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Though I arrived in Peru on Saturday it's only now, finally, this early Wednesday morning that I've got enough time and active brain cells to tell you what's going on here in Peru. Frankly, it's overwhelming. There's incredible beauty here played out in extreme poverty in ancient stone and brick buildings, wood and corrugated metal shacks, cobblestone streets (I brought the wrong shoes); and in Lima, modern buildings of glass and steel. I'm sitting in the cafe' of my hotel in Ayacucho; an hours flight in an 18-seat plane from Lima (or a nine-hour drive). Lima's hospitals are comparable to US hospitals; well equipped with supplies and specialists but understaffed and without all the frills we Americans enjoy.
I'm sipping strong coffee, and munching Pan Chapla (small, pita-like rolls). I'm bombarded with sights, sounds, feelings and smells and so challenged to communicate even the most basic things with my high-school Spanish, I can't help but wonder if this is how babies feel. Sarah McCune, an intern spending a year in Peru with CARE, is assigned to guide me through the week. She's living proof that people can embody brilliance. Such a person. Resilient, kind, assertive, professional, smart and so warm and funny I feel like I'm traveling with an old friend (though she's only 24). It's been a marathon of travel, tours of healthcare facilities and interviews with doctors, midwives, nurses, dignitaries and pregnant women.
Americans are so lucky our babies are virtually guaranteed delivery in safety, privacy and dignity. The exceptional care they provide to the poorest of the poor here in the towns and villages of the Peruvian mountains is a sharp contrast to the services we take for granted in the US. Here, they're focused on a three-tiered model to provide obstetric care for women, many of whom live hours from the closest clinic. Prior to 2000, fewer than 30% of women delivered in a hospital in large part because they were terrified, unaware of their risks and couldn't get to the hospital. The death rate was some of the worst in the world. Everything's different now because of CARE's work on the ground level with hospitals and communities. I'm amazed.
Yesterday, I drove in the cab of a pickup truck for three hours on rough, narrow, muddy, rocky, cliff-hugging roads; through a fast-running stream, deep into the Sierra mountain range to get from Ayacucho's regional hospital, which cares for all complicated obstetric patients in this province as well as local healthy women. This was a "Raiders of the Lost Ark" experience; dodging pigs and toddlers who wandered into the road and passing open cargo trucks filled with 20 (or more?) men packed together in the truck-bed. We were inches from the edge of a cliff (no guard rail) but due to Oscar's (our driver) skill, luck and some kind of magic, we avoided plunging into a deep ravine.
Half-way to Vilcashuaman (our destination village), we had to pee. Oscar found a shack with "Bano" scrawled on the wall. We paid a young girl to let us enter the shack and found a line of filthy stalls (with doors that provided minimal coverage) with holes in the ground. I employed all my best "camping-girl" techniques, held my breath and did my thing while wild dogs and roosters filled the yard outside. Then we were back in the truck for another couple hours of white-knuckle driving in beautiful mountains.
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