Cruzando la frontera -- crossing the border to Tacna, Peru

Once again I am way behind on my blogging -- I am almost two weeks behind on this Tacna post! But as usual, better late than never.

Tuesday, October 4th our group loaded our giant, aquamarine turismo bus once again and started on the road to Tacna, Peru.  It was a very quick ride, only about an hour in total (30 minutes to the border + 30 minutes to Tacna), but somehow in that short amount of time we crossed two time zones. Crazy, right? We loaded the bus during Chile time and got off the bus in Minnesota time! The first night we just got settled into our hotel and ate dinner at the restaurant there, which was really nice. It was on the seventh floor of the hotel and had a beautiful overlook of all the beautiful city lights.

Overall, the differences between Arica and Tacna really surprised me.  The actual size of the two cities are pretty similar, but they felt so different.  Arica has the feel of a small town - everything is very calm, even the downtown area. The city mostly consists of single family one-story homes and small tiendas.  Tacna, on the other hand, really felt like a city. The first thing I noticed is that everything is so much taller.  Two story buildings equipped with rebar and scaffolding so they can be built up even more, and even some interesting architecture. The downtown streets were lined with wedding dress shops and specialty medicine clinics - dentists and orthodontists, plastic surgeons, optometrists, etc.  While it may seem random, there is a little reason to it:  Tacna is a tax-free city so Ariqueños (people from Arica) and Chileans as well as Peruvians travel to Tacna to utilize these services.  In fact, most of the city's revenue is generated by "foreigners" that travel to the city for just that reason.  The city really felt like a metropolis - everything seemed to move at a faster pace - which was a nice change from the sleepy city of Arica.

Wednesday morning we left for our first pasantía to Peruvian health center.  We were greeted by one of the directors of the hotel who presented a really fascinating powerpoint on the fundamentals and basics of the the health system in Peru. After that we broke up into six groups to participate in visitas domiciliarias (home visits) to various patients of the clinic.  The different groups included tuberculosis patients, pregnant women, the elderly, newborns, and two others that I can't remember.  I chose to participate on the newborn visit, which we did with a matrona (midwife or OB/GYN).  It started off with a bit of a rocky start since our patient wasn't home, but we ended up just visiting a different one.  The last time the woman had visited the clinic was during her eigth month of pregnancy, which was when the clinic referred her to the hospital for her birth.  During the visit the matrona asked her questions about the labor and delivery, post-delivery procedures, breastfeeding, contraceptives, etc. Unfortunately, the woman had a very, very bad experience at the hospital.  This was her second child, and because of a bad experience with the first one she wanted the delivery to take place at home.  However, she developed a case of pre-eclampsia and was rushed into an emergency c-section.  From there, the anesthesia didn't take and she could feel every single part of the surgery.  To make it even worse, there was a team of medical students overseeing the procedure, and she could hear everything the doctor was telling them.  It was an incredibly traumatizing experience for the poor woman, and as a result of it she no longer had any trust in the health care system (which is why she hadn't been attending her controls, or check-ups, with her new child, which is why the home visit was necessary). The rest of the visit went smoothly - the matrona emphasized the importance of solely giving breastmilk to the child for the first six months, they discussed contraceptive methods, and went over signos de alarma, or warning signs that tell you that your child is very sick and needs to be brought to the doctor or emergency room.  Overall it was an incredibly fascinating visit and I feel really privileged that we were able to partake in it.  Afterwards the matrona assured us that "horror stories" as this patient's aren't the norm, but that unfortunately, they do happen.  It really opened my eyes to how good we have it in our country.

That afternoon, after an amazing lunch at Mar Adentro, a great seafood restaurant in Tacna, we visited a comedor, or community kitchen.  The comedor provides one meal a day, at a very cheap price, to participating families who rotate doing the cooking.  About 40 families participate in the center we visited.  I got the chance to talk to two of the leaders of the comedor and they told me that one of the hardest parts is the lack of refrigeration.  Many, if not most, families in Tacna cannot afford a refrigerator.  For this reason, food needs to be bought every single day; the concept of "buying in bulk" does not exist because there's no way to store the food.  This also limits the types of foods that can be made, as the only available items are whatever's at the market that day.  All in all, it was great to see how the community comes together to provide for each other when few resources are available.

Thursday morning we headed to Viñani, a small health center located in the poorest area of Tacna (you could almost consider it a slum).  After touring the health center we went to the "conference room" of sorts to participate in a nutrition workshop for pregnant women and recent mothers.  These women voluntarily sign up for classes that occur every two weeks that have varying topics on pregnancy and motherhood.  My Peruvian partner for the workshop was named Carmen, and she had a newborn baby who was only 10 days old!  We learned about which foods are appropriate for children of different age groups and also learned about the importance of nutritious diet while pregnant and breastfeeding.  At the end we prepared our own meals based on what we learned and presented them to the class. It was a really, really great experience -- probably one of the things I've enjoyed most so far this semester.

After another lunch at Mar Adentro we headed back to the same neighborhood (called Ciudad Nueva, or "New City") and met up with with a group of second-year obstetrics students.  Most of the girls were around our age and were studying at the local medical school in Tacna.  We paired up with them (I was with two great girls named Leslie and Jenny), and were given a paintbrush, can of paint, and some stencils and were put to work painting house numbers in Ciudad Nueva.  The neighborhood is essentially a giant slum that's just popped up over the past ten years.  The houses are organized in blocks called manzanas, but within those manzanas it's hard to tell what the home are actually like.  From the outside, it seemed like many of the houses were just dirt floors with metal sheeting for doors and walls and a tarp roof.  Consistent running water is also a scarcity as most of it is consumed by the local copper industry.  Anyways, as you can imagine, having house numbers would be beneficial for many reasons, but our primary one was to assist the health teams doing visitas domicilarias, or home visits.  It was nice being able to get involved with the community and interact with Peruvian girls my age -- it always makes me feel more confident in my language abilities, if nothing else.  We took lots of pictures together afterwards, especially ones showing off our new blue Avatar-ish hands (a result of the non-washable paint).

                               

Friday morning we met with another group of obstetrics students at their university, this time with girls in their fifth and final year. We split up into groups and discussed various health problems in the Peruvian context - my group discussed eating disorders, specifically anorexia.  It was interesting to see how their views and experiences of eating disorders compare and contrast with ours.  After that we had the rest of the afternoon free.  I, along with many others from the group, decided to take advantage of the tax-free city and bought some more alpaca gear.  After a few hours of shopping and wandering the day came to an end, and we once again hopped on our turismo bus and headed home to Arica.

Oh, I almost forgot - we also booked our train tickets to Machu Picchu. I can't remember if I ever posted about it, but about a month ago I got my flight home pushed back and I am officially returning to Peru and visiting one of the New Seven Wonders of the World!

Chao,
Brittany


and of course, food photos!