11-19-20...a farewell to Lima

Ai-yi-yi...by 9:30 am the line was out the door in our little clinic...60-some women hoping to be seen/examined and/or treated before Las Americanas left their barrio... we ran our bootys off for hours.

At mid day a huge surprise... the midwife in the birthing center upstairs brought down a newly-born baby girl, rushed into my "exam room" (which is actually the OR/c-section room when PINCC is not here.) to suction the baby and clamp the cord and warm her up. Mother and baby doing fine (see photo above).

As we said our good-byes to our colleagues/trainees at Medisol Clinic, they treated us to Pisco Sours...a yuummy drink for which Peru is famous.

Had dinner in the "Latin Quarter"...Comidas tipicas at a jazzy little bistro across from our hotel before 3 of our group headed out to the airport.

Now for a good night's sleep before my 16-hr trek home :-/

Thanks for being here along the way,

Mai

We had a sad, chilling reminder today of why this work is so necessary and important for these women: a 58-yr old woman arrived with her husband...no prior pap screen...seen/examined and found to have invasive cervical cancer, undoubtedly terminal...our Peru Dr. had to break the news to them. They never shed a tear. The weak would not survive here.

This case was fortunately followed by three more women with early treatable lesions biopsied in clinic today...which lifted our spirits to say the least.

We're having a Pizza party tonight to begin our goodbyes as tomorrow is our last day at MediSol clinic..before our team will be heading out Saturday for separate destinations home.

I haven't begun to process all the high and low moments..(more high than low)...but the 14-hours from leaving Sat. am to arriving @ SFO 11pm Sat. will give me time.

Cheers,

Mai

11-17-10

102- yr old patient of MediSol clinic (not our pt.)
Peruvian street seller
love that smile!

Just as our spirits were beginning to flag after a somewhat frustrating day near the end of my 3 weeks in the trenches...our beloved Jefa carol gave us a wonderful surprise: reservations at the famous L'eau Vivre french restaurant (run by a French order of nuns)...in a restored 1824 Spanish Colonial mansion in the heart of Lima near the presidential Palace and Plaza..

The order of Senora Del Carmen (their saint of the poor) The nuns cook and serve in the restaurant and live above it. The proceeds are used to fund a "bazillion" projects for the poor here in Lima.

After being served drinks - a flawless vino tinto- the 8 nuns fanned out around the perimeter of the dining hall and gifted us with a song, 'Ave Maria', the achingly sweet voices rising above us and echoing off the ancient wood rafters 20 ft. above our heads. (see: http://www.youtube.com/watch?v=aKC8RH0djIs )

Each plate served was met with rave reviews...the poisson, the poulet, the pomme frites., all cooked to perfection...finished with creme brulee, mousse and crepes flambe.

I had to keep pinching myself to be sure I wasn't dreaming ("ok, I am still on a PINCC mission, right?!). It was one of those unforgettable evenings one keeps in the memory box for life. Thanks Carol.

Back to reality at the clinic tomorrow.

xox,

Mai

our sweet staff at clinica MediSol

Barrio Villa Maria Triunfo (where our clinic is)

Another low-key day...another 30-some women/pt's seen and treated and another good training day for the Dr's here...We had all gotten used to a far more intense pace and are grumbling...though with only 3 more days here in Peru, it's good to wind down.

One OB doc told us she had traveled all night by bus from her home to arrive here for our training...and worked all day alongside us. Their gratitude is palpable. I can only imagine her home clinic...One gynecologist for 4,500 fertile-age women...wow. They are so thankful for this one-stop/one-day diagnosis and treatment regimen which PINCC teaches for HPV...as follow-up, quality of lab results and costs are ultimately huge problems for these poorer populations.

Once again the group split up to persue after-work agendas: the Inca Market for tourist shoppiing ...meeting friends for dinner, etc. (and in the case of our Jefas, Carol and Dr. Melissa: more work). Gratefully there is a quiet bistro across from our hotel: "Las Tejas", for cuchinos (shish-kebabs) and cerveza

Abrazos y besos,

Mai

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Medisol clinic

Bundled up in jackets and headed for the outskirts(Barrio Villa Maria Triunfo) at 7 am. We were greeted by a huge sign announcing our presence at their clinic today (see photo). They are a full-service Women's clinic including an on-call 24-7 midwife who lives above the clinic.

Today was a bit "sketchy" as they say...a slower pace than normal though they trickled in at a steady rate till nearly 6 pm. One woman stated she had traveled 2 days from the Amazon to attend our clinic today...that knocked me out.

The good news is that of the 40+ women seen at clinic today, none were high-grade lesions which speaks to how well they are caring for the women in their area after the prior PINCC trainings. Our work is nearly done here. However the trainees hoping to be certified this week in cryo and biopsy need more serious cases to see to become competent.

But tomorrow IS another day, as Scarlett would say.

Cheers,

Mai

Our Hotel, 'Hostel El Patio is a little slice of heaven...(not used to such luxury on a trip but I think I could get used to it)

Today we welcomed Dr. Jennifer Seidel from Denver onto our team. The group split up and went with their own agendas to see and do today.

Lima is a city of contrasts from the very old to the very new buildings and everything in between. The weather is quite like San Francisco in Fall here in Lima...a bit cool but sunny.

******

We are told there is a troublesome petty-crime problem here and to be vigilant on the street...however it seemed o.k. to me. I took a 3-hour walk around the City Center, exploring what there was to see without a twinge....until I made change from $US to Soles from a moneychanger on the street who we were told were trustworthy...he gave me fake coins among my change...oh well.

******If you're looking for a coffeeshop in Lima there is one on Avenida Larco sandwiched in between the McDonald's and the Payless shoe store - it's called Starbucks. Hello Globalization, bye-bye local merchants? Though I did manage to find a local Cafe for some good Peruvian coffee.

******Tomorrow we will be working in 2 clinics on the poorer outskirts of Lima under the auspices of 3 groups: Pathfinders (Dr. Guttierez and Dr. Garcia) 2) Instituto de Salud Popular (INSAP) and 3) Proyecto para Salud Reproductiva (ESAR). This is PINCC's 2nd visit. We are training Dr's and Midwives, some of whom will become trainers and hopefully run a training center in Medisol in the near future.

The work marches on...up at 6:30 am tomorrow for a lite brkfst and the trip to the clinic.

Cheers,

Mai

Greetings from Mira Flores

s

Mira Flores Av. Larco, Lima Peru We bid a fond farewell to the Duena of Casa Tazumal and our wonderful cook, Ydalia and spent a last few hours playing "Tourist" before heading to the airport.. Unfortunately our Dr. Nancy Levine heads back to her life in New York today - but another fine Dr. will be joining us for the Peru leg of the trip.. .Arrived after dark and found our hotel...a bit of Luxury here n Miraflores (feels strange to be in the Big City again ) Our Hotel is like something in the French Quarter of New Orleans - very charming. Now for a long rest and a sleep-in tomorrow (Sunday!) Cheers, Mai

on doing this work:

To Be of Use

The people I love the best jump into work head first without dallying in the shallows I love people who harness themselves, an ox to a heavy cart, who pull like water buffalo, with massive patience, who strain in the mud and the muck to move things forward, who do what has to be done, again and again. I want to be with people who submerge in the task, who go into the fields to harvest who move in a common rhythm when the food must come in or the fire be put out. The work of the world is common as mud. Botched, it smears the hands, crumbles to dust. But the thing worth doing, well done has a shape that satisfies, clean and evident. Greek amphoras for wine or oil, Hopi vases that held corn, are put in museums but you know they were made to be used. The pitcher cries for water to carry and a person for work that is real. Marge Piercy

(A portrait of the Artist in Residence, Cristian Lopez, at Pedro Tesak School for Creative Intelligence.)

..part of the compound where, in the closing hours of a long busy week seeing hundreds of women, our dear friends, the staff of the Clinics under Ministerio De Salud honored us with an overwhelming, over-the-top tribute to PINCC this evening in Barrio Delgado...

This came as a total surprise to all of us.

The National Army Band was there, as well as the young ones of the school in an indigenous drumming corps...complete with 10-ft-tall walking puppets to greet our arrival.

the Director of one of the clinics gave us a presentation and distributed Certificates of Appreciation to all of us on behalf of the El Salvador Ministry of Health....expressing extreme gratitude for the gift PINCC is leaving them: an electrical excision biopsy machine ($15K I am told). We were given a tour of the grounds and gardens and feted by a trio of musicians at the supper hall...

What can I say? I was (almost) speechless... (o.k., when have you ever known me to be speechless?). I only wish Dr. Kay and Pat Sax, the founding mothers of PINCC were here to receive this as they are the ones who truly deserve it.

We will be wrapping up our stay here in San Salvador tomorrow and flying down to Peru in the afternoon

Next stop: Lima

Abrazos,

Mai

DDa
Wall in the garden at our homestay, Casa Tazumal

The Goddess of Volunteers smiled on us today...ONLY 50+ women showed up...a few being hard/sad cases - and the weather being alot more humind :-/

but mostly worked through and got off early....

walked to a local cantina and let loose! a few cervezas, lots of dancing then said our goodbyes to the amazing staff at ProVida who are toiling in the trenches here in Nijapa, a very small pueblito on the outskirts of San Salvador. Side note: ProVida does not mean what you might think...they are VERY pro-women's right to quality healthcare.

Tomorrow we will be setting up at anothe clinic for our last full day here in El Salvador.

Time flies when you're having fun,

Cheers,

Mai

You know you're not in Alameda anymore when the view out your bedroom window is the lightly smoking volcano Cojutepeque visible over the rooftops in the distance.

We arrived at work ready for a busy day and got our bootys kicked! Busloads of women (110! - a PINCC record I am told.) arrived throughout the day.... We literally ran from 7:30 am till 6pm and managed to see/examine and/0r treat everyone who needed to be seen! As exhausted as we were I believe the entire team was high on accomplishment - laughing and high-5'ing each other at the end of the day.

It was a priceless feeling to work side-by-side in the trenches with our Salvadorean colleagues

to get the work done...to give these women what they needed. This is an experience that can't be bought.

Said farewell to mi miJita, (roomie) Lupita who left the team tonight and will be heading home...I MISS HER ALREADY...lucky me, she lives in Walnut Creek, 20 mins from me :-]

Only (ONLY?!) expecting 80+ tomorrow when we move to the San Martin clinic. Wish us luck.

and a good night's sleep.

Cheers, Mai

11-09-10

Our day began at 6am as We had 70 patients to be seen at the clinic beginning at 7am.

Lupita, Carol and I did an awesome teaching session with the women first...an overview of HPV, breast self-exam and what to expect from ther exam today...

Worked straight through side-by side with our companeros/companeras/trainees and managed to see every woman waiting to be seen.

In fact seven who shared their history of being sexually abused were referred to the on-site psychologist and seen the same day with appointments for follow-up therapy. That made my day. Moving to our second site tomorrow.

I was somewhat surprised and saddened by how many women my age we see who tell me they've had 8 or 9 children...only 3 or 4 living - until I thought, of course, these children would have been in ther 20's in the 1980's when a whole generation of men and women freedom- fighters lost their lives in the war.

A large group went after work to the Cathedral where the fallen martyr, Bishop Oscar Romero is entombed. (been there).

I miss our Dr. Kay but Dr Melissa is doing an amazing job of filling her unfillable shoes.

Cheers,

Mai

Arrived at Clinica de Salud, San Jacinto early this am to a LONG line of women waiting...and the pleaure of many competent trainees...worked through the day managing to see/examine/treat 64 women! Our new PINCC Med Director. Dr. Melissa from Texas was a pro.

(only one invasive lesion required a referral for surgery...SO thankful she came in today!)

Our Registration staff, Jan, a psychotherapist was treated to a surprise birthday cake by the Clinica staff at the end of the day. Que carinoso

The work went extremely well all things considered...and we will be certifying staff there after another busy day tomorrow (another 70 women expected).

one eeky cultural side note: Can't help wincing at the site of 3 or 4 kids riding loose in the back of a pick-up truck whizzing down the highway! A common site here. (egadz...organ-donormobile?)

Now to put my feet up and enjoy a Salvadorean cerveza..

Cheers, Mai.

a day of fun...and remembrance...

Visited the Centro de Arte y Paz Y Reconciliacion' in Suchitoto...a testament to the strenth of these people to overcome war and oppression and make a peaceful life for themselves here.

Most of our group took a boatride around the lake which is a bird sanctuary as well.

Now to prepare for a big day in the Clinic tomorrow...

love.

mai

Greetings from San Salvador, El Sal 11-

the memorial garden at 'la UCA', San Salvador

Spent the day packing up and traveling from Esteli down into Managua...(some of the team split off to head home)..then headed for the airport for a 5 pm flight to San Salvador, El Sal. Said our goodbyes to Dr. Kay :-/

(Arriving at San Sal airport I had a flashback of a short self-funded project to San Martin my dau. Kira and I took - where Kira lost her passport IN the airport - requiring an emergency trip to the US Embassy the next day for a replacement - alls well that ends well.0

Returned to the PINCC's favorite hotel here in San Sal: Casa Tazumal...a very "homey" atmosphere... and the Duena is like a family friend. We added two to our team tonight: Anne, an OB Phys. Asst.from Denver and Jan who will be assisting registration/med records (yaay!)

Today we have two OB's flying in...Melissa from Texas and Nancy Levine from New York.

We will be going to SuchiToto today...a picturesque nature preserve/bird sanctuary and the site of the Peace and Reconciliation after the war in El Sal. There is a collective of women artisans/entrepeneurs there (many are widows from the war) who have beautiful handmade items for sale.

Tomorrow the really busy and hard work begins. Being the Capital city, San Sal has about 75 women a day show up hoping to be treated. Additionally, we well be travelling to 4 sites in 5 days which involves unpacking and repacking our offices into luggage :-/ Wish us luck,

love, Mai

After seeing another 20 women/patients and leaving the Sweaty and basic working conditions in the Centro De Salud, Jalapa - leaving a good start on training a few of their Docs/Nurses in a more doable method of diagnosing/treating HPV....

we packed our bags and headed down the mountain into Esteli to spent the night at the Hotel Los Arcos ( a little slice of paradise after having to put a bucket of water in to flush the toilet at our last Hotelito)...see my companera de cuarto (roomie) Lupe's ecstatic joy on her face!

Cheers,

Mai

Hasta la vista Jalapa

11-05:

Worked a busy, productive day at Centro De Salud...will fin ish up there today and head for Esteli' this pm where we will spend the night. Not able to certify the staff here as yet, but hopefully next year when PINCC returns May '11.

A much needed NGO here: "Spayers without Borders" - so many homeless puppies :-/

(strange) side note: a (very "Extreme Sport" here in Nica: Volcano Boarding! _ Like snow booarding only going down the sandy/ashy decline of an active volcano! (I kid you not - see: www.bigfootvolcanoboarding.com )

Unfortunately, Our Fearless Leader,

dr. Kay is heading home from El Salvador on Sunday...leaving the Medical authority in the capable hands of Dr. Art and Dr. Melissa *(an OB from Texas who is joining us in El
Salvador.).

Cheers, Mai

mas fotos de Leon- y Jalapa...

Greetings from Jalapa...11-03-´10

Sadly not able to download my photos from this connection (no wireless)

Today was challenging and frustrating as this is not the first visit to this site by PINCC though Dr. Kay says it feels like starting over. The medical records are more organized but the trainees are newbies...like starting from Ground Zero.

(And the Hotel is - to be generous- BASIC. Note of perspective: it beats an army cot in Haiti...been there, done that.)

Tomorrow we continue the training here before packing up and moving on.

Wish us luck,

cheers, M

Tues 11-02

Before leaving Leon we joined a procession to the Cemetario for Dia de Difuntos (day to honor the departed). The families sweep the gravesites and plant flowers and sit in quiet communion with their dparted. deeply sweet.
Stopped at a Botanical Garden near Esteli for lunch (near the killing fields in the mtns in the war between the Sandinistas and the Contras...finally arriving in Jalapa...a small and basic pueblo where we will do a training at the Pulic Health Clinic (such as it is) tomorrow...there is zero-not one OB-Gyn in this village but we will hopefully train a nurse-midwife in our procedure for detecting HPV lesions
Now for a cold shower...and hopefully sleep...without mosquitos molesting us!
Cheers, Mai