When in Perú, do as the Peruvians do...

So, I decided to join two of the girls from the Institute for a little run on Saturday...what I found out, after I had agreed to it, was that this run was an 8K that started at 7 at night - "Corriendo Bajo La Luna 2008". Well, I probably need the exercise anyway and how often do I get this experience? So, I took a few micros and met them over at this little park called Parque San Miguel for our "little"run. By the time all of us got there, it was time for the race to start and the Peruvian national anthem was being played. We ran in, got our numbers, grabbed t-shirts, took off all the winter clothing (and put the clothing along with wallets, keys, and cell phones into the bag I was carrying and continued to carry all through the race...), and literally took off running. No stretching, no warm-up - just absolutely cold. I think my knees will probably hate me for that...haha. I managed to keep up with all the girls and run (these girls don't jog), despite the fact that I've had three weeks here without running or any sort of formal exercise. (I do however do sit-ups and squats in the room where I work when no one is looking...shhh) I guess I should count my blessings though that these girls were not Kenyan men whom I had decided to go running with at 5am in the mornings. (I have made this mistake...) I also ran without using my arms because I was holding a bag onto my back the entire time, trying to keep it from flopping around. I count it as a success...most definitely. Best thing about running with Peruvian women - they have little short legs like me and can't run in large strides! Yay - short people!! After the race, they had a huge gym full of racers and families of racers dancing cumbia, salsa, and merengue...so yeah, I did that too - do as the Peruvians do, I always say. Nothing like adding a little bit more exercise to top off the evening!!

Ready for round 2! Who is with me?

I must say this has been a crazy week. I woke up every day around 5:30am and had to be out waiting for my bus to Canto Grande every day by 6:45am to be able to get to work by 8:30am (long bus ride...). Mary, the woman I am living with was gone for the week with a group of students from Iowa State to Cuzco as part of their program here. So, on top of getting myself up and out the door (which was quite a feat in itself some days...), I was in charge of two dogs and making sure they were fed, taken out, and back inside before i left every morning. I also then had to feed them, take them out, keep them from barking, and put them up before bed every night. I partially appreciate why moms are always so tired...(considering these are dogs and not children).

The beginning of the week was rather stressful because I had to call a taxi and explain to him where I lived in order to get to the Institute to head out to Canto Grande. I said my street on Parque Colombia and he took that as "I live on Parque Colombia STREET" and couldn't find me for about half an hour... In the midst of that, I got frustrated, which meant my Spanish went out the window and all that came out was English (Deybi, my teacher from the Dominican Republic knows this one all too well from me...). I finally made it but made everyone late who came to meet at the Institute. I'll blame it on first day gitters.

The next day, no improvement. The traffic was so awful that it took an hour and a half to get from my house to the Institute (a 30 minute drive) and Ivan, our driver to Canto Grande, kept calling and checking in on me. Day 3 lead me to an insane stressout because I had left the Institute on the public transportation with another lady working there, but had absolutely no idea how to get home. Here's the situation that unfolded Wednesday afternoon. The training of the Healthcare workers had continued with questionnaires in the afternoon and then a discussion back at the Canto Grande site about problems they saw, questions they had, etc. It's rolling around to about 6:30pm - which is when it gets dark here year round and I am so confused about how I am getting home. So, I ask the lady I came with if I could go back with her. That meant finding a taxi from there and paying a lot more...but at least I would know what I was doing to get back home. She told me she was staying that night to visit a relative and wouldn't be going home. Right...

So, everyone started talking over everyone else trying to tell me the best way to get home. It started by the gringa pulling out her map (which I had to have!) and having 2 women explain the best way to get home. Unfortunately, they had different ideas about the best way to get home. One of them was showing me the fastest way, the other - the way with the least amount of buses to take. Then, 3 more women chimed in with their opinion and it soon became a gaggle of women huddled over my head and over my map discussing, at the same time, the best way for me to get home. The problem is, I didn't understand a thing and I had actually gotten pushed back out of the gaggle in order for them to "discuss". Unnerving. I cried. I now know how to shut up a room full of 20 Latinas who are all talking over each other crescendo-ing upwards into all out screams....cry. The room was silent. Hey, it turns out, I need to know ONE bus, and that bus goes right by my house. One of the ladies, Luciola (whom I love!), actually went out of her way to take me home that first night to make sure I got there ok. My stop is about 30-45 minutes out of her way... She then met me the next morning to go with me again so that I would feel comfortable about it. Moral - crying does work....at least for women...haha.

Today (and I expect clapping) I made it to and from Canto Grande by myself with no help from anyone. Both trips were in the dark because of the hour.

I end up staying late most nights now helping with getting the questionnaires and observation papers in order with questions from the previous day addressed. Coding a lot of these questions is really the hard part because the observation/evaluation has to match with the questionnaires so we have a 'gold standard' to go by without the questions being too open or too closed (open = blanks left for responses and mother or observer can write whatever. We then, have to figure out how to code that in a computer. closed = multiple choice answers with little room for discretion. This boxes the observers and the mothers into a specific idea and may not be actually what they are thinking or doing at all.)

Photos:
(1) - Laundry hanging in Canto Grande
(2) - Some of the ladies and I outside of the Institute's Canto Grande field office
(3) - some houses up on the hill
(4) - funky chickens with feathers all over their heads and some on their feet (!)
(5) - one of the trails up to the houses on the hill that we have to climb every day to interview or observe mothers and children

just a few pictures while crawling up the mountain to get to peoples' houses to interview them. I still haven't gotten used to the sight of the shanty towns so I keep taking pictures of them. I also can't get used to the smell of dog poop and open sewer everywhere... (might be worse than the original smell of gasoline, burning trash, and dirt) We will revisit this idea later.

I had to put a small video of Canto Grande up here....I snuck it in today while no one was looking. It's not long, but it gives you an essence of the community. We are up on a rocky hill getting ready to interview a woman about her feeding habits for her baby.

When I smell burning trash, my thoughts immediately go back to Nicaragua...almost immediately. I think of Nueva Vida (our village where we worked) as we drove through in the "gringo bus" through the bumpy dirt streets waiting for the cows to cross and watching the barefooted children play in the trash heaps. I get a certain feeling when I smell burning trash, like I am back there. I can feel the dirt clinging to my skin as I sweat while playing football in a dirt pitch. I can hear the sounds of pots clanging together as the mothers cooked lunch for their families, the sound of the kids laughing as they run (asking for candy from the gringos), and the sound of the local evangelist driving through the town with a bullhorn. Every time, that's what comes back into my head. I never thought I would crack a smile at the smell of burning trash.

Now, burning trash AND exhaust from all the buses and unregulated cars...that's a different story. THAT is Kenya. The fast pace of the cities is mixed with the tranquil lifestyle of the rural areas as they butt heads exchanging a few loud horn honks and goat bleets.

Today, I was brought back to Muhuru Bay, Kenya where I worked in a medical clinic. There is something about dry dirty, gas fumes, and burning trash that gets into you and leaves a lasting mark. I am working now near Lima in a town called Canto Grande with a group of field workers trained to take and record surveys etc for the Institute. Every morning we go into a house in small groups and observe how the mother interacts with her child during feeding, what she feeds the child, and whether the mother gave the food because it was time to eat, because the kid was hungry, etc etc. It's about 58 questions long for breakfast, snacks, and lunch. I'm writing constantly...and I keep saying, "como se dice (point to something) esa comida en español?" I am still learning all the Peruvian fruits and vegetables as well as the names of the dishes when they are all compiled. I think I'm learning more than helping...but maybe that was the point anyway.

I arrived at the Institute at 6:15am because my cab driver misunderstood what time I told him to be at my house....6:30am. He got there 2 minutes after I had gotten out of the shower at 5:50am and discussed with me rather in depth that I had said 6. My thought was, "either way, you're still wrong because I have 10 more minutes." (He later looked at his card and apologized to me...yeah baby!!) So I used those 10 minutes although I never got my coffee this morning...for those of you who know me - sad news! So, I arrived at the Institute and waited for close to 45 minutes (could have been sleepy time!!) this morning until one of the other ladies showed up to take me to Canto Grande. I am NOT getting on a bus by myself to get there...sorry. I still haven't learned the public transportation system very well in my area...I'm not taking it an hour outside of the city...haha. We got to Canto Grande around 8:15am and went out into the field and began our work.

Sidenote: Canto Grande as well as many other shanty towns around the city are built on private property and include many people who do not own land. This makes it rather interesting when it comes to development because these people may have lived there for 10-20 years, but they own no title to the land and can therefore be kicked off at a moment's notice. Lima is also very dry with huge sand dunes and large rock formations. These squatters often set up residence on these high hills with plywood and little keeping them from falling if a storm or an earthquake hits. Many of these places do not have running water or sewage so sewage runs down the hills and a truck comes around to deliver potable water. Quite a change from parts of downtown Lima (or where I live) where everyone waters the grass and flowers in the medians and in the parks to keep them green. If it weren't watered...it would all die.

I'll stop now, more to come. Enjoy the pictures. (I cannot use my big camera so side snapshots will have to do in areas like this. The ladies are sure my big camera will get stole in about 3 minutes flat.)

The weekend begins with a shake...

So, rather interesting...this morning we had a small earthquake (un terremoto) here in Lima. Nobody was hurt but it was rather strange to wake up to! I have never experienced that before! For those of you who read Spanish, here's an article on it.

http://www.peru.com/noticias/idocs/2008/6/7/DetalleDocumento_517239.asp

(So far I can't find it in English...it might be out later today or tomorrow)

Group Training

Our research project on complementary feeding in summation:

Day 1: Observe women who have children 6-24 months of age who are still being breastfed but are also receiving other foods as well. These observations will be recorded for any food fed during the day: breakfast, lunch, dinner, snacks, as well as breastfeeding events.

Day 2: A different field worker returns to the same house that was observed the day before, this time giving a questionnaire to the mother regarding what she fed her child the day before and the way she interacted with the child during the feeding episodes.

The observations and the questionnaires will be analyzed in comparison at a later date to look at breast feeding, complementary feeding (adding in food after 6 months), and responsive feeding (interactive nature between the mother and the baby before and during feeding).

Right now, we are in the middle of training the people who will be going out into the field to do these observations and questionnaires. Our group is trying to make sure we have consensus on our responses so that we have valid results throughout the study. The funny part is...what we end up discussing:

'When the baby is in the mother's lap sitting down, is the baby considered "sitting" or is the baby being held by the mother?'
'When the baby then stands up, is it considered standing or being carried by the mother?'
'Also, when the baby is on the mother's lap, is the mother frente al frente (facing the child), al costado (beside the child), or atras (behind the child)?'

We had the first discussion yesterday...and it literally took 15 minutes to come to a consensus about what was what. The same applied for the second decision today. It makes me giggle a little inside although I totally know it is necessary so that everyone is on the same page for research validation purposes. However, the part that was extremely frustrating a few days ago is now a little but humorous as well. All the women want to weigh in on the decision...but they want to do it at the same time. It would be overwhelming in English too I'm afraid...and that's my native language. We go out into the field on Monday although everyone living at or near my house will be in Cuzco so I get to find my way to the Institute before we head out into the field to begin observations. Suhweet. I also have a weekend to explore and learn my part of the city...THAT, I am excited about!

Top picture: our house
Bottom picture: training session at IIN

Breasts! (well...breast feeding that is...)

So I would just like to say that Obama is now our nominee for president and I couldn't be more ecstatic!! Even though I'm in Peru, I shall still be pulling for my candidate.

Onto life at the Institute (which I can probably bring back to Obama somehow if I wanted to...). For those of you who are interested, the website for the institute where I am working is:

http://www.iin.sld.pe

It gives all the information on the researchers working here, current research going on, and past research published and unpublished.

I began working on a reproductive feeding project through Dr. Hilary Creed-Kanashiro that is currently training women to go out into the field to collect research on how women in parts of Peru are supplementing infant feeding between 6 months and 24 months of age. The World Health Organization (WHO) recommends that women breastfeed until at least 6 months and then begin supplementing the diet of the child with a variety of food sources along with breast milk (breast fed, pumped, etc) until 24 months of age so that the child gets adequate nutrition after just receiving solely breast milk. (Yes - this applies in the states - breastfeed your children! There's tons of research out there.) The research is being conducted to see what the current practices of women are and how research could influence breastfeeding toward the positive.

I'm supposed to be helping to train the women as well...but I know so little Peruvian foods that I'm not worth much there I'm afraid. The first day was an absolute terror for me because I got thrown into a group full of women who all are speaking Spanish at the same time and trying to talk over each other to answer questions and give suggestions. My head HURT after yesterday. Today was definitely much better and I realized how much Spanish I have. I will always be learning Spanish and have a lot to learn yet...but I'm getting there. In this project I will be involved in data organization once the health workers go out and collect data from the mothers. It's at least a 3 month study so I will only be involved in 2 of the months...but I am soo excited about it. I think it is going to be a great opportunity!

I am slowly learning my way around the city...and for not having a map yet I think I'm doing awesome! Haha. My house is in Surco (a district) and the Institute is in La Molina (I have posted a map so you can see the districts) so it takes two "micros" (pronounced "me-crows") to get to work and back. I was expected to use public transportation on the first day of work but that freaked me out enough that I was able to convince people that was a very bad idea. I didn't have a phone yet and if I got lost, I didn't have a map either...so I would wander aimlessly through the streets. That would make me a liability...hahaha. One of the other professors who is staying with Dr. Penny as well took me around part of the city this evening and let me see the indigenous market and other cool restaurants and stores...so I am feeling a bit more comfortable with getting around and getting my bearings.

We shall see what life has in store for me tomorrow. Life is always an adventure.

Welcome to Lima, Peru

So I made it to Lima late Saturday night and finally got to the house where I was staying around 3am Peru time (4am NC time). There are other students (around 20) here from Iowa State working on a Nutrition course through the University who got in Saturday as well throughout the day and will be here for a month working on different field placements alongside courses held at the Institute. The unfortunate thing is that they are staying at a hotel quite a distance from me so I may not have friends...haha.

I am living with one of the researchers at the Instituto de Investigacion Nutricional for the next two months and will be working on different research projects. I think I begged hard enough to get here that they accepted me here for my summer practicum even though there weren't any specific projects lined up. I will more than likely be working on pilot projects in order to validate research before it goes through ethics approval. (You have to get all research presented through an International Review Board (IRB) to make sure the work you are doing is conducted in an ethical fashion for any person participating. It is required in all human research.)

I am living about 20 minutes away from the Institute (although about 45 with traffic) and come to work every day with Dr. Mary Penny (the woman I am living with). I however, will have to take alternative transportation home in the evenings because otherwise I will be waiting for hours for Dr. Penny (I have been told). The interesting thing though is that there is no public funded transportation here. Different "micros" as they are called are owned by private companies and have different routes. As it stands, the traffic is a bit hectic and somewhat unorganized (although there are specific routes that are laid out).

I am in the midst of trying to figure out the city. It is huge though, with over 8 million inhabitants and when you include the incorporated areas as well, closer to 9.3 million people. I am looking for a phone and a gym...those are the only two commodities outside of food and water that I have decided I have to have. The phone for emergencies, the gym for my sanity.

I will post soon as more stories occur and I have taken some pictures. I will try and keep the blogs shorter this trip so that you guys don't have to read novels again (like what happened when I was in the Dominican Republic). PS - for all my Dominicans out there - I still love Santo Domingo better...probably because you guys are all there. :)