Saturday nights until 5am!). Chickens make their morning cawk a doodle dooooooo and I am really good at tuning them out and sleeping just a little tiny bit longer J. Nonetheless, life really does get started around 5am here and so I have begun my morning running routine (not until 6am though). I rise to a beautiful mist of clouds and set off along the dirt road. Life is alive and awake, and not only my neighbors think I am crazy. They stare and laugh and stare some more. One morning as I ran past a lush tree a bird began to make its call in the sound of an alarm! Oooo aaaa ooooo aaaaaaa oooooo aaaaaaa, exactly like an old school ambulance. I laughed out loud. When I run I feel like a show on the road and more recently some of the neighbor kids like to join me, making a bigger and much more entertaining show! It all started with my neighbors Priscilla and Ruben, 17yo and 12yo. Then others wanted to join in and each day I run I have a few more new partners. My favorite partners are the 9yo, Jean Carlos who planted our casa de espera garden and Brisette, the sister of the babe I delivered in Pucallpa a couple of months ago. We race and play and laugh. Last night we ran as the full moon rose up in the jungle sky. Beautiful!

Cherlita hasn’t given birth yet. She is rumbling, but only is dilated to 2cm and hasn’t had any consistent contractions. As I type now Cherlita is sitting next to me singing to the music of Dina Paucar, typical Peruvian music de la Sierra, that we have playing on my computer. She just turned to me and said, “When this baby comes I am going to name her Anita Elizabeth.”

3.27.10 – 50/50

2010-04-04T16:23:00.001-07:00

After Juana’s magnificent birth, life filled again with the daily routine of health post work, but not for long. The day after Pedro Daniel arrived, the husband of a gestante came to the clinic with his 4 year-old-son to do a well-child check. Anita knows every single one of the millions J of members of the communities she serves and so she asked if his wife was contracting yet (her due date was approaching). He paused and nervously responded, “She gave birth yesterday.” OOOOoooooh Anita was mad. In Spanish we say, “Me da colera” when we get really ticked. It’s one of my favorite new sayings. The phrase is said with a type of disgust. Anyway, we packed up for a post partum home visit. 19 year-old Vanessa gave birth to her second child with a partera (traditional birth attendant) in her home the previous day without complications. She says that she did not intend on having a home birth, that their family’s 2 forms of transportation broke down, that no transportation was available at noon the day she delivered, and that her labor was very fast. However, because there was a partera present that had traveled from a far distance to be with the family close to Vanessa’s due date, both forms of transportation were working the day we visited, and other clues, Anita and I feel sure that Vanessa and her family planned a home birth. Without judgment, I would love to know their real reasons for planning a home birth, but because I am associated with the health post I might never get to know those real reasons (but I have lots of ideas). I’ll keep trying though! My PhD thesis perhaps, eeeeeek!

Later in the week Anita and I were out in the field visiting each community’s health leader when we heard of another one of our patient’s who delivered in her home. We visited her for a moment as we were nearby and all was well. She told the same story as Vanessa, but also was attended by a partera. She had a wicked tear and transferred to the hospital for sutures the same day that she delivered. She brought her baby to us a few days post partum and we discovered an infected umbilical cord. With 2 home births this month, 1 birth at the health post and Cherlita at the casa de espera until she delivers, our March health post birth stat is 50%. Poco a poco I think we will see this number increase. We have many women come for their paps and say they want to get pregnant just to come utilize the casa de espera J and deliver vertically. In addition to Juana and Cherlita, they will help spread the word.

On another note, this week I did a total of 28 well woman exams and a total of 25 paps. Pap land success! I am getting to know each of the communities and starting to recognize women and their families as they come into the clinic. What an honor it is to serve these amazing Amazon women.

After our long Saturday, Anita and I packed for our weekend return to the city. This time we not only carried our personal belongings and dirty clothes from the week, but we also hauled the empty stove gas tank with us. Gas is cheaper in Pucallpa. If there is no Luz, there are no gallinas.

3.23.10 – Where’s Juana?

2010-04-04T16:22:00.000-07:00

Juana has not come yet. I am thinking about her. Early this morning a woman came knocking on the door to our house and I thought for sure it was Juana. I sat up in bed and began untangling myself from my mosquito net expecting to see Juana ready to push out her babe. Alas, it was a woman who had come to pay Anita for a previous clinic visit. Where’s Juana?

Anita wants to start a sex ed program at the school house. What a great idea! We walked down to the bright blue building where school is held in about 6 classrooms to look for the director. He wasn’t available but we will continue to work on that idea. Anyone have materials in Spanish or experience with teen sex ed programs? I would love any ideas or suggestions.

Spent the day doing more well woman exams and paps until the lights went out. Having electricity does not mean that we ALWAYS have electricity. My computer still had some power left so Anita and I hung out in our respective single frame beds that are stuffed into our tiny little room and listened to my favorite banjo music (Thanks for the GREAT banjo music Luc!) until we heard a tap tap on our door. Guess who? Juan, Juana’s husband J.

Juana arrived contracting lightly but dilated to 4 cm. We showed her family to the casa de espera where her 2 little girls went to sleep soundfully. Juan, Anita, and I returned to the health post where I massaged Juana’s back by candlelight until she felt the urge to push. She wanted to birth horizontally, but liked the idea of pushing in a comfortable bed instead of the hard exam table of which most women that deliver in health posts are accustomed. Anita and I had prepared everything for any type of birth (any position and any complication) and bought a huge piece of plastic to cover a comfortable mattress on a 70s like bed frame. The bed frame must be an old medical model because the head inclines, which worked out well for pushing. Electricity returned just in time to dar a luz (give birth) and big beautiful baby Pedro Daniel was born at 23:43 under the bright fluorescent lights of the health post. I passed Pedro directly to his mama with cord intact and his mom and dad rejoiced! Just after I sutured a small tear, the lights went out and we enjoyed a post partum recovery by candlelight and free of complications. Juan and Juana asked that I name their new little babe and so together we came up with Pedro Daniel. Pedro after Juana's brother and Daniel for my best man friend in Denver. Juana, Juan and their beautiful family lived and loved in the casa de espera for 2 full days.

As Juana and family packed up, Cherlita and Riker packed in and for 1 day the casa de espera was occupied by 2 families! One of the local boys, Jean Carlos, who is 9 years-old planted a garden in front of the casa de espera upon his own volition. He planted it smack in the middle of the entrance J and as the casa de espera blooms, so will bloom its beautiful welcoming garden, literally, at its front door.

3.22.10 – Week 3

2010-04-04T16:21:00.000-07:00

Arrived at the health post this morning after our routine bus ride with my favorite mouth honker, Cesar, and 2 women were waiting for our arrival. They live in San Martin at CNC Km 4 near Juana and brought news that she is having light contractions today. I packed my bag immediately to visit her in hopes to convince her to come to the casa de espera with me. Anita stayed behind to run the health post. Upon my arrival I found Juana resting in her home (which I have described previously, see pics on flicker) with 2 of her daughters at her side. She was comfortable and happy. We chatted and conducted an OB appointment in her bedroom. She is not contracting yet nor does she have any warning signs, either of impending labor or danger in pregnancy. Her baby has dropped significantly since her last appointment a week ago. We discussed the casa de espera again at length and she says she will come this afternoon. Her husband, Juan J, is in Pucallpa and she wants him to accompany her with their 4 children when he returns this afternoon.

On another note, Cherlita, a 16 year-old gestante, 39 weeks pregnant came to visit us after we gave her a tour of the casa de espera last week. She lives at Km 86 of the main highway from Pucallpa and is excited to come live in our community with her boyfriend, Riker this week as her due date approaches.

Luz is back, thank God. She killed one of the gallinas (chickens that roam free) that a patient gave us last week and we ate the most delicious and famous caldo de gallina, a chicken broth with noodles and potatoes. Though caldo de gallina is a traditional meal for all in Peru and in the jungle (most often for breakfast), women always enjoy a freshly prepared bowl after giving birth. For example, Anita tells me that when Juana comes to live in the casa de espera she will carry her chicken with her and her husband will prepare caldo de gallina for her and the family after she delivers. Everyone travels with their chickens here. Perhaps I find it amusing because I grew up in the city, but when Luz packs her chickens into a little sack and we set off for Pucallpa each Saturday afternoon, I chuckle chuckle chuckle. Those little chicken heads pop out of their bags on the bus.

In addition to eating caldo de gallina after giving birth, many other traditions exist. Juana has informed me that it is customary for the husband to cook, clean, wash clothes, care for the other children, etc for one full month after a new baby comes. Excellent idea! Let’s make it longer J! Also, women wear a white cloth baby diaper around their head for 15 days after delivering. The cloth diapers are much thinner and more like a blanket wrap here than in the US. Juana says the wrap functions to prevent dizziness, headache, cold, and chills. See photos of the women in their head wraps. I like them. It’s kind of kung fu, like she has won a battle and indeed she has, through her strength and courage she has brought new life into this world.

3.20.10 – Swiss Family Robinson

2010-04-04T16:20:00.000-07:00

Me da cuenta (I realize) that I live the Swiss Family Robinson life!!!! My sisters and I LOVED the Swiss Family (how could you not!), and I could never have imagined that one day I would live this jungle life.

First though, I have to tell you that Luz (Jose Antonio’s mom) is not here this week. OH man, what will we do? Anita and I don’t have time to prepare our food and though we have electricity, we don’t have a refrigerator. We prepare our raman noodles every night and I fry platanos. Mmmmmm, I love fried platanos, but I love having Luz here more.

This week was yet another FULL week of action. Anita and I visited another 5 remote communities only this time our mission was to Pap it up home visit style.

After doing 20 paps and well woman exams at the health post, we packed for more paps in the jungle. First we attempted to get to Nueva Jerusalen (a community about 20 Km away) but motocar pushing became tiresome. Every 5 minutes we came across large mud puddles, baja’d the motocar, and started pushing. We kept thinking that this muddy mess would be the last, but there was always another waiting. We looked like chanchitos playing in the mud!!! After the heavy rains we have had over the past few days, we should not have attempted to get to Nueva Jerusalen, but we thought that the long day of strong sunrays would have dried out the mud by now. Not so much. Luz swept rain from our house most of the day of rain as it seeps everywhere with its force. After our failed attempt to get to Jerusalen, we switched gears and went to Santa Rosa where we held a women’s clinic at their tiny health post. When we arrived to the quiet town, we walked the small square surrounded by houses and advertised our pap clinic. 6 women came and I did paps and breast exams on a little mattress in a makeshift clinic room. I use my headlamp as an exam light and am not sure that I will ever give up this routine even when I return to the US. It really works well.

The very next day, Anita and I traveled the CNC to KM 12 to visit 2 small communities today: Nueva Juanjui and Libertad de Pasa Raya. Neither town has electricity or running water and both towns are lush and beautiful, inundated with palm and platano crops. Juanjui doesn’t have a town center and appears to be a few houses each hidden amidst its owner’s crops. It often took us awhile just to locate a house, let alone the time it took us to locate the owner’s of the house. Luckily, as I have mentioned, Anita knows ALL!!!!! And I have learned the special call we use to alert people in the jungle that we are looking for them. It’s a little like a cross between a monkey and a bird call. You can see Anita doing the call in a photo on flicker. You have to form your lips into a trumpet horn. I LOVE it!

I did a well woman exam with a woman who raises cows with her husband in Juanjui. Their land and home is beautiful and they live there with their 3 children. They met and fell in love in their home town of Iquitos, but because land is so expensive there they decided to leave their families behind and start their own life together in Ucayali. They are younger than me and have built a beautiful life for themselves here.

Home visits are one of my favorite activities because I get an insiders view into the life of an Amazon jungle mama. You all have read about the small farm chacras that we visit. They are BEAUTIFUL and often tucked away and surrounded by lush jungle and crops. Not only are the homes surrounding by lush beauty but they are constructed in an open home fashion. Imagine a wooden frame built about 2-3 feet off the ground in case the rivers grow (we are completely surrounded by rivers, small and large). Add a thatch roof on top and vua la. Most families build a few small frames in a cluster. One frame serves as the kitchen, another as the main living home, etc. The main living home most often consists of 2 stories. It has a tall ladder that takes you up up up closer to the thatch roof for slumber in the sky. Slumber in the sky in this jungle includes a blanket underneath your body, your dreams, and your loved ones nearby, nada mas.

I HAVE to tell you about “nada mas.” Here in la selva, the Spanish makes my head swoon starry starry night (one of my favorite songs) fashion. My new favorite sounds in this entire world are musica de la selva, sonidos de la selva, and selva Spanish. When I hear the music from this region, my body moves and my bottom begins to shake all by itself (Check out Juaneco, a group from this region)! When I hear the sounds of the selva, my muscles soften and my nerves crawl into their cave to sleep. And when I hear the Spanish of the selva my smile and my soul grow as quickly as the platano leaves after a long day of rain. OH HOW I LOVE THE SOUNDS! Selva Spanish is rustic and pointed, yet it smooths off the tongue. It’s a combination of indigenous languages with lots of hard “K” sounds and as many soft “ssshhhhh” sounds. In addition, in the carretera communities, everything gets the “-ito” end, particularly if one is impassioned, and most everything is a topic of passion to these beautiful and very passionate people. When discussing pain, women point to the pain and say “Todo todo todatito todito le duele, acaaaaa, aaaaaaKa, aca de todadito de mi curepito…” I get so caught up in the sounds of the hard “D” and lovely “-itos” that I forget to mind the importance of the signs and symptoms to which I am assessing and frequently have to ask for a repeat story. At first, I couldn’t understand a word of Selva Spanish. Now, I live for it AND understand it sometimes too. So, back to “nada mas.” “Nada mas” = “That’s all” or “no mas” = “nothing more” get added to most complete sentences. It’s SO beautiful to me, nada mas. Drop me off here, no mas. I miss and love you all, nada mas. It adds strength to what you are saying, but you have to say it with a certain tone, like you are shrugging your shoulders, obviously, nada mas.

I will say goodbye for now but hope you all are doing fabulously! Nada mas.

3.17.10 – Anamalitos

2010-04-04T16:19:00.000-07:00

Thank God I read Barbara Kingslover’s magnificent novel Prodigal Summer before I left for the jungle. One of the 3 protagonists, Deanna, lives in the mountains of Zubulon County in southern Appalachia and works as a ranger for the National Parks Service. She lives alone in a cabin deep in the woods. Among the thousands of other animals, birds, and insects that Deanna observes and articulately describes, she details the sounds and life of a snake that lives in her ceiling all summer. I, too, live with creatures in my ceiling, only mine are LOUD and incessantly playful at night. Murcielagos (bats). I don’t sleep so well sometimes.

I carry the last paragraph of Prodigal Summer with me in my journal “Solitude is a human presumption. Every quiet step is thunder to beetle life underfoot, a tug of impalpable thread on the web pulling mate to mate and predator to prey, a beginning or an end. Every choice is a world made new for the chosen.” Life in the jungle of Peru only exemplifies this beautiful quote. Unfortunately, I am often the prey in this world…

I have had Isangos twice now. Connie, my stepmom won the “What are Isangos???!!!???” competition. CHIGGERS! They love me. I have a Doctora de Isangos named Juanita. She is 15 years old with impeccable eyesight and she comes over to pick Isangos out of my bum cheeks and bra line once a week on average.

Anita, Luz, and I eat dinner in plastic chairs in our 3ft by 8ft kitchen and 1 or 2 little flies always seem to fall from the millions bouncing off the florescent light above. Luz looks up occasionally and says, “OHhhhh, these anamalitos.” I laugh and laugh and will forever and ever call insects little animalitos.

I have decided that I am officially a jungle woman now. My body is full of bites and even living anamalitos at times when there isn’t time to pick out the Isangos. No me importa. I really don’t mind. I eat, sleep, daydream, and work immersed in anamalitos and figure that if I make them my friends, I will live a longer life in the end.

3.13.10

2010-04-04T16:18:00.000-07:00

Anita is keeping me BUSY here and as we near the end of my first week I feel as though we have accomplished a month worth of work. We have visited 5 of the 13 remote communities that we serve, kicked off a well-woman exam extravaganza, and I conducted 2 education sessions to groups of women and men promoting women’s health, natural empowering birth, la casa de espera, and the pap extravaganza program. No births this week, but many due dates approaching quickly. Oh, as I am typing a beautiful brown horse just ran by the open clinic door, two pigs (chanchos) snorted outside (a grey one and a pink one that travel together frequently. They visit often), and the breeze is lovely. I am looking out at a gorgeous jungle full of green leaves and tall trees. I wish you all could be here!

3.11.10 - Smiles

2010-04-04T16:16:00.000-07:00

Birth stories abound here and I want to hear the details of each and every one of them!

Yesterday I gave a gestante, Dina, due 4/17/10, who lives in a very distant and difficult to access community called Nolberth, a tour of the casa de espera and encouraged her to come live in it close to her due date. She is unsure. All her babes have been delivered in her house. She attended one birth herself, alone. Her last babe was a fetal demise at 6 months. She went to hospital Yarinacocha for delivery and then later had retained placenta and endometritis. “Please come to the casa de espera!!!!,” we begged her. We discussed her increased risk for post partum hemorrhage as well. She fears delivery in our health post and in hospitals because “she has heard and seen how women are treated there.”

Another woman named Juana lives in San Martin, our closest community outside of Olivos about 7 Km away. We visited her in her home today after realizing that she hasn’t come to her prenatal visits for over 2 months. She was thrilled to see Anita and I and welcomed us. When we explained why we had come, she set a thick beautiful blanket onto the floor of the empty main living area in her thatch-roofed home and there, on the big blanket, we conducted her appt surrounded by her 2 hijitas (little girls) and their neighbor friends laughing and playing as they stared at the weird looking gringa girl! This will be Juanita’s 6^th babe. She has delivered 1 in her home and 4 in health posts. Her 5^th babe died at the age of 1 month. Anita tells me that he was born healthy at our health post, but developed what she calls Pemphigus because of the type of blisters that he had all over his body when he presented to the clinic. His parents didn’t bring him to be checked until he was very weak and sick. He had lost weight from diarrhea, etc. He was taken to Neshuya where he died the next day. Juanita says that she is excited to utilize the casa de espera and have her baby with Anita and I in Olivos. I look forward to working with her in only a week or so!

Naturally, in addition to birth stories, there are a mountain of stories of human suffering, women suffering. Chronic ailments abound and with very little “plata” (dinero, money), there is often very little hope for treatment. Today a young man, Franklin showed up at our little casita on his motobike at 630am. He brought news that his mom has chronic pelvic pain and wants us to come to their chacra to see her. Anita and I hopped on his bike and the 3 of us traveled the dirt roads to Santa Rosa de Guinea, about 10 Km from Olivos. There we met Octavia and her husband, Guillermo, and another son, Juan Carlos. Octavia has had chronic pelvic and low back pain for years. She has tried a series of natural remedies from her local curandera in addition to seeing specialists in Pucallpa. She has had 10 babes and I am sure she has a prolapsed uterus, perhaps among other things... I need to learn how to fit pessaries!!!! Franklin shows up at the health post roughly once a week so our visits to Octavia’s farm have become routine. I massage her belly (I wish I had learned Mayan Uterine Massage before I left the states too. I realize that I am closer to the origins of uterine massage here in the jungle, but I can’t find anyone that has heard of it. I believe it comes from… Belize?) and Anita gives her an analgesic injection. Their family is lovely. Her son Juan Carlos might be one of the happiest people I have ever met. He is in his 30s, an artist, and has traveled all over Peru selling his beautiful silver jewelry. He came back from his travels after 4 years to be with his sick mama. He smiles and laughs chronically (seriously) and when I asked him where his many brothers and sisters live and what they do, he smiled as he said, “Well, 5 of them are dead” (in spanish) and chuckled. I didn’t ask further because this family speaks REALLY fast Selva (jungle) Spanish and mostly speaks Quechua, so I don’t understand much, but I love visiting them all and soaking in the chronic smile of Juan Carlos and the sound of Octavia’s mix of Spanish and Quechua. I frequently run along the dirt road of the CNC and sometimes Juan Carlos passes me on his motorbike. I see his smile before I see the bright red bike J.

3.9.10 – Day 2

2010-04-04T16:15:00.000-07:00

As I have described in previous posts life here changes rapidly and most often I don’t have a clue.

Today I was learning the ropes here at the Monte de Los Olivos health post, observing an OB Intake (1^st prenatal appt), when one of those serious looking 4 wheelin’ USAID trucks pulled up. Out popped a super lively smiling man named Lucas Vargas. He works for another NGO named MSH, which is based in Boston, and came to deliver a health registry to one of the communities with which we work. Despite thinking we would be working in the clinic at Monte de Los Olivos all day, Anita and I quickly changed gears and packed up for a day in the jungle (Fetoscope, measuring tape, blood pressure cuff, etc). However, I had no idea what a day in the jungle really meant.

We loaded into the grey truck (padded on the inside with very thick rolls of foam and thank GOD or my head would be mush) and drove deep into the jungle. DEEEEEEEP into the jungle we went with our bodies bouncing, flinging, and flying back and forth in the backseat. WOW is this jungle beautiful. WOW I totally understand why pregnant mothers prefer to stay home and deliver their babies. The road is ugly and I felt like my insides were going to fall out from the bouncing. Imagine if your baby was part of your insides! Uggghh.

Cadena Tropical is one of the farthest communities that we serve located 25 Km deep into the jungle. Cadena translates to “chain” or “network” and as the first settlers of this beautiful community arrived (completely exhausted) to the land in which they would settle, they couldn’t help but notice the chain of “up and down and up and back down again” of the hills through which they traveled in their new lush forest. For this reason they gave their community the name Cadena and added the self explanatory “Tropical..” In this very small community of about 31 familes (110 people) we encountered one small house. No one was home. After exploring a bit further, we found a path descending one of the cadenas of hills and down we went. On our way, we met a man carrying large blocks of wood tied to his back and supported by the strength of his forehead. Woooooooh! Exporting wood is one of the few ways that this community survives. They also grow platano, yucca, and rice.

Though we were accompanying Lucas on his mission, Anita and I had a mission of our own. We were looking for Gestantes that haven’t come for their regular appointments or are newly pregnant. When we find them, we conduct home OB appointments, educate, and promote the casa de espera. What FUN!!!!! I love my jungle career!

On our way back from Cadena Tropical we passed through Virgin de Carmen where another gestante lives. She is about 32 weeks pregnant and has not come for a prenatal visit in Monte de Los Olivos. We found her working hard in her open-to-air home, washing the clothes by hand, doing dishes, and preparing food for the day. She and her husband own a palm farm and raise chickens. After preparing a delicious papaya juice for us, she sat down to visit. We discovered that she had already begun her prenatal care in Neshuya (the closest town with 24 hour emergency service) and has had 2 visits during her pregnancy. She didn’t know about the casa de espera. Because she lives so far away her and her husband rent a small apartment in Neshuya in which they plan to live close to her due date. She said that she would consider stopping by our health post before heading to Neshuya if she is in labor. She did not have interest in staying at the casa de espera because she has already committed to renting the apartment in Neshuya. Oooooooh this made my stomach sink.

Anita and I immediately began brainstorming ideas to get the word out to women that we have a free casa de espera to use!

3.8.10 – Magnificent Mujeres

2010-04-04T16:13:00.000-07:00

For every magical small man angel that abounds exists a beautiful woman angel who created him.

How beautiful that I start my work for women on this International Day honoring… WOMEN! My life continues to be full of beautiful, strong, creative, and brilliant women that never cease to inspire me. You know you all are one of them!

Anita is one of them as well. She works and works and works and her batteries appear to never run out. Her amor, Jose, and family live in Pucallpa, yet she lives full-time in Monte de Los Olivos. Monday through Saturday she works around the clock and returns late on Saturday to spend the evening and 1 full Sunday with the loves of her life. That one Sunday is full of laundry, cooking, cleaning, and preparing for the next week in Los Olivos. Peruvian career culture is serious! Normal hours are Monday through Saturday. Who came up with that silly idea? Saturday??!!???? I am not a fan of the Saturday workday. Granted, I’m a Midwife, so normally I don’t pay much attention to the days of the week, but as visiting Midwife to Monte de Los Olivos it’s impossible not to notice. Imagine being one nurse and one Midwife in a small town of 70 families in addition to serving 13 other small towns that aren’t that much smaller. I’m learning a lot about public health and family medicine. In addition, a family size here is not the family size that we are accustomed to in the US. Families are BIG here and include Gmas, Gpas, sisters and brothers each with their own children, etc. Wooooooooh. In addition, Anita has done this work for 15 years, working either for small native river communities or carretera communities like Monte de Los Olivos. She has been a nurse for 18 years. She tells a good story and I LOVE hearing her stories about birth. She once delivered a breach baby in a river. WOW!!! She is often the only trained medical professional for miles and miles and miles of jungle.

So, as Anita works, I work. Hard.

Anita and I arose in Pucallpa at 0430am, caught a motocar to the central bus station, and hopped on a bus to the jungle at 0530am. This is my new Monday morning routine. The Pucallpa bus “station” is a very small garage where taxicabs vie for your attention and where 1 bus sits waiting to take off. Waiting is the proverbial verb when the bus is concerned J, hence the existence of the taxi cab drivers who stuff 2 passengers into the front seat, 4-5 into the backseat, and 1 or more in the hatchback trunk if possible (we frequently take the taxicabs home from Olivos). We got to the bus station early enough to claim our very own seat which actually makes waiting fun at 6am (sleeeeeeep). The bus involves 2 smooth operators: 1 to do the actual driving and 1 to do the co-piloting. Co-piloting involves 2 things: 1. LOTS of mouth honking and 2. Lots of life risking. I described the motocross track style of this city previously… There are no rules in Pucallpa and there are ESPECIALLY no rules on the highway just outside of Pucallpa. It’s a big huge playground full of moto heaven and the bus is not to be excluded. Cesar is ALWAYS our co-pilot. He has poofy, yet aerodynamic dark hair that appears to be permanently windblown back, helmet style. Like the chicken and the egg, I’m not sure which came first, his hair-do or his job! He hangs out of the door that lies in the middle of the tall bus and calls out or hand signals to potential passengers standing on the side of the road. He is responsible for when the bus stops and when the bus goes and his remote control is his mouth. I LOVE the way he mouth honks. Seriously. He says “YAaaaaaaaaaayva!” (Lleva) to carry on and “BaaaaaaaaaHaaaaa!” to drop a patient off (Baja = down). I have sort of fallen in love with the mouth honking here. It has cadence, a little bit of rhythm, a 2 toned jingle, a life of it’s own that comes alive outside of the person’s mouth that creates it. Who knew I could love mouth honking so much. I even tried it myself the other day. It’s really fun.

The bus drops us off in a small dusty town called Neshuya and from there we take a motocar 7 km north up a VERY bumpy dirt road called Caratera Neshuya Curimana (CNC) because it lies between Neshuya and Curimana. Though traveling from Neshuya to Olivos gives me a headache as my brain knocks up against my skull, it’s also a beautiful journey. The Amazon is just beginning in this part of the jungle and the land is flat. This creates perfect terrain for growing crops and most families own a small farm called a chacra. They mostly grow palm and platano, though there are some sugar cane, maize, arroz (rice), and chocolate J crops as well. The palm is harvested for its oil and used for cooking. Traveling the small road to my new house means being immersed in the beauty of the crops of palm and platano while soaking in the beautiful view of the wilder jungle in the distance. Anita tells me that only 20 years ago this jungle was full of Coca Cocaine crops. Imagine! So much change in a short period of time.

We arrived at Km 7 of the CNC, Monte de Los Olivos and stood in front of the door to my new little house around 8am. AND, guess what!?! Man Angel #1’s (Jose Antonio) mom, Luz, greeted us with a freshly prepared breakfast (EGGS, my favorite). This is only one example of the truth that for every man angel there exists a super star woman angel who created him. WOW do I love Jose Antonio’s mother. She whistles and sings beautiful Peruvian songs every morning. She cooks yummy Peruvian food. She fries platanos. MMMmmmm. She laughs out loud when I say something that I mean to be funny (which can be hard to pull off in my new language). She takes care of Anita and I and I won’t ever be able to express to her how much I appreciate what she does for us. And to think, I loaded up with top ramen Peru style noodles and peanut butter thinking I would be roughing it.

Anita and I got right to work after enjoying our breakfast. We walk up a tiny hill to the health post where patients are often ready and waiting. We attended patient’s all morning and as soon as the clock struck one we descended to our house to enjoy freshly killed and freshly cooked cow. Climbed up our little hill after lunch and attended more patients in the afternoon. Descended in the eve for more fresh animal goodness. And that is how my first day went, up the hill and back down again soaking in the beauty of my new life in the country jungle.

3.6.10 – Rockin’ Women

2010-04-04T16:12:00.000-07:00

Spent the last week of my work in Pucallpa training with INMED. INMED Pucallpa consists of 4 women (all from Peru) who run the show. They implement and often also develop training sessions for both patients and community volunteers throughout Pucallpa and Yarincocha. The group sessions focus on keeping mothers and babies safe, family planning, utilizing local health posts, risks during pregnancy and birth, breastfeeding, etc. These 4 INMED women travel all over town by motocar carrying their materials, laptops, and yummy treats for the community volunteer sessions. When you think of Pucallpa, you can’t think of a city like we have in the United States. You have to think wilder, smaller, WILDER, dirt roadier, and WILDER! This frontier city is a really large version of a motocross track or bumper cars gone WILD and the drivers fit the picture. It’s a live video game! I mention this to exemplify how super cool INMED women are as they bump and grind via motocar to their dusty destinations to get the empowering woman word out. Rock stars they are.

3/3/10 Small Man Angels Abound

2010-03-07T15:32:00.000-08:00

This is the most recent post so don't start here. Start under March postings and read from the post at the bottom of the page up...

See photos at http://www.flickr.com/photos/48184061@N02/

When I arrived in Pucallpa I knew that man angels existed and I have been so lucky to have a few long term ones in my life already. My 2 dads are serious man angels and my friend Dan make 3 man angels that I love dearly. However, I could never have known that man angels would be sent my way so frequently here in Peru! Small man angels abound.

Small Man Angel #1- Jose Antonio, Anita’s husband who doesn’t cease to sense when I feel crappy. He just knows and then he comes and finds me to help. Also, when he heard I love peanut butter, he went to the only store in Pucallpa that sells it. Their selection includes: Jiffy creamy, Jiffy crunchy, Skippy, and Peter Pan. He asked the store worker which peanut butter was the tastiest and brought me home Peter Pan Honey Roast Creamy, an excellent recommendation from the only grocery store in town!

Small Man Angel #2 – Raul - Ruli, friend of Ana Luz. We met at the dinner table of Anita’s house. We were chatting when I proceeded to vomit voraciously in the backyard. Small Man angel #2 watched me vomit after having just met me and has proceeded to call me every single day to check in on me. He is a nurse and I guess vomiting women don't bother him so much.

Small Man angel #3 – Daniel, dance instructor and smallest of all the small man angels, though very big in spirit and moves his butt like no man angel I have ever met. You saw pictures of him in my Porn Peru posting. He introduced me to La Saya. The first night Janneth and I went out with him he introduced us to all his dancing friends. The women were in their traditional dance costumes, which includes an enormous amount of eye glitter. Don’t be shocked everyone, but I LOVE eye glitter. When I complimented the dancers' eyes, man angel #3 took a sample of their eye shadow directly from their eyes and brushed it on my wrist. It was such a lovely moment. His glitter gesture gave me the man angel idea, so in a way, man angel #3, Daniel, created the concept of man angels in my mind. WOW! Or as they say here, !Pucha!

Small Man Angel #4 – Jorge, friend of my neighbor David who helps me with my Spanish sometimes. Jorge is from Iquitios but has spent his life learning English from tourists with whom he has worked throughout Peru. Jorge and I met in passing and passing one another on the street has become our theme. Not a day goes by that I don’t see Jorge randomly! The first day I met him, we ran into one another later in the day and enjoyed dinner together. The next day, I was having a rough day, left work hurriedly with thick tears in my eyes and as I opened the big steel door to the office of INMED, there he was, small man angel #4, walking to his basketball training session at a park nearby. He is a group leader for boys basketball and other teen boy activities around town. His smile alone cheers me up.

Thank you Universe/Goddess/Love/God/Pucallpa/Peru for sending me so many lovely small man angels.

I will try to keep posts coming everyone. Thank you for reading! I leave for the jungle tomorrow and won't have communication access during the weeks. I will be back in the city every Saturday and Sunday

2/28/10 Last Day to Dump Water on Your Neighbors Head

2010-03-07T15:29:00.000-08:00

Today marked the closing of Carnival and left me with irreplaceable memories. Left Monte de Los Olivos at 5am and arrived in Pucallpa for breakfast. Enjoyed my typical peanut butter spread on a white bun chased with peach tea loaded with sugar. I LOVE peach tea. Slept the morning away and awoke to a barbeque a brewin’ in the courtyard of my house. YUM! Beef heart and chicken, yucca, potatoes, corn, and rice all grilled to perfection quickly filled my very happy belly. Though I still prefer not to know exactly what kind of meat I am eating, at the very least I am acclimating slightly and don’t want to vomit when I figure out it’s beef heart for lunch or duck lips for dinner J.

Every Sunday the mama of this casa invites me to “da la vuelta, no mas” and off we go. It’s like our 50s style Sunday drives only in Motocar. We load up the kids and moto around the city for an hour. The idea is to catch a break from the sometimes intolerable heat and enjoy the breeze that the speed of the motocar provides. I have learned to always say yes to any invitation as I never quite know what adventure is in store for me. However, today I actually felt pretty self-assured and coolio because this time I knew what we were off to do. Habits are forming, I´m getting the hang of things here, starting to have a clue you know. Well, as you can imagine, I didn’t have a clue. We stopped off at Ascela’s sister´s house and no sooner than exiting the motocar was I DRENCHED in the festivities of Carnival which include dousing friends and family members (or even anyone that walks by) with buckets of water. OK. I HATE being uncomfortable. I’ve never particularly enjoyed getting wet. I don’t like being messy. I meticulously dry my body after I get out of the shower. You get the idea. But I LOVED THIS DAY. Grandmas, Greatgrandmas, Dads, moms, sisters, brothers, and kids. We were ALL soaked and laughing and dousing and laughing and drinking beer of course, and dousing again and laughing. Most of the streets here are bumpy dirt roads so there was some mud bathing going on, some beer dousing, you name it. Motocars would pass and they would get doused too. It was hilarious. And then we began the dancing around the tree again which you all are already well-versed in. I cut down my second Carnival tree today. I really AM a deforester now.

Alas, cleaned up and went into town for my daily dose of my reincarnated grandmothers chocolate cake and here I am happy and clean in my bed ready for sleep.

Goodnight!

2/27/10 Beth the DeForester

2010-03-07T15:28:00.000-08:00

Today I gave my presentation at the hospital. It went great! I wish I could have recorded the faces of my audience as they looked at photos of many different birth positions. They were enthusiastic about the new information and various ways of birthing. However, they couldn't believe that 99% of our births occur in hospitals and only 1% in homes and birth centers. This is their current goal in Peru and they were astounded when I told them that many CNMs in the US are working to get normal low-risk birth OUT of the hospital where more risky interventions and infections can occur. I'm not sure what the statistic is in Ucayali, but Anita says that about 30% of births are in homes attended by family members or traditional birth attendants and the rest are institutional. My audience also couldn't believe that studies show that birth is as safe in homes and birth centers as long as their is a CNM attending. They LOVED my stories of the water births I have attended. Thank you to Joy and Geri for sending me GREAT photos and sample presentations. I used many of the photos and the powerpoints gave me great ideas.

After saying goodbye to my sweet Josefina doggy at the hospital and all my friends, I rushed back to the house to get ready for the anniversary celebration at Monte de Los Olivos. Janneth put a beautiful braid in my hair.

Arrived for the festivities and had no idea that I would be in the hot seat! I sat in one of the prime seats, on display with all the official head honchos of Ucayali. The governor gave a speech, then the mayor gave a speech, then another somebody made a speech, then Anita made a speech, and then… They passed the microphone to me!!! Oh! So, then I made a speech. I wonder what I said…

The community named me Godmother of the Casa de Espera. What an honor!

In addition to it being the 23rd anniversary of Monte de Los Olivos, it was also the last weekend of Carnival. Each year every community or neighborhood of Peru plants a tree to be decorated on the last Sunday of Feb Carnival and each year everyone dances around the tree at 6pm and takes turn cutting it down with an axe. The decorations include Tupperware plates, cups, sievs, candy, rice, and more. As the tree hits the ground, everyone runs to grab the decorations. It’s reminiscent of piñata parties when the candy hits the ground so do all the kids.

We danced the night away and by the time we wanted to go home, all the motocar drivers were too drunk to take us, so I spent my first night in my little jungle house.

Photos – My captive audience at the hospital. Presentation at hospital. Preparing for Olivos anniversary later that morning, Me with all the officials at Olivos, Tony Tan (Godfather and former governor of Ucayali) and I breaking the bottle of champagne to initiate the Casa de Espera, Anita and I, the decorated tree we cut down, me dancing with an axe in my hand…

2/26/10 La Saya – Peru Porn

2010-03-07T15:26:00.000-08:00

Daniel is my dance teacher at Erika’s spa, the gym where Janneth and I go for our bi-weekly dance aerobic classes. To start, Erika’s “Spa” is fascinating. Did you all know that I worked at Thrillseekers climbing gym on Broadway for years? I did. And if we can call that old x-rated theatre turned climbing gym a spa, then we can call Erika’s of Pucallpa a spa too. Or, if we can call any old hole-in-the-wall gym on Broadway a spa, then Erika’s is a match! Here in Pucallpa, Erika’s “eSpa” is high class and I feel at home. Thrillseekers was a second home to me in college so it’s perfect that I have found another Thrillseekers right here in my new home. Our dance class costs $1.30. No membership required.

Daniel, my dance teacher is a rock star. He runs into class with his dance shoes, socks pulled half-way up to his knees, and his short and red and TIGHT work-out shorts with the white stripes down the side. He’s about 4’10” maybe. I love him and hope that one day I can shake my booty the way he can.

After my last dance class with Daniel (see photos of my BIG white person self in class) he invited Janneth and I to a dance practice at his friend’s house. Last week we met all his dancing friends at the kick-off dance competition for a traditional sierra dance called La Saya. His friend’s group is called Sensación and they really are a sensation! The dance is beautiful and lively. They practice 7 days a week for 3-5 hours every night. One of their mom´s cleared out her backyard and that is where they choreograph barefoot under the moon. This particular night, after they finished practice, a few of them stayed to teach me a few steps. You can see exactly how the night progressed. "Porn Peru" I call it as I started the evening with all of my clothes on and ended the evening with my undies showing under my traditional Saya dress. WOAH!

2/24/10 - Fumigation at hospital. Last La Guardia. 4 babies.

2010-03-07T15:21:00.000-08:00

I have been well for days, tum-a-tum happy and now I can officially share a secret with you all. I have kept the secret for way too long in Beth time. It’s sort of two secrets wrapped up into one. Ready?

My grandma, Signe, has been reincarnated and works in the kitchen of our largest heladeria here in Pucallpa named Ces’t Si Bon. Seriously!

I have discovered one of the most amazing, delicious, soft, perfect, delightful, rich but not too rich, heavenly Torta de Chocolate (cakes) EVER and I sneak into town and eat it every single day at least once. My grandma is the only person that has ever made a chocolate cake that makes me crazy and this one comes darn close to the goodness she created. Grandma is surely here with me. It’s so like her to set up shop in a famous sweet station and get to her boogy bakin’ ways. She was always a busy woman and I am so happy to have her here! See the picture of my Signe cake and I.

This is my last week at the hospital and I am SO relieved. I have learned a tremendous amount. In all hospitals I think, birth is so the same in some ways and yet so very different (here) as well. There is a lot of what I perceive to be abuse. I get a deep pit in my stomach, hollow and haunting, and I want to run away and take these mamas with me! I believe that in order to promote institutional birth, we need to examine how to change birth culture in hospitals all over the world to start. Women are scared and need support that they aren't often receiving. I hope that I created a little pocket of love for women and babes whenever I could. And perhaps in all the crazy newness that I suggested or exemplified, I planted a seed in the minds of my fellow Midwives and Interns. Certainly they have planted many seeds in mine and shared so much patience and kindness with me.

This week I had 2 night shifts. The first was a super slow night, but a woman came in for a C birth and I scrubbed in for a front row seat. See my photos. It was a beautifully conducted C section with my favorite Dr. Perez.

2 nights later, I spent my last and busiest night at the hospital attending 4 births and working with Alex the intern who attended the other 4. Paperwork is out of control here and though I have finally learned how to write all my notes in Spanish (history, physical, soap notes, etc) it still takes me a really long time. Ugggggh. But… I can write medical notes in Spanish!!!!! After explaining my work with INMED and my passion for empowering women in birth the Midwife working that night wanted to watch me do a vertical birth and had me convinced that the women I delivered could chose their birth positions. Unfortunately, when we discovered that each one was complete, the Midwife would tell me that there wasn’t time after all for a vertical birth. DARN IT!!!! One primip REALLY wanted to squat and the Midwife wouldn’t let her. I think there is so much fear around new positions here because they don’t see it often and have certainly never done it. They tell me that it’s done frequently in the mountains and in the jungle, but almost never in the hospital. She did let me pass a baby right to mom after birth and delay cutting the cord, which I thought was exciting after hanging babies upside down for a month. The one mom to whom I offered her baby right after birth didn´t want anything to do with it!!!! She was freaked out by the idea. DARN IT AGAIN!

Morning came and L and D was packed and nurses were bustling (ajetreo cintinuo – hustle and bustle). Nurses had moved the waiting benches outside and were shooing people out. Then came the beds complete with woman and babe – they wheeled them right on outside! I thought, “OH, very interesting, they just wheel the whole bed out when there isn’t room inside anymore.” It’s always fascinating to compare what my mind thinks is happening to what ACTUALLY happens in this Pucallpa world. Well, my intern friends grabbed my hand and led me outside with everyone else and it was then that I saw the smoke billowing from every hospital pore. And so…. What is your mind thinking?.... NOPE! Not a fire. Fumigation time!!!! It was 6am and the fumigators were doing there regular round of bug killing. That sealed the deal for me. I was OUTIE, OUT, CHAU (they spell it like this here “chau”), Goodbye, hasta luego, OUT. And I said goodbye as I held my breath and walked out of the big hospital gates. See pics of the fumigation!

Don’t worry, I returned the next day to give me BIG FINAL presentation…

2/21/10 Agua in Aguaytia

2010-03-07T12:16:00.001-08:00

Just returned from my trip with Janneth and Adrianne (her 9-year-old son) and we had a BLAST. Arose from the stiff as a board bed with an equally stiff as a board body this morning. We slowly got ourselves put together for the day, bathing suits to play in the river and a pair of dry clothes. I lathered up in sunscreen and off we went. Started our day in a breakfast café where a little cockroach popped out of the sugar bowl as Adrianne spooned crystals into what they call coffee here (looked like tea to me). Mmmmmmm. And I wonder what is causing my stomach cramps… Nonetheless, great breakfast cake that I was happy to feed my parasite friends hatching in my belly J. See the photo of our cockroach breakfast.

See pictures of our car trip to Aguaytia too - me and a LONG line of cars along the ONLY road to Lima, the capital of Peru. Work is always in progress on this road and many parts are dirt and more than bumpy. Beautiful jungle! Adrianne and Janneth in the car. In Peru, it’s SO not cool to smile for a picture. Keep that in mind. The wind was blowing in my shirt on the way there and my boobs were getting BIGGER every moment. How can I not share that with you all. See the photo! Next, the little town of Aguaytia. Our arrival! Evening phoosball championship.

Caught a cab to the falls and BOOOOOOM, down came the rain. The cab plopped us off in a tunnel just before the falls and promised us 2 things…

The rain would pass quickly.
He would return in 30 minutes to scoop our soaked bodies up and take us back to the hotel.

As you all have guessed, neither of those things came to pass but we didn’t know that yet so we geared up for a soaking in our complete and utter ignorance, laughing and splashing and having a great time. The falls were beautiful and the rain brought out all my favorite colors again, greens and browns and blues rich. Headed back to the refuge of the dark tunnel, changed into our dry clothes, goose bumps a-plenty, and waited eagerly for our guaranteed ride back to town. And we waited…

And waited…

And “Here he is!!!!!! That’s our car I’m sure!!!! YAY YAY YAY!!!!!!” Picked up our bags as the car slowed, honked, passengers stared at us as we realized that this was not our car nor was there space for us inside. Honk.

And so we waited…

And waited…

More cars came, honking trucks, honking busses. They all passed slowly, stopping, looking, galking, honking…

One truck with passengers even stopped, honked, rolled down the window, snapped a photo of us, and then went on it’s way… WHAT!!!!!!!

And so we waited some more…

We waited 2 hours. And we aren’t dumb. We started fishing for a ride after a half hour or so, but all vehicles were full or only wanted to gaze at our drenched and nearly naked bodies and/or snap a photo. See my fun photos! I think the yellow triangle sign in the waterfall photo says “Beth, CAREFUL!! You might die here today with your friends.” J

Finally, a BEAUTIFUL and lovely family in a motocar stopped to check on us genuinely concerned for our safety. At this point we had just started to walk through the very dark tunnel to the nearest town and were ecstatic, though worn out. The motocar was full in my mind, but one can apparently never underestimate the capacity of a motocar. Though motocars are seemingly made for 3 passengers and some fresh bananas in back, they are most often filled with 6-9 passengers, a banana TREE in the back and more cargo attached by rope to the sides J. Adrianne hopped in the cabby and Anita and I hopped on the back and stood on the trunk for the next few kilometers. WHO KNEW!!!! See photos again!

Arrived home safely only to discover that I was to be assistant to minor surgery on my favorite little hombrecito Valentino who had Isangos all over his genitals and nether region. Poor guy. Now, I have been warned about Isangos and I have heard the Isango horror stories. I have been informed that I too will experience the horror of Isangos soon. Nonetheless, this was my first true reality of the Isango saga. THEY SUCK!!!!!!!! I can’t figure out what they are in English. TRIVIA TIME people. Tiniest little red devils I’ve ever seen that burrow into your skin and cause a welt. They love genitals and underarms, including nipples! Great. And I am sure to have them. The cure is to pick them out of your skin or splash alcohol and then pick them out of your skin. They are about 0.5mm. (Today is 3/3/10 and I just figured out that these red devils are a type of mite (ácaro)).

Poor Valentino!!!

Must be off. Ascela’s husband died exactly one month ago and there is a mass for him tonight at the main Cathedral in Pucallpa. I am honored that the family has invited me. Jeans here have a different meaning than jeans in the US and you can wear them to work, to school, to bed, to a famous person´s house, to your sister´s wedding, to the farm, and to the mass of your friend’s deceased husband. So, that’s what I am wearing, jeans. Hotty jeans that I bought in Aguaytia because hotty is just what you wear here and my US jeans don’t fit me anymore. SPA PERU.

Beth

2/21/10 – Preparty Aguaytia

2010-03-07T09:54:00.000-08:00

Photos aren't posting everyone! I have spent the day troubleshooting and motocar-ing around to different internet places to no avail. Alas, See my flicker account to view the rest of the photos. Thanks! I will try to post more photos on my flicker account so keep looking!

http://www.flickr.com/photos/48184061@N02/

I am using this opportunity to post pre-party Aguaytia photos. We are waiting for our collective cab to pick us up for our rode trip to Aguaytia, a little hilly town in the jungle about 4 hours from Pucallpa. YAY! See pictures of Anita, Anita´s daughter (Ana Luz) in the purple dress, Anita´s half sister (Janneth), the son of Ana Luz (Arturo) and I laughing, and a few lovelies sitting at the dining room table for breakfast.

I’m not sure that I’ve explained my living situation fully. I sleep at the house across the street from Anita’s house with Ascela who you all have met previously, but I basically live at Anita’s house. Anita’s family cooks, so I pay them for my 3 meals a day. Anita lives in Monte de Los Olivos during the week and at her house in Pucallpa during the weekends. Her family of 6, as described above live in a tiny 2-bedroom house with concrete floors and a dining room that also functions as the kitchen. The only other room in the house is converted into an internet café. They live comfortably and happily and there is always room for more, like me. They all sleep together in a total of 3 beds, 2 doubles and 1 single. They have a small dog, 3 cats, and 1 brand new crippled baby grey kitty who was born to one of the 3 big cats. Her back legs are deformed and don’t function. She scoots around joyfully playing with her mom and my feet. Stray dogs come to visit when there is food cooking… there is always room for more. Other kids come to play in the small house… there is always room for more. Uncles, aunts, cousins, nephews, nieces, grandparents and friends are always visiting... there is always room for more! We all sit around the table that fills the kitchen-dining room and enjoy our time together. Despite the concrete floors, the wooden walls, the out-house for a bathroom, the small space, I am overwhelmed by the fact that in this house and in this country there is ALWAYS room for more. Love is without boundaries here and I am so grateful to be a part of this family.

2/20/10 - I swallowed an IUD

2010-03-06T10:51:00.000-08:00

OH MY!

I had an IUD once not too long ago and MAN did that thing cause some SERIOUS uterine cramps. I would be in the middle of conversation and one could see my eyes roll back in my head as I suffered the grip of my very own uterus. For this reason, I believe that I have swallowed an IUD. I’m seriously pretty sure. My tummy cramps just won’t quit. I am putting myself back on Cipro just to cut the waves. Any ideas, smart family and friends?

Spent the week doing mostly Paps and family planning clinics at the hospital. I think that’s where I swallowed the IUD!!!! Just joking…They don’t have IUDs here. Resource issue and I see one of the many future grants I will be writing. I need to start writing the emergency birth control grant for Pucallpa too. Abortion is illegal and we all know what that means. Add the lack of adoption services…

Spent a little time in Sala de Parto and delivered a few more beautiful little babes. Labor and Delivery continues to be difficult for me though. The suffering of women and the use of older OB practices are so challenging. Additionally, this is a yelling kind of culture. We all have our weird little things, and yelling is one of their “things.” They yell a lot - up the stairs to see if I am still sleeping, down the stairs, when you are standing nearby or far away, and sometimes even within whisper range.

Honking by ALL automobiles is favored here as well. Yep just heard a few honks as I type. You honk to tell people you are driving by, you honk when you pass one block and start another, you honk when you pass a random stranger, you just honk and then you honk some more for no apparent reason. So I think of the yelling as a form of honking only from your mouth. It makes the yelling a little cuter. Mouth honking.

Still, mouth honking in labor and birth just isn’t my style and I struggle with it. Also, I have repaired too many unnecessary episiotomies, had too many mama’s on their backs pushing… and could go on and on about what I have experienced. I have asked the Midwifery director if I can give a presentation about Birth in the US, similarities and differences, and plan to highlight Midwifery practice, vertical birth, water birth, mom-baby bonding immediately after birth, waiting to cut cord, and why we don’t cut epis anymore. I have been discussing the differences in practice with the Midwives and Interns here since I arrived and everyone is excited for my presentation. I will let you know how it goes!

Also, I don’t think I have mentioned that women at this hospital don’t have the option to have an epidural. Resources are too slim. For this reason, it’s an IDEAL place for vertical birth. On a different note and just for those of you who are curious, there is only 1 NST machine and it might be the first one EVER made ;). Monitoring babe doesn’t happen much, even with Pit practically free flowing. We just got a shipment of hand-held dopplers and they are considered golden, almost untouchable. We mostly use the cone and our stethoscopes still (which I have finally mastered). Imagine, remove the Pit from within arms reach and natural beautiful birth could really happen here. We’ve already got great music playing constantly – salsa, cumbia, latin rock… Add more baby listening, more education, some massage, a little less mouth honking, disassemble those scary birth tables and magic could happen!

Despite the challenges, I LOVE the people with whom I work. Here are more photos of all of my hospital friends. Also see photo of the room and the table on which women deliver. The woman in purple, Christina, is a Midwife who worked in the communities of the Andes and has lots of experience with vertical birth, not cutting epis, etc. She’s helping me with my presentation. She’s lovely.

2/17/10 - MotoButt

2010-03-06T10:19:00.000-08:00

Beth’s Motorcycle Diaries Part 1

I have officially fallen in love with zipping around Pucallpa and Yarinacocha on the back of a motorcycle. That sentence completes my motorcycle diaries, but I thought I would share nonetheless as the ride has become my refuge, relaxation, sunset soaking time, and full body massage.

Beth’s Motorcycle Diaries Part 2

Yesterday Jose Antonio and I went to Monte de Los Olivos via motorcycle. The first part of the trip was AMAZING. Clouds made the jungle colors pop out in deep greens and browns. Then I realized that my butt sure did hurt after the hour on the highway and half hour of four wheeling on a two-wheeler. Still, I LOVE the moto life I lead here.

Anita had a USAID (NonGovernmentalOrganization, NGO) assessment on Wed so Jose and I went to document the occasion and support her amazing and successful efforts to improve the communities in the jungle. We left the house at 5am and arrived to Monte early. Helped Anita prepare and soon it was time for USAID to arrive. The whole community was waiting and had also been preparing. Apparently USAID comes once a year to interview large groups of community members (including kids). After the interviews, they go to individuals houses to do community health assessments – asking where the family keeps their trash, do they have a toilet area, how do they clean their water and cook their food, etc. It was a busy day full of activities and I was happy to get to know some of the USAID projects and people behind them. USAID has a HUGE presence all over Peru and like INMED-ANDES are doing amazing things.

See photos of Anita presenting, interview of mom’s at the casa de espera (the pink room), photo of a well-kept large garden outside a Olivos family’s home, a large but typical kitchen, and Anita and Jose resting in our little house in the jungle after a long day.

Moto Diaries Part 3

Jose and I hopped back on the bike. My butt hurt even worse on the way home and is in a physical therapy program now called Beth's MotoButt. 1-2-3 MotoButt!

2/15/10 – Madrina = Godmother

2010-03-06T10:02:00.000-08:00

And I am officially one now! First time Proud Auntie in December and first time proud Godmother in Feb.

Thought I was headed for a Sunday of rest after a long night of shaking my booty this way and that way when I received an early morning call from Janneth (Anita’s sister who shook her booty with me all night). “Get dressed and get your worn out self over to Anita’s house to attend a birth in Monte de Los Olivos!” I got dressed and rushed over to Anita’s house to find Mercith, a term pregnant lovely resident of Los Olivos who had come to Pucallpa with her husband in their family’s run-down taxicab because… Well, I realize now that I have no idea why they came down to the city. There could be lots of reasons… Anyway, I assessed her with another Midwife friend and we diagnosed her with pregnancy induced hypertension (at the least) and late term, and accompanied her to Yarinacocha hospital. There, she was induced and I returned to the hospital later that evening to labor support her and deliver her sweet little baby girl, Francis, on Saint Valentines Day.

Francis was diagnosed with Down’s Syndrome the following day and the day after that the diagnosis was revoked, but they spent a few days in the hospital observing baby Francis. Moms that have recovered but stay with their babes in the hospital after 24 hours sleep on the hard floor in a room together. So, Mercith was recovering from Pre-eclampsia, pregnancy and delivery and sleeping on the floor with only a sheet under her for 2 days before she got to take the very bumpy ride home to Los Olivos. Imagine! I can’t.

See pictures of Mercith, baby Francis and I in the hospital on a bed before her 24 hours was up (that’s a thermometer in Mercith’s mouth not a cigarette). Baby Francis with the dress her Godmother brought her and then 2 weeks later at a party in Monte de Los Olivos. You can see the whole family from left to right, big sister of baby Franicis (Brisset), dad to Francis and Brisset (Manuel), Mercith and babe, and Mercith’s mom. They are looking healthy and happy after a stressful few days in the hospital!

My name in Monte de Los Olivos is Elicha. That’s the native way of making a name cute and lovey. Take off the end of the name and add –cha to women and –uco to men. “yooooco’ is the man pronunciation, like yucca only with an o at the end.

2/8/10 ER Episode #1 and hopefully the #1 and only

2010-03-05T11:07:00.000-08:00

Finally HELLO again Colorado!!!!

I am going to attempt to catch you all up. So much has happened and I hope I can remember the good stuff.

Sick again in early February and I’m fairly sure I didn’t eat for a full week. Uggggh. SPA BETH PERU as my sister calls it! I’m tan and on an unintentional weight loss program J. Broke out in a wicked rash all over my body that everyone in Peru calls “INTOXICADO” so I got to be the INTOXICADO lady for a week in addition to everyone laughing hysterically that I was from Colorado and the color “Colorado” too. It was a rough start but a funny one! (I’m sure the rash was from the Bactrim, no more Bactrim thank you). See the photo of my room (and the windy stairs that lead to my room) where I spent my days moaning and where live now.

Finally decided to hit the ER but ONLY to request a 3-day parasite lab test. They weren’t into just giving me my parasite jars, so I had to go thru the whole workup. Darn you medical professionals. I refused the IV and the lab draw considering the state of my immune system and the lack of hand washing that happens here. After a quick 30-minute exam and conversation I had procured my parasite samples, HAH! Sweet! I asked the very kind doctor if I could pay for the services and he showed me to the bathroom J. That’s how good my Spanish is getting people. I know you’re jealous now!!!!!

Discovered that I had some kind of amoeba, but had already started cipro and was recuperating rapidly. Apparently that’s all I needed. YAY Cipro!!!!! Boo or better yet Poooooo Bactrim ;)

In the few hours of health that I was granted, Ascela took me to see the “lanchas” that ship out daily taking people and papayas to Iquitos (a beautiful jungle town in northern Peru that I hope to see one day soon, the trip is 3-5 days by river and apparently breathtakingly beautiful). See photo of Ascela and I. Vale came along too. Also see my pretty nails that Janneth fixes up for me every few days.

Loving you all!!!!

Blessings in Disguise - Week 3 Pucallpa

2010-02-05T11:03:00.000-08:00

Pictures to come as internet slow again...

There are truly too many blessings in disguise to count at this point. The best one yet though came in the form of vomiting my brains out. Those pesky brains get in the way sometimes. I was super sick with travelers GI hell, moaning to myself in my prison cell of a dorm room at the hospital when Anita called to check in on me. She said that her husband kept pestering her to call, she didn’t want to bother me, but he insisted. THANK YOU Jose Antonio Banderas (his name is really just Jose Antonio, but I remember his name better when I put Banderas there and Anita did it first:) husband of Anita!!! She came immediately to the hospital and snatched me up. I packed a bag to stay at her neighbor’s house for the night and decided I never wanted to leave (for my short time in Pucallpa anyway).

I had NO IDEA how isolated I was in that room at the hospital. I think the white walls themselves were giving me panic attacks, and the noise that came from discotecas below was enough to start my very own club. Earplugs barely cut the BULLA (that’s the Peruvian word for SICK ASS NOISE/loud music). It’s perfect. You say it with a BIG BIG BIG BOOOO like we might say BOOOOOM. I ended up having my choice of 2 neighbors houses in which to stay and chose the one directly across from Anita’s house. The mama of the house, Ascela, just lost her husband to cancer 2 weeks ago. He was diagnosed suddenly in Sept 2009. She doesn’t want to sleep alone after having his companionship for most of her life, so we share a room. We turn the lights out and “pillow talk” before falling asleep. I think it’s good for both of us.

Despite the dusty streets, loud motocar engines, incessant honking, buggy insects vying for a piece of my skin every second, and the hottest and most humid climate I’ve ever experienced, it’s still easy to find the magic in this city. Glimpses of deep green dragonflies that flicker through my life for a moment, the hugest turtle I’ve ever seen crawling in my backyard as it rained all day yesterday, a monkey that comes to eat breakfast with me at a café I like in the city, new friends at Anita’s house that paint my nails with glitter and butterflies, the breeze that really isn’t cool at all but feels like it might give me a moments rest from the heat, and the sound of the pouring rain on the tin roof. (Spot the turtle in my backyard in one photo and new friend, Anita's sister, Janneth and I in another).

I have new kid friends to play with at the house where I stay and the 1 year old walked for his first time 3 days ago as I played with him in the courtyard. The whole family was there. We cheered and cheered and baby Luciano felt like pretty hot stuff. Now every time he stands up he looks around to make sure someone is watching him, then he whizzes off into his step by wobbly step of a performance. Wheeeeeee! The older little guy is 5, Valentino, (see photo) and him and I share playdough time. “Plastelina” is the word I think he uses for playdough and it’s nice to have a friend that I can speak kid with. A nice break from the Spanish.

Haven’t spent much time at the hospital as I was sick not just once, but twice this week for about 24 hours each. Still recovering from yesterday’s bout and considering the idea that maybe I have picked up parasites. Gross.

The time I did spend at the hospital was filled with learning though. Took a break from Sala de Partos (Labor and Delivery) and did a rotation through the clinic. Did lots of pelvic exams, spec exams, ob intakes, ob revisits, etc. Witnessed twins (both cephalic) delivered vaginally one morning and could have delivered them myself if I had worked the night sihft L. Would have LOVED that! See pictures of the Midwife Intern that did attend that birth and the beautiful mama and her babes. Mama’s father came to help her in the hospital and when I saw him I said exuberantly, “CONGRATULATIONS!” and he looked at me sadly and sincerely and said “Why? Where will we put these babies? We have no money.” He explained that the father of the babes is not in the picture, his wife left the family years ago, and he doesn’t work. He inquired about adoption and the Midwives say there are absolutely no options here…

Found the birthing balls this week. Who knew that there were birthing balls!!!! Got a laboring mom on one and did some good old fashioned labor sitting/massage the way my spectacular mentor midwives taught me and had all the interns in the room with me watching and sitting with their patients. I hadn’t seen that before!!!! YAY for more love to the mamas! Also found out that I will be doing mostly vertical births in the small communities and at the birthing house (partos vertical is what they call mama’s birthing the way they were meant to, versus partos horizontal).

Started taking an aerobics dance class with Anita’s sister. This is the class that I called a salsa dance class in one of my earlier posts. It’s NOT a salsa class. Darn it. I seriously hated it. I’m a big white girl giant in the class that can’t shake her booty and am literally lost at every turn. Nonetheless, I’ll keep going in hopes of catching on sooner than later. I’ve dropped 10 pounds since I’ve been here as I usually do when I embark on my adventures. With this routine of illness, more might be to come. I feel so weak. Hoping that my stomach finds peace soon, but not holding my breath.

Zipped around the city with Anita’s husband today on his motorbike trying to find one, just ONE, that’s all, one map of this city. Finally!!!!!! We found one, but we had to go to a few different official government places to find it. Everyone tells me that there realllllly realllllly realllly are NOT Spanish or dancing classes here and I guess I just have to get used to the idea. I don’t think there are enough tourists to support it, so I understand, but am bummed. Anita’s family is teaching me lots though.

I’m eating fresh papaya and banana right now and drinking yet another jungle fruit juice drink that I can’t identify but LOVE!!!! I’ve never had so much juice in my life. The good news is that I’m eating today!

Miss you all!

Beth

La Guardia (Night shift) # 1

2010-01-29T14:24:00.000-08:00

I’ve delivered four babes here now and am technically getting accustomed to hanging the baby upside down after delivering, but don’t think I will emotionally acclimate. Though baby hanging is seemingly set in stone at this point, other practices might not be so firm. I was thrilled last night that I almost convinced the team to help mama get into hands and knees for an occiput posterior baby. They were really thinking about it!!!! I thought we were about to do it, and then the mama pushed so hard and out came her sunny side up, facing directly up, BIG for Peru, baby.

My second baby catch was beautiful and everyone applauded me for doing it their way. The mother of that mama came back to the unit during the afternoon of the next day and gave me a huge bag of fruit. Wow did that feel so nice. See photo of mama and her 2kg baby! I shared the bag of fruit with everyone. Here, everyone shares everything. It’s beautiful.

On another note, I can officially say that I have slept with an intern now. I’m not sure that was a goal exactly, in fact, I’m sure it wasn’t !!! but… See pictures of my best friend on the L and D unit who helps me with millions of things. We haven’t been super busy on the unit, so we found a bed to lay down in. Everyone sleeps together in the few beds on the unit when it’s slow. I actually slept for a minute despite the two of us beinig squished into a tiny single bed! Also see photo of one of the Midwives who is so kind to me. They wear purple scrubs.

Though I don’t have fleas, thank the lordee, I did discover ants all over my bed. Ick! They are tiny and all over the place here. I am desperately trying to be ok with sharing my bed with them and making them my friends, but am having a hard time. (see photo of my bed and my bathroom that I have made all my own). I have never been a bug killer, but have had to make some tough choices here... Look what I’m becoming! Killing bugs and hanging babes upside down...

I still feel short of breath when I think of home. I have realized that these are mini panic attacks that I experience anytime I’m alone and without distractions. They are REALLY hard. Sleep deprivation isn’t helping and I had my second major breakdown.

Came into the city to call family and friends in the US. Call and Cry I call it. Like Shake and Bake, only different. Hee heeeeeee.

Came up with a plan and am busy implementing it today. Decided that one thing I need is to not work 18 hour shifts twice a week. That’s hard in the US where I have a support network and get great sleep during the day, let alone when I’m trying to learn a new language, culture, make friends, live in a room where the water comes out brown, sleep with ants,… All that stuff. I had a friend come check out my ants and she said it’s totally normal here. Vivimos en la tierra, Elizabeth! We live in the earth!

As I went to talk to the director of Midwifery today to tell him my plight, the one and only psychologist at the hospital called my name, and called my name again and again, until I realized he was calling to me! How apropos!!!! He must be goooooood at his job. I confided in him and he was so supportive and lovely. He opened his door to me and said that anything I told him would be in confidence. What a good psychologist/therapist man. This gave me more courage to talk to the director, who also completely understood and informed me that they want to support me in whatever way they can. Of course, I could possibly be making up stories in translation again J. Either way, I like the way it all turned out and I will work less hours during the week now.

Really want to find some Spanish classes to take, but haven’t had any luck. Found some salsa classes and hope to start tonight. I need to dance!!!!!

Encountered my first english speaking looking person on the streets of Pucallpa after crying in a telephone booth during my Call and Cry session yesterday. I couldn’t help but approach him for some English conversation. He is from Australia and we talked for an hour before meeting up with his two friends from Spain. We ate a refreshing dinner together. They left for Spain today. Hope to have a few more encounters with English speakers soon!

I think about how great it would be to just come home ALL the time and every single day, over and over again, question whether I have the strength to do this.

We’ll see!!!!!

Love to you all,

Beth

PS, couldn’t help myself - took my dirty clothes to a lavandaria today. Thank GOD!

Does your Husband Travel? – Day 3 at Yarinacocha Hospital

2010-01-29T14:23:00.000-08:00

That’s right. It’s a very VERY important part of the medical history here. If your husband travels, your chart is marked with a POSITIVO in red pen. Negativo if he does not travel. What it means is that you have a much higher risk of STDs and it is their way of finding out about it. Sneaky and hilarious!!!

Today was a slow morning, but I work tonight from 7pm until 1 in the afternoon tomorrow so I will make it short. My schedule is a rotation of Manana, tarde, noche, manana, tarde, noche. That doesn’t sound so bad until you realize that EVERY day is a manana day. For example, I work every single morning Monday through Sunday from 7am to 1pm. In addition to that I work a rotation of 1pm to 7pm one day, next day 7pm to 7am, etc … So, Monday = 7am to 1pm. Tuesday = 7a-7p, Wed = 7am-1pm and then 7pm – 7am, Thurs 7am-1pm, Fri = 7am – 1pm, etc. I don’t know if I can do it and be so immersed in new culture and language…

I had a nice conversation with a midwife today who tells me that just like in the US, midwives here are trying to improve the conditions of birth for mamas. She says that there is a struggle between doctors, nurses and midwives around what positions women can and should deliver in, what happens with their baby immediately after birth, etc. She says that some midwives don’t hang the baby upside down to cut the cord, there are some that attempt to immediately pass baby to mom after delivery but they receive lots of resistance to this from nurses.

I can’t eat all the rice that the cafeteria gives me at each meal so my leftovers along with chicken bones go to the dog that lives on campus with us, Josephina or Roberta (she has two names), the mascot they call her. She gets really excited to see us.

The midwife interns are teaching me all the local slang. It’s reallllllly fun! And also really hard. I’m so exhausted just from attempting to understand and learn, let alone work so much. Woooooh!

Headed to sleep for a few hours if I can.

Found a place to wash my hands and see that some others wash their hands sometimes too!

Beth

Angels of the Night - Day 2 at Yarinacocha Hospital

2010-01-29T14:21:00.000-08:00

Here they say that the frogs that sing are angels of the night. I’m not sure why yet. I can guess and make lots of stuff up (which is basically what I do full time now). Though my Spanish is improving, I still only catch words in sentences and then I create stories around the words. It’s pretty fun! Pema says that life is like dreaming anyway and in order to stay unattached we must perceive this life like a cloud passing, or leaves falling, or foreign chic that doesn’t speak the language so well making up stories! I told my new Peruvian girlfriends about all the stories I make up daily and they laughed and laughed. I informed them that I probably understood 10-20% of what they tell me, but that each day the percentage is growing. It’s so nice to feel like this is all ok. Like I don’t have to know every detail. What a lesson in letting go. Of course I ask lots of what’s and where’s and how’s and huh’s but usually it’s just a lot of work to really get to the bottom of it all. Better to let it all soak in, in time. “Poco a poco” they say here.

Today we received 5 babies between 5 of us. We each got one and all supported one another. In Peru, the Midwives are about half and half men and women (or so it seems thus far). They deliver twins, preterm babes, normal pregnancies, complicated pregnancies, breech babes, etc. They deliver as though they have been doing this their whole lives, have each caught at least 200 babes already and are expected to attend at least 250 births before graduating. They study for 5 years intensely before having one year of a very intense internship. They are pros at catching babes in the hospital style to which they are accustomed and have swift and remarkable hand techniques.

Because they are so accustomed to one way of birth, I share the way we do things in the US with them, how we are attempting to transform birth in many ways, empowering with education, water births, various positions, etc and they are very receptive to the ideas, but…I’m not sure but what yet. More understanding to come. Nothing is ever really as it seems in life I am finally accepting.

One of our babies today was 27 weeks with gastrochisis born with its stomach and intestines hanging outside of his tiny little body. He is still living and doing well thus far. He was born to a baby mom of 14 years old. She pushed him out with such confusion and fear. He has been transferred to Lima for surgery. I send him love.

I sprayed the whole room with cord blood today and we all laughed and laughed. I am so used to waiting to cut the cord! Now I am learning to wash the blood out of my clothes by hand with the rusty water in my bathroom... A new friend showed me how they filter the water with a plastic bottle that has cotton stuck in the top of it. Hang it upside down with your shower head inserted, and Vua La!

I have decided that Peruvians are the nicest, most genuine and welcoming people on this planet. This hospital and everyone that works here have simply accepted me into their space as a fellow human being (and midwife) wanting to learn how they do things here and share how I have learned to do things in the US. They feed me and house me and train me for free, without question. They smile at me, call me beautiful all the time, grace me with patience, never seem to judge my mistakes as far as I can tell (I especially mess up the paperwork!). When they are laughing, I never feel like they are laughing maliciously. The interns aren’t upset that I am yet another person wanting to attend births (births that would be theirs if it weren’t for me). Walking this small hospital campus each day fills my spirit with a sense of love. Peruvians seem to love, simply. They take care of their homeless dogs, their neighbors, their friends, families, and me. And I feel so grateful for it.

No fleas in my bed!

More to come!

Beth

The Trembling Earth Beneath Me - Day 1 at Yarinacocha Hospital

2010-01-29T13:49:00.000-08:00

Spent the day with Fernando yesterday enjoying conversation, gourmet Peruvian food, and the Parque Natural of Pucallpa. It was a perfect day and just by spending the day with me, Fernando gave me the gift of feeling more at home here. Thank you Ferndando!

Today was my first day in the hospital. Threw on my cute new Obstetra outfit as I attempted to shake away the natural nerves of first days anywhere in the world. I was very kindly received by all and feel completely welcome.

Rain poured down as we received our first patient and little did I know how metaphorical the earth’s tears were. She was 12-13 weeks pregnant and began bleeding heavily this morning. We had to do a vacuum aspiration as the babe had died. Rain, rain, and more rain. Mom was anesthetized to physical pain, though it didn’t kick in so well for her, and I can’t begin to imagine the rest.

Our second patient came in at 4 cm dilated with her 3rd baby. I tried listening to babe’s heartbeat with that cone instrument (fetoscope :) for the first time and had no luck. They all laughed at me kindly and said it takes time. This mama was started on a Pitocin drip and with manual dilatation by a Midwife intern for the following 15 minutes delivered a healthy baby boy. They had me catch this baby and were confused (and a little panicked) when I somersaulted the baby out of its tighter nuchal cord instead of reducing it or cutting it at the perineum. They were REALLY confused when I tried to give the mom the baby right away instead of hanging it upside down by it's feet and clamping and cutting the cord immediately. Pitocin is standard practice to create faster labors. EVERY mama gets it (unless they are preterm). Very little fetal monitoring is done, even with the fetoscope and pit drip. Family members aren’t allowed into the delivery rooms and women lay on their backs on an exam table in stirrups. For first time mamas episiotimies are also standard practice. Handwashing is not done nor are there resources to wash hands if one so desired. There is no waste in this hospital. Everything used is re-usable and nothing is wasted. Babies are hung upside down (as I described above) just after they are born until the cord is clamped and cut and then passed directly to nurses. After being dried and warmed they go back to mom and stay in bed with moms until they are discharged 24 to 48 hours later. Breastfeeding is the only way here and I haven’t even laid eyes on a bottle of any kind. Good news for breast feeding!

Windows are numerous and ALWAYS open. The fresh air is SO nice. I LOVE that.

Gathered up all my things after work and loaded up a Motokar. Off to my new house. See the pictures of my incredible view of the jungle and lake Yarinacocha. The windows are in fact only screens and the frogs and dogs are singing loudly to me as I type.

As life in this new world whirls around me, the earth feels unsteady… and it literally is! We had a mini earthquake as I explored the streets near my new abode this evening. I was in a small street side shop asking about the neighborhood when the earth seriously rocked gently under my feet. “Tembloroso” everyone said as we exited the tienda to be sure not to be buried underneath it.

As I expected, here just as it is in the US and around the world, women are suffering in birth. We create the world in our wombs and then summon the strength to share it and yet we suffer so tremendously. Others telling us how we should do it, where to put our hands, our feet, our backs, our legs, stay still, just breath, relax, so many impertinent rules for our bodies, families and babes. When will we summon the forces to embrace our incredible strength, beauty and natural connection to the heart of life in order to follow our instincts in creation? And how can I be a part of helping this happen?

ON another note... I think I might have fleas in my new bed…

ALWAYS Take Note of a Man's Tshirt

2010-01-23T16:39:00.000-08:00

Today I awoke early (unfortunately) and started my day with another yummy excellent hotel breakfast. These are my last few days in the rockin' hotel in Pucallpa with air conditioning, big comfy beds, wireless, fridge, running water... so I am thoroughly luxuriating in these pleasures while I can. I thought that tonight would be my last night here but Fernando informed me that they payed for me to stay through Sunday night. YAY! Though i am looking forward to living on the hospital grounds, I also realize that life will be VERY different there.

Moto'd over to the central market to buy a man's work shirt to hide my burning skin (see my photo of the man's shop I bought it from, hee hee) and then off to lake Yarincocha, which connects to the river Ucayali and rented a boat for the day. My motokar man was lovely (or so I thought). His name is Joseph and I enjoyed talking to him. He says he's been a single dad since his babe was 1 and a half and that mama lives in Lima. His son is 10 years old now and Joseph is 35. He invited me over to have lunch with his whole family (mom, son, aunts, etc.) tomorrow. I thought I'd met my first friend outside of work. Later, as I downloaded my photos for the day, I took a closer look at him. Check out the T shirt on that boy! DUDE! Really? The picture is self explanatory and the words in Spanish say "Fast Food." I won't be having lunch with him tomorrow. Call me a judger, what can I say!

Nonetheless, I did arrive safely at Yarinacocha, so I thank him for that.

Met a true friend named Mario who motorboated me around Yarinacocha and to the first indigenous community in the Ucayali region, the Shipibos. Wonderful, colorful, kind people. See the boys that watched our boat while we went to check out the community. Also see the little Shipibo puppy and I. Mario has been tour guiding for 30 years and showed me LOTS of cool things in the jungle. We saw dolphins, chameleons, monkeys, anacondas (monkeys and anacondas in cages in small zoo for tourists, :( sad to say), and he introduced me to a yummy seed (see the pic). You eat the white fur off the seed, which tastes a little like banana, and then spit the green/red seed out. I ate a few seeds as he laughed at me before showing me that we are to spit the seeds out. Silly American in the jungle.

We ate dinner together on the river after a 4 hour journey to San Francisco (where the Shipibos live) and back. I had my first Cecina (dried, salted meat - maybe cow, maybe not) and fried plantains. Mario taught me about all the different meats that exist in the jungle and how yummy they are, but I am filled with new Spanish words and won't remember all that he revealed. I've got Cecina down now and that's about it.

Shipibo girls and one little guy sang a beautiful Shipibo song that I will try to download (download didn't work...). Shipibos are famous for their pottery and yet I saw no pottery. I bet we didn't go far enough into the community. I will have to ask Dan's mom Flora who has been to where I went today.

That's it for the day!

No breakdowns yet and getting ready for bed so I think I am in the clear. It was a wonderful day full of adventure and new people. Just what I love.

Loving you all too,

Beth

I'm Pregnant!

2010-01-22T12:55:00.000-08:00

Everything is different in the jungle and as it poured down rain I was suddenly 40 weeks pregnant and ready to pop!!!!! See my preggers photo. I'm telling you, things grow rapidly here.

Fernando, Kati, Anita and I laughed and laughed today after I put my rain coat on over my purse and decided that I would be the first mama to deliver at Monte de Los Olivos. Anita will attend my birth. JaJaJaJaJa. I delivered rapidly and am back in the city. No pains! That place is magical. Now ALL the mamas will come from everywhere.

Today was SUCH a better day. Thanks for sending all the love.

Arose early again to clouds and impending rain, had breakfast on the roof terrace with Fernando, and motored over to pick up Kati. We set out for the jungle and wow was it a beautiful drive. Finally I could breath.

Met my newest friend Anita who works for Centro de Salud at Monte de Los Olivos and her and I will travel to all the small communidades together starting in March. I love her! She is smart and kind AND I understand her Spanish.

Also visited my casita (which you all have seen in the evite photo) and will LOVE living and working there after I finish at the hospital. On the weekends, I will live with a family here in Pucallpa if I chose to come back to the city. I might never come back to the city ;). I attached a picture of the beautiful Monte de Los Olivos school house, one of Anita, Kati, and I waiting for a taxi to take us back to Pucallpa (Anita is on my left, Kati on my right), one of our Monte de Los Olivos meeting where we made very important decisions today, and one of all of us drinking fresh juice on the side of the road. One of my favorite things thus far is how I have NO idea what we might be doing next. One moment we are driving along in a taxi to Pucallpa and the next moment we are relaxing on the side of the road. Who could have guessed. Life is different here.

Sister, I've been telling EVERYONE about my new little nephew Tillman. They are so happy for you and our family to have a new little one.

Not much else to report. Thinking of you all.

Beth

First Big Breakdown

2010-01-21T17:39:00.000-08:00

Oh man. Up and down and up and down. I thought I was in the jungle now, not the mountains!!!!

Before leaving Lima, I had a HUGE plate of ceviche. OH YUM! It was awesome. Just before the ceviche, I managed to burn the bejesus out of my arms while sitting on the top of the MiraBuuuuuuus touring central Lima. Really? Did I really have to start my time here with a wicked sunburn? I did descend into some very cool catacombs at the San Fransisco cathedral to no avail. Arms are still a-burnin.' I included a picture of the burnin' for your enjoyment.

Arrived in Pucallpa late last night and one of the first things I saw was a woman riding on the back of a motorcycle breastfeeding her babe. GO SUPERSTAR mama!!!!!! I was cheering for her in my mind as I enjoyed my first motokar ride. I want to be like her someday I thought to myself.

I LOVE Pucallpa thus far and am enchanted. Lima felt a little like Spain, while Pucallpa feels a little more like India (though it's really NOTHING like India I'm sure, you all know what I mean...). I am told that there are no available maps for the city of Pucallpa because it changes so rapidly that no one can keep up. Hmmmmm... I've never been so good with maps anyway... I think this is just my kind of town!

Arose early with Fernando to meet all the top dog health dudes and chicas of the Ucayali region. Holy crazy!!!! Couldn't believe that the hospital director in Yarinacocha took the time to have a meeting to welcome me to the hospital and understand every detail of what kind of experience I want to have. He had a band of executives with him. He also had a very health director kind of face, only the angel executive kind :) that sometimes find ways to work good in a not always so good system. He reminded me of an old lab director boss of mine only Peruvian style and I loved him for that (Ridgway in Peru! Who knew).

After a 3 hour tour of the hospital and my future abode (Plans have changed and I will work at the hospital for 2 months - thank the lordeeeeeee! Because of my intense intern style schedule, I will live on the hospital campus with a BEAUTIFUL view of the jungle in a little apartment and in the same building as nurse, midwife, and med interns...I might have friends in Pucallpa one day ;). All the blue abodes in the pictures are hospital buildings. The building I will live in is the 2 story one, clinics abajo. You can see the farmacia and the little cafe in which I will eat all of my meals. And it's all free!!!! And also check out the really cute veterinarian house with Oliver's picture outside. WOW, someone has met my little Oliver here in peru and loved him so much that they drew him big on their shop.

So, back to ...after a 3 hour tour... we zipped off in another motokar (la la la I love you motokar) to meet the regional director of health, director of women's health, director of public health programs, director of directors of other directors of health....... LOTS of directors today. And the other thing - Motokars do NOTHING for my hair as you can see in the photo. But they sure are FUN!!!!!

Anyway, finally to the "mountains." After a long day, I simply lost it everybody. Toooooooo much Spanish and toooooooo much meeting directors and I was exhausted! Came back to the hotel and thought about little Oliver curling up with me for a nap, practically suffocated in missing him so much and had my first big breakdown. OOOOhhhh did it feel oh so bad and oh so good, but mostly really bad actually. Read a little bit of Pema Chodron's "Comfortable with Uncertainty" (Thanks Chris!!!!!) and pulled myself together for dinner. Wooooooh.

Took my favorite new form of transportation (Motokar! Could you have guessed?) to a dinner spot and thought all was well until a little doggy mama came to eat with me. Then a doggy guy without a front right foot hobbled over. Then the kids with the gum. Then the old man with few teeth and very little meat on his bones with a handmade newspaper to sell. Then the woman with the necklaces. Then different kids with the same gum.

I couldn't help but feed the mama dog. Bought the paper from the old man and thought I was ok, not going to lose it again... then a young teenager, maybe about 11 asked if he could sit with me. I had seen him pass by a few minutes earlier and this was his second passing. He had a backpack on and seemed harmless and lovely and friendly and I REALLY wanted him to sit and chat with me... Nonetheless, out of fear I told him that I had other things to do. Reallllllllly Beth?!!!!? IT KILLED ME!!!!! And that's when I lost it again. I got scared of that little guy sitting with me. Scared of what? I wondered after I balled my eyes out at the table again, thinking of the teenager, my fear, my heart nervous with fear to be as open as I am in places I know well, the little dogs, the woman, the old man, the suffering. Holy shit! The old man came back after I finished my food and asked if he could box up the rest and take it home with him. "Hell YES!!!! " And then I balled again as I walked home until I didn't feel safe walking anymore and hailed those cutest of transportation motokars ever. They sure do cheer me up.

I feel much better after lots of love from friends and family via email and I am SO ready for bed.

Tomorrow I will focus on breathing. Just breathing. That's all I have to do tomorrow.

We go to Monte de Los Olivos tomorrow to meet everyone there. It's an hour away by car and considered a very small community of about 70 families. After my 2 months of "internship" in the hospital at Yarincocha I will spend 4 months in tiny communities around Monte de Los Olivos. That's the new plan for now and I am filled with hope for more spiritual, personal, emotional love growth, open hearts to help me, love from all of you, and more more more jungle fruit juice!!!!

WOW the jungle is beautiful here. I can't wait for more of that too. And the food! I spent $2 on dinner which included a huge fried yucca, a big pile of something orangish and starchy and yummy, a grilled chicken and a glass of the best fruit juice on the planet to my knowledge thus far called maracuya (this just means passionfruit, but still!!!! It's gooood.)

Love to you all and thanks for all the WONDERFUL blog and email comments!

Janice, I am TOTALLY using your pastry idea for the birth house. Consider it done :)

I move to my new abode Sunday and start at the hospital on Monday. That's when it gets really good and really hard too I bet. I'll keep you all posted.

One day down sin diarrhea!!!!!!

2010-01-19T19:24:00.001-08:00

That's right! YAY!

Hello all!

You've inspired me to start this blog action. Thanks!

Oliver and Dan sent me off in the airport at the security gate yesterday morning as I balled and balled after saying goodbye to my little man. Little man...I love him... (he's my doggy

guy). I arrived in Lima late last night. A wonderful couple from INMED held the sign inscribed "Elizabeth Tucker" in a sea of similar signs at the airport and I was overjoyed

to find my very own. Big smiles and laughter introduced me to Ursula and her husband Carlos. They are LOVELY and have taken great care of me.

Now, my first full day of this exciting and emotional Peruvian adventure is coming to an end. I can't believe it. Started with a meeting with Doctor Fernando Perez about the projects I will work on in the Ucayali region of the Amazon and an introduction to the next few months of life. Though i am enjoying Lima for it's easy access to internet, food, etc, I am ready to bust OUT. I leave for Pucallpa tomorrow night with Fernando and after brief introductions in that smaller city, we will travel about an hour to the "selva" jungle and stop in Monte de los Olivos. This is a newer community in and around which I will be working primarily.

A few days later we will travel back to Pucallpa. I will live with a family for a month there and deliver babes in the local hospital in a suburb called Yarinacocha. The following 5 months will be spent working with small communities around Monte de Los Olivos. As I practice, deliver, see mamas, babes, adults, and children in the clinic, etc I will focus on attempting to discover why women aren't utilizing the local waiting (birth) house to deliver their babes. They seem to prefer the home. My job is to make the birth house at Monte de Los Olivos a place where women want to come. Sounds kinda big (and super exciting!) so send me any ideas! :)

On a different note, today I enjoyed my first glass of chicha morada (a sweet juice made from purple corn! yum), a canelone which was seriously an italian burrito stuffed with spinach and cheese and smothered in red cream sauce (it was pretty good considering), and got kissed by a llama at the famous Lima Incan ruins. What fun! I also found some of my favorite cookies in the whole world, pet a sacred peruvian hairless dog (they are found in Mexico also and are believed to heal bone and joint ailments. sweet!), and took my first ciesta. Ahhhhhhhhh.

My spanish is already rapidly improving, though Ursula and I laugh hysterically when I get super tired and say things like "when I pay for something, I buy it." I guess that's better then when I started in the clinic at Denver health and said to my first patient "I would like to take your breast now" instead of "I would like to take your weight now." WOOOOoooops.

Thank you all for each and every blessing and farewell in the last 2 weeks and an AMAZING goodbye party! I am still swooning from the fun. Also thank you for all the well wishes and thoughts that I have received electronically, emotionally, spiritually, financially, and physically. I can feel them all!!!! :)

I miss you all tremendously and will share when I can. Sending my love.

Beth

PandoraPeru

3.31.10 – Semana Santa

3.27.10 – 50/50

3.23.10 – Where’s Juana?

3.22.10 – Week 3

3.20.10 – Swiss Family Robinson

3.17.10 – Anamalitos

3.13.10

3.11.10 - Smiles

3.9.10 – Day 2

3.8.10 – Magnificent Mujeres

3.6.10 – Rockin’ Women

3/3/10 Small Man Angels Abound

2/28/10 Last Day to Dump Water on Your Neighbors Head

2/27/10 Beth the DeForester

2/26/10 La Saya – Peru Porn

2/24/10 - Fumigation at hospital. Last La Guardia. 4 babies.

2/21/10 Agua in Aguaytia

2/21/10 – Preparty Aguaytia

2/20/10 - I swallowed an IUD

2/17/10 - MotoButt

2/15/10 – Madrina = Godmother

2/8/10 ER Episode #1 and hopefully the #1 and only

More Stories to Come!!

Blessings in Disguise - Week 3 Pucallpa

La Guardia (Night shift) # 1

Does your Husband Travel? – Day 3 at Yarinacocha Hospital

Angels of the Night - Day 2 at Yarinacocha Hospital

The Trembling Earth Beneath Me - Day 1 at Yarinacocha Hospital

ALWAYS Take Note of a Man's Tshirt

I'm Pregnant!

First Big Breakdown

One day down sin diarrhea!!!!!!