One Year. One Physical Therapist in Trujillo, Peru.

Combining passions of global public health with travel and cultural immersion... With the help of the Catholic Medical Mission Board, I was afforded the opportunity to live outside of Trujillo, Peru for one year's time (2010-2011). Check out old posts about my experiences as a PT working in hospitals, a school, an outpatient clinic, doing research/community based rehabilitation, and a little teaching too. And my experiences with an entire calendar year of holidays, cultural customs and new culinary experiences!

I make it back about once a year with university students/CMMB projects, so I will periodically provide updates :)

Sunday, June 24, 2012

Seeking Donations!

A group of physical therapists and Regis University physical therapy students are seeking equipment donations for an August 2012 continuing education event and community-based rehabilitation project!

Looking for small lightweight rehabilitation type objects to bring down to Peru this year, such as:
-goniometers
-theraband
-stability balls
-gait belts
-notepads and pens

as well as any Spanish-language physical therapy or public health resources!

Please email alaska.walker@gmail.com if you have any questions, or would like to donate something.

Mail donations by 7/20/12 to:
Nancy Mulligan
Regis University, School of Physical Therapy
3333 Regis Blvd, G-4
Denver, CO 80221


MUCHISIMAS GRACIAS!!!

Thursday, May 3, 2012

Photography Fundraiser!



Still looking for the perfect Mother's Day gift? Look no further...

Help support CMMB's efforts in Peru! I'm doing a fundraiser for CMMB's project "Rehabilitación con Esperanza" on Sunday, May 13th (Mother's Day!) - see information below. (If you don't live in SLC but are interested in seeing/ordering some of the prints, please let me know! Email: alaska.walker@gmail.com)


When: Sunday, May 13th, 2012
Where: St. Catherine of Siena Newman Center
            170 University Street, Salt Lake City, UT 84102
Hours: 8:30am-12:30pm and 7:00pm-9:00pm
The Goods: Photography - matted, framed and non-framed, and select images on canvas - a wide array of sizes and scenes ranging from Peru to Alaska, Southern Utah to Tuscany! Special thanks to photographer Fred Walker for his numerous beautiful donations!

About "Rehabilitación con Esperanza"
Catholic Medical Mission Board (CMMB) began a new Community-Based Rehabilitation project in 2011 targeting a population with disabilities. “Rehabilitación con Esperanza” is a public health program in the district of La Esperanza, Trujillo, Perú with two main focus areas:
  • improving access to healthcare services, rehabilitation-trained community health workers, assistive devices, transportation, education, support groups, work, and recreation for persons with disabilities
  • improving access to continuing education resources for physical therapists 

The project currently has a population of 20 children with disabilities, and utilizes community agents and support groups to address the needs of caregivers as well. While the project is organized by CMMB, it relies mainly on funding via grants. Unfortunately the grant process has not yielded support yet, and the entire project is currently running by the big hearts of a few volunteers.

This community-based rehabilitation program is hoping to build on its’ sustainability and improve the quality of care received by participants by involving collaboration with international volunteers. This year, Regis University (Denver, CO) will be sending down physical therapy students and faculty to assist with this public health project and the hands-on training of community health agents, local physical therapists, and families/caregivers of the children. In addition, two physical therapists from the US will lead a 2-day continuing education conference in the training of rehabilitation for neurological conditions to 80 local physical therapists in Trujillo.

All donations received at the fundraiser will go toward the facilitation of the training/education sessions in August 2012 and supplies such as the rehabilitation equipment that each child in the project needs. Please stop by - learn more about CMMB - and support this great cause!

Muchisimas Gracias!

Monday, April 30, 2012

Peru, Take Two!

Great news- I couldn't get enough of Peru, so I am thrilled to announce that in three months I will be headed back! Unfortunately this time I will only get to stay 3 weeks, but hey, better than nothing.

This year I'm going down with a group of Regis DPT students and faculty Nancy Mulligan. Similar to last year, as a service learning trip, the students will do some touring of healthcare facilities and meet with leaders at the Peru Ministry of Health in Lima, before heading to northern Peru to help with CMMB's public health project "Rehabilitación con Esperanza." There, students will assist with outcomes collection and the training of community agents, PT's, and families/caregivers of 20 children with disabilities who are currently enrolled in the project. We also aim to strengthen our collaborative relationship between Regis and two of the local universities in Trujillo.

The students will also join two physical therapist volunteers from the US, Sarah Ingram and Cindy Potter, to lead a 2-day international continuing education conference in Trujillo with a focus on physical therapy examination/evaluation/treatment of neurological conditions (specifically cerebral palsy and stroke, the two most common neurological pathologies found in northern Peru) - August 11-12, 2012.

Of course, I'll be heading down early to make time to see my family and friends in La Esperanza - and get my share of mama Nelly's aji and home cooking too! ;) Can't wait!



Sunday, November 20, 2011

Culture Shock, Take Two

I arrived back to the US last week and am still getting used to my own culture again. Alaska gave me a nice welcome with -20 degree weather and a big bull moose grazing in the backyard. I think the two worlds I’ve lived in could not be further apart!
Home sweet Alaska...
 Aside from the obvious climate differences, I am taken aback by almost every aspect of daily life. The other day I stood for several minutes just staring at the choices in the grocery store. I keep saying hello, thank you and excuse me to people in Spanish. It took me 6 tries to check my voicemail the first time because I kept pushing the wrong buttons, and still takes me ten minutes to write a text message in English (well, lets be honest, that may be normal for me). Other big news - People here abide by traffic laws! There’s no swerving or hanging out of moving vehicles, and transportation itself here is so lonely- everyone with their own car and so many going to their destination alone. I can get all my laundry done in one day, and with a dryer! Tap water doesn’t have to be boiled, dishes go into this contraption called the dishwasher, and I can flush my toilet paper down! Doctor waits are minimal. TV and music are so foreign. And it’s so QUIET.

view of Anchorage flying in
I can’t shake the feeling that there are holes in my life after Peru. I miss everything-everyone- to the point of feeling a physical ache. I miss the symphony of roosters, buses rumbling by, horns blaring, bicycle peddlers, children shouting, latin music blaring, dogs barking. The organized chaos that is the public transportation system. Peruvian babies. The view of the ocean as we round the curve to Huanchaco and the bliss of riding a wave on a surfboard. Greetings from strangers on the street. Stray dogs. Slow walking pace. My neighborhood market. Freshly squeezed juice. The mass in Spanish. Picarones-arroz a lo pobre-lomito saltado-ceviche-papa a la huancaina-tallarines saltados-chifa-chicha morada-helado de lúcuma-aji-arroz con leche-hamburguesas y sandwich de pollo-yuca-mango-choclo-Cusqueña-pisco sour. (in no particular order!) But most of all, I miss my Peruvian family. My patients – the laughter of my peds patients and the stories of my geriatric patients. Neighbors, colleagues, co-workers and nuns. Peruvian and gringo friends alike. My friend and Spanish coach Maria. Pancake and taco nights with family. The shouts of my host cousins as they race upstairs to feed the dog. Night-time tea and laughter. I miss the culture, lifestyle, and though I feel so blessed to have had such a great experience, I can’t help but feel pretty bummed that it’s all over. However, it has been amazing to see family and friends again - 14 months is a long time to be away!

“Most of us live the greater part of our lives submerged. Certainly in my own case I can say that not until I left America did I emerge above the surface.” Awhile ago my friend shared this quote by Henry Miller, and it definitely mirrors my own feelings about living and working abroad. I don’t think I really “got it” until I spent a good chunk of time in a developing nation. Now that I’m back in the US, I find it’s hard to convey the exact experiences and feelings of life in Peru to others. It’s hard not to compare everything to life in Peru and bring it up in every passing moment. It’s also hard not to judge others, nor to be guilt-ridden and disgusted by parts of American culture.

Someone responded to Miller’s quote with, “The tough thing is to make personal changes as a result, without turning into a sour cynic about your own culture. ‘Enlightened’ people usually turn into judgmental people. Enlightenment with humility of a good thing.” So, two months post-life-in-Peru, I find myself faced with this challenge and still in a bit of mourning over my separation from South America. I hope that my new lifestyle and many of life’s lessons learned - the Peru “magic”- will somehow live on in my life.
on the descent to Anchorage
So, I guess this is my last post. I hope you've enjoyed hearing about my experiences and will carry some "Peru magic" into your life as well. Thanks for all of your support over the year! 

Y gracias de nuevo a mis queridos Peruanos- siempre contigo! (y hasta pronto!)


Saturday, October 1, 2011

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

Wednesday, September 28, 2011

Cuidado!

One of my biggest frustrations with the Peruvian culture lies in the reality of (lack of) safety. I’m not just talking about the lack of seatbelts or the common transit/pedestrian dangers of daily life. I’m talking about the daily dangers surrounding each woman – and likely not just Peru, but presumably all of Latin America. Now that I’m about to leave, I feel like I can comment on it a little bit (without hopefully freaking out my parents too much!)

It’s hard not to be a bit paranoid here. Whenever anyone asks me where I live, I get the gasp and the “Oh, no, you shouldn’t be living in that neighborhood, it’s so dangerous!” Parts of my neighborhood are notorious for murder and gang problems, but fortunately I live in a “nicer part of the ghetto” as it’s affectionately called. I chose to forego the comfort of an apartment in Trujillo for the many benefits of immersion– in order to truly get to know the community for work in public health, I wanted to become a part of it. It worked out well - my living arrangements have been excellent – complete with wireless internet, my own bathroom that now has hot water(!), great proximity to the clinic, and the best part of all… an AMAZING family!

Sure enough, once they began to recognize me as a long-term volunteer at the local health clinic, it was clear that my neighbors “had my back” and I really began to feel more like part of the community. True, I still get stared at all the time, but I certainly feel safer walking around my community. During the day, the main worries are robberies. Peruvians are constantly looking over their shoulders as they walk. Don’t talk on your cell phone outside of the house- someone will run by and snatch it. Don’t carry a purse unless you absolutely have to. Avoid certain streets that are notorious. Don’t sit near the door to the public transportation- someone may run up and grab your bag. Don’t use the bridge unless you have to- they wait to rob you there. Lock the house 3-4 different ways.

Many Peruvians in my neighborhood are terrified to leave their homes at night. I’ve become much less social at night, simply because it’s not safe to go out. If I want to go play soccer at 8pm in Trujillo, by the time we finish, the public transit will have stopped running and I’ll have to take a cab by myself back to La Esperanza at night. It was frustrating at first, but now I’m used to it and instead use night hours to either work from home, spend time with my host family, or read and drink tea ☺
La Esperanza is working to improve the crime situation
Trujillo and many other parts of Peru have had an escalating problem with what they call “extortionistas” – basically, groups of thugs who select homes or businesses and threaten them. They demand monthly payments and if they don’t receive the payment, they blow up the home. I’d heard of these groups before but didn’t realize how bad the problem was until about 6 months into my stay here. We were sitting around the table after dinner talking, when all of a sudden we heard a series of extremely loud explosions that were so close they made the house shake. We began running around in circles in the living room, unsure of where to go or what to do. They evacuated the sisters who had been in the back rooms and we huddled near the other side of the house, trying to figure out what was going on without leaving the front door. It was then that my family confessed to me that their neighbors had been having problems with the extortionistas. Just before I arrived in Peru, their neighbors’ house one street away was blown up because they refused to make the payments (fortunately, nobody was home at the time). The house across the street from mine is currently being threatened and the family has been making the monthly payments.

This news terrified me – it was suddenly a much more real threat. I began to worry that these people would see me entering my own home and start to threaten my host family since they have an obvious gringa living with them. Fortunately, nothing has happened, but it’s been a constant worry. On top of that, I’ve had many friends who have been mugged. I know people who have been kidnapped in taxis and taken out to the desert - and luckily somehow got away to tell. Safety is a real concern – whether you’re Peruvian or not.

It’s obvious that God’s watching over me during my time here. I am still amazed that I haven’t even been robbed (knock on wood!) I’ve had a few attempts but have managed to get out of each situation. I have a handful of taxi drivers that I know and trust – as for the rest, I only use taxis as a last resort – and almost never alone. I’d rather it take 30 more minutes but be on some type of public transit where the worst that could happen would be a robbery. I only get into certain types of taxis, and they have to pass the “face” test - Creepy? Bad feeling? Young? NEXT. Elderly man… okay! (Maybe we’ll get in a car crash because he’s half blind, but at least he’s less likely to kidnap me!)

My biggest struggle this whole time has been in how 2-sided my life is. I’m walking in Peruvian shoes for a year, but deep inside I’ve known that come October I’ll be whisked back to my safety net of top quality health services and few personal safety concerns. It seems so unfair that Peruvians, and in particular Peruvian women, have to live in daily fear like this for their entire lives. They are constantly worrying – Where can the kids play safely? Will someone rob the home? Sexual assault? Taxi kidnappings? Extortionistas? Muggings on the street? And it never ends. They say that with the new president Ollanta, Peru should start to crack down on crime…. let’s hope they’re right. 

But, safety concerns and all, Peru nonetheless feels like home now – a beautiful place and at it’s heart, beautiful people who I will miss deeply – come Saturday. Can’t believe the year is coming to an end!

Monday, September 26, 2011

Corre, Gringita, Corre!

With my new running buddies (and random bystander)
Yesterday, in honor of my last Sunday in Trujillo, I participated in the “Pedro Horna Montoya maraton” (actually a 10k) race. And get this - for the cost of 3 soles (one dollar) I signed up and got my t-shirt! I’ve been looking for races in Perú all year and was pumped to finally find my South America running experience!

It was a great final farewell in the city I’ve come to love and call home over the last year. I was amused by the little Peruvian touches – “a big medical work-up prior to race” was a blood pressure measurement; “be there at 8 and race starts at 11:30” was really be there at 11, race starts at 12. At the race start, I was literally left in the dust- all 150 participants took off in full sprint! (But then, a few blocks later, some people were walking.) I was the only non-Peruvian in the race and the crowds did not let me forget it. “Corre, gringita, corre!” (run, little gringa, run) and “MIRA a la gringa!” (LOOK at the gringa) were most common, but I also heard a little kid say, “Mamá… mujeres corren también?” (Mom, women run too?)

Whenever I approached a man in the race, he would look at me with wide eyes and take off sprinting full speed ahead for a few seconds to lose me. Given my lack of consistent training, I was in too much pain to care about the scene I was inadvertently making. At the finish line, I was sieged by a mob of Peruvian men who wanted to take a photo together. They informed me that I got third place out of the women (really not that impressive, considering there were maybe 25 of us) and that I won a prize! They called “Mary Bocker” up to the podium (and somehow they lost my first name in there somewhere!) and proceeded to give out medals, a certificate, and a cash prize – 100 soles (30 bucks)! Yeah! Aside from dodging cars, pedestrians and dogs, and the occasional inhalation of bus exhaust, it was a semi-normal running race – and for me, a very unforgettable day.