Passing the Torch

My last week in Peru has been all about closure, and it’s been very emotional. I had my last day of work with patients at the clinic and bid old co-workers farewell at the Hospital. I taught my last course for about 50 people at the University. I had one last meeting with the support group for caregivers of children with Cerebral Palsy. I passed off the final plan for the community-based rehab project in La Esperanza. Participated in a parade with clinic staff. Met with my focus group of PT’s one last time. And bid the nuns - Hermanas del Buen Soccorro, host family, neighbors and friends farewell.

Anniversary parade!

The support group meeting again opened my eyes to new aspects of challenges faced by caregivers of people with disabilities. We talked about diapers and how costly they can be, as many of the kids/young adults go through 4-6 a day, not to mention time and money spent on frequent laundering of urine-soaked clothing. We also talked about the challenge of taking the kids to the dentist, and how difficult it is to find a dentist that has enough patience with their children. We discussed problems with the taxi drivers, who often discriminate and raise prices against the families of kids with disabilities. Again I am inspired by the incredible strength of these women and their daily perseverance. This creative and talented group of caregivers is developing some great leadership - I look forward to seeing where it will go and have high hopes that it will be around for my next visit to Perú.

My heroes - incredible women

We are fortunate to have some new CMMB volunteers joining us to form a team in the community based rehab project. One nurse, one psychologist, one occupational therapist, one physical therapist aid, one specialist in public health and one doctor make up the current core team who are planning the interventions for start date of January 2012. The project will begin in a high-risk zone called Nuevo Jerusalen, which sits atop a hill in living conditions that include sand for roads, no water or electricity, and many health disparities. “Rehabilitación con Esperanza” is based around the training and use of local community health agents (promoters) as “gatekeepers” into the spectrum of program services. The community agent volunteers will help identify potential participants in their neighborhood, determine their assets and health service needs, administer a baseline outcome tool, and be part of basic health education. Participation is based on a family approach; people with disabilities and their caregivers will have the opportunity for home and group therapy sessions with professionals across various disciplines, and will be expected to participate in support groups and educational sessions to fulfill the program criteria. The project will tie in resources from a local university and physical therapy students and staff from Regis University (Denver, CO) while also aiming to network with the local church and other organizations in the community. Long-term goals include self-sustainable projects in micro-lending, an assistive device workshop run by people with disabilities, labor and career training, and the improvement of access to medications, transportation and recreational opportunities, with an ultimate aim to foster change on the political level through connections with the Peru Ministry of Health.

Survey in action - Nuevo Jerusalen

I’ve learned throughout this process (and many other aspects of Peruvian life) the importance of patience – it’s certainly an understatement to say that community health is slow going. Last week I finished up a manual for the community health agents that gives an overview of what each profession offers, tools for starting support groups, and a set of care models for 12 of the most commonly encountered types of disability in the district. This will supplement another manual that trains agents in the basics of community based rehab across the lifespan. It’s been an amazing learning experience to start the project from the ground up – beginning with the survey created last November – and throughout the year, including very valuable input from the Peru Ministry of Health in Lima. Although I am sad that I will not see it all the way through, I know it’s in good hands.

Now for the difficult goodbye process. They don’t make it easy on you here- meeting with someone to “say goodbye” is apparently a three step process in Peru. Step one- meet, bring parting gift, give it to person and express your heartfelt emotions, and then as they depart – get invited to something else later on in the week to “say goodbye one last time.” Step 2- goodbye meeting #2, which ends the same way as goodbye meeting #1 – with future plans to again see that person. Step 3 – Finally meet one last time, while insisting that yes, tomorrow I will actually be leaving on my bus as planned. And Step 4 (optional) – Re-goodbye at bus terminal. It’s a bit overwhelming and tiring trying to express my emotions in Spanish so many times, but nonetheless reflects the beautiful heart and soul of Peruvians.

I really don't have sufficient words to express how I feel today and what this last year has meant to me. It has pushed me and given me so much personal growth - so much more than I ever expected. Call me cheesy but I don't care - my soul has found the other half of its home. I am filled with great dread to leave - but also great joy that I now have two distinct cultures and families in my life. 

Luckily, I have a "little" distraction to ease my heart-ache … Before my re-insertion into American culture, I’ll be making a detour down towards Patagonia! ☺

Random side note - Thank you Steri-Pen for sending me a new water-cleaning tool! It’s working great!

Y Perú – MUCHAS GRACIAS POR TODO! Nunca me imaginé tan increíble seria la experiencia y nunca te olvidaré. Muy agradecida por todos los Peruanos en mi vida y esta oportunidad bonita que he tenido en el año pasado. Siempre contigo… No es Adios, sino mejor HASTA PRONTO!

Con mucho cariño, La Gringita