The most crazy, unbelievable, funny coincidence...

of my trip was:

NOT that my cousin Anne and I discovered we were both to be in Lima on July 29^th, and arranged to meet for dinner in the artsy neighborhood of Barranco,

NOR that the feminist science fiction novel I traded to a fellow traveler in Galapagos was offered back to me by someone else several weeks later at a book exchange in Peru,

NOR that in this age of cell phone communication, where meeting up with someone seems to require that both parties are continually in contact via phone up to the very instant their eyes meet, that WITHOUT having spoken or seen each other in over a month, I was able to meet my friend Alejandro (coming from Argentina) at 10pm on July 19th in a hotel in a tiny Peruvian town neither of us had heard of previously,

What I still can barely believe happened, was that while Alejandro was flying a local airline from Lima to Trujillo (Peru), he saw me on TV! When we met up, he said “I don’t know how it can be true, but I was meditating on the plane, and when I opened my eyes, I swear I saw you on the TV.” I scanned my memories, trying to think of how I could have inadvertently ended up on an airplane safety video? Or maybe in a crowd scene of Superman 3? They did film right outside my health department office last summer…

He said, “It was really bizarre, you were inside one of those portable toilets, and when you tried to get out…”

“I stepped into some kind of a board meeting!!”

It was me!! It was that Canadian version of Candid Camera that I randomly ended up in when I visited Montreal last summer. Justo Por Reir (Or…I don’t know how they spell it, it’s in French so it probably has some extra silent letters “Justeax Pourt Reirrrre.”) Anyway, you may or may not remember the crazy story of how I ended up knowingly participating in the filming of that strange, (supposedly candid) segment, but I never imagined anyone I knew would ever see it, since they told me it was only going to air on TV in Quebec. Now my fame has spread to LanChile flights within Peru!! And someone I know was there to witness it.

Postscript: Jaimee (wouldn't you know it!) said she found the clip on YouTube. http://youtube.com/watch?v=E0kW73NbT2Y

my moments of fame are even briefer than i imagined!

Hiking in Peru

Things in Peru got off to a bit of a rocky start…I took an overnight bus from Ecuador, which involved a 4am border crossing. I wasn’t in a great mood. They had played the same terrible movie at full volume twice during the ride down. The plot was: rich, fat, older man rigs a beauty contest so his incredibly voluptuous, vapid young girlfriend will win. Much is made of her breast size, which she (falsely) claims is natural. Then at the last minute, she develops a problem with her implants, and has to have them removed, with the implication that now she could never win the contest. I’m not sure what happens at the end, because I tuned out, but suffice to say, the plot was stupid and sexist, and only served to worsen my annoyance with being kept awake.

When I groggily stumbled off the bus to have my passport stamped, I was set upon by various men, one who grabbed my passport “to help me fill out some forms” (and then asked for a tip) and several who wanted to change my Ecuadorian currency. I remembered reading that the money changers at the border are sketchy, so I recovered my passport and pushed inside the office. Stamped passport in hand, I passed back by a uniformed man sitting at a desk who asked to see my passport and told me I needed to pay $10 for a tourist visa. It sounded fishy, but I asked the people standing around and everyone nodded. I reluctantly handed over the cash, but as soon as I got back to the bus, the driver affirmed it was a scam (it was one of the money changers who had fooled me). The bus was about to leave, but I was so mad at having been taken in (if only for $10), that I ran back and made a scene (totally unlike me, but I think I was fueled by frustration from that stupid movie). Various officials appeared, along with someone from my bus company. The money changer in question had left, but one of his comrades sheepishly explained that the guy had only wanted to help me change money. The second guy offered to give me the $10 in Peruvian soles, and retrieve the dollars from the other guy later. Done. I ran back to the bus, still angry, but glad to have caught them in their deception.

I checked into a hostel in a small beach town on the northern Peruvian coast, which I had picked because the Lonely Plant noted a hot springs/mudbath/hiking area nearby. After a few hours sleep and some legitimate currency exchange, I found a mototaxi driver to take me the 11k to the mudbath. The driver/guide looked to be in his late teens, and offered me a fair price upfront, so we set off. The guy seemed shy but friendly, and we chatted about the usual things…where I was from, what I was doing in Peru, what he liked to do for fun. The hot spring was tiny, a pool maybe 8’ square. Only one other person was there, an older mad who appeared to be a caretaker. One end of the pool had a trough containing the sulfurous mud, with which one might apply a mask. My guide put some mud on his own face to demonstrate, then applied a bit to mine. I was a tiny bit uncomfortable with him touching me rather unexpectedly, but decided to enjoy the facial treatment.

Until he decided to apply some to my back, pulling me really close to him and wrapping his arms around me in the process. I was totally taken aback and pushed him away. It was really bizarre. He gave me a blank look, as if nothing unusual had happened. It wasn’t threatening; it was just completely socially inappropriate (from my perspective) and uncomfortable. A applied the rest of my mud treatment and we talked about other things. Then I asked the caretaker about hiking possibilities, and he suggested several. The guide and I got out of the bath and started down a trail, at which point he wrapped his arms around me again. A pulled away and asked him what his deal was, and he said he just wanted to show me the way, and grabbed me again. I backed away, unsure how to respond. His gestures didn’t seem aggressive or forceful; it was more like he didn’t realize you’re not supposed to just touch people whenever you want to. But, there wasn’t anyone else around where we were, and the whole thing seemed sketchy, so I told him to just drive me back to town, which he did without further comment. Once again I was seething mad, and since we were 11k from town, I had time to decide whether I wanted to pay him, and what I wanted to say about his behavior. I decided on half of the agreed payment, and rehearsed a brief speech about the nature of sexual harassment, how it was illegal, and how it was not acceptable to touch people against their will in any context, be they clients, friends, or lovers.

He seemed shocked when I only gave him half the money, and pleaded several times that we had made an agreement. I repeated my comments about his behavior, we stared at each other for a few moments, then I turned and walked away. I was rather shaken, mostly by the confrontation, and was thinking the rest of the time I was in the town about how awkward it would be to run into him again. Luckily, I didn’t. Also luckily, I was sharing a room at the hostel with a tall, blond woman from Denmark, who perfectly understood how tiring and irritating it was to be constantly attracting objectifying attention from men. We commiserated, and I felt much better.

After that abysmal start, things got much better, and I loved my time in Peru. Besides obnoxious male behavior, the think that made the biggest impression on me in the beginning, as I traveled through northwestern Peru was the landscape. Desert. Dry and dusty, with only short scrubby trees. Coming from the cloud forest in southern Ecuador, where things are perpetually damp but also verdantly green, it was a shock but also a bit of a relief. Thoroughly dry laundry, what a treat!

My friend Alejandro and I met in the tiny coastal town of Huanchaco. I know Ale because we worked together in New York (he’s a health educator at a school clinic). He was visiting his family in Argentina, so he hopped over to join me for part of the Peru segment of my trip.

Huanchaco is famous for having fishermen who still make and use traditional reed boats. Ale braved the freezing seas to take one out for a float, promptly being drawn by the current into an area of high waves where the boat owner had told him not to go. In spite of the concerned fisherman’s wild shouting and gesturing from the shore, Ale continued unconcerned, overturning a few times but otherwise escaping unscathed. Or at least not seriously hurt…he did receive some nasty scrapes from being dragged along the rocky shore by the surf. But he felt triumphant nonetheless, and jokingly reiterated his claim to being a true fisherman for the rest of the trip.

Our first day together we went to a large local market. Ale grew up in Argentina, but hadn’t been in the sprawling chaos of a developing country market. You can buy anything from a rice cooker to a lacy pair of underwear to a fresh whole cow head. My favorite thing is too see all the fresh fruits and vegetables and the bags and bags of grains, spices, and other food sold in bulk. He proposed we share a glass of a dark purple mystery drink that the vendor said was made of corn. It was sold from a bucket, served in communal glasses. I don’t remember if it was fermented or not. This is pretty much the epitome of the street food travel advisors tell you never to eat, but Alejandro was undaunted. It was quite tasty, and neither of us suffered digestive consequences. I feel I have met my match in terms of the iron stomach!! Alison was impressed that I brush my teeth with tap water while traveling, even in the rural communities of Ecuador. But Ale may even surpass me, having drunk freely from bathroom faucets at several of the archeological sites we visited.

From Huanchaco we went to Cusco, the largest city in the Sacred Valley. This valley is home to Machu Picchu (MP), but it is also amazingly beautiful in its own right. Because of logistical complications related to reaching MP (the only way is to take a train, which fills quickly), we ended up staying 2 extra days in the Sacred Valley while waiting to go to MP. We stayed in several small towns in the highlands, mostly hiking. We took hikes to archeological sights, a salt mine, and a Incan horticultural experiment site (all cool), but the most impressive part was the beauty of the landscape. We had 360º views of steep and jagged mountain peaks, many covered in snow. There were small lakes, and rolling farmland colored red and golden and brown. There were terraces cut into the steep hillsides, so even the mountain slopes could be farmed. We walked and walked and walked, and kept repeating over and over, “I can’t believe how beautiful it is here…”

One afternoon we were walking through farmland outside a small town and saw a group of people clustered around a pile of straw. They were sifting fava beans from their husks. Several people tossed shovelfuls of the pile in the air and the heavier beans fell to the ground while the lighter husk and straw blew to the side. Several other people tossed stray beans back into the pile. We later came across another group of people in a preliminary part of the fava processing, guiding three donkeys to spin around in circles on top of the pile of favas, to break open the husks. It seemed like a pretty tedious process, and for fava beans, no less. Blech.

The Sacred Valley seemed very prosperous, and we weren’t sure why. It’s not that people seemed especially wealthy, but there wasn’t visible poverty. Or maybe it was that there weren’t huge income disparities. Most people dressed similarly, everyone had shoes, the houses all seemed to be in good condition and of the same clay material, no one was begging. Maybe it was the trickle-down effect of tourist dollars? (It’s really expensive to visit MP) Maybe the terrain is so beautiful and the ground looks so fertile that we just imagined prosperity. Maybe small farmers do still manage to make a good living from their land. Several people with whom I spoke said they mainly grew food for their own families, and sold a little on the side. A man on the ride from Ecuador described how the government had broken up traditional farming cooperatives about 15 years ago and given each family a tiny parcel of private land. Many people didn’t have the skills to manage their land independently, so they sold it to large companies. They were then forced to either become employees of the companies or move to the city to find work. In either case, many have ended in poverty. This didn’t appear to be the case in the Sacred Valley. One person said the land was private, but man still use the system of working in common, a process called minka. In any case, they seem to have a good thing going. I can see why the Incas called the valley “sacred” – it’s beautiful and fertile.

While in Peru I ate 3 new fruits – 2 winners and a loser. The loser was called tumbo, it’s closely related to the granadilla (a kind of passionfruit) that I LOVE. They’re both filled with a bunch of crunchy seeds in a mucousy membrane, that’s quite creepy looking. But granadillas have a sweet, delicious flavor and the poor tumbo was sour and nasty. Not to be repeated. The winners were lúguma, an orange-sized fruit with an inside the color and texture of boiled egg yolk. It had a mild sweet flavor, and got a thumbs-up for having such a unique texture for a fruit (and also being tasty). But the winner, surpassing the granadilla as my favorite weird fruit, was the cherimoya. I think I’ve actually seen cherimoya in the supermarket here (and my spellchecker recognizes them!), but I had never eaten one. And just looking at it, you might not want to. It’s about the size of a grapefruit, but can be various lobular shapes. The skin is greenish black with a scaly-looking pattern. You peel the skin, and eat the fleshy inside – the texture of a pear and the flavor of a fijoa (strawberry/pear/banana?). YUM!

Speaking culinarily, I also had some alpaca meat. Alejandro felt I was quite a traitor, because earlier in the day we had come across an alpaca while hiking and I had chirped at it in a very friendly way until it was brave enough to come and sniff my cheek. Then I ate its brethren for dinner. Quite good. Tender, mild flavor. Goes down a lot easier than guinea pig, with which you have to get quite intimate, what with all the little leg and rib bones.

Going back to the hiking adventures, we hiked to an archeological site which they say the Incas used to test farming techniques. It is a series of concentric circular terraces, cut into deep bowls in the earth. They crops would have been protected from the wind, and the elevation change is great enough that plants that normally grew in different climate zones could all be grown in one place. There was a sophisticated irrigation system, and stone steps connecting the terraces. Very cool.

That same day, after nearly 20k of hiking, we ended at a salt mine. It’s built around a warm, very saline spring coming out of a hillside. It had terraced pools, which fill with water then evaporate, leaving salt. The pools are all connected to channels, so when they have emptied out the salt they open a tiny gate that refills the pool, and the process begins again. Looking at the hillside, it looks like it’s covered in snow – but the crystals are all salt, rather than water.

We were in Peru at the height of the tourist season, and there were certainly more visible tourists in the city of Cusco than anywhere else we visited. But at the same time, when we were wandering around in the Sacred Valley, or even visiting the craft markets, it felt like there was hardly anyone around. Even at Machu Picchu, which is supposed to get more than 1000 visitors a day in the high season, when we took a hike off the beaten track, we barely saw anyone. I felt quite lucky to avoid the masses and see such beautiful places in peace and quiet.

Which brings me to Machu Picchu, the reason it occurred to me to visit Peru in the first place. It’s quite a production to go, you have to travel the last two hours by train because there are no roads, so pretty much only tourists go, so the prices are sky high and trains and hotels sell out. Our fluid and relaxed travel style (read: fly-by-the seat-of-our-pants) caused us a bit of a problem here, but after some finagling of our schedule and a bit of unplanned expense we made it to Aguas Calientes (the nearest city) and secured a hotel room. We paid dearly for a dark, musty room with bright fake flowers and super cheesy art. The classic Machu Picchu photo was gilt framed, and we took our pictures in front of it, not even guessing that could have been the closest we got to seeing Machu Picchu. Here’s what happened.

We got up before 5am, to arrive at the gates early and be allowed to enter a trail inside the park that only 400 people a day could walk. When we arrived, the park was blanketed by a fog as thick as pea soup. We couldn’t see anything, much less the supposedly amazing view over the ruins and into the mountains. But, after a few wrong turns, we found the gate at the trailhead and started hiking. The trail ascended rapidly, and the hills dropped off steeply to our sides. Fog prevented us from seeing more than a few yards in any direction, so we didn’t really have a sense of where we were going. We hiked steadily up for maybe an hour and a half, but couldn’t see anything. I was really tired, having slept poorly the night before and gotten up so early. We were hoping the fog would burn off, so we would get to see the view that was the point of the hike. And so, in spite of feeling a bit odd, we indulged in a 2 hour nap on the side of the trail! And sure enough, after 2 hours of sleep, when we opened our eyes we were greeted with a breath-taking view. We were about ¾ of the way up a steep, cloud-forested mountain, looking over a river valley. We pushed on, first dipping down to an archeological site on the back side of the mountain, then circling back up a STEEP trail to the peak. For all their short legs, the Incans built TALL steps! It was a seemingly endless stair climb, steeper and steeper until we actually had to climb a ladder up a rock face. Eventually we came to the peak of the mountain, and looked out down over the other side, where we could see the ruins of Machu Picchu. We realized that we had actually scaled the rock spire that is the backdrop of the famous image of Machu Picchu!

Coming down the front of the spire was even sketchier than climbing up the back. Steep, narrow steps, one side of which clung to the mountain, the other side of which plunged off into a rocky abyss. With nary a hand rail. There had been a casual warning at the trailhead that people should be fit in order to take this hike, but I had no idea... I think if it had not been foggy when I started and had actually known the hike I was in for, I might have had second thoughts! However, the view was well worth it, and I triumphantly reentered the park to see the ruins close-up, legs shaking with fatigue (and perhaps relief that I hadn’t dropped off the cliff.)

I could go on about Machu Picchu…there is a mysterious and interesting history, and the images of such an ancient city perched in the mountains are eerie and incredible), but it’s time to wrap up this travelogue.

The last story is from my taxi ride to the airport. I eventually gave in to the $15 taxi, after doggedly trying to take a $.30 van/bus (against everyone’s advice…I love riding public buses and I think people’s anxiety about theft is a bit extreme). Even at 8pm, with a van passing every 3 minutes, the vehicles were so jammed with commuters that no one would let me and my big back pack on. When was the last time you rode in a minivan with 20 people??. So I hopped in a hotel/airport shuttle that happened to pass by, and had a luxury van to myself. Inevitably, the driver started to quiz me as to my relationship status, why an attractive young woman like me would be single, if I planned to have children, yada, yada, yada. To shift the focus, I asked him about his family. A wife and three kids, the oldest of which had been born when the driver was about 20. He said, “I was really young.” A started talking about the work I had done in Ecuador with family planning, and asked if he had planned to have a child at 20. Definitely not, he said, but they hadn’t been using any method of birth control, and thus had three kids in close succession. Then, deciding that three was plenty, the wife had gotten an IUD and had been using it ever since (maybe 15 years).

This conversation was enjoyable to me on several levels. First, it was a successful break from the sexual innuendo of “do you have a boyfriend?” Second, I’m impressed with how open and frank people in Latin America are (especially men) about talking about contraception. I mean, how often do you have a casual conversation about sexual health with someone you meet on the street in the U.S.? It’s pretty amazing to be able to, without putting people off. I like to think it’s an indication of healthy social progress. Third, his was a success story. He and his wife both recognized that the kids were coming earlier and faster than they wanted, and were able to put on the brakes. Hooray for public health!

And with that, I was at the airport, happy to end my Peruvian adventure with a male interaction about which I felt good, remembering all the beautiful images of the Sacred Valley.

Cruising the Galapagos

My friend Alison (from Columbia) spent a week studying Spanish in Cuenca, then met me in the communities. We spent a week in Chacanceo while I worked, then flew to Galapagos for 10 days. We spent the first days by ourselves, visiting local beaches and taking short hikes. My first impressions were of the difference in flora from the mainland, and I guess from what I expected of the islands. Given the amazing fauna, I was expecting lush greenery, like a jungle. Instead, it was more like a moonscape, with a few strange plants. The islands are all volcanic, and relatively young. As such, there is little soil, mostly just rock. So pretty much all that grows is a strange, huge species of cactus that looks like a cartoon tree, and a white barked tree that at least when we were there had no leaves, so looked (basically) dead. Those two things covered much of the landscape on the islands. It was bizarre, but after I realized it wasn't that all the trees were dead, I grew to appreciate the novelty of the plant life.

Our second day we went to a bay where there were supposed to be flamingos. There was a path to a marsh where it was pretty clear the flamingos were _supposed_ to be. There was ONE, and it seemed they had planted the lonesome guy there so the flamingo observatory would not be mis-named. As diligient bird watchers we observed various flamingo behaviors: standing. preening. sleeping. and, the most exciting...eating! or at least digging around in the mud for something. But, it was a real, live, bright pink flamingo. I wanted to give it a lawn ornament companion, just to it wouldn't be alone.

Galapagos was a lot less developed and touristy than I expected. For example, in the height of the tourist season, we were the only people at the flamingo beach, which is one of only a couple of places to visit on the main island. It was at the end of a long, gravelly road, and there was barely a sign to indicate its presence, much less anyone selling anything, even water or food. I think I expected it to be more like the places that cruise ships stop, where you can't walk 5 feet without running into someone hawking an armful of jewelry or a tray of rum drinks.

After the days by ourselved, we took a tour boat with 14 other passengers for an 8 day cruise. Most of the islands are not inhabited by humans and have no developed infrastructure. Our boat made a circle around the main island, stopping at many smaller ones. You jump off near the shore (sometimes onto a rock, if the shoreline allows) and then walk around the island. There are marked trails to keep you from trampling the delicate plants or stepping on birds' nests. Most days we spent some time walking around and some time snorkling. Each island is home to different animals, some found on no other place on earth, even on other islands of Galapagos. As advertised, the animals are amazing. Meter-long sharks, sea lions, seals, giant tortises, penguins, all swimming right around us. On land, various kinds of iguanas, flamingos, blue-footed boobies, albatross...a million birds.

Our boat carried 16 passengers in tiny 2-person rooms, as well as 7 crew members, including a naturalist guide. Alison and I were the only 2 passengers from the US, several were from Europe, and 7 from Israel(!). I'd never met Israelis while traveling in Central America, but here there are many, all young people, many traveling for 6-9 months after their 2 year military service. It was really interesting to hear about their lives, so different from ours, some living on kibbutz, and all serving in the army. Alison and I seemed to be the most outgoing, trying to learn everyone's names and a little about their places of origin. (And which ones didn't like sweets, so I could pilfer extra desserts). Most people kind of stuck to the person they were traveling with, or other people from their country, but everyone was friendly. We tried to mobilize a crowd to go dancing the nights we were in port (rather than sailing overnight between islands). We had little luck rousing others, but had a good time dancing anyway. There were many groups of Ecuadorian middle and high school students on school trips, and the first night we went to the bar, it was full of 14 year olds, rocking out! After their 10pm curfew the place was pretty empty. The music was latin pop, but the music videos playing on the wall-size screen were 1980s Boy George and George Micheal types. A surreal combination.

While we were at sea, often our boat would be followed by giant black frigate birds. The cook would sometimes throw food out the kitchen window, and they would catch it on the fly. We watched them from the sun deck on top of the boat. They could keep up with us without flapping their wings at all, just gliding along on the wind currents. Sometimes they seemed to be playing, or fighting, and they would dive at one another, narrowly missing our boat. Indeed, one jettisoned a digestive load during a close overhead sweep, and I was hit! Also from the sundeck, we watched giant manta rays jumping out of the water. They were several feel across, and leapt high into the air before splashing back into the sea.

My favorite snorkeling was at a place called Post Office Bay. There were many giant tortises cruising the shallows, and their enormity and gracefulness underwater was amazing. There were also many kinds of sea urchins and brightly colored fish. The water was freezing, and we all used wetsuits, but even so, we only snorkeled in hour-long stretches before the cold was too much. The sea lions were fun too, but a little unnerving. Of all the animals, they seemed the least disturbed by the human influx, and would curiously approach you both on land and in the water. They are so much more agile than we are in the water, and they would swim right at you, narrowly missing you to swim underneath (and out of your range of vision). I think they were just playing, or checking us out, but it was strange to be so close to a wild animal. Post Office Bay is so named because before there was any kind of mail service in Galapagos, people left letters in a box there, in hopes that someone sailing near their letter's destination would carry it along. People still leave postcards there, and I collected several headed to the US, including one destined to my tiny hometown of Forest Grove.

I didn't suffer any sea sickness until the third day. We had a really rough night at sea, the boat rocking back and forth so hard we had to hold on to keep from falling out of bed. One motion sickness super patch soon had me in fine form though, and I didn't get sich again the rest of the trip. Pretty much everyone was taken down by that night at sea, and I shared my patches with a couple of boat-mates, one of whom was hooked and kept coming back for more. Alison too became addicted, and suffered withdrawal (nausea) when she took hers off on land several days later. Strong stuff! It was funny to be on land after so much time on a rocking boat. Periodically, we both felt things were rocking for several days afterward.

In a moment of extreme confidence (and perhaps some desperation), Alison convinced me to give her a haircut on board. I have often cut her hair, but in this case, the only scissors we had were on her Swiss Army knife. And on top of that, the boat was rocking heavily. The boat was pretty much rocking heavily the whole time we were on it. Anyway, I did it, and it actually came out ok. The one benefit was, it was quite windy on the sun deck, so all the little hair pieces just blew away and no clean up was required. If my public health career founders, perhaps I have a future in ship board hairstyling.

My favorite island was one that had a giant 100 year old lava flow. The rock was pitch black on the surface, and billowed in beautiful patterns over kilometers of terrain. There were patched that looked bubbly, patches that looked like sponge, and patches that looked like spider webs. In crevaces, you could see layers of 5 different colors, depending on the concentrations of minerals. The only things growing as far as the eye could see were three small cacti. Our guide, who had been working the islands for 30 years, said those same three cacti had been there the whole time.

My favorite piece of natural history I learned from the Kurt Vonnegat novel "Galapagos," which Alison brought along to read. The many species of Galapagos finches were key to Darwin's development of his theory of evolution. The finches fill distinct ecological niches that in other environments are filled by other animals. There seem to be more varieties of finch than there are islands. For example, there is a finch that gets grubs out of trees like a woodpecker, one that slurps ants like an ant-eater, and one that has a beak that can crack open nuts. Darwin theorized the finches evolved in the ways they did to take advantage of different kinds of food, but all came from one common finch ancestor. They are poor imitations of the animals that fill those niches in other environments, but those other animals weren't around to compete. Fascinating. Go Darwin.

In sum, Galapagos was indeed amazing. But I definitely felt the press of humanity on a delicate ecosystem. More and more people go there every year. Even though everyone has to be with a guide, people still get too close to the animals, trying to capture the perfect picture. Even if they don't run or fly away, to me many seemed very nervous. Any the boat crew who had been around for a long time said there were fewer of some animals than there used to be. It's a delicate balance, because many people want to see a place that is unique on earth. And of course the tourism revenue is very welcomed by Ecuadorians. But, the more people who go, the more precarious the survival of the ecosystem. I'm not sure of the best resolution. But, I feel fortunate to have been able to go, and I hope a good part of the hefty price tag of the trip will fund research and preservation of the environment.

Ecuador: work in the communities Part II

Several weeks later, I find a few hours to sit down at a computer and take up where I left off: in the cloud forest communities of Ecuador. I feel eons away, now in the coastal desert of Peru, but looking back at my list of memorable moments…

Usually Lupe (the doctor) takes off from her part time teaching job to travel with me the whole time I’m visiting the communities. This time, because I was there for so long, she stayed in Guayaquil to work during the week and only came to the communities on the weekend (as is her usual practice when I´m not there). I missed spending time with her, because she is energetic and fun, and also invaluable in terms of problem solving and communication in the communities. But, it was also good to be there without her. I realized that both I and the local folks rely on her as an intermediary, and having to negotiate and organize everything directly made me feel closer to people, and I think made them feel more comfortable with me. Another huge benefit of being there for so long was that I spent more time than ever before just hanging around and talking with people. I encouraged people to lead us on some “ecotourist” trips. Several of the proms worked many years ago with another NGO that trained them as nature guides and tried to help them set up infrastructure for ecotourism. The project never took off, but they often hearken back to it.

In that vein, we went on several hikes, cut sugar cane, crushed it in a water-powered mill to release the juice, and boiled it down to caramel. Digna is the most entrepreneurial of the proms, and the one who did most of the guiding. She took us to her parents cane fields. Her mom is one of my favorite people in the communities. She must be almost 70, but is spry and witty, and never without a huge machete and a fashionable straw hat. The day we visited, she set out to do some ditch digging as we went to cut cane. She returned at lunchtime to help cook and ply us with her homemade cane liquor. Lupe says she herself doesn’t drink, but she has coquettishly offered me her personal brew every time I’ve visited. This time with a little sugar water to take away the burn - very tasty.

We also learned how to milk cows. It’s harder than it looks! And I’m feeling traitorous to my Moooove to 1% milk campaign, because here there’s no such thing as low fat milk, and I have to say I’m enjoying every drop of whole milk I’m tasting: rich milky coffee, hot cocoa, fresh yogurt, homemade cheese….especially after the tiring task of milking, I appreciate it even more.

One hike Sarah, Alison and I took with Wilson and an old man from Chacanceo nearly had an unpleasant end. There are mining companies trying to survey in the area, with hopes of extracting various minerals. It is very controversial, with most people very opposed to even letting them enter the area. The companies promise all manner of things that people desperately want: roads, schools, jobs. But, people are well aware of the environmental and health consequences of mining, and so are not taken in by the companies’ (often empty) promises. On that day we hiked about an hour up a hill overlooking Chacanceo, through property owned by a local family. When the owner saw us there, she stormed out of her house and shouted far up the hill “You are not welcome here, get out! Watch out or I´ll shoot!” She thought we were from a mining company. Our guides (who knew her well) approached her to talk. She shouted at them for at least 20 minutes about their nerve to accompany such evil-doers onto her property. They calmly heard her out, and eventually convinced her that we weren’t miners, but it was quite hairy for a bit.

Chacanceo now has electricity. It was the talk of the town the whole time we were there. And not without reason. The government paid for the materials, but it was the task of the community to bring in the posts and run the wires over many miles from the nearest power source. Everyone told tales of arduous hikes up and down mountains, 15-20 people carrying 10 meter wooden light posts. They would point out to the horizon and say, we had to walk from there, all the way carrying posts. It’s mountainous. I’m talking jagged peaks. What an incredible force of will! They talk about how different it is, now that they have electricity. Clearly it’s a great leap forward for them. For me, it was a mixed blessing. Now everyone is in possession of my least favorite modern amenity: television. From 5:30 in the morning and late into the night people now have TVs blaring, in what used to be peaceful, wide-open silence. I tried to smile when they proudly showed off their new “screens” but inside I felt a sense of sadness and doom. Incessant marketing of garbage, manufacturing desire for things no one needs, and promoting lifestyles that are unsustainable. Such is modernity.

On our last night in Chacanceo they threw us a dance party in the casa comunal, now with the possibility of CDs played on a boom box. People appeared, food was proffered, CDs were on hand. We had electricity; there was a functional light bulb in the building. But alas, we discovered no where to plug in the music. Not to worry. A group of young men disappeared and shortly returned with some lengths of wire and wire cutters. In a matter of minutes they had jerry-rigged some sort of connection for the music!

. . . .

The promotores in Manta Real have talked about the need for potable water in their community since we first started working here. They have piped water to all the houses, in a system built 2 years ago by a water agency called ETAPA. The problem is, the system is full of leaks, the holding tanks have no tops, and there is no chlorination or water treatment. The problem is complicated by bureaucracy and fighting in the community, a huge debt they owe to ETAPA, and bureaucracy and profiteering at ETAPA. We have tried in the past to understand the situation and help them move forward in resolving it, but with limited success. This time, with more time to spend, momentum from Lupe and the proms, and a new community board (the first female president, secretary, and treasurer in Manta history!) we made amazing progress. The past community board had lost or refused to turn over any documentation related to this issue, so it was unclear what the community owed or what ETAPA was contractually obliged to provide. The women of the community board were at the point of resigning, feeling overwhelmed with the water problem and very unsure of themselves as leaders. In contrast, the promotores of Manta (also 3 women), are very self assured and eager to push forward on the problem. Lupe did some amazing pep talking, and convinced the president to collaborate with the proms and take a trip to Cuenca, to meet with ETAPA. (Which ARSE financed). In short, this resulted in two engineers from ETAPA visiting the community, inspecting and agreeing to fix the problems in the system by August, and clarifying the unfulfilled responsibilities of the community: purchasing a small plastic tank for chlorination and sending at least two people to a free two week course in Cuenca to learn how to operate and maintain the whole system. One of the proms agreed to go, along with the young man who now is in charge of maintaining the system, and we agreed to pay their expenses. (The reason no one ever went initially was lack of money).

The experience was all at once fascinating, frustrating, and very rewarding. Negotiating community dynamics, helping people prepare to meet with ETAPA and advocate for themselves, analyzing the confusing contract, tromping around with the engineers inspecting the tanks and talking about water systems, helping the proms write project plans and budgets to get money from us for their trips…it was public health in action!

On a completely different level, I had a breakthrough with one of the proms in dealing with a mental health issue he has been struggling with for many years. Javier was 19 when I first met him in Manta, and he was in the first group of promotores to be trained. He has stood out for every ARSE person who has visited, because he is incredibly intelligent and hungry for knowledge about everything from anthropology to biology to philosophy. In a way that’s notably different from others, he seeks us out to talk about the “big picture” of community health, about the conflict between modern developments in biomedicine and traditional practices, and the role of people like us who come to the community to help. From the beginning we also heard from Lupe about strange problems in his family, where various siblings (he has 11!) have exhibited unusual and socially inappropriate behaviors. Many people in the community attribute such things to witch craft. Over the years, Lupe told us that Javier too had started hearing voices and occasionally behaving strangely. He never spoke with any of us directly, and continued to be involved as a promotor, but more and more often seemed disconnected or zoned out. This time when I arrived he was in Cuenca; his family reported he was receiving treatment for “psychological problems.” He reappeared a few days before I was to leave, and I asked Lupe if she thought I could ask him directly what was going on. She said yes, and that same night he appeared outside my room to talk. At first when I asked, he changed the subject, but eventually returned to it, and described what seemed to me to be psychotic symptoms, including one acute episode that lasted several days in which he basically became childlike and unresponsive to those around him. He hears voices, sees things that aren’t there, feels like his head is burning inside, and feels depressed and hopeless – like he’s dying. Terrible.

His family has been sending him to a traditional healer for 4 months, something that appears to have helped his siblings who he says are all better now. But the baths and medicines are not working for him, and he had no idea what to do. I described schitzophrenia, how it often begins at the time he started having symptoms, how the symptoms are similar to those he describes, how the cause is not known but probably a combination of genetic and environmental factors, how doctors attribute the symptoms to an imbalance of chemicals in the brain, and how many people successfully treat the symptoms with chemical medicines. He was very interested and relieved. The next day we went into town, and I printed some information from the internet (which he was reluctant to read because people told him one cause of his problem was that he worked his brain too hard). So I read it to him, basically repeating the things I had said the day before.

By this time his affect was completely different, and he seemed comforted and hopeful to have another explanation for what was going on and a hope of making things better. He asked if I could help him talk to his parents, to convince them to let him stop going to the healer and seek some other form of treatment. While in Manta I had been eating all my meals with his family (his sister Ruth is also one of the proms) and had gotten to know them much better over this trip. His father was the president of the community at one point, and their family is very influential. Anyway, although the task of talking with his parents was daunting, we had developed a lot of affection for one another over the month, and I felt like I was in a good place to offer support for Javier and also help his parents understand his problem in a different way. I explained my perspective on the situation, and suggested that medical expertise and medication might be helpful. Ruth was very supportive, acknowledging the problem was bigger than they thought. His mom was still in denial, wanting to take him to spiritual healers (“like you see on TV!”), or some local Gregorian Brothers. She compared his feelings to tough times she had suffered in her youth, which she cured herself of by keeping busy and having a positive attitude. His father was mostly silent. Eventually they agreed that the current treatment wasn’t working and asked me to help them find a psychiatrist in Cuenca who could offer a modern medical treatment. I agreed, and told them how lucky he was to have a family who supported him and clearly wanted to help him get better. The next day was my last one in Manta, and several times his mother asked me to please help them find treatment for Javier. I’m really glad we all spoke directly; Javier and I both acknowledged we should have done so long ago. I was afraid of intruding on a personal problem or imposing my view of the situation, and I think he was terrified to acknowledge what was happening. Luckily, I think we were successful in getting support from his parents for a new kind of treatment, and hopefully he can get it and it will be helpful. That’s all for now.

Next episode: Gapalagos.

Ecuador: work in the communities Part I

Hola con todos desde el Ecuador! I´m back on another ARSE adventure in Ecuador, this time combined with 10 days in the Galapagos and 10 in Peru, to celebrate by recent Mastery of the field of Public Health (and current freedom/unemployment). The work in the communities here where I´ve been coming the past 6 years has been more gratifying than ever, and a perfect way to spend my first months out of school. We´ve been doing community health work for many years, but I feel like a have a whole new perspective, and it´s so much fun to put into practice the very things I´ve been studying. Hola con todos desde el Ecuador! I´m back on another ARSE adventure in Ecuador, this time combined with 10 days in the Galapagos and 10 in Peru, to celebrate by recent Mastery of the field of Public Health (and current freedom/unemployment). The work in the communities here where I´ve been coming the past 6 years has been more gratifying than ever, and a perfect way to spend my first months out of school. We´ve been doing community health work for many years, but I feel like a have a whole new perspective, and it´s so much fun to put into practice the very things I´ve been studying.

The promotores, some of whom have now been involved for three years, have leapt to a whole new level of confidence and leadership, even since I was here last December. One of my favorite moments in all my years so far occurred in a community meeting in Chacanceo this trip. This is the most remote of the communities (think 3 hour UPHILL mule ride, no road). First, the promotores had taken the initiative to organize a community meeting for the first day we arrived, in the absence of both Lupe, the Ecuadorian Dr. with whom we work, and the local teacher, who is the main community leader. They had a written agenda, and took turns leading the community in discussion. (Yay! We taught them those skills!) Wilson (the youngest) excitedly presented his idea of a community project to build wood burning stoves that vent outside the house, rather than the smoky versions that most people now use. He listened to others’ opinions, and then articulately and confidently presented his ideas. He has been a promotor for 2 years, and learned about the design of these wood burning stoves during a trip to an international health conference he attended with us 2 years ago in Cuenca. But the thing that made it so special for me to see him promoting clean stoves for his community was that on my first ever trip to Chacanceo, he was sent down to meet us with his family´s mules. He guided us back to the community. At that time, he was a tiny, shy 12 year old boy who I first guessed was about 8. We engaged in halting conversation for much of the hike up the mountain. He was sweet and curious, but like many people in his rural village, fairly reserved. Now, at age 18, he is truly a community leader, and the transformation is amazing. He also has a playful, goofy teenage boy side, which brightens our workshops and long hikes. But I feel so lucky to have seen him grow up, and to be able to support and encourage his commitment to his community.

This trip I spent a week working with the 3 proms in Manta Real, the biggest community, then another week with the 3 proms in Chacanceo. In daily sessions we talked about the value of various kinds of data collection, implemented a community survey about family planning, discussed the theory and practice of popular education, and designed a small project that ARSE will fund and the proms will implement in each community. Each group also planned and led a popular education style workshop for the community. It was a busy two weeks!! Here are some highlights:

In Chacanceo the community organized so we would eat with a different family each day. (At this point “we” is my fiend Alison from Columbia, who joined me after a week of language school, and a nursing student from San Francisco who came along as a volunteer.) Chacanceans are farmers, so the community is widely dispersed and the terrain is MOUNTAINOUS. I know I tease the east coasters about their description of the Berkshire Rolling Hills as “mountains,” but these Ecuadorian mountains involve some SERIOUS incline, even by my Oregon standards. Anyway, we were getting good workouts because each walk to a meal could be a 15-40 minute serious hike. One time a tiny 7 year old was sent to guide us to his uncle´s distant house. At first he was too shy to even speak to us, but it was clear he was there to take us, so we followed him off down the path. Soon he warmed up, and started to be playful, running ahead, hiding, and jumping out from behind trees to startle us. He insisted that we skip, then wanted us to run. He pointed out sights: “7 chicken,” “a pig,” “a butterfly,” “my uncle’s house” (seemingly miles away down the hill). I couldn´t help compare him with Wilson, and hope that 10 years hence he too might be a promotor.

Sebastian, another promotor from Chacanceo, has a daughter who´s 4. She appeared one day carrying a long stick with a rope attached to one end. I asked what it was, and her dad said “It´s a horse.” I was terribly confused, until I realized it was kind of like an old-fashioned hobby horse, only headless. And sure enough, the little girl soon mounted up, and took off galloping across the field, swatting her “horse/mule” with the attached rope and shouting “Cho! Cho!” (which is how you get your Spanish-speaking mule to move forward.) Next she stopped her mule next to the soccer goal post, dismounted, and proceeded to tie the beast up with an elaborate knot, using the same rope. It was such a perfect replication of what she must see adults doing every day, it was precious.

There is a dramatic generational gap in terms of family planning attitudes. People who are around 35 and up tend to have huge families, 5-12 kids. No planning methods other than some of the younger women in that bracket now have their tubes tied. Younger women may have 2 kids by their early twenties, but most of them are currently using some kind of family planning (depo provera injections or the pill, according to my sense from collecting data, not yet analyzed). One family where we went to eat had 9 kids, one a baby, and the mom in her early 40s.I asked about family planning, and the dad replied that he didn´t want his wife to use anything because those things cause cancer. I invited them to come to the workshops we were doing with the proms, because they were curious what was going on and I didn´t want them to feel excluded. They came the day we were practicing the questionnaire, so there was a lot of discussion of family planning, it turns out the oldest prom (early 40s) also felt that modern methods caused cancer, but had successfully combined the rhythm method with condom use with his partner. I decided not to confront the cancer myth in the moment, because I was getting the idea it was widespread and wanted to think about an effective and respectful way to address it.

Anyway, what unfolded was beautiful. The guy with the huge family left soon after we started the questionnaire, I think because he may have been uncomfortable with so much of the proms’ talk of why it´s desirable to limit family size. His wife, however, hung around. When we started practicing the survey, she said, “Call him back, ask him the questions, I want to hear what he says! I want you to ask him! I don’t want any more kids, but he won’t do anything!” So the proms called him in, and administered the questionnaire. Then they started to ask why he was opposed to family planning. The oldest prom, who is a similar age but with only 3 kids told his personal story. He said “I had two kids and didn´t want to have more. But then the third one was born, and I didn´t know what to do. I went to a workshop and learned about the rhythm method. You don´t have to use those things that can hurt your wife, you just have to count the days from when she has her period, and from the 14^th day…” And he explained how it works, how it required cooperation and communication between the partners, how you have to use a condom if you want to have sex on the unsafe days, almost textbook perfect. Ok, sure, the rhythm method is not 100%, but the prom has 3 kids, and the other guy has 9, and they´re the same age! It was an ideal illustration of the power of community health workers. We sat back and said nothing, while he non-judgmentally shared his personal experience with his peer - how he had been unaware and frustrated with a situation, had received new information, had changed his behavior and was pleased with the outcome. Now he wanted to offer the same information to the community. Perfect. Later in the week we talked about family planning myths (cancer! infertility! impotence!) with the proms, and it was one of the things they chose to include in their community workshop at the end of the week.

I don’t know how it could be better! I feel like now I’ve been here so many times, have relationships with the proms, and can much better communicate with them. When we discussed “myths” (a word they had a hard time understanding and suggested we change to “false beliefs”) they were completely open to hearing new information. They asked lots of questions, shared the things they’d heard, and puzzled through the story problem I gave to illustrate the ideas of confounding and causality (diagram thanks to Alison): Twenty women take the pill. Five get cancer. Twenty women don´t take the pill. Five get cancer. What’s going on? What is cancer? Why do some people who take the pill get it and some don´t? Why do people get cancer if they don´t take the pill? Why do people associate cancer with the pill? It was an amazing discussion, which they replicated themselves with slight modifications and a slightly confusing description in their own workshop. Seven women – IUDs – 5 deaths…I think they got tired of drawing women, and high death rates make for engaging drama!

Ok, not even halfway through my list of community adventures, but i´m now in the Galapagos and the internet café is about to close. Tomorrow Alison and I take of on an 8-day boat trip so I want to get some sleep while still on a stable surface. More later.