The Results Are In.....

During our week north of Lima we accomplished the following:

We performed 251 dental extractions and numerous children's checkups. Most of the extractions involved surrounding villagers and the children's checkups included the local communities and the orphanage where the clinic was located. The oldest patient was 91 years old and another patient was elderly with a diagnosed brain tumor. Several wisdom teeth were extracted.

1,151 pair of glasses were issued--some were prescription glasses while other were reading glasses. Because of the language problems the eyechart in the background uses only the letter "M" turned four directions while the person being tested holds the letter in the way he/she sees it on the chart. The tester moves progressively to smaller letters and when the person being tested can no longer accurately hold the letter in the same position as the chart, their eye strength is calculated for each eye and a set of glasses is assembled with those strength lens. Crude and basic--but it works. Reading glasses are much easier--the person being tested simply tries different strengths until they are satisfied.

The medical staff treated or consulted 1,284 people during the week. Many were basic but essential child physicals--most of the children had never been to a doctor before. Some minor tumors were removed and other ailments treated. A significant number of pregnant women were examined but no babies were delivered on this trip.

The pharmacy was always busy and at times overwhelmed. Much of what we dispensed involved painkillers and antibiotics. Since we were only there a week and it will be at least a year until we return it wasn't possible to prescribe long-term medications since it would be impossible to have them refilled.

Checked Out the Ancient Capital of the Inca Empire Today……

Cusco, or Qosqo, represented for the ancient Incas the “navel of the world” or the origin of life. With the Andes peaks towering overhead, it is a beautiful area that was established long before the Spaniards arrived. At its peak, Cusco was in the 14th Century a city of sophisticated water systems, paved streets and no poverty for the 15,000 Incas who lived here. Less than a century after the Incas reached their greatest influence the Spaniards did arrive and the rest, as they say, is history……..

Under Spanish rule, the Incas really got shafted big time. It was a Spanish military tactic to capture the king, torture him until they had all the information they could get, and then publicly execute him. When his heir took over he met the same fate—probably cut down on in-house intrigue within the royal Inca family. But as long as the Spaniards held the king the Incas wouldn’t revolt.

With the rediscovery of Machu Picchu in 1911, Cusco has again become an important Peruvian city and much of its ancient charm still exists. The public plazas are the most beautiful I’ve ever seen. Today it’s considered a jewel of Inca and colonial architecture and I stayed back today and explored it on foot. Most of the group took the day trip to Pisac, another village nearby with an alpaca farm, but I visited it last year so I spent the day walking I don’t know how many miles up and down the cobblestoned streets and sidewalks.

The Peruvian government, to its credit, it trying to protect the cultural heritage of the city and the area but the reality is that it is now a city full of European and American backpackers with the assorted issues they bring. I would conservatively guess I was offered marijuana or cocaine at least a dozen times today by streetvendors.

I walked quite a ways down to the artists market looking for gifts, not drugs, and found a few items but for the most part it wasn’t particularly good quality stuff but still interesting to wander around and look. On the way back I stopped at a textile weaving center and bought myself a nice Peruvian rug that I intend to use as a wall decoration.

For lunch I stopped at a restaurant on the main plaza, or Plaza de Armas, and got a table outdoors on the second floor looking out over the plaza. I had an alpaca steak and a local soup and it was really peaceful and restful. I shot a video of the plaza which is embedded here and you can see the beautiful flowers (spring is starting here) and


ancient architecture of the two churches. You can also see it’s raining in the background and was slowly coming toward the city. As I was eating, they were playing a Peruvian Andes pan flute music—you know, the kind Zamphir used to hawk on cable television in the 1980s—but here in this setting it sounded really neat. It’s a relaxing music and I had one of those rare moments—they don’t happen often—but everything seems so perfect I really don’t want to come home.

But as usual the moment doesn’t last and the rain arrived along with heavy sleet so I moved back just inside the open doors and sat there drinking coca tea till the rain let up. The plaza had been full of people but when it started raining they all headed for the buildings except for one old man who just sat in the rain talking to himself. When it started sleeting he still sat there as it built up on his shoulders and hair until a policeman went over with an umbrella and brought him in.

After the rain stopped I returned to the hotel for a short nap then walked around a couple more hours. There are four very old Catholic churches here but they charge tourists to visit and that annoys me so I just wandered around the outside and appreciated the architecture.

At night the group—only ten of us continued on to Cusco—had supper together at one of the Plaza de Armas restaurants that featured good food and traditional (pan flute) Peruvian music.

Tomorrow around noon we’ll fly back to Lima and spend Tuesday as free time in Lima and fly out around midnight Tuesday night—arriving in Houston around 6:30 am.

Machu Picchu Hasn’t Changed Much in the Last Year……

.....but then it hasn’t changed much in the past 2,000 years. But for an ancient civilization it is relatively new to us since it was only rediscovered in 1911. Of all the places I’ve been fortunate to visit I think Machu Picchu, Angkor Wat in Cambodia, and the Pyramids in Egypt are the three most amazing things I’ve ever seen. All three have similarities and their fascination with the astrological association to earth is a common thread.

We started the trip at 4:00 am with a bus ride up into the Andes to the ancient fortress at Ollantaytambo. The trip took about 1 ½ hours and sunrise is early here so we got to see the sun come up over the peaks as we were driving through small villages and it was an interesting drive. We didn’t take the train from Cusco like we did last year since there is a worker’s strike that has the station closed there but we did catch the train at Ollantaytambo and made another 1 ½ hour trip up through the Sacred Valley to Machu Picchu. Overall I thought it was more interesting this way since just riding the train gets old after a few hours.

We arrived really early and were one of the first groups into the park. Amazingly we got the same guide as we had last year and did about a 2 ½ hour guided tour of the ruins. Since I had done this last year I was able this time to concentrate on just the things I found interesting and this was a lot more meaningful this time. It was a much smaller group this year and at the end of the tour most of us climbed up to the guard house overlooking the ruins where the most spectacular views are.

Since I posted on the blog extensively about Machu Picchu last year I’m just going to include some new photos here.

Zero to 11,200 feet in 55 minutes......

Checked out of the hotel at 5:30 and took a bus to the airport and caught an early morning flight to Cusco. The flight is only one hour but is really strange in that you take off, reach cruising altitude and land without ever descending. You literally go from sea level to 11,200 feet in one hour. In Cusco we caught a bus to the Royal Inca Hotel—where we stayed last year—and everybody split up. I think we needed alone-time at this point. I don’t care how good of condition you’re in that altitude change tears you up—headaches and short breath. I started drinking Coca tea immediately which is a local remedy for altitude sickness and have done pretty well so far but two of our group are already pretty sick. I wandered around the ancient Plaza de Armias and adjoining cathedral plaza for a couple of hours—just looking and not buying anything. Monday we are going to the Pisac Market in the mountains so I’ll probably buy there.
Around noon I was hungry so I found a place on the main plaza—upper story with a great view of the main cathedral—and had a pizza and bowl of guinea pig soup. Guinea pig is a big menu item here and I’d always wanted to try it. Tastes like chicken.

After lunch I returned to the hotel and took a two-hour nap then wandered around some more and checked my email at an Internet Café—the hotel doesn’t have Internet.

In the evening a small group of us went to a restaurant on the main plaza and I had a local trout dinner and it was back to the hotel and to bed early. We leave for Machu Picchu at 4:00 am.

Friday was a lighter day.....

in that we finished around 2:00 pm and it took a couple of hours to box up our equipment and it on the bus. Before we left the director of the orphanage invited us to the soccer field and the children sang some songs and presented us all with “medals” for being here. Evidently several church groups support the orphanage financially and even visit from time to time but we were the first group to actually spend time here and set up shop. It was kind of an emotional time—some of the group members were teary-eyed when we left. I wasn’t—but then I’m tough.

The work load Friday, although shortened, was still interesting. We had an elderly man brought in who had a brain tumor. He also had severe teeth problems but the local dentals wouldn’t treat him because they were afraid of the tumor. The poor old man was so miserable he couldn’t talk and had been that way for a long time. The dentist with our group didn’t hesitate and pulled almost all his lower teeth and the poor old guy was so happy he was praying, crying and crossing himself.

We had a bunch more children brought in on the last day and I’m including a short video of an extraction on a young teenager. If you can zoom in on the video and play it, it is kind of graphic but does give an idea of the conditions we worked under—flashlights, no running water, etc. To view the video double-click the small triangle on the lower left side of the photo.

We ate supper on a pier—really nice restaurant but frankly I doubt if very many people really appreciated it. We were so tired but it is a tradition to have a nice meal after the last day.

We got back to the hotel even later than usual and had to get up for a 5:30 bus to the airport. Tomorrow it’s up to Cusco and Machu Picchu.

Finished Up Our Next to Last Day Today and the Crowds Have Grown Each Morning.....

Monday was relatively light but Tuesday the crowds had started to grow and we were tired Tuesday to the point some were dozing off on the bus at the end of the day. Wednesday was really heavy crowds and some of the group skipped dinner and went straight to their rooms. Tonight (Thursday) we sent out for pizza to be waiting at the hotel when we got in tonight. Tomorrow will be the final day and it has been much more hectic than last year but we've seen a lot of people who haven't had medical services here for several years.

We had television crews come in today with some very important looking people whom we later found out were from the Ministry of Health and that always causes apprehension and concern but today, possibly because of the cameras, the government fully endorsed what was going on at the orphanage and approved of our group's work. In fact we were called together as a group before the bus left today and told the governmental agency for this district has proposed to employ up to ten doctors/medics to serve the clinic on a regular basis next year. The orphanage director felt our group had a lot to do with that decision. If this even partially develops in the future it will be the greatest contribution we could have made.

We had four dentists today and I spent the entire day helping two children's dentists. Despite the trauma of dental work, they seem so appreciative of having their toothaches disappear. This afternoon we had a group of ethnic indigenous Indians come in--the Peruvians call them "Mountain People"--and they looked like they could have been models for a National Geographic cover. We saw five or six of the women--their faces must have a thousand wrinkles, they have long braided hair almost to the floor, wear distinctive hats and hooped skirts over pants. And of course their clothing is the beautiful distinctive Peruvian woven colors.

We had a 91-year-old man come in today and when the doctor asked him what was wrong his reply was "I hurt all over." I'm not sure what they did for him but he passed his physical with flying colors--that is a very rare age up here in this area.

Yesterday we had a little girl brought in with a severe cleft palate and the dentist with our group thinks there's a very good chance he can refer her to a specialist in Houston that will do the operation without charge. The paperwork's already been initiated.

The stories just go on and on--a lot of them are tragic but many have good endings and some are even funny. One of our group escorted a woman to the pharmacy for antibiotics and while he was waiting an older man came over and got right in his face. Our member realized he was blind as a bat when he asked "Where America?" When told "Texas," he responded "Oh, yeah." Later when our group member saw him again the man was standing there looking through a dirty window and shaking his head. They had fitted him with a pair of Coke-bottle lens but he looked like he was amazed at the things he was seeing out the window with them. As our guy was walking over to congratulate him on his new glasses he turned and yelled out "Viva Texas!!!"

I've lost track of how many dental extractions I've assisted but we've had some tough cases and have done several wisdom teeth including one impacted one that was removed sideways without cutting the tooth in half--a very difficult procedure from what I was told.

Tomorrow will be our last day here and from what our group leader told us tonight, it may be our last trip here ever--if the government keeps its promise and employs doctors and medics here we won't be needed any more. That's what it's all about....

Of course I can't close out this post without a picture of one of the little girls who came in today. Her mother got the dental work but we had to take turns holding her because she was so small. In the picture you can see her big dark eyes and also her mother's missing tooth.

One more day tomorrow; Saturday to Cusco; and Sunday to Machu Picchu again......

We Had Much Larger Crowds Awaiting Us This Morning.....

As we arrived this morning the crowds had already formed at the gate. It's still not the sense of urgency that we had last year when the crowds stayed in line all night so as not to lose their places but it was much busier today.

The dental clinic was much busier and I got out from behind the sterilization vats and got to do some over-the-shoulder help today. I was working with one of the Peruvian dentists and she doesn't speak English so that made for an interesting afternoon but overall we got a lot done. She specializes in children's dentistry which can be both rewarding and gut-wrenching. It's kind of difficult to watch the little ones--and some are really little--come in and you can see the fear in their eyes. Then they go through the pain-killing shots and the trauma of having teeth extracted. We don't do fillings here--no drills--so it's basically pulling teeth all day long. On the other hand, some come in with their mothers and watch with fear from the corner while their mother gets her teeth worked on.

Today I did a lot of topical anesthetic application and holding the flashlight. I enjoy it and it's personally rewarding. I literally tower over the dentist so holding the flashlight is easy enough for me.

Since this was our second day--and first full "organized" day--we met this evening and discussed what we had experienced. In addition to the many children we've had a number of really sad cases involving pregnant women who had been abandoned by their husbands--one is expecting any day now and was dumped in a park last weekend and had been sleeping on park benches the past two nights. We had a cocaine addict come in asking for money to attend a rehab program--he got a referral slip instead. A lot of the children are basically healthy but had never had a medical exam and their mothers just wanted to assure themselves their children were healthy. As I said Monday, I feel many of the children from the orphanage have better dental hygiene, overall health and often seem happier than the children from the surrounding villages. It's something to watch them--they're always in groups--and they take wonderful care of each other. They hold hands in lines, watch over the really small ones and seem to have a real sense of caring for each other. I guess when they don't have parents they have to watch out for each other but they are really good at it.

Set Up the Dental Clinic Today.....

We have a Canadian and two Peruvian dentists and started our clinic this morning. It is much less hectic here than it was in Piaura last year--the lines are shorter and we don't have that sense of urgency we had on the last trip.

We had a relatively light case load but that will probably pick up as the week progresses. For a while today we saw the children from the orphanage and according to the dentists they had overall very good teeth.

My job is sterilizing the equipment--scrubbing it and then doing a "cold sterilization" with chemicals. I'll do other jobs as needed--charting, escorting to the pharmacy, holding flashlight, etc but mostly I just sterilize. I enjoy it, it keeps me busy but also allows me periods where I can roam around and help in other areas.

It's a hour and a half ride both ways in a bus and that's almost the hardest part of the day--the bus isn't particularly comfortable and the roads are rough plus we have to start early and arrive late.

Tonight we walked, as a group, down to the ocean and ate at a local seafood restaurant. I love Peruvian ceviche and had that with some shrimp and squid. The group this year is a good group--different from the members last year--but a good diverse group.

It's late, I'm tired, and this will be a short post. Should be another interesting day tomorrow.....

Visited the Orphanage Today and Set up the Medical Clinic......

We made it back to Lima and had some problems getting through customs but finally got to the hotel on the southern part of the city called Miraflores and we are in a hostel about two blocks from the Pacific Ocean.

Today we took our bus about an hour and a half to the north of Lima to an orphanage where we'll be setting up the clinic for this week. The orphanage is the work of one man and is a large complex spread out over a fairly large area and we'll be working in a building that's only partially finished but is already a basic medical clinic so we already have some equipment to work with and the facilities are better than the school where we worked last year in Piaura. We have four dentists, two medical doctors, two nurses, two physician's assistants and two pharmacists. For the first time we have a OBGYN which is kind of a big deal since many of the patients who come in are expecting or have just had babies and it's not unheard of that one or two deliveries may be made this week.

Although we're working in the orphanage, we will be mostly treating the surrounding villagers and this is an extremely impoverished area--most of these patients have had no medical services since this group was last here. I'll be working in the dental area this year and don't know for sure what I'll be doing yet.

After we set up today we got to take a tour of the orphanage--they prefer to call it a "community." There are about 650 children here aged from a few days old to teenagers. All have been abandoned, orphaned, rejected, mistreated or outright abused. I felt like we were violating their privacy by touring their dorms and dining hall and taking photos but they all just loved having their pictures taken and all clamored to be held and hugged.

As you can see from the top photo I made a new friend fast. The nursery was especially touching--how small babies could be abandoned is beyond me but they seem to be well cared for here. The orphanage is dirt-poor but here seem to be plenty of volunteers to take care of the children and they all seem happy. I said it last year and still believe it.....Peruvian children are the most beautiful children I've ever seen but it's kind of gut-wrenching to see what some people can do to small children. As much as I'd like to be optimistic, these children are abandoned in an impoverished country that provides few if any services for children and I'm afraid the future doesn't bode well for many of these kids, especially the girls.

Tomorrow we head out early for the first day. It'll be hectic in the morning but by afternoon we should be starting to operate smoothly and it should be a very rewarding week.