September 27, 2013

  • Colca Extreme

    The past two weeks, I was part of a medical team that trekked through the Colca Canyon in Peru. I have to say that it combines a lot of things that I love, such as exercise, the outdoors, birds and wildlife, mountains, and of course medical work to needy people. So in a sense, it was therapeutic, maybe more for me than the people we went to see. The Colca Canyon is one of the deepest canyons in the world, although it is hard to quantify those things. From the deepest portion to the top, at places it is over 13,000 feet deep, more than twice as deep as the Grand Canyon. We had a team of 10 people. imageVicente, our diminuitive leader, was someone who could do anything, I believe. He was also the only person on our team who spoke fluent Quechua, a necessity in the Colca Canyon. Here is a photo of Vicente. image Then Cathy Huiza, also a worker with MMI in Peru. I was already friends with both of them, as they were both involved with the team in Arequipa last year, and it was great to be reunited with them. Here is Cathy and Grace, our dentist for the trip. Then Eduardo Carpio, a physical therapy student who functioned as translator, physical therapist, and general motivator for the patients. GraceGrace, a dentist from Texas was a relatively late addition to the team, and one for which I was grateful, as I don't know much about teeth. We had 2 nurses, Amanda and Bethany who functioned admirably in a multitude of tasks, including triage, pharmacy, and nursing orders. Amanda had spent 6 months in Peru with MMI and working in Arequipa, so she was fluent in Spanish. Also from Peru was Domi, our gourmet cook, whose cooking with limited resources in the valley kept us functional despite long days of trekking. Then Matt, a pre-med student who hopes to go to medical school next year, functioned as pharmacy assistant, along with Bethany every day. And Luke Janssen, our only Canadian, came along as general helper and became Grace's right hand assistant in the the dental clinic.
    So we met in Arequipa Saturday, a bit unsure of how we would mesh as a team, but God was gracious, and in a couple of days, it was like we were best friends. Devotionals each morning let us see a bit into the heart of each person, and also drew us closer to God ourselves. There was a lot of honesty, and sharing of pain, or other experiences that helped us see ourselves as well in the light of God.
    Sunday morning, we left after attending a local church for part of the service in Arequipa. The journey of 5 hours by MMI van, very ably driven by Vicente, up and over the mountains, to the village of Chivay took about 4-5 hours with stops. We stopped for coca tea, which helps with the altitude sickness about 1/2 way there. Peaking out around 16,000 feet at a pass, some of our group started to feel the effects of altitude. Chewing on coca leaves helped a bit, but also descending to Chivay helped as well. We ate in Chivay, which is the gateway to the Colca Canyon, but soon left for the village of Cabanaconde, where we spent the night in a hostel there. During the night, I slept in the same bedroom as Luke, and I noticed that he was having increased work of breathing. In fact, I counted his respirations, and they were 50-60 times a minute. He had also had the nausea, anorexia, headache, and other symptoms of altitude sickness. I realized that we had no way of evacuation in the next week or so, so I prayed, hard, that God would remove his altitude sickness and miraculously heal him. The next morning, he was remarkably better, and I credit that to God's hearing and answering prayer. Thank you Lord, as I was helpless, and had no good medicine to give him. He was not able to take altitude sickness medicine, as he had contraindications to the medicine.
    The next morning, we all loaded up into the back of a farm truck which had carried a few cattle in its day, I presume, and made our way slowly down into the depths of the canyon. The trip took about 2 1/2 hours, as we switched back and forth on the dusty road with dropoffs without guardrails, and mountain on the other side. When we got to the bottom to the Colca River, we saw our task in front of us. To ascend on a narrow trail up out of the canyon back to a mesa where the town of Llanca was perched above us. I don't know exactly how far it was above us, but I estimate 4000-5000 feet. It was warm at the bottom of the canyon, and the burros were waiting for our gear to be packed up as well. We all carried backpacks with water and snacks and lunch for the day. The warmness of the day, the bright sun, the altitude, and the constant uphill trek all combined to make this the hardest trek for me. I ran out of water about 1/2 way up, but other team members replenished my supply, and so I made it to the top with not much to spare. That trek took about 5 hours, but was very strenuous. But we all made it to the top, thank the Lord.
    The town of Llanca welcomed us with open arms, and put us up in the school there. Cold showers were available, and the first night, we all slept in the same room, as there was not a lot of space available. The following day, we set up for our first clinic, and I saw around 30 patients or so. Kept the pharmacy busy all day filling prescriptions, as just about everybody needs something. Everybody was very busy, but by about 4 pm we were wrapping up things. I slept well, despite being in a room with 10 people and lying on a hard wooden floor in my sleeping bag. The night was cold, but not excessively. The next morning, as is my custom, I took a shower, but as it would be the rest of the trip, freezing cold Andean mountain water makes it a lot shorter than average.
    That day, Wednesday, we had our nicest trek of the trip, not excessively steep, but a pleasant walk to the next village of Ucuchachas. Ucuchachas was the smallest village that we visited, and has a reputation for many of the population being alcoholic. It also appeared to be the most run down. A pleasant surprise was a church that must have been built in the 1500s, with a bell forged with the date 1574. Although deteriorating, it was a very substantial structure for such a small town, and wondered at the motivation that the Spaniards had in getting out to even places where now there are no evangelical churches, and even the Catholic church has no priests out there. In fact, I did not see any alive churches in the whole area, so an unreached area...
    The following day, our smallest clinic of the trip.. I don't think I saw even 20 patients. By this time, everyone on the team was feeling good, and so we had time in the evenings to interact by playing games such as scum, spoons, or golf using standard playing cards that I had brought along. We had great times together, but generally by 9 pm, it was time to go to bed for me. In the canyon, the days were often shorter, as the sun would go behind the mountains by 3:30 in the afternoon, and darkness followed along with the cold.
    The trek from Ucuchachas to Choco promised to be our most difficult of the trip, although generally the times listed were longer than we actually took, so I was hopeful that 10-12 hours it said would be more like 7 or so. It took us down, then up for a long ways, and then an incredible descent for probably 5000 feet or so down to the valley floor once more to the village of Choco. By this time, being used to the trails and the trekking, I didn't think it was too bad. Two of our group, the young guns Matt and Eduardo were somehow not listening when directions were given, so when they got to the river, they turned right instead of left. So instead of a 1/2 hour journey into Choco, they were actually headed to the town of Miña, about 9 km up the mountain. They never met a soul on the trail, so when they finally got to Miña, and asked, "Donde esta Choco" they were pointed back the same way they came. They arrived exhausted to the town of Choco around dark, at 6 pm or so. There were several worries that day, besides them. I was hiking with Vicente, and we realized that we were not seeing anyone come behind us. We knew the burros were still behind us somewhere, but weren't sure where Grace and Bethany were, as they were somewhere behind us as well. The trail was not always very obvious, and we had taken one little detour which was wrong as well, so we were afraid they might be lost. So we decided to wait on the trail, until we saw the burros. Well, finally, the burros came over the ridge, and Domi was with them, but no Grace or Bethany. So we continued to wait, and after a period of time, we saw that they had joined the burros as well. Turns out that they had gotten lost as well, and decided to wait for the burros to find out where they were supposed to go. And then, once everyone had shown up, except for Matt and Eduardo, Domi was still no where to be found. She was having the most trouble on the steep, slippery downhill, and had already fallen once, and so she had not shown up by 5 pm either. So I headed back up the trail, but was relieved to find her slowly making her way down in spite of the trouble she was having with her knees. The ladies of the town furnished us a delicious soup that evening, so that she was excused from the usual task of cooking. And about the time we sat down to eat, here came Matt and Eduardo, looking beat, but after water and soup, looked much better. We laughed and laughed once it was certain that they were all right and that is how our group was all reunited again.
    The next day clinic in Choco was our busiest of the campaign. I saw 55 patients, and then had one old man who requested that I see his wife at the house. So we went down with him to the house where his wife was. Her name was Serafina, and it was obvious that she was suffering some kind of dementia. She was lying on a sheepskin there in the courtyard, and apparently that is how she was every day. Her blood pressure was dangerously high, despite the fact that she was on blood pressure meds, and she also had decubitus ulcers on her backside from lying all day in that condition. The husband was very attentive, but he had to work in the fields all day, and they had no children or other source of help. So Amanda and Eduardo dressed her wounds, and I adjusted her meds, and gave what little help that we could. However, on the next day, we stopped by the house to say goodbye on our way to Miña, and wonder of wonders, she was sitting in a chair, and looking much more alert. I have no explanation for that, but it was miraculous, that is for certain.
    As that day was Sunday, we took a little more time that morning to sing, and each person shared something of their life story from a spiritual perspective, a very meaningful time with tears, laughter, and true worship. What followed then was the trip to Miña, which by the way Matt and Eduardo knew very well; it was a beautiful hike through a gorge, but along the river bed, so not extremely difficult or steep, a hike of only 4 hours. So we arrived there in time for a late lunch, and then an early supper, as Domi just kept cooking all afternoon. We entertained ourselves by seeing who could dunk their head in the icy stream and hold their breath the longest. Luke won that contest, and so proved that he was basically over the altitude sickness.
    Clinic in Miña proved to be our next busiest clinic, but for some reason, no one wanted their teeth worked on. The dentist Grace and Luke kind of chilled out that day instead. That concluded the trekking portion of our trip as well, as Miña was the only town that we had traveled to with a road that actually could have a car on it. The next morning, we loaded into the familiar farm truck, and most put masks on for the dust, and bundled up warmly. We ascended and ascended, higher and higher, eventually topping out at around 17,000 feet, before descending to the Altiplano where the next villages were located. At that height, you are far above the tree line, and about the only industry is the herding of a few cattle, and many llamas and alpacas. But people live out there, and we had clinics in Sihuincha one day, and Oyujo the next. Both of these communities were very isolated, and actually not as much as a town, as a place to put the school. And it was frigid at night, somewhere in the teens, I would estimate. At Ojuyo, all the pipes were frozen in the am, making the morning shower impossible, even if you would have wanted an icy shower. After breakfast, one of the pipes unfroze, so I had a quick shampoo, without shower while we were packing, now into a bus for the ride back to Chivay.
    The ride of 5 hours to Chivay was very bumpy, more than once making something hurt as we hit a particularly hard bump, descending once more out of the highlands as we got back down to the river once more. That afternoon, we were treated to a couple of hours soaking our weary bodies in the hot springs of Chivay--quite nice for muscles that had been stretched more than they should have been....
    A final night in the valley in a motel with "hot showers", my first in a couple of weeks, and the next day we headed back to civilization in Arequipa, a ride of 4 hours total. It was good to get back and start looking at the whole trip with a more discerning eye. What all had been accomplished while we were there? Had any health problems had been changed overnight Not necessarily, because most of the things that lead to their health problems still were unchanged. But perhaps, we had communicated the love of God and His love for all mankind in a more tangible fashion, God's love with human skin on it. And that is what maybe we accomplished...

August 27, 2013

  • Vida Diaria (Daily Life)


    What is the average day like for me here?  My schedule of actual work is not extremely strenuous.  I have to be at the clinic La Fuente by 8 am, and we work straight through lunch until 1 or so.  Some days are longer, but most of the time we are finished with all the patients by 1.  So my usual method is to get up at 6, and either go for a run, or if I am lazy, just proceed to start the day.  A cup of coffee does well to get me started, and then it is time for a shower, and then breakfast.  Before or after breakfast, I have enough time to have my morning devotions, and then it is time to go to La Fuente.  It is always important to dress warmly, and I have learned the multiple layer trick.  I usually have t-shirt, shirt, sweater, and then coat to top it off, and that keeps me relatively warm most of the time.  You hardly ever get to go without the coat, and so my Alabama tan is long gone with arms that haven't seen the sun in 2 months.  To get to the clinic, I have to leave by 7:40.  I walk down the hill to Avenida La Cultura, to get an appropriate bus.  When I first got here, I didn't know all the bus lines, but by now it is second nature to get the right bus.  I have twice gotten on the wrong bus, and had to do some scrambling to get where I wanted to go.  A lot of the people in Cuzco live up on the hills, and some live quite a long way up the hills.  So usually I see people half jogging or running down the mountain to get the buses as well.  On most street corners, it is possible to buy from a sidewalk vendor a hot breakfast, but it is usually noodle soup or rice, or just a piece of bread with juice.  Also, on the corners are ladies who sell bundles of green barley plants.  This is the preferred food for the many guinea pigs that people raise for food, and so they sell large quantities every day.  I see the big trucks coming into town loaded to the gills with green barley, before it is distributed to the corners. Of course there are many students going to school, but since there are no school buses (that I have seen) the students all get on the buses too.  So there have been a few times in the morning when the buses are so crowded that you feel a bit claustrophobic.  

    Upon arrival at the clinic, the first thing that we do is have a devotional by one of the staff, and then we have time for prayer requests.  Of course, it is very important to greet all the staff before you start.  The men get a good handshake, and the ladies get a Peruvian kiss, which is typical in South America.  Then, by 8:15 or so, we are ready for the first patient.  Today (Tuesday, 27th) we had an unusually high number of non-Spanish speakers.  I think I saw 4 patients in a row who needed translation.  I do know a few words in Quechua, enough to say Good Morning, how are you, but after that, I am dependent on the translator.  Of course, almost all of our patients are Quechua, it is just that some have never learned Spanish.  I do love treating the patients, and they are so grateful for anything you do for them.  The older ladies frequently call me Papa, or Papacito, which is term of respect, and they say it with such reverence.  I don't know how I feel about being called Papa by a 85 year old lady, but that happened today....and happens most days...Health care here is with the availability of lab work and we also have access to xrays.  Although they are somewhat expensive to them, by American standards, everything is so cheap.  (I probably should get my blood work down here too?!) So we have access to diagnostic things that help with the care here.  The types of problems here are similar to the states, but often involve musculo-skeletal problems, since so many people do so much heavy labor.  Particularly when I see a lady carrying one of the heavy barley bundles up a steep incline, I often start to hurt too.  However, we do not see anyone who smokes, although there must be some here, we just don't see it.  I guess it is a tough environment for smokers at 11,000 feet elevation.  Of course, there is no malaria, as mosquitos can't take the cold or the dryness here.  Now, if someone has been down to the jungle, that is still a possibility.  But mostly, there are not a lot of tropical diseases.  Diabetes, like in most places in the world, is increasing, as activity levels decline, and people get a bit heavier.  But certainly, there is not much obesity, and much less of those problems than in the United States.  Blood pressure troubles here are also rare, as the altitude must be a bit protective of that problem.  Certainly, in the jungle of Peru, we saw much more of that problem than we see here...We have seen some interesting cases, including a girl with new onset leukemia.  She is currently in Lima starting chemo, so hopefully that will be able to cure her problem.

    By 1 pm, I make my way home by bus, and have time for a quick lunch, and then do some studying or other work until my Spanish lesson from 3-5 pm.  I decided that there was no better time to improve my Spanish when I can learn and practice every day.  And it has helped tremendously.  My teacher, Johan, is from Arequipa, and for about 3 weeks he has been there, but we were able to still do the lessons on Facetime every day with basically the same success.  He is very good with his understanding of English, but has another job as well.  He is not dependent on just teaching gringos, although I have been blessed to have him for these months.  Supper is usually at 6:30 or 7, and then it doesn't seem long until missionary midnight (9pm) when it is time to go to bed...

    The time has flown by rapidly.  I am looking forward to going to Machu Picchu this weekend.  I will leave on Friday morning, take the train to a small town close by, and spend the night.  Then, early Saturday am, I will go to Macchu Picchu and my first order of business is to climb to the top of Wayna Picchu, the mountain in the background of all the pictures.  It is not supposed to be all that strenuous or dangerous, and then I will have the rest of the day to explore, before leaving in the afternoon to get back here by Saturday evening.  Then the following week, I will leave to go Arequipa, which is about 12 hours away by bus.  This is the location where we will meet as an MMI team to go to the Colca Canyon on September 8th.  We will be there for 2 weeks, with a medical/dental team in the wilds of Peru.  It should be interesting, but don't expect any communication until after my I will also sign off this time without photos...maybe later..!

August 11, 2013

  • Sacred Valley

      Well, I am back in Cuzco after a whirlwind tour of the Sacred Valley, or Valle Sagrada.  It has been a couple of strenuous days.  I finally bought my tourist ticket, which enables you to visit about 15 different sites.  It is 130 soles (about 50 dollars) but after this weekend, I think I will say it is worth it.  I didn’t go on a tour, but did my own tour. Friday evening, I spent the night in Pisac in preparation for the next day's journey through the Sacred Valley.  The Inca's believed that the path of the Willcamayu River (Now called Urubamba) mirrored the Milky Way in the sky, and it was lifegiving in the crops that could be produced in the valley.  It is about 500 meters lower than Cuzco, so a bit more conducive climate to crops there. 

     The Inca ruins at Pisac are up on the mountain, and to save money, and for exercise, I decided to climb up the 1300 feet or so to the top. The path was a bit steep and rocky, but it was the same path that people have traveled for time immemorial to work the fields up on the terraces, and to go to their sacred sites.  I can honestly say that I never was scared hiking the Grand Canyon, since we always had a pretty wide path, usually 4-6 feet wide.   Maybe I have gotten older, but as I kept moving up, I started getting a bit panicky, and thinking I would come to a place where I couldn't go anymore..  At times, I was on a 2 foot or less wide path with a 1000 foot dropoff.  I started hugging the side of the mountain more than ever.  But I persevered, and finally reached the top in about an hour. I had started out early before the park actually opened, so there was no one else in sight to give moral support.  To me, it seemed like a hundred foot dropoff didn’t bother me, but the higher ones did, and that didn’t make sense, since either one would be deadly.   But really, the ruins were worth it after getting to the top!  I don’t understand the Incas.  Number 1, if you want to build a really impressive something with huge heavy stones, why pick the top of the mountain?  I suspect most of those stones came up the same path I took? Scary to think about. And then the amazing terraces.  They would build a 10-15 foot high terrace, and then on top, the field was only 15 feet wide--hardly worth the extra land, but they do that even now.    Anyway, I explored to my hearts content, and then decided that I would rather take a taxi down, and not brave the path once more, even if it was 20 soles.  However, on the way down, it only cost 2 soles--go figure.

        After a great breakfast with a talkative family back in Pisac, (coffee, and an egg sandwich--I was starved), I left for the next place with ruins, Ollantaytumbo.  That involved taking public transportation down the Sacred Valley.  The farm land along the river is very fertile, with huge mountains on both sides, sometime narrowing the valley just to a few hundred feet.  Also, great views of many snow-capped Andes peaks.  I realized that I was looking at the South side of the peaks, and they had multiple glaciers, and lots of snow, but I guess this is their winter.  At Ollantaytumbo, there were some very nice smooth, huge stones, with what appeared to be some that were never put into place, but very nicely carved.  I really enjoyed those ruins.  Then, on the opposite mountain face there were some other ruins, way up the mountain again, that my previous trouble had not taught me a lesson.  Once again, I became well acquainted with the mountainside, as I inched up as close to it as possible.  This time, there was no taxi down, so I came down as cautiously as possible, and made it all the way to the bottom safely.

      The next ruins at Chinchero were much less imposing and not as scary, so it all worked out very well.  I ate a great meal at a restaurant there, around 3 pm.  I had Lomo Saltado, which is a very popular Peruvian dish.  Peppers, beef, with french fried potatoes along with rice up underneath all of that stuff.  It sounds like it would be soggy, but actually, it is quite good.  By that time, I was ready to head home, as it was starting to get dark.. All in all, a very good day, and well worth my money, and I enjoyed the fact that there I could go at my own pace, and not be dependent on a tour group.  I have documented some of it, so I will see if I can load these pictures...

    Here is the path as it started out--not to bad I admit.  It was later I had the trouble

                                                                                          One of the rocks at Ollantaytumbo, not yet fitted in. It was lovely pink granite, and they had already had some of the rocks fitted in place.  These rocks came from a quarry across the river, more than a mile away, and they were at least 300 or so feet above the town.  Notice the size of the person there, which makes you realize how big the rocks they were working with!! How in the world may you ask, and maybe more so, why?

                                                                                         Church at Chinchero--what a magnificent structure inside, ornately decorated, in a small town in Peru.  Notice the Inca walls in front of the church.

                                                                                        The town of Otallantaytumbo from the ledge high on the other side                                                                                                                                                                 Here is a detail of some of the Inca walls--notice how all the stones fit together without any mortar whatsoever  


    This is a typical street in Chinchero, with the trough down the middle to take away rainwater.  Again, this town dates from years ago--not a recent construction

                                                                                                                                                                                Bridge that was part of the path up to the ruins to Pisac. Although creaky, it did it's job well


    And here is a closeup of the terraces that I had to ascend getting up to the top of Pisac.  Aren't you glad that they didn't tell you that you are working in the top field today.  That would have meant a climb of more than 1000 feet up to work in the morning. The picture doesn't do justice to the steepness!

                                                                                            t                                                                                          Two examples of some of the stonework at the top of the fortress of Pisac.  They did not have those stones there.  They all had to be brought in, again put together 600 years ago with no about that, you masons?


    Here are some of the snow-capped Andes mountains in the background in the sacred Valley.


August 6, 2013

  • Cuzco 102

    Cuzco 102


    It is not hard to fall in love with Cuzco, the city that is the “navel of the earth” according to the Incas.  It is a mixture of 700 year old buildings mixed with developments that are forced to go ever higher up the mountains that surround the city.  It is a little like being in Europe, where things here predate anything substantial that you can find in all of North America.  Despite the diesel fumes and frequent dusty conditions, the air somehow seems purer at 11,000 feet.  Beauty abounds in the midst of trashy areas as well at times.  To my North American mind, there are some things that are hard to explain, but that is Peru.  

       For one thing, It is a city that has many dogs, and they seem to be a bit more vigilant than most dogs in Latin America.  On several occasions, I have had the occasion to have my course of action changed by a couple of dogs.  Of course, I am a bit more wary down here, since I don’t want to risk getting bit where I don’t know anything about the rabies status of an animal.  Several weeks ago, following a hike recommended by a guidebook, I encountered some dogs at a farm house.  I was probably more than 200 yards away from the house when they spotted me, and running down the hill, all the way to where I was, they convinced me in no uncertain terms that I really did not want to go on that hike anyway.  And on our street, there was an American Bulldog that looked like our dog Moses, except uglier, and most of the time, he paid absolutely no attention to me when I walked to the bus in the am, or back at night.  But on a couple of occasions, he acted like he wouldn’t mind having one of my legs to gnaw on, and once, he snapped at me.  Unfortunately for him, he was hit by a vehicle last Saturday, and the last time I saw him, a large crowd of people were gathered round, and some were crying, so I assume he didn’t make it.  Amazingly, despite nonstop traffic on Avenida La Cultura, I have seen large numbers of dogs make their way safely across and never get hit.  They are survivors, that is for sure.  And probably because there are so many dogs, there are not many cats.  I have seen only 2 in the city, and that is enough for me.  

      Also despite many numerous close calls, I have not witnessed any accident scenes other than one Sunday, a car hit a motorcyclist at an intersection close to where I was running. And I didn’t see that, but heard the crash.  I ran to the site, and found the motorcyclist without a helmet,  lying on the street with a gathering crowd around,  but  more stunned than hurt.  Many in the crowd were snapping photos, (por que?, no se!) Amazingly, there were police and nurses there in less than 90 seconds, and they had him loaded on a backboard, placed on the back of the police pickup, and hauled off to the hospital, probably within 4 minutes of the accident.  Of course, there was not time for a complete assessment, but I suppose he did okay.  But don’t try that at home.. There is a definite extra instrument with driving which is the horn.  I never knew how many different ways you could communicate with the horn.  Buses and taxis lightly tap their horn when they are passing a bus stop, to see if anyone wants them to stop, a little louder says I am stopped and would like some passengers, a little louder means that a bus is in their way, and the loudest beeps seem to be reserved for other taxis, which many times force their way in between as best they can.  I try to sit in the middle of the bus if I can, so that I am neither in the front or the back in case of an accident, but so far, so good....Of course, if it is standing room only, you don’t get many choices.  I counted 70+ people in a bus that seats less than 30, but the rest piled in somewhere.

    The other day, we went out to the city of Lucre, about 30 kilometers from Cuzco.  There, we stopped at a trout farm that is owned by one of the Mennonite pastors.  They appeared to be rainbow trout.  The water is constantly running through 4 cement ponds that he had built, and he had to install water pipes from a spring about ½ mile away to bring fresh, clean water at all times to the fish.  The river water can't be used because it will kill the fish when there is a lot of muddy water in the river. They started a restaurant as well, and they cook meals with their fresh trout.  There is only one thing on the menu, but what a treat!  Once we told them we wanted 5 plates, they took a net and went into the one pool and in no time had 5 beautiful rainbow trout, probably more than a pound a piece in a bucket.  And about 40 minutes later we were eating beautiful fried whole rainbow trout (trucha) with papas (potatoes), maize (large Peruvian corn with kernels about 5 times larger than our corn), salad, and avocado.  The best trout I have ever tasted, I think, and I have eaten a lot from the Delaware Bay over the years.  There was a missionary couple from Northern Peru, Heinrich and Runell Groenewalde (missionaries from South Africa) visiting here this week, and it was a delight to get to know them and also eat with John and Cindy Kreider, my gracious hosts here in Cuzco.



    Here is typical scenery in Lucre, 30 km outside Cuzco      



                                                                     Here is Main Street in Lucre



    "Going Fishing"                         




                                                       Ah, Success!



    Outdoor restaurant, but with the chill and the wind, we ate inside                      



                                     Beautiful, freshly fried trout, with the trimmings


    Heinrich and Runell Groenewalde, L, and John and Cindy Kreider, R


       This owner was getting ready to plant corn in his one field, so he had opened up the canal to drain water over his field to get it wet enough to plant.  Rains won’t come for a while, but the corn can be taken care of by the irrigation until then.  They were planning to plant 4 days later, so I guess that means that frosts are less likely now.  And indeed, it seems that temperatures are moderating slightly as the days are getting longer, here south of the equator.  Seasons come and go, but as the days lengthen here, it means less light for you Northern Hemisphere dwellers.





    And here is building a house Peruvian style, the whole family, even children were helping with the project, mixing mud, etc.






July 27, 2013

  • Cuzco 101

    Well, what is Cuzco like, for those of you who are interested?  Cuzco is probably one of the most popular tourist destinations in South America, because of its proximity to Machu Pichu, and also the many Inca ruins right in Cuzco, and the surrounding area.  It is situated in a rather narrow valley, with mountains on both sides.   At the far end of the valley, you can see snow capped Ausengate, almost 21000 feet high.  Although 40 miles away, it is usually visible on a clear day, which is normal case for this time of year.  Even though it is only the 10th highest peak in Peru, it is still more than 500 feet higher than Mt. McKinley, the highest peak in North America.  Because it has high mountains on 3 sides, the only way to land at the airport is from the East, and the only way to take off is from the West.  I guess they don’t have that much wind to make it necessary to reverse that, because it is not going to happen.  

     I live only a block away from one of the busiest streets in Cuzco, the Avenida La Cultura.  This is the main road that takes people into downtown Cuzco, and so it is always quite busy....Luckily there are traffic lights that allow pedestrians to cross, and most of the drivers here obey the light signals.  Down the center of the Avenida Cultura is a Ciclovia, or bikeway, which is also good for pedestrians and runners.  It has steep banked grassy areas which protect the middle from vehicles, and also enhance its beauty.  There are also a lot of flowers and trees in the median there, and every day, there are multiple workers watering, weeding, sweeping, and just in general making it look nice. 

     I take a bus to work and back about 4 miles away every day.  The city buses are frequent, and you don’t have to wait long for the appropriate bus to come by.  Each bus or combi (vans which are smaller that also carry people) has a driver and then one person who collects the money--70 centimos (about 25 cents) to go anywhere in the city, basically.  I enjoy listening to the collectors barking out the future stops at any stop--they would all make good auctioneers, because they run through the names of future stops in 5 seconds flat.  Also as you drive along, they call out the next stop--Puente, Andino, Sol de Oro, etc.  If you want to get off at that stop, you say “Baja” (down), and the bus stops to let you off as you pay...If there is no response, the collector says, “Puente, nadie” (Puente, no one) in a downward trailing tone of voice, such that it seems that he is very disappointed that there was no response...It is very reliable transportation, and once you get used to it, it works quite well.  I always try for the bigger buses, so that way if you have to stand up, which is frequently, you have enough room to stand straight up.  The combis require bending your head over at an awkward angle if you are Americano.  The Peruvians in general are short enough that no bending is required.  Occasionally on the bus, someone will get on and make a spiel from one stop to the other, or longer, usually trying to beg for money for some cause or another.  One fellow was asking for money for himself because he was in the hospital for 7-8 months, and had surgery, and to prove it, he pulled up his shirt to show large abdominal scars with some hernias too.  I think, TMI, but I still gave him money.  After they collect, they get off at the next stop, and they never pay anything for their ride so I guess it is gratis (free). I would have to say this is the first country that I have seen that.  

    Finding your way around downtown is a bit difficult, because they change the names of streets every block.  The names of the streets are rather interesting, and that is only the ones that I know in Spanish.  Names such as Matara (he will kill), or Afligidos (the afflicted ones) don't inspire confidence late at night.  I am sure the Quechua words are even more interesting, but I don't know how to interpret those yet...

    Last weekend, I headed to a country church in San Juan de Quihuares  with Dr. Derek Brubaker, his father Bob, and his brother Jeremy, (visiting here from the states) and then Gloria Mamami, one of the ladies from the church here in Cuzco.  We were planning to get there for the service, and then afterwards there would be a health talk, and eat together.  Well, the first part of that didn't happen, as we got delayed by road construction several times enough to miss the service.  But at least we got there in time for the fellowship meal!  When we first got there, they made us go drink tea and eat some bread, which was very welcome as it was getting late.  Then Derek and Gloria did the talk, and then we had a fellowship meal.  Some of the roads to there are not for anyone who is scared of heights.  No guardrails, with huge dropoffs, and there is slippery gravel as well.  We had to climb the mountains too, at one point topping out at over 14,000 feet on one of the passes.

    Well, I would love to write more, but tonight seems like sleep may be more important.  So I'll live you with this site if you want to look at pictures of some of these things.


July 22, 2013

  • Motivations for Missions


    In the past several years, I have had numerous opportunities to function in a missionary setting.  And yet, there is always a bit of ‘angst’ in the background, at least for me in trying to figure out my motives and to strip away the extra.  I have been reading “Gracias” by Henri Nouwen who spent 6 months in Peru (of all places, including Cuzco) and Bolivia.  In there, he talks at some length about why people become missionaries and leave the comfortable life to go to the unfamiliar or unknown.   He lists the following..

    1.  A desire to serve Christ unconditionally

    2.  An urge to help the poor

    3.  An intellectual interest in another culture

    4.  The attraction of adventure

    5.  A need to break away from family

    6.  A search for self-affirmation

    7.  Guilt

    8.  Desire to save

    I can think of several other motivations that he did not list, such as a desire to build up “good works” in an effort to look good to others, or even to God.  Also, we may be trying to make up for past failures, although that may correspond to guilt as well.  I could probably see all of the above in my motivations as well, although of course the correct answer is Jesus!  I don’t want to overanalyze, but sometimes I can’t help it....

    He lists the last 2 as the most damaging motivations, because both make the missionary and life on the mission painful.  For example, when I go to a foreign country because I feel guilty about my wealth, I am in for a lot of trouble.  Guilt can not be taken away by hard work, and acts of service still make us vulnerable in that we still are much richer than those we serve.  In the same way, the desire to save people from sin, from poverty, from exploitation, or whatever causes despair when the harder you work, you realize that you are very limited in actually accomplishing anything.  So depending on the success of “saving” makes your life destructive and depressive.  Although they are damaging, it is probable that no one in the mission field is completely free of those particular motivations.  

    But, the great challenge, is to live and work out of gratitude.  The Lord God took on our guilt and saved us.  So our task is to give visibility to the Divine work in the midst of our daily existence.  When we finally come to the point that we realize our guilt has been taken away, and that only God can save, then we are finally free to live as missionaries.  Clinging to guilt is resisting God’s grace, and wanting to be a savior is competing with God’s very being.  And both are forms of idolatry.

    None of that is particularly earth shattering, and I have taken most of the last 2 paragraphs out of his book, but that somehow helped me to strip away the extra layers of motivation, and get down to the basics of what serving Christ is about.  No matter where or when or how, it is God at work, and we join Him in the work that He is already comforting, and relieving of guilt for long hours with little results, or service without recognition.  In the midst of a large city and thousands of people, the task seems too large.   Even in relating to people at home, or even a mission board sometimes feels like justification for existence as a missionary needs to continually be provided.  And yet, I feel a freedom in this work right now.  In fact, the thought came to me today that maybe the only reason I am here in Peru is to share the gospel with my Spanish teacher.  And if that is the only reason, then I need to be sure and do that, or I will have failed.  (Oh, there is the guilt again).  

    So these are thoughts that come after only 12 days in what will happen in the next 60 days?  We will see.  

July 14, 2013

  • Back to Peru

    Well, that is bad when you can't complete writing of your one trip, before you go on another.  How is it that I am back in Peru so soon?  Well, a year ago, I signed up for a Medical Mission International (MMI) trip to the Colca Canyon area of Peru.  Normally this is a very sought after trip, as it involves hiking long miles up in the mountains of Peru to Quechua Indian villages, and so you need to sign up early.  So after my service with EMM (Eastern Mennonite Missions) in Africa, I decided to see if they could use any help in their medical work in Peru, since I was going to be down there anyway.  I was given the go ahead to come down, that several doctors were on extended furlough over the summer, and they could use the help.  And then while I was arranging that, I got the call from University of South Alabama medical School that needed people on the trip to Iquitos.  I made the EMM work here in Cuzco go up until the trip to the Colca Canyon, so that was one trip, but couldn't quite combine all 3.  So I flew back down here on Wednesday, from Pensacola, to Atlanta, to Lima, and then Cuzco.  Connections all went well on the journey, but for some reason (age 55?) I had a brain freeze, resulting in my checked bag staying in Lima.  When I was checking my bag in Pensacola, for some reason I asked if the bag would go all the way to Cuzco, with Delta cooperating with LAN.  He checked his computer and said that it would.  Somehow that translated to telling me I don't need to worry about it until Cuzco, forgetting that I need to run it through customs in Lima before putting it back on the checked baggage carousel. And I had just done this a month ago!!  So, that meant I had no stethoscope, camera, or computer, not to mention my coats, and toothpaste and toothbrush.  Somehow, i didn't pack very smart, did I?  I was able to get my bag on Saturday which has given me a lot more clothing options, anyway.

    Sleeping in the Lima airport with absolutely nothing to sleep on is not much fun.  You could try a cold tile floor up against a wall, with lights and racket all night long but I don't recommend it.  I spent Wednesday night there before leaving early for Cuzco the next morning.    In Cuzco, I am staying with John and Cindy Kreider, long term missionaries with EMM.  They have been in Peru for 14 years total over 2 separate stints.  They have a daughter still at home, Orianna, but otherwise are empty this will work out very well.  I went by bus to the La Fuente (the fountain) clinic on Friday for my first day of work, as Thursday was spent in getting acclimated to the high altitude. Cuzco is at 3400 meters, which is at 11,400 feet, and there is not as much oxygen up here.  It was interesting that everyone in the clinic has an oxygen saturation of around 90 % which would provoke panic in the US, but is not worthy of a second look here. 

    The first afternoon after a nap, I went to the the center of Cuzco, again by bus.  Cindy showed some of the sights to me, then left to go shopping.  I had a map, and explored.  The Inca buildings are incredible.  They had no iron tools, yet the stones are interlocking, and put together without any cement, and there is not a space between the blocks to put anything in.  It reminds of king Solomon's temple with it's perfectly carved stones.   They also built them with perfectly inward slanting walls, which made them by earthquake proof, since they won't sway and topple over. They also built all this without the benefit of the wheel, which seems incredible.  Someone explain that too me.  The plaza de Armas is the center of what was the Inca capital, and many of the palace buildings of the Inca Kings are still in use in the downtown, although they are now coffee shops, stores, or tourist traps...

    Work in the clinic was busy the first day, but we managed well with 2 doctors doing the work.  It is very well equipped, even having a second building for ophthalmology, they do ophthalmological surgery such as cataracts there.   I didn't have too many language struggles the first day, but I am starting Spanish lessons on Monday--4 days a week for 2 hours a day.  That will be in the afternoon, as I work until 1 pm or so in the clinic.  So my usual schedule will be to work 8-1 every day, and then lessons in the afternoon.

    Oh, By the way, it is cold here at night...about 30 degrees this morning, but relatively pleasant during the day if the sun shines, which it normally does in this their dry season.  It still feels good to have a sweater around most of the time (and now that I have my suitcase, I do have that, at least, as well as winter coats...)  Since I didn't have my camera until yesterday, pictures will wait.  I do have better internet here, so hopefully can do better with updating at least...In Christ and su amor,  Jon


July 1, 2013

  • The Jungles of Peru

    In the first part of June, I was invited to go to Iquitos, Peru with a group of medical students, both 1st and 2nd year students, from the University of South Alabama.  They needed another doctor, and I was ready and willing to accompany them.  Duane Baxter, the leader of the group, knew my son Robert in Troy University Campus Outreach program, and so that is how they got my name.  There were also a couple of prospective PA students, a pharmacist, a pharmacy student, and one student from LSU medical school, as well as 2 pediatricians from Mobile, Susan Ashbee, and Faye Roberts.  I didn't know what exactly it would involve, but on June 8th, I joined the rest of the group in Mobile, for the short 2 hour bus ride to New Orleans International Airport...It was a stretching exercise in missions.  Our goal was to fly to Iquitos, which is the gateway to Amazon in Peru, and then take a boat up the Amazon River to different villages for each clinic.  

    The trip down to Lima was uneventful, but got the award for the bumpiest flight I have ever had.  Constant turbulence made it difficult to sleep, as we were always bouncing.  That seemed to go on for hours, but the flight was only 5 1/2 hours, but the seat belt sign stayed on for most of that time...I did get some rest, which was good, as we got there at daybreak.  Then on a flight to Iquitos, arriving around lunch time, almost exactly 24 hours after leaving Mobile in the bus.  Amazon Medical Missions is a ministry which is based out of Georgia, and led by Mike and Susie Dempsey.  They have been in this ministry for more than 15 years, and I don't know how they work so tirelessly.  It is a real blessing to the workers who come down.  Check out this website if you want to know more about their ministry.  We had amazing accommodations..I would say sort of like a mini-cruise ship.  The rooms held 2-3 people with air conditioning, and a large dining hall, with gourmet food every day.  You sort of forgot you were in the jungle, until we stopped at a village, and went to work...then it was easy to remember.  The first day, we set up our large leaky tent in the rain (it rained every day) and the only piece of level ground was by the river in a muddy area.  The mud had a crust on it, but would sink in about 3-4 inches as you walked on it.  By the end of the day, however, we were breaking through.  I was glad to wear just my sandals, so that I didn't have as much clean up.  However, the mud must have harbored quite a few chiggers, as the following days they manifested themselves with a vengeance, itchy places up and down my legs....but, hey, we have those in Alabama too.  The people of the village would gather, and then we would have a short evangelistic message, and then we went to our stations.  I would normally have 2 medical students working at my station, and with the Peruvian doctor Tony, we would have 4 stations to see the patients in the on area of the tent.  It was not high acuity of emergencies, but it stretched my capabilities, as I was translating their Spanish....(to be continued)



June 6, 2013

  • Grandson Ethan Philip


    Last Thursday, May 30, oldest son Robert and his wife Michelle were blessed with an addition to their family, Ethan Philip.  He weighed 8 pounds, 8 oz, and was 21 1/2 inches long.  For those of you keeping track at home, that is my first grandchild, and of course grandson.  It is quite a blessing to have a healthy baby, and Ethan seems to be doing just fine after a week.  He is a great eater, and tolerates all the attention that he garners with minimal fuss.  He is named after his great grandfather (Dawn's father) and his grandfather (Michelle's father), and I think that is quite appropriate as they both are preachers.  What a great example for him to pattern his life after.  I pray that his life will be used of God to call people to God, whether that is as a preacher, or whatever God calls him to be.  We are blessed.  He of course is going to be spoiled, I am sure, but that is an extent...I have plenty of photos, of course, but would like to say that he had a genuine smile the other night as I was holding him and crooning to him.  You may think that it was just a gas pain, but I don't think so...He knows Grandpa, and that is all I am saying about that.....



    15 minutes old, still not cleaned up completely


    Now this is more like he looks after a couple of days


    Michelle, Ethan, and Robert


    Aunt Kristin holds Ethan


    He fits well into the corner of my arm....


    His first cousin Eli gets introduced to him for the first time...while daughter and other aunt Amber holds him




April 15, 2013

  • Near the Cross

    Last night, we had communion at our church, Mennonite Christian Fellowship in Atmore.  The theme of the service was "The Cross of Christ".  As we journeyed through the very meaningful service, we sang the song "Jesus, Keep Me Near the Cross" written by Fannie Crosby.  When I was younger, this song was not a favorite of mine.  In fact, I got tired of singing it, because we had an older brother in our church back home in Delaware, Brother Ervin, who would always request that if there was an opportunity.  Number 175 in the Life Songs #2, if you want to know, a fact that I can still remember after 45 years....Anyway, I felt like it dragged, and didn't have that great of a tune, and didn't really think much of the words.  Fast forward now to last pm, and as we sang this song, tears were streaming down my face, as I absorbed the words.  They have become much more meaningful over the years, and I focused on them.

    Jesus, keep me near the cross,
    there a precious fountain,
    free to all, a healing stream,
    flows from Calvary's mountain.

    In the cross, in the cross,
    be my glory ever;
    'til my raptured soul shall find,
    rest beyond the river.

    Verse 2:
    Near the cross, a trembling soul,
    love and mercy found me;
    there the bright and morning star
    sheds its beams around me. 

    Verse 3:
    Near the cross! O Lamb of God,
    bring its scenes before me;
    help me walk from day to day,
    with its shadows over me. 

    Verse 4:
    Near the cross I'll watch and wait,
    hoping, trusting ever,
    'til I reach the golden strand,
    just beyond the river.

    I was transfixed by the thought of me, certainly a trembling soul needing God's mercy, and realizing that it had made all the difference on my life, through the ups and downs that it has brought...And so I want to say, "Brother Ervin," who of course has passed beyond the river, "Brother Ervin, you got it right!  You got it right!"