Alpaca Bag
Feeling the beauty
I realize I’m severely slacking in the blog department. Maybe this is why I didn’t do one when I was in Ecuador. But at least I’m doing it now. The last time I wrote was in January, I believe. Since then, time has flown, but it has also crawled by. It’s a weird feeling. In January, another cmmb volunteer arrived, who I had no idea at the time would be a lifelong friend. Brynn came at just the right time. The excitement of the holidays and traveling had just ended, and although I did have (and still do have-I promise I’m not a complete loser) friends here, I still needed someone of my own culture to share the experience with. We are the same age, and pretty much in the same point in our lives (and by that I mean that we joke about how much we still need to figure out).
Brynn’s arrival made me realize how important it is to have a confidant. No matter where you are in your life, no matter which country, now matter how beautiful your surroundings are, you still need a good friend. Especially with this experience. I spent the first few months of this experience learning that it is okay to be alone and learning how to be self-sufficient, but I needed a good friend in the last part of my experience to show me how important it is to have people around you to support you through difficult times. Together, we are able to share the joys and frustrations of this experience.
At the end of last year, Mary, Mercy, Nadia and I wrapped up therapy with our patients in early December to allow time for end of the year activities and a break from therapy for the holidays. When we returned for the new year, we spent most of our time working in the office. As I mentioned in one of my previous posts, the four-woman team I work with has to manage everything to make the program run. Contrast this with the hospital where I worked in the US. There, the materials were usually already prepared, or at least easily accessible. The therapies are scheduled by the scheduling department, the therapy spaces were cleaned and prepared by environmental staff, etc. Here in Peru, the behind the scenes work is completed by these four dedicated women.
All of this is normally a huge task for this team of four women and myself. However, at the end of last year, our program manager, Ericka, sadly decided to leave her position at cmmb. Where Ericka was responsible for coordinating the entire project, we as therapists were previously responsible for managing our patients, therapies, and documentation for therapies. However, this change required the four of us to quickly take on the role of managing the entire project. For most of January and February, the four of us quickly took over the role of managing the project. Mary, who is the other speech language pathologist, was formally named as the project coordinator; however, because it was such a large undertaking, we all needed to take a role in managing the project. The behind the scenes work is a large task, so much so that it was a full-time job. Therefore, we spent the first two months of the new year learning the inner workings of the NGO’s project and how to successfully manage it.
This part of the experience for me has been eye opening, because typically, a speech pathologist in the US will only preform therapy. The programming, scheduling, managing, and organizing of the program is usually left up to the program manager. However, here in Peru, circumstances are somewhat different. I’ve previously seen these therapists perform many tasks with regard to managing the project before including cleaning the therapy space, scheduling the children, doing evaluations, and completing evaluation and treatment plans; however, now they are running entire project, which includes budget proposals, recruiting new children, managing activities outside of therapies, and coordinating with schools and health posts for the childrens’ checkups. Although quite a challenge to now manage their own therapies as well as taking a hand in managing the project, they’re doing a great job.
After all the madness of learning how to manage the project, we finally got to start doing evaluations and therapy in March. Because the families have had a few months of a break, they were instructed to continue practicing what they had learned in therapy, as to not lose their skills that they have learned. When they returned, I was so happy to see that almost all of the children had maintained their skills during 3 months of a break from therapy, which is a true testament to how diligently these mothers work with their children in their homes.
I continue to work mainly in the area of alternative communication and feeding with my children here. One of the most frustrating aspects of working in feeding here is the lack of a very specific product I need, called Thick-it. If you’re a speech pathologist reading this right now, you may want to stop because this will be difficult.
About three or four of the eighteen children I see every week are aspirating on thin liquids. Basically, this means that they are at risk for getting pneumonia because anytime they eat or drink anything that is the consistency of water (or sometimes even the consistency of tomato juice), their muscles and structures in their throat do not protect their airway. This means that food or drink can easily go into their trachea instead of their esophagus. As speech pathologists, we usually try to implement some strategies for strengthening muscles, or find some compensatory techniques to help the food/drink be directed away from the trachea; however, with these children, these techniques aren’t enough. They need a product called Thick-It. This product can be easily found in any pharmacy. You’ve probably walked past it a million times in a CVS but never realized what it was. This product is a powder that thickens liquids so that they flow more slowly down the throat, allowing the child’s muscles to react better, and therefore decreasing the risk for aspirating (when food/liquid goes down the trachea instead of the esophagus). This product is nowhere to be found in this country. Anywhere. I’ve been to a bunch of different pharmacies, but it does not exist. So just imagine: something that is so easily found in the US that is vital for some people, is nowhere to be found here.
These four patients didn’t know what aspiration was before doing therapy. They would swallow thin liquids and almost choke on them, because their bodies couldn’t handle it. The first few sessions were a nightmare for me, because the patients were spitting up, coughing, and obviously aspirating, but the mothers just continued to feed them, because that was their normal. Through no fault of their own, they had no idea just how dangerous it was. In therapy, we’ve had to become more creative. We’ve been thickening pureed foods with potatoes and bananas and we’ve been thickening liquids with a food called maizena (which is kind of like a gelatin). Even with these modifications though, these children are still aspirating.
Ariel, who is the country director, was kind enough to bring two huge tubs of Thick-it back to Peru from his trip to the US. We began to use it sparingly with the patients, and the mothers were thrilled. It was amazing seeing them watch their children eat without aspirating. Unfortunately, though, we only have a limited amount, and it is not often that people are flying back and forth from the US to Peru (so anyone with any ideas of how to get it here would be fantastic!). We continue to work here to make sure that these kids can safely eat and drink without aspirating.
Aside from therapy, I’ve been soaking up the sun here in Peru. The sun is surprisingly strong in the afternoon. I continue to learn more and more about the culture and have even been called Peruana a bunch of times. I’m getting really good at haggling with taxi drivers, and I’m late to almost all events that I’ve been invited to, so much so that my Peruvian friends often show up before I do to events. I’ve picked up surfing, and had gotten pretty good at it (I haven’t gone out in a while, but will get back to it soon).
In February, Brynn, myself, and a bunch of friends went to a town in the mountains called Cajamarca for Carnavales. It’s pretty much a weekend where everyone buys a color that they would like to paint their living room with, but instead of putting it on their walls, they throw it on your face. Paint tastes disgusting, by the way. I suggest not eating it if you can avoid it. It was a blast, and I took the longest, coldest, shower I’ve ever taken in my life in Cajamarca to get the paint out.
The following months were filled with weekends at the beach, surfing, hanging out with friends, and continuing to explain to people why I am the only person who they have ever met who doesn’t like ceviche (I’m sorry, the texture creeps me out!).
In March, my friends came to visit Peru and we had an AMAZING time! Julianne (my childhood friend who lived next door to me my whole life), Krissy, Krista, (friends from elementary school all the way through college), Lauren (friend from college), and Mike and Tome (Krista and Lauren’s boos) flew all the way from the US to Cusco to spend time with yours truly, and I was so grateful that they made it all the way down here (and without any problems too, which is a blessing). We spent a few days frolicking around Cusco, vising some historical sites, and eating and drinking our way through the city. Then, we set off for a four-day Salkantay Trek to Machu Picchu. We were all pretty nervous about our hiking abilities prior to the hike, but we all realized we were pretty much going to go at the same pace since we all stopped to huff and puff about fifteen minutes into the hike. Each day we woke up at the crack of dawn and we spent our days at high altitudes, hiking for hours along beautiful landscapes in the mountains and in the cloud forest. We played games along the way, complained to each other, and even complained to our guide, Ken. I actually think Ken told us that we were the biggest group of complainers he had ever led. We know he loved us though.
One the last day of the trek, we woke up at 3am and hiked up 2000 stairs to Machu Picchu. After which, poor Ken explained the history of Machu Picchu to a group of miserable, wet (it was pouring), cold, group of people who probably looked like corpses. As the sun came up, however, we livened up and were able to enjoy the beauty that is Machu Picchu. To experience something like that with such an amazing group of people is something that I will never forget (I would like to soon forget the blisters the size of golf balls that the trek left on my feet though).
The last few months, and even my last few days here have definitely made a mark on my life for many reasons. I’ve met a lot of great people. People who have made me evaluate my life and want to change it for the better. My visit with my friends has also made me realize how much I miss my family and friends at home. And my last few months here has really showed me that it doesn’t matter where you are, but the people you surround yourself with are what really matter in life (I know, a bunch of you are probably thinking, “You didn’t have to go all the way to South America to learn that, Megan.”). But I still have more learning to do, as I’ve recently realized from a very special person I’ve met down here who has taught me to really start seeing the beauty in the little things in life. I promise, I will return, but I still have some learning, exploring, and searching to do down here. My next stop: Argentina.
Until next time (I promise to try to write sooner than every 5 months),
Meg
xoxo