Summer Trip Details

Who are we and what are we going to be doing?

This summer, I am joining a Medical Missions team to the Amazon Jungle of Peru through Global Partners, the missions arm of the Wesleyan church.  Although part of me is really interested in sustainability of healthcare, this trip is really centered on meeting the more immediate health needs of the Amazonian indigenous peoples.  Because our focus is on immediate needs, we are going to be holding medical clinics in several rural villages along the Amazon.  The team is comprised of an interdisciplinary team of dentists, doctors, nurse practitioners, nurses, public health students, EMTs, and students.  Because I am getting my Masters degree in Public Health with a concentration in Global Health, as part of my schooling I am going to be collecting some research data regarding gastrointestinal (GI) parasites which can be used in the future to make these short term medical trips more holistic and sustainable.

What is the clinic set up?

We have 5 stations in each of our clinics, a triage station, pharmacy station, dentist station, medical station, and a Gospel station.  The triage station is where the GI parasite data will be collected as well as the gathering of basic medical information for use by the clinicians.  The pharmacy station is where all the medications we bring with us are set up, organized, and dispensed.  The dentist station is where dental work is done, because hygiene is virtually nonexistent, we mostly just pull rotting teeth rather than doing other dental work.  The medical station is where the doctors and nurse practitioners will be treating physical needs and prescribing necessary medications.  The Gospel station is really the most important.  Providing free healthcare functions not only as an inlet for the missionaries to make first introductions and begin building relationships with people in villages, but functions as an act of goodwill that begins to build trust with the people there.  Those relationships turn into life-changing conversations, new believers, and the seeds of new churches springing up all throughout the rainforest!

St. Francis of Assisi said, “Always preach the Gospel; when necessary use words.”  By caring for the physical needs of people, the love and compassion of God is made manifest in places where the name of Jesus has never before been heard.  The full-time Global Partners missionaries in the Amazon Rainforest accompany our team into every village talk with people as they wait in line to be seen in clinic.  Each and every person that comes through the door is prayed for by the missionary by and receives a Bible in their language.

What are our methods of travel?

Of course to get to Peru we are going by airplane to the country’s capital of Lima.  While in Lima we travel by Flipper bus.  Because we are traveling to the jungle which is located in the northeast of the country and Lima is on the central coast, we will also go by airplane to the largest jungle city of Iquitos.  Throughout the city of Iquitos we travel by mototaxi which is like a converted motorcycle with a covered seat - these are much like the Thai Tuk-Tuks and were originally shipped to the Peruvian jungle from India.  To get to the villages we go by large boat and canoe-like boats with motors.  Everywhere we are we tend to do a lot of walking which is pretty fun in the cities especially.  In 2011 I led a team to the same area in August which was during the dry season, and when we went to one of the villages we had to hike about an hour through the jungle to get there which was awesome; we were able to see a lot of Peru that most travelers don’t get to see.

How do we bathe, eat, and sleep?

We usually set a base camp in one of the villages so we don’t have to take all of our stuff with us everywhere.  We take a bigger boat from Iquitos to get to the base camp, and then to get to all of the other smaller villages we take the smaller boats.  In that base camp, we sleep in army hammocks which are hammocks that have netting built in to prevent mosquitos from getting in.  That is sometimes a challenge because we Americans are heavy so ally of us hanging could make the small, poorly built houses fall down.  Sometimes we use blow-up mattresses on the ground, so we partially hang and partially lay on the ground.  It sounds really uncomfortable, but its actually not all that bad.  The heat in the middle of the night is the worst part about it - I've never sweat so much as I do in Peru.  We also bathe in the Amazon River where the natives also bathe – in safe areas hopefully free from piranhas and other dangerous animals.   The river isn't all that clean, but it isn't any different than swimming in any lake in the US - other than the possible dangerous animals of course.  Every trip we go on we bring a couple of cooks with us, who are associated with the Wesleyan church in Iquitos, along with several live chickens.  There is nothing like eating foods that are normally eaten in Peru like fresh fried chicken, plantains, yucca, and local fruits.

Where do we go to the bathroom?

In Lima and Iquitos they have indoor plumbing and have normal bathrooms.  They might not be as fancy as you are used to in the States, but they are very nice in comparison to what you get in the jungle.  One strange thing that you have to keep in mind is that many of the houses in Iquitos have a delicate plumbing system with small pipes so when you go to the bathroom you have to throw the toilet paper in the trash can.  Yeah that really does get pretty disgusting.  Just make sure that you don't throw away anything that you didn't mean to because you aren't going to want to put your hand into the trash.  In the jungle, most of the villages have at least one latrine or outhouse that is basically just a toilet bowl and a barrel of river water to 'flush' with.  Most of the village people don't use the outhouse though, they just go in the jungle which is why parasites from the fecal-oral contraction are a problem.

Why do this?

There is nothing like helping people, especially using your talents.  It takes a lot to live in the jungle, sleeping in hammocks, and bathing in the Amazon River, but helping people and meeting some of their basic needs makes it worthwhile.  It is hard to see children malnourished or with medical problems, and just being able to put a smile on their face rocks your world.  I recommend this to anyone to get out of their comfort zone and do something for others.  It is also a way of sharing the Gospel using your whole self instead of just your voice.  When there is a cultural barrier and a language barrier, sharing Christ using your actions and your heart is an unbelievable spiritual journey.

Planning A Trip

Planning a trip all starts with figuring out what you want to do.  Do you want to go sightseeing?  Do you want to visit popular destinations?  Do you want to volunteer?  Do you want to teach English?  Do you want to do Medical Missions?

Some of the most popular destinations in Peru are some great natural wonders of the world.  Almost any city in Peru is packed with adventurous destinations and historical sites, but probably the best place to start is in the country’s capital city of Lima which is a historical center with beautiful colonial constructions, the best museums, archeological places, as well as a host of luxury hotels and restaurants.  Huacachina is an oasis town that is surrounded by sand dunes, known for the opportunity to sand board and take dune buggy rides.  Chan Chan is an ancient city built by the Chimu around 850 AD.  Manorca has one of Peru’s best beaches and is a popular surfing destination with a great nightlife and a whole host of luxury restaurants and resorts.  Iquitos is the largest jungle city located off of the Amazon River which is a great starting point for boat tours to see some of the best and rarely seen flora and fauna of the world.  The Nazca Lines are located between Nazca and Palpa along the northern Pacific coast, and are figures of monkeys, fish, spiders, llamas, and human figures created on a large scale that can be seen via air.  Santa Catalina Monastery is located in Arequipa and is one of the most important monasteries of colonial Peru and Latin America.  The Uros Islands are artificial islands made of dried totora reeds on Lake Titicaca which is also a top tourist attraction.  Plaza de Armas is a plaza built by the Incas in Cuzco and is known as the “square of the warrior.”  There are awesome sights in the Colca Canyon in the Andes mountain range in southern Peru which is a canyon more than twice as deep as the Grand Canyon.  The most visited and one of the most beautiful of the ancient sites in the world, however, is Machu Picchu which is the “Lost city of the Incas” that is located on the slopes of the Andes.  

  

Specifically I am involved with Medical Missions that is through an organization called GlobalPartners which is the missions arm of the Wesleyan church.  I am not Wesleyan, but I went to Indiana Wesleyan University for my undergrad, and went on a trip through the school.  If you want to go a Medical Missions trip there are several organizations that do so in Peru.  There is Handsof Hope, Doctors Without Borders, International Medical Relief, AyacuchoMission, Operation Smile, Cross-Cultural Solutions, along with many others. 

After determining when you want to go, what it is that you want to do, what organization you want to go with (if any), it is time to get organized.  You need to purchase plane tickets, plan in country travel (whether it is taxi, moto taxi, or boat), get hotel accommodations, and purchase any other needed tickets.  What I mean by purchasing other needed tickets, in Macchu Picchu for instance, they only allow so many people to visit per day so tickets are needed.

Now you are set to go on your trip!  See my future post on details on packing for a trip.

Empowering Women - Family Planning

A major problem worldwide is the lack of a voice in women.  I wanted to talk about Half The Sky Movement which is an organization that cutting across platforms to ignite the change needed to put an end to the oppression of women and girls worldwide, the defining issue of our time.  It is inspired by journalists Nicholas Kristof and Sheryl WuDunn's book which has the same name, Half the Sky: Turning Oppression into Opportunity for Women Worldwide.  It brings together video, websites, games, blogs, and other educational tools to not only raise awareness of women's issues, but to also provide concrete steps to fight these problems and empower women.  change is possible, and you can be part of the solution.

Be an advocate, use your voice, speak up, and make a difference.  It is easy.  See the Quick Action Guide in order to see what you can do in the next 10 minutes.  

One thing that they talk a lot about in the book is safe and effective family planning methods.  Family planning is often used as a synonym for 'birth control,' but it is much more than that.  It includes contraceptives, sex education, and natural family planning techniques.  The purpose of family planning efforts is to prevent pregnancy-related health risks in women, reduce infant and maternal mortality, help prevent HIV/AIDS & other STIs, empower people and enhance education, reduce adolescent pregnancies, and slow population growth.

Contraceptives 
The problem with contraceptive use is that there are just so many barriers to overcome.  Whether it is religious beliefs, personal beliefs, fear, side effects, access, etc.  The problem is that the positives aren't highlighted.  Birth control reduces health risks by delaying first pregnancies, which carry higher risks in very young women; cutting down on unsafe abortions, which account for 13 percent of all maternal deaths in developing countries; and controlling dangers associated with pregnancies that are too closely spaced.  When you hear stories of pregnant mothers that have birth after birth, risk mounts and the possibility of an extended (8 hour or more) pregnancy can result in maternal and infant deaths, or fistula.  The Fistula Foundation is very important in several low income countries whose women suffer from this devastating medical issue.  The main thing to know about contraceptives is that all birth control methods have a failure rate—even sterilization. Unless your method is abstinence, there’s always a possibility that heterosexual sex could result in pregnancy. But the risk of failure per year is less than 1% for many methods, as opposed to the 85% chance of pregnancy if you don’t use birth control.

Birth Spacing & Family Planning
The major emphasis over the last few decades in reducing maternal mortality has been to decrease the total number of pregnancies per woman through family planning; there has been a drop in the total number of pregnancies per woman and this is responsible for the decrease in the lifetime risk of maternal mortality.  Unintended pregnancies increase the lifetime risk of maternal mortality by increasing the number of pregnancies.

Need for Family Planning

The State of World Population 2012, says that at least 200-million women want to use safe and effective family planning methods but can not, either because they are not available or because social attitudes prevent it.  The need for voluntary family planning is growing fast, and it is estimated that the 'unmet need' will grow by 40 per cent during the next 15 years.

Finances

Since parents are responsible for providing education, shelter, clothing and food for their children, family planning has an important long-term impact on the financial situation of any family.   Family planning has a positive multiplier effect on development. Not only does the ability for a couple to choose when and how many children to have help lift nations out of poverty, but it is also one of the most effective means of empowering women.

Population Control

John D. Rockefeller, III said: In the long run no substantial benefits will result from further growth of the nation’s population. Rather, population growth is an intensifier and multiplier of many problems: environmental, social, political, economic.  Population control is important because ecologists believe that the world population will continue to grow until the quality of life has been degraded for all.

Abortions

More than 50 million of the 190 million women who become pregnant each year have abortions. Many of these are clandestine and performed under unsafe conditions.  Every year, an estimated 74,000 women die as the result of unsafe abortions.

Maternal Mortality

WHO estimates that 1/2 million maternal deaths occur each year, 99% of which are in developing countries.A new study by researchers at Johns Hopkins University shows that fulfilling unmet contraception demand by women in developing countries could reduce global maternal mortality by nearly a third, a potentially great improvement for one of the world’s most vulnerable populations.  The authors of the Lancet study, researchers at the Bloomberg School of Public Health at Johns Hopkins, found that the number of maternal deaths in those countries in 2008 would have nearly doubled without contraception.

Peruvian Food

Lifestyles are always dependent on social class in developing countries.  People in lower classes usually work several jobs, live in the outskirts of cities, and eat basic foods.  The upper class usually have more leisurely lifestyles, they work in the morning, have a traditional main afternoon meal, and a siesta; afterward they either return to work, hang out with friends, watch soap operas, or play sports.

The food in Peru is directly influenced by the multitude of cultural influences from immigrants.  There are a lot of Chinese influences in Peru, and there are a ton of ‘chifas’ or Chinese restaurants.  Be careful on the ones you select, however, food sanitation is not always present. The Chinese modified their cuisine and incorporated many Peruvian elements (mainly Spanish, native and African) into their cuisine.

The three traditional staples of Peruvian cuisine are corn, potatoes, and chili peppers.  Peru has 3800 different types of potatoes which is why it is considered the birth place of the potato in South America.  They differ in size, shape, color, skin, pulp, texture and of course in their taste.  However, all types have their place in the Peruvian cuisine.  The word "papa" is originally Quechua and simply means tuber, and in Spanish it means potato.

Casava or yucca is common as is the plantain.  I love both of them, they are two of my favorites. Fried yucca and fried plantain chips are amazing! 

 Of course because Peru is a tropical country, a variety of fruits grow naturally.  Native fruits include lucuma, camu camu, prickly pear, cape gooseberry, cocona, pacay (technically a legume but used as a fruit), guanabana, dragon fruit, pepino, papaya, ciruela, mammee apple, banana, passionfruit, cherimoya, granadilla, moriche palm fruit, and tamarillo.  A couple of my favorites are the lucuma, camu camu, and guanabana.  Stay away from the cherimoya, its gross.  In the city of Iquitos there are several ice cream shops that have ice cream flavors with native fruit flavors.

Ceviche is a South American dish of marinated raw fish or seafood, typically garnished with herbs and served as an appetizer.  Tiradito is a related dish that shows the influence of Japanese immigrants and sashimi techniques.  Regarded as typical from Arequipa, Chupe de Camarones is regularly found in Peruvian restaurants specialized in Arequipan cuisine.  It is made from a thick freshwater shrimp (crayfish) stock soup, potatoes, milk and chili pepper.

There are many popular and delicious Peruvian dishes.  Pollo a la Brasa or grilled chicken is one of the most consumed foods in the country.  It is delicious, especially at Pardos restaurant in Lima.  Cow heart (anticuchos) is also delicious and you can get it at Pardos; it tastes like steak.  Arroz con Pollo is one of my favorite Peruvian dishes which is simply Peruvian yellow rice and roasted chicken.  

In the jungle there are various animal species that are hunted for food that you cannot find elsewhere in the world.  Some of the standouts include paiche (one of the world’s largest freshwater fish), and many other types of fish like gamitana, sabalo, tucunare, boquichico, palometa, bagre, and piranha, that are prepared in variety of dishes.  Other standouts are motelo (land turtle), and the charapa and taricaya (river turtles).  Other random foods that I have tried include alligator, monkey, jungle toad, Cuy (guinea pig), and Capybara (one of the world’s largest rodents).

 Peruvian desserts that are delicious include alfajores which is two cookies with dulce de leche in the middle.  Lúcuma juice, ice cream, and corresponding lúcuma shakes are very popular throughout Peru.  Arroz con Leche (rice-pudding) is one of the more common desserts found in homes and restaurants of modern-day Peru that consists primarily of cooked rice, cinnamon/nutmeg, raisins, and milk.  Of course there are also numerous flavors of helado or ice cream, especially in native fruit flavors which are delicious!

 Beverages that are common include my favorite drink Inca Kola which is the national beverage of Peru which is a lemon grass flavored soda that tastes a little bit like cotton candy.  It sounds gross, but it is actually delicious, I always bring home a couple liters whenever I go to Peru; it can only be found in national markets and select Peruvian restaurants in the states.  It is usually offered alongside Coca Cola at most restaurants.  One thing to beware of is water, make sure not to get any water that is not in a bottle, and also be weary of ice cubes – parasites like giardia are common to travelers, even in nice restaurants.  In the jungle, try the refrescos which are juices mixed with water and sugar.  In the jungle city of Iquitos at Ari Burger, the best restaurant in the city, they sell refrescos made with many different local fruits like lucuma and guanabana.  Chicha morada is also a common beverage that you will see in Peru.  It is made when purple corn (maíz morado) that only grows in Peru is boiled along with cinnamon and cloves. When the water cools, chopped fruit, key lime and sugar are added.  It is pretty tasty and the kids love it, it is the Peruvian version of Kool-Aid.

A traditional alcoholic beverage throughout the Amazon Basin is called chichi.  It is made most often with cassava root and sometimes plantain.  Traditionally, the chicha is prepared from cassava root by women, using a very simple method.  Pieces of washed, peeled root are thoroughly chewed in the mouth, and the resulting juice is spat into a bowl.  The bowl is set aside for a few hours to allow the juice to ferment.  This chicha is a somewhat opaque blue white, similar in appearance to defatted milk, and its flavor is mildly sweet and sour.  Cassava root is very starchy, and enzymes in the preparer's saliva rapidly convert the starch to simple sugar, which is converted by wild yeast and/or bacteria into alcohol.  In the amazon of Peru it is usually called masato and is traditionally offered to arriving guests.  I have never tried this nor ever would want to.  I would suggest that travelers avoid this as parasite transmission would be likely due to its minimal alcohol content and preparation process.

Music & Tradition

Peruvian music is eclectic because it is a combination of sounds and styles that draw on Peru’s Andean musical roots, yet is also influenced by Spanish tradition.  The addition of Chinese and African influences also has a profound inspiration on the country’s musical style.  Andean influences are heard through the use of wind instruments.  African influences are heard mostly through the use of percussion instruments and rhythm.  European influences are heard in the harmonies and stringed instruments.  No matter where you are, music can be heard somewhere.

Every town, village, and city has its own traditions and legends that they celebrate.  It is strange, but the culture within an area can be dramatically different from village to village or city to city.  The celebrations and traditions include music, dances, meals, and beverages.  The differences are because of the different integrated influences and due to availability.  Music is likely to differ based on the city’s inhabitants and their cultural histories, dances are likely influenced most on religious and historical legends, and the meals and beverages are influenced by what is available and native to the area. 

There are many religious celebrations like Christmas and Corpus Christi, and there are others that incorporate indigenous beliefs with Christianity.  They choose not to forget their cultural history which is admirable.  Other traditional holidays that Peruvians celebrate include All Saints’ Day on November 1^st where the spirits of the dead are celebrated, St. Peter and St. Paul’s Day on June 29^th, and the Immaculate Conception Day on December 8^th. 

Peruvian traditions, music, and the arts all stem from their multi-collaborative histories and cultural influences.  They don’t just ‘change with the times’ which is common in America, but they remember their history.  

Peruvian Religious Beliefs

Peru is a largely Christian country.  Because the country was settled by the Spaniards, they also brought with them their Roman Catholic beliefs.  The country maintains their Catholic heritage which can be seen depicted everywhere with crucifixes and paintings.  There are also Protestant and Evangelic churches in the country.  The Wesleyans are actually a growing denomination in Peru, especially in the jungle via Global Partners missionary activities.  

The native and rural people have beliefs that are mixed between Christianity and traditional beliefs.  In the jungle, witchcraft is common.  Witch doctors are in almost every village.  Many of the people, even the educated individuals believe in the spiritual, whether good or evil, dwelling in people.  Evil is what some attribute to diseases.  When the medical community fails to treat diseases and ailments, most people usually resort to witch doctors.

The country’s primary example of its religious beliefs can be seen with the Cristo del Pacifico in Lima.  It isn't too hard to find because it is a statue of Jesus that stands 122 feet tall in the Chorrillos region along the coast.  It is said to be a copy of Rio de Janero’s Christ the Redeemer statue, except this one lights up, changing color with particular holidays.  It was a sort of farewell gift from the president Alan Garcia that he said was to bless and protect Lima.  

Peruvian Hand Gestures

Most Peruvians speak more than one language, the national language is Spanish, but many also speak Quechua or another tribal language as well.  Very little English is spoken unless the people are professional with professional schooling; even then it is still rare.

Talking with your hands is commonplace in Peru, especially because Peruvians are very animated.  Behavior scientists say that during face-to-face conversation, 5% is verbal, 38% is vocal (including tone), and 55% in non-verbal and gestural.  You do have to be careful though.  Be aware that some familiar hand gestures can have very different meanings.  If you don’t know the language well, gestures are powerful communication tools, and are helpful in learning the language.  I have learned almost half of my Spanish words from just asking ‘que es’ (what is) and pointing to things. 

Gestures can get you into trouble, and although most Peruvians will assume that the foreigner just doesn’t understand, not everyone is understanding.

Come Here

In Peru you beckon someone or say ‘come here’ by turning your palm down while opening and closing your hand.  It is kind of like how you would shew someone away in the US.  Using a single finger like you would in the US is more or less lost in translation.

Nevermind

In the US, throwing your hand down palm to the ground and bending at the wrist means ‘nevermind’ or ‘whatever,’ in Peru it implies that someone is homosexual; this is highly offensive in a largely Catholic country.  This is a good way to start a fight.

Excellent

In Peru, making the ok sign, but rotating it 180 degrees (with the three fingers down) means ‘nice or excellent.’  Be careful though because it also implies that you yourself are homosexual or that the person you are talking to is homosexual.  Again this can start a fight, so it is best to avoid so as not to offend anyone.

Kill

The hand gesture of making a gun with your hand and pointing is very offensive and could actually provoke a fight.  I think it literally means ‘I am going to kill you.’

F-You

In Peru, when bending the pointer and ring fingers at the first knuckle, with the knuckles slightly ahead of the fingers - thus symbolizing genatalia, is the same as flicking someone off.

Secret

When someone taps the side of his nose with his forefinger, it signals a desire for confidentiality or secrecy in many cultures.

Pay Me

In Peru, the act of sweeping the hand and arm across a table means ‘pay me,’ although the same thing means that ‘someone is stealing’ in other Latin American countries.

Hungry

By extending the arm, bunching the fingers together and bringing your hand towards your mouth means that you are hungry

Packed

With your palm up, opening and closing the fingers and thumb (bunching the fingers) is slang for ‘it is packed.’

Cheeky

When tapping the cheek with fingers, palm facing towards or away from the face, means cheeky.

Watch

Pulling the bottom of the eyelid down means ‘I am watching you’

Blow/ Fight

The hand chopping sign usually means that there is violence or someone took a blow.

Hang Loose

The bullhorns gesture with your middle three fingers bent with the pinky and thumb out just means ‘hang loose’ in Peru

The People of Peru

The People:

Peruvians are strong-willed individuals, but they are also very accepting people.  They will try to accommodate and please others, especially tourists.  Something that is notable about all of South America is that there is a really relaxed concept of time in Peru.  Buses and many other transportation services are unreliable because of this fact, so be sure to keep this in mind when planning.  Peruvians are more interested in relationships rather than the time schedule.

From experience, a couple travel mates and I got separated from the rest of our group because the driver of the tiny vehicle that they call a bus, packed with 20 people or so, had to chat with everyone as he was dropping people off at their stops throughout Iquitos.  It was a little scary, the three of us spoke very limited Spanish and we were literally side by side, almost sitting on top of other Peruvian travelers; some of whom looked like they wanted to kill us.  It’s strange to feel lost with complete faith in someone you can’t even communicate well with.

Although some experiences can be a bit scary, you have to make wise decisions and a keep a keen eye out for thieves, especially if you are white.  White people usually mean rich and an easy score for them.  Don’t completely trust everyone, especially at the Lima airport.  Not all of the taxi service people are honest, so don’t let your bags out of your sight. 

Being careful is always good, but also don’t be afraid to ask for directions, most people will actually take you to where you want to go.  This goes for anywhere mostly, but specifically in the nice parts of Lima, people are very willing to help.  It is true, most people generally are good people.

Family:

Families are very important to Peruvians, usually whole extended families live with one another.  The women tend to stay home and take care of the house, the children, and the elderly.  It is their outlook on how important they see people that makes them so hospitable.  From experience, they will often times give up their beds and meals to travelers or visitors.  My team holds medical clinics in the jungle and the people there are so excited to have you there, to provide them with something that they have possibly never had, that they will do anything for you. 

 Children:

The Peruvian children are very different from American children.  They are very much directly impacted by their culture because they are very trusting.  You don’t even have to introduce yourself.  In the jungle once we arrive, flocks of kids just come.  They mostly just come to see white people and touch our skin and hair, but most of them just want to play, be held, and loved.  That is one thing that I am definitely good at.  It is so easy to form quick attachments with them because they are so open and loving.  They are non-judgmental, they love you for no reason which is for sure something I wish came easy to me.

Gestures:

I am going to talk about hand gestures in a future post, because that is something important to keep in mind.  Not all of our common hand gestures here mean the same things in Peru, and many of which can be very offensive.

When introducing yourself for the first time, members of the opposite sex shake hands.  It is common for men who know each other well to shake hands or pat each other on the shoulder or back, this is more a sign of respect for one another.  Just like anywhere else, when someone shakes with a tight grip or intentionally twists to make their hand on top, it shows power, but it also is offensive because it shows that you aren’t on the same level; it makes you look like you are better than the other person.  A light lingering handshake is generally more favored in Latin America, and to withdraw the hand too quickly could be interpreted as an insult.  Women who know each other will kiss each other on one cheek.  This is also a common greeting for most men and women if you know them.  Hugs are also common, but women should be wearier because it can also send a wrong message.  One common sight between men is that you might see friends holding hands, there is no ‘gay’ connotation to that in Peru or in other areas of the world for that matter; it is very common in different parts of Africa as well.

When talking to people, it is common for friends to call each other by first names.  Out of respect, older people and people you don’t know well should be addressed by title, either ‘Senor’ or ‘Senora’, and last name.  Only close friends and family use first names.  Professionals should be addressed by their professional title and last name, just like in America. 

Other common conversational differences include animated hand gestures, vicinity, and eye contact.  Like I said, I will touch on hand gestures in the future.  Vicinity focuses on the fact that Peruvians traditionally stand very close and touch each other when they talk, sometimes the closeness is very uncomfortable.  To make things more uncomfortable, maintaining eye contact is also important.  Talking to a person without eye contact is kind of insulting.  Picture standing five or six inches from a person maintaining constant eye contact having a conversation with someone.  It is a little awkward at first, but you will get used to it.

Ages & Dress:

Peru is a rather young country because most of them live in urban areas and over half of them are under the age of 15.  This is because the mortality rate is high for adults.  Only 6.5% of adults are older than 65 years old. 

In urban areas Peruvians usually wear western-style clothing and tend to dress up when going out into public.  It is inappropriate to go out of the house wearing dirty or old clothing.  This is different in the jungle, however, some more traditional villages wear traditional ‘indian’ clothing, although western t-shirts and shorts are commonplace.  Many in the jungle do not wear shoes however, especially the children because they don’t have access.  The people that live in the mountains also wear different clothing, theirs is usually heavy and usually made of alpaca fur.

There are a lot of aspects that make up the Peruvian culture, but all of which are important to at least have a working knowledge of when visiting the country.  Just live and love the people, it will give you a whole new outlook on your own life.

A Little Peruvian History

Peru is a South American country that is bordered by Ecuador and Colombia in the north, east by Brazil, and south by Bolivia and Chile.  Before being settled by Francisco Pizarro and other Spanish settlers in the early 16^th century, the country was home to some of the oldest untouched ancient civilizations.  The Incan Empire occupied much of the South American countries surrounding the Andean mountain ranges, although much of its history can be seen in Peru.  Remains can be seen in Cuzco and most notably at Machu Picchu and the Nazca Lines, highlighting their ingenious knowledge of infrastructure, spirituality, and the sciences.

 Peru is what is called a representative democratic republic which has elements of both the parliamentary and presidential system of government, and is divided into 25 regions.  The country’s capital is in Lima which is on the southern coast is the most developed.  It is a beautiful city with a lot of history, and a lot of tourist attractions.  Even with such beauty, poverty can be seen on the mountainside in shanty towns.  It is estimated that the Peruvian poor that live in the urban environment have a 20% higher mortality rate.  The Lima shanty towns are rampant with cocaine and the cheaper alternative of base cocaine, and diseases there spread like wildfire.

The most notable region to me is the Loreto region, or the jungle region which containing a large portion of the Amazon basin.  This is a mostly unsettled region of the country where Iquitos, the largest jungle city, and the sixth largest city in the country.  It is nicknamed the ‘Capital of the Peruvian Amazon.’  The most notable thing about the city is that it is the largest city in the world which cannot be reached by road, only airplane or boat.  There is one road to the small town of Nauta, which is about 60 miles south.  Let me tell you, that road cannot be considered a road in American standards.  It is very rocky, hilly, and dusty, which makes carsickness common.  Yeah, not all that fun when there is a small bus packed full, hip to hip, with people.  There aren't many cars in Iquitos because of the expense of shipping them there, but they mostly use moto-taxis which are motorcycles with carts built on the back.  These are fun, but very dangerous.

Peru is considered a developing country meaning that it is relatively poor.  And it is a melting pot of ethnicities.  The first time I went to Peru I was confused because there is a ‘Chifa’ or Chinese restaurant on every street corner.  The high prevalence of ethnic groups is because they were shipped in during the rubber boom to chop down trees and work the silver and copper mines.  The major economic activities include agriculture, fishing, mining, and textiles.  Most of the men in the jungle do a lot of logging which contributes largely to the destruction of the Peruvian jungle.  Another thing that led to destruction of the jungle started during the rubber boom, the Amazon was one place natural rubber grew. 

Peru is 496, 225 square miles of beauty.  It contains the Andean mountain region which defines the regions of coastal, mountain, and jungle.  This is what gives the country varying climates which varies from tropical in the jungle to desert in the west. 

The official languages include Spanish and Quechua.  Quechua is more of a jungle language and one that was spoken by the ancient Incas.  There are also a variety of other jungle and rural languages that are spoken. 

Ok that is about all the information that I could quickly put together into one post.  Stay tuned for more information about the people, travels, and research.

First Post!

Hey guys!  This is my very first blog post so that is exciting!  My blog is going to be centered mostly around Peru and traveling to Peru.  It will also serve as a source to update people on how my research is going.

While getting my undergraduate degree at Indiana Wesleyan University, I went on a Medical Missions trip to the Amazon Jungle in Peru, through Global Partners.  I fell in love with the people and culture of that area and have been going back ever since.  My desire is to become a Medical Doctor, specializing in Internal Medicine and Tropical Health so I can continue leading and taking trips to the Peruvian Amazon to hold clinics and ultimately decrease rates of morbidity and mortality in the region.

At the end of May through the first week in June, I am going on another Medical Mission trip to the same area.  Currently I am getting a Master's degree in Public Health with a concentration in Global Health from Wright State University.  As part of my degree I am to do a research project, so while I am in Peru I am going to be gathering data regarding needed medications and parasitic disease prevalence in the region, as well as utilizing demographic and parasitic disease rates to determine possible interventions that could decrease rates of reinfection.

My following posts will begin with history, planning a trip, travel needs, and more updates on my research.