Arequipa - Andean Condors - Approval Process

Road-side vendor on the way to el Cañón de Colca from Arequipa

 I arrived in Cusco just before the start of a long weekend for Semana Santa, I knew it was going to delay the final approval of my project, so I decided to take advantage of the long weekend and travel to Arequipa.  It was such a culturally rich trip with so many experiences I couldn't possibly cover it all without writing a book...
So, I'll write some blurbs about what I think are the most important parts and throw in some pics - click on the links for more info :)

Plaza de Armas - Arequipa

Arequipa - known as "la ciudad blanca" or the "white city" - for the white volcanic stone that was used throughout the city's cathedrals and spanish colonial buildings.  The city is GORGEOUS! A great example of spanish colonial city planning while maintaining a lot of it's native history.  There are 1,500 year old terraces that pre-date the Incan Empire throughout the river valley and the outer districts of the city that have been preserved and designated as world heritage sites.

El volcán Misti overlooking Arequipa

Overwatched by three impressive snow-topped volcanoes (El Misti, Chachani & Picchu Picchu), Arequipa sits at 7,000ft above sea-level on the banks of the river Chili (quechua for "cold")...during my stay during Holy Week I was able to observe native arequipeños participate in the "stations of the cross" which they observe by visiting each of Arequipa's 14 churches to pray - the streets are filled with people, vendors, activities throughout the night and there are certain secluded churches only open on this day for the general public (such as the Santa Catalina Monastery)

Vibrant Colors of Santa Catalina

Top of Misti peaking over the Cathedral of Arequipa

Cathedral at night - Plaza de Armas - Arequipa

I also saw a religious process for La Neustra Señora de las Angustias   (aka Our Lady of Anguish)
- It is a representation of the virgin mary that is worshiped in Arequipa
- policemen, firemen, and the military were all involved in the procession along with the sect of followers

La Sra. de las Angustias procession through Arequipa

 Watch a portion of the procession at the video link below:

I also had the opportunity to visit the Cañón de Colca to see the majestic Andean Condor and enjoy the natural beauty of the canyon.  I absolutely loved the Canyon de Colca, the natural beauty was overhwhelming and I would love to return for an extended hike into the valley.  On this trip, we focused on visiting the local villages as well as visiting the Mirador del Condor to see the Andean Condor fly through the Canyon.  We also spent some time in the outdoor mineral hot springs that were intially built by the Incas - the aqueducts funneling the heated water from the bowels of the mountains are still functioning and in use for the current version of the hot springs :)

Casa de mi Abuela - Colca Canyon

Chivay - entryway to Colca Canyon

Cañón de Colca - "worlds deepest canyon"

Condor doing a "fly-by" about 30 feet overhead

Condor winging it in the Canyon

Pool #5 - La Caldera - Hot Springs outside of Chivay

It was an AMAZING trip! I absolutely love Arequipa for the yummy food, the natural beauty, the unique peruvian culture and the city.  I highly, highly recommend a trip if you are ever in Peru - if you do go, Casa de Mi Abuela is the place to stay in both Arequipa & Cañón de Colca. 

Queso Helado = Traditional Arequipeño Vanilla Ice Cream

Chupe de Camaron - traditional Arequipeño dish

I am glad it was such a good trip because on my return I've been furiously trying to network and work the system to expedite the approval process for my project.  The fact that I already have approval on the national level and that I completed a portion of my project at a national hospital didn't seem to help all that much.  I am currently in week three of the approval process and still have not received the green light to start in Cusco.  I'm hoping to be able to get it going by this Friday.  A little bit frustrating as I was told the process would take 1 1/2 weeks - 2 weeks tops since I already had approval at the national level but it's all part of the experience.  When things get too frustrating I go to my happy place...hanging out with the baby alpaca on the way to Cañón del Colca at 15,000ft above sea level ;-)

Hanging out with a baby Alpaca

More to follow on the project and life in Cusco as I start settling in...

Whoop!

Cusco Day#1

Today I landed in Cusco and met up with an old friend from my last visit - a year and a half ago.  Boris was the guide on my Inca Trail trek and we became fast friends.  He helped me find a GREAT apartment and settle in.  Great dude!  The apartment is a furnished two bedroom, two bath, with wi-fi internet and all utilities included for the same price that I pay in New Haven for half of a two bedroom one bath without utilities or internet.  This place is much nicer as well....Cusco rocks.

I went exploring and my lungs could definitely feel every inch of the 10,000 ft above sea level.  The apartment is about a 20 min - 30 min walk downtown and a 15 min walk to the Regional Hospital.  Once I got to the city center, it all came back to me and it felt like I never left, eventhough I was huffing and puffing a little more than I remember ;)

Tomorrow I start in earnest by meeting with the Regional Health Director in Cusco for Obstetrics and Gynecology as well as the office of investigation at the Regional Hospital in order to get my study going for next week.  I also hope to meet a contact that can help me with heading out to the local health centers in the Andes within the region of Cusco.  All that and I still need to pack for my Semana Santa holiday / early birthday present for myself trip.  

This week is La Semana Santa - "Holy Week" or Easter Week, which means HOLIDAY!!! Most peopel will be taking the week off and, from what I understand, it's an important holiday over here so there will be minimal staffing whenever possible.   I'm taking advantage of tomorrow to make sure the approval process is in gear, so I can start familiarizing at the hospital next Monday.  In the meantime, I've arranged a little get-away to Arequipa and the Cañón de Colca where I hope to come face-to-face with the mythical Andean Condor and with a wingspan over 10ft maybe I can ride him back to Cusco ;-)

Have you ever read the Alchemist? I thought of a line in that book today.....when you are doing what you are meant to do, the entire world conspires to help you.....that's how I felt today walking around in downtown Cusco as I headed back to my apartment and thought about preparing for tomorrow's activities and the month ahead....

Pictures from Day #1 in Cusco:

The new digs...

View from my bedroom ;)

The path to the Historical City Center

Headed towards Downtown Cusco - Historical Center

Guardian of the fork in the road = almost there!!!

Final path to the Plaza de Armas & Cathedral in the center of Cusco

Night fall in downtown Cusco

The old Incan Temple turned Church

I know, I know...no pics of the Cusco Cathedral or the Plaza de Armas...but I'm saving those! They deserve their own pictures and contemplation apart from anything else.  More to follow....

This morning I woke up in Lima at sea-level finishing up my first 20 days in Peru....
tonight I go to bed in Cusco at 10,000 ft starting my next 30 days in Peru......

I don't know what the next 30 days will bring but I'm ready to find out!

Whoop!

20 days in Lima...

My first 20 days in Lima have come and gone...

it feels like I just put my bags down for the first time, after an all night red-eye flight, to catch a cab to the university a couple of days ago.  Tomorrow, I leave for Cusco...the city of the Incas, the starting point for Machu Picchu, the tourist trap, a melting pot of catholic faith and indian mysticism....I'm excited to discover Cusco for who Cusco really is....past all the paparazzi fanfare, cultural consumerism and artistic facades....I'm ready to see what's behind all the doors when the lights go dim and the tourists go home....

but first, I need to reflect on Lima...it has truly been an amazing, life-changing, eye-opening experience...I've done a lot of traveling in my 30 years, all over the world, in a variety of uniforms and roles but I've never had such an enriching experience.  I'm still trying to put my finger on it and figure it out.....I know it will come...right now I'm just being present and living through this experience.

How do I describe Lima....it's dirty, loud, and definitely not the most attractive city....it's not as sexy as Paris, or as Gucci as Rome, not as romantic as Venice, or inspiring as Washington D.C. but Lima is attractive in it's own way...it has a pulse, a palpable echo of it's chaotic past and violent mixing of cultures, that's present in it's people, in it's politics, in it's food, in the way that each person walks through their day....it's a city as real as it's people, not always pretty, often times scarred but beautiful none-the-less when you know where to look and where to find it....and sometimes, it surprises you...

like some of the best all you can eat Sushi buffet..say what!!?? Yeah, I know! Who knew...
for those of you who are familiar with New Haven...think Mia's Sushi with all of it's freshness, creativity, tastiness + all you can eat buffet prices and you have Wasabi's in Miraflores - the best place for all you can eat sushi anywhere in the world....courtesy of some local Peruvian friends I met at the hospital.  Not a bad last night in town.  We crushed through 19 different rolls - including two dessert roles ;) Whoop!

Somehow in the middle of all that, I finished my research and met my sample size goals - crazy!!!

Next time I'll be on top of the world at over 10,000ft in Cusco....Whoop!

Machu Picchu - Yale - Peruvian Governmental Palace

In 1911, Yale Archeologist Hiram Bingham re-discovered the Inca City that has come to be known as Machu Picchu.  All the artifacts that were found were technically on loan from the Peruvian Government for a few months but Yale decided to keep for about 90 years or so.

Peru's current out-going President, Alan Garcia, personally contacted President Obama to have the artifacts returned.  Eventually, an agreement was reached and all the cultural treasures will be returned to Peru in a series of shipments until 2012.  The artifacts will be held by a University in Cusco who, along with Yale, will open a new museum in Cusco to display the cultural riches.

This is BIG news in Peru.  SO BIG, that the first shipment of artifacts received from Yale on March 30th were displayed in the Governmental Palace for free to mark 100 years since the "discovery" of Machu Picchu - originally set to be open for one week it was extended to two weeks.  As a current Yalie, I could not afford to miss such an experience.  To avoid the crowds, I decided to play hookie from work and went in the afternoon mid-week ;) Not to worry, I worked the night shift and still got my sample size! Whoop!

As my new Peruvian friends like to remind me, Peruvians are ecstatic that they have received their cultural treasures and made Yale honor their initial agreement.  When negotiations were still on-going with Yale, there were banners along every bridge crossed by El Metropolitano like the one below.

Translation: YALE - return the goods of Machu Picchu!  Viva el Peru!!!

SO, what did I find....  An amazing Governmental Palace and some pretty cool pieces.
Check it out:

City Center of Lima on the way to the Palace

Square in front of the Governmental Palace

Benjamin representing Yale in front of the banner - Whoop!

 Banner outside the
Govermental Palace reads:
Center Top:
"The archeological treasures of Machu Picchu"

Bottom - as you read it:
"Governmental Palace"
"Free entry"

Exhibit Hall Continued

Exhibit inside the Governmental Palace

National Geographic pics from "the dig"

Cool pic from the Gov't Palace

Former resident of Machu Picchu

 

Pottery!

More Pottery!

 They had an array of tools, metal working, ceramics and pottery....with some more pottery.  I just tried to show some of what I thought were the highlights. Not all that mind-boggling interesting unless your an archeologist ;)

Interested in reading more? Check out this article in USA today:
http://www.usatoday.com/news/world/2010-11-19-inca-artifacts-yale-university_N.htm

Just about reached my sample size which represents the end of my initial research in Lima.
Next, preparing for the Cusco portion of the trip....lots to do and lots more to follow....Whoop!

Peruvian Presidential & Congressional elections - April, 10th 2011

The general elections that occured on Sunday April 10th decided the Peruvian Political Leadership for the next 6 years.  All the congressmen voted in will stay, however, regarding the Presidential elections there will be a second round in August.  They do not have primaries in Peru and they have a thriving pluralist system so the fight for the presidency was really between 5 primary candidates although there were many more.

There was one socialist - left leaning former Soldier who was supported by both Hugo Chavez from and Evo Morales - Ollanta with over 30% of the vote.
Then there is Keiko with about 23% of the vote - daughter of former president who is currently in jail indefinitely on corruption charges.  I guess the equivalent would be if Chealsey Clinton ran for the Presidency.
Then there were the three amigos - 3 x moderate to conservative candidates that really could have one the presidency outright with 51% of the vote if they decided to support each other.  As it was, they all pretty much split the same voters and none of them are going to the second round.  Among the three amigos are Castaneda with 5% of the vote, former mayor of lima and responsible for the Metropolitano, Toledo with 15% of the vote, former shoe shine boy who came to the U.S. to study at Stanford and Harvard - he's an economist by trade and also a former Peruvian president, then there is PPK with around 20% of the vote, businessman and economist with dual citizenship in both Peru & the U.S. that may have been a strike against him with the average Peruvian.

In the end Ollanta won by a large margin, followed by Keiko  so they will advance to the second round of voting in June.

The topic everyone is talking about is the obligatory voting and how that has catapulted Ollanta.  Most peruvians are of lower socioeconomic status and are voting for Ollanta because he wants to even the playing field at all costs.  Keiko also receives a lot of support from the outlying provinces as well as poorer districts around Lima.  If the three amigos would have united, one of them would have easily advanced to the second round which is what most educated Peruvians wanted.  They are afraid the economy will tank and foreign investment will drop with Ollanta as President.  They are also afraid that he will try to make Peru a dictatorship ala Hugo Chavez.  It's been an interesting weekend and monday morning around the water cooler ;)

BUT, experiencing the actual voting was the best of all....pictures speak a thousand words so check out the pictures below with the brief synopsis....

People finding out where their assigned voting posts are located

 Voting age is 18 - 70 and it is obligatory - those who do not vote are fined 180 Soles or about $60USD which is a lot of money for your average Peruvian.  Anyone older than 70 has an option to vote or not to vote, that is the question.  There are tables manned by people all over the city so they can find their assigned voting locations.

Rosa heading to her assigned voting post

 Most people are assigned a voting post close to their home or where they grew up, so a lot of people go back home to visit family and make it a family event - it is obligatory afterall.  Rosa was kind enough to let me tag along and document the experience.  The surprising thing I found was all the security around and within every voting post - local police, national police, and the Peruvian Army were deployed to provide security, deter corruption and ensure a smooth voting process.  Military members and National Police in Peru are prohibited from voting.

The purple finger = proof of the vote

 The last thing everybody does to ensure one person - one vote is tag each voting card with the voter's fingerprint in purple ink.  I don't know if they cross reference them or not but it's pretty awesome watching 100's and 100's of people trying to clean-up their purple fingers!
p.s. - middle fingers in Peru don't have the same meaning as in the U.S. - everybody points with their middle fingers in latin america!

NO Ciclodia --> Closed for the Vote

 EVERYTHING is pretty much shut down for the vote, it is obligatory after-all.  Some shops are open and there are a TON of street vendors.  The streets were full of buses, cars and taxis shuttling tons of people to their voting posts.  As you can see on the side of the street, it is FULL of people lining up to vote.  Most polling sites were situated in Universities.

People lined up to take buses to their polling sites

 Lines of buses rotated at all the bus stops and lines of people would form only to get scooped up and taken to their voting station of choice.  Polls opened at 8:30am and closed at 4pm - traffic steadily increased throughout the day.

One of the bigger and busier polling sites

This polling site was a large University situated behind a park and it was by far one of the busiest voting locations I saw - there were a TON of people lined up, street vendors, families hanging out in the park after the vote - very festive.  Slightly different from the U.S. but a great experience!

Of course, all news-stations and newspapers covered the voting process and it was all everyone was talking about all day Monday morning.

Care to take a crack at your Spanish? Check out this website from El Comercio one of the bigger and better newspapers / reporting agencies in Peru - at least I think so.
Link below:
http://elcomercio.pe/elecciones/

Another busy week of observations, I need to pull it into 5th gear if I'm going to get it all done before I fly out to Cusco! More to follow...

Whoop!

Islas Ballestas

Islas Ballestas

Islas Ballestas - named by Spanish mariners who found that the caves present throughout the island reminded them of crossbows --> Ballestas = Crossbows.   The islands are also sometimes called "baby galapagos" for the abundant avian as well as marine wildlife surrounding the island and "Bird Guano Islands" for a variety of reasons that I will discuss a little later down the road. 

The Islands are part of a national preserve in Paracas in the Povince of Pisco.  It's a red desert martian landscape next to the sea.  Buses from Lima to Pisco leave about every 15 min for the 4+hour drive.  We decided to do it overnight/early in the morning to get there as early as possible and spend the day.  We took about a 1:45am bus and arrived in Pisco just before 6am.  We then took a taxi to Paracas and the port that is used to start the boat tours of the Islas Ballestas.  It's a 2-hour tour around the island and nobody is allowed on the island unless your part of the workforce that collects bird guano every 8 years.  It's one of the world's principal producers of bird guano and the last collection occured in 2007.  They had 400 workers spend 4 months on the island shoveling bird guano onto barges to a total of 25,000 tons and over $11 million dollars - according to the tour guide.  After seeing the islands, it may even be an underestimation ;)

My friend the Humbolt Penguin

La Candelabria

One of the unique attractions of the tour is the proximity you can get to the wildlife and unique animals such as the Humbolt Penguin that live on the islands.  Upon our arrival, I made fast friends with a penguin that was showing me the best routes to the island.  The Candelabria is a HUGE heiroglyph in the sand which has a ton of speculated uses, one of which that it was used to guide incan mariners along the coast. 

We arrived in Paracas about 6:30am and after haggling for a good tour price we purchased the tickets and found a little cafe where we had a light Peruvian breakfast of coffee, fresh mango/orange juice and some cookies.  The tour started at 8am and it was amazing! A little chilly out on the water but we saw bottle nosed dolphins about 15 - 20 feet from the boat on the way to the candelabria and it was also breeding season for the South American Sea Lion known in Peru as the Lobo Chusco.  Females could be seen lounging on the rocks, Humbolt penguins were partying on small outcroppings, and the birds....the birds....were everywhere. 

Sun bathing Lobos Chuscos

Partying penguins

As we maneuvered the boat through the rocky outcroppings of the island we were within feet of penguins, sea lions, sea lion pups, and local indigenous fisherman in their wooden boats but we were SURROUNDED by birds which, literally, covered the island.  I felt like I was in an Alfred Hitchcock movie.  A picture would not do the scene justice.  SO much bird excrement, the islands are made of red voclanic rock but are stained pure white from all the bird guano.  There is a station where 4 caretakers watch over the birds permanently and a set of buldings to house the 400 workers who come every 8 years to shovel bird guano for 4 months.  Once you moved to the internal portions of the island the smell was pretty intense as well.  Birds make the island and it's an interesting economic as well as tourism asset for the national park.  

However,  the absolute highlight of the tour was when we floated past the rocky beaches within Isla Ballestas.  As I mentioned before, it's breeding season for the S.American Sea Lion and the beaches were COVERED with nursing pups, pups learning how to swim, and females.  We had the opportunity to see a couple of males on the beach and the males usually have harems of 35 or more females - these bad boys are HUGE.  They will also kill any male pups to reduce competition so the mother has to expend a lot of energy protecting male pups if they are going to survive.  The pups are slick black and were just getting beat up by the waves as they tried out their sea flippers and when they got tired they would run back to momma to nurse for a bit and chill out.  It was an incredible seen and it definitely helped make the long 8 hour bus ride worth the effort.  

South American Sea Lion pups learning to swim

After the tour, we went to a local restaurant on the beach and had fresh mariscos (sea food) consisting of ceviche, fried fish, avocado salad (known as Palta in Peru) and some grilled local Peruvian Sea Bass.  There were four of us (myself, the spaniard and two U.S. medical residents who are taking an infectious disease course at Cayetano) and we all shared the food along with some homemade lemonade.  Since it's election week no alcohol can be sold anywhere in Peru until after the elections are over, hence no cold cerveza to accompany the seafood :(

But the no alcohol sanction is yet another interesting aspect of Peruvian Election laws.  More to follow on the Elections which are taking place today....I had a great morning walking around and observing all the voting posts as well as people watching.  Initial results will be posted after the polls close at 4pm.  I'll post some more on the elections later tonight or tomorrow....so far, It's been a great weekend!

Check out more on the Islas Ballestas at the links below:
http://www.go2peru.com/gal_ballestas.htm
http://en.wikipedia.org/wiki/Islas_Ballestas

Whoop!

lost iPhones, PPH, and IUDs

#1 rule when you travel to latin america - don't lose your iPhone!!! I was a little bit tired after a few long days at the hospital figuring out how everything works and I think I left it on a locker in the changing room or it fell somewhere on the Metropolitano....I got back to the hospedaje and NO PHONE! Booo :(
I raced back to the hospital and I couldnt' find it, nobody saw anything but it's also somewhat of a high use area....no way I was going to locate anything on the Metropolitano.  So I just took it as a lesson re-learned.  Keep track of all your valuables at all times when travelling in foreign countries.  Life without my iPhone for the first 24 - 48 hours was ROUGH but now it's not so bad, I'm adjusting.  I can't wait to get back to the states and replace it, given that Japan has recovered enough that the iPhone has not faded into extinction.

PPH = Peruvian Public Hospitals.  My research involves another definition of PPH but I think talking about Peruvian Public Hospitals is important.  There is universal health coverage in Peru as well as a fair amount of private hospitals, however, most of the population is of low socioeconomic means and rely on the public hospitals for the majority of their healthcare needs.  I think the best image would be to think of the VA system back in the U.S. and imagine if Yale, for example, as a private institution helped to run and staff the VA Hospital but the VA was responsible for providing healthcare for everyone in Southern CT and not just veterans.  That brings up images of understaffed departments, over worked personnel and older equipment - small snippet of insight of what it's like.  However, you also have motivated individuals that do the best they can day-in and day-out.  In a one-room labor floor with 5 beds and a delivery room with two beds they attend to almost 5,000 births annually.  One fetal heart monitor for all 5 beds and one doppler.  They have an "intern pump" on their IVs - which is to say a thumb, a timer and counting the number of drops per minute - to regulate their infusions.  Tocometers are replaced by human touch - feeling a mother's uterus as it contracts and gauging the contractions on a semi-standardized scale while recording the duration.  Lots of one on one time with the mothers, lots of leopold maneuvers, lots of going back to the basics.  The delivery rooms are fairly modern and their techniques and procedures are not too far from the states.  It's been an interesting week so far figuring out how their systems work.  I'll have more to add on a later about the medical training system - their interns and Residency selection process are a different from the U.S. but otherwise they're pretty close and the structure is very familiar when working in the hospital.

One of the highlights of the week was attending a speaker panel on the employment of IUDs in the postpartum period sponsored by USAID.  A Dr. from Paraguay presented a study he did at the national hospital on the insertion of IUDs in the postpartum period and the current placement rates, complications, training, etc.... then a series of selected speakers commented on the presentation and the presenters as well as the panelists took questions from the audience.  among the panelists were a past president of the Peruvian Society of Obstetrics and Gynecology, the Peruvian Minister of Health for Reproduction and Sexual Health, and the president of the Peruvian College of Obstetrics.  Great questions, awesome presentation and what a great idea!!! Peru tried a smiliar initiative similar to the study in Paraguay back in the early 90's based on the experience of some success in Mexico.  It eventually went away but now it's coming back.  Especially, with the issues of family planning, continuity of pre-natal care and lack primary care access the Copper IUD is a great solution.  I think one of the most interesting points was the fact that a lot of the time it's the providers not feeling comfortalbe with the IUD as an option that limits it's use - it's a lot easier to prescribe a pill and a shot every 3 months than to take the time to counsel and maintain the proficiency on properly inserting an IUD.  I thought this would be a great option for many of the uninsured and immigrant populations in the U.S. that don't have continuity of care.  Another interesting project to follow-up on in the future.

Sorry, no pictures on this blog!!! No iPhone :(  However, I'm working on getting an inexpensive camera so I can keep sharing the Peru that I am experiencing.

This weekend - Islas Ballestas & General Elections!!! Whoop!

The week ahead....

Today the work has begun in earnest....
Before you can put in a looong week's work you need to fuel up with a good Desayuno ;) Typical breakfast at Hospedaje Cayetano? Start with some fine peruvian coffee, some freshly made pineapple juice (delicisouness made by Rosa!), some brightly colored hard boiled eggs from Peruvian Godornises (aka quails - or 6 quail eggs to be exact) w/Peruvian chili, and some other yummy delights to energize the day.  I do like to "macro-phage" ;-)

 After breakfast, it was off to Cayetano! Another quick trip on the plush Metropolitano and I was putting the final touches on all the required approvals and paperwork to get the study finalized so I can complete it without any issues.  TONS of beauracracy....ethics committee at the national institute of health, ethics committee at the unversity which is different from the ethics committee at the hospital and they don't collaborate eventhough they are on the same block and pretty much on the same compound....and both have separate offices that receive and process the paperwork before it gets to the ethics committee and once it's approved so I can actually receive the proper stamps and signatures.  However, everyone has literally moved heaven and earth to expedite the approval process.  It took me 3 months to get my protocol through the process and approved at the university from Connecticut.  Since my arrival, I've been able to accomplish in three days what usually takes three weeks.  It's actually been an amazing experience and I'm still blown away at how supportive everyone is of the study and my efforts to make it happen. Everyone I've worked with has also expressed tons of interest in the results.  It's extra incentive to make it the best study possible within my prescribed time limits and resources. Tomorrow is the day....I get to walk by the Universidad Peruana Cayetano Heredia sign everyday when I get off the Metropolitano to walk the last few blocks to the hospital.  I'm looking forward to seeing that sign every morning for the next few weeks.

UPCH - guarding the route from the Metropolitano to the Hospital

 

 One of the absolute highlights of the trip has been working with Calidad en Salud - a USAID health quality program in Peru.  They have been incredibly helpful and supportive in being proactive to get through all the required processes to get the final approval at each study site in the region of Cuzco within the Peruvian Andes.  I have all the main approvals out of the way but now each ethics committe or office of investigation needs to give their stamp of approval before I can begin.  It would be 100x more difficult without their help.  They are also helping me meet the right people to give me the best perspective on peruvian maternal-fetal healthcare and to support my efforts in completing the study.  

USAID - Calidad en Salud link: http://www.calidadensalud.pe/quienes_somos-mision_y_vision.asp

The most interesting thing coming up are the Peruvian General Elections - Sunday, April 10th.  Everyone in Peru has to vote, it's required by law.  If you don't vote, you get fined!!! How crazy but awesome is that!? Can you imagine if they did that in the U.S.?! Not that it would every fly with U.S. voters but what about incentives if you vote?? hmmmm, taxbreaks or 30% off at Walmart? Interesting to think about.....with so many people out exercising their right to vote, word on the street is that it's almost like a festival....everyone is out, there are food vendors, people hanging out, some post election parties going on, etc...it's going to be an interesting event....

check out this newsite on a Peruvian woman living in Miami who is going to vote to avoid a 'fine' -

http://business.highbeam.com/6033/article-1G1-144238587/peruvians-vote-required-even-abroad-peru-strict-mandatory

to cap it  off, I'm doing my final travel arrangements to arrive in Cuzco...I'm going to arrive withing the Semana Santa or Easter Week...which is religous procession and celebration season in Cuzco...I was thinking about traveling somewhere else but I think this is the season to be in Cuzco and a once in a life-time opportunity to have a unique cultural experience while getting to know the people and experience the culture in a new and vibrant setting.

check out the link:

http://www.southamericatravelblog.com/travel-blog/2011/02/semana-santa-eastern-week-in-cusco/

Lot's going on this week....but I'm looking forward to it.

Whoop!