Standards of Living...

I recently moved from a very nice house (which I was house-sitting for a missionary family), to a very cute apartment right around the corner from our English language institute, where I work. (For you New Yorkers, this would be somewhat akin to moving from Westchester to the Village - less space & comfort, much more central location.)

The owner we're subletting from owns a restaurant and lived in Spain for 11 years. We're also neighbors with a dentist, and we have a security guard, so it's basically an upper-middle-class building. And our apt's pretty nice - 3 bedrooms, living room, kitchen & laundry, probably about a 900 sq. ft in all. However it's also got no heating, so it's freezing at night; the pipes in my bathroom smell like raw sewage; and we rely on a small hot water tank for hot water, so we have to switch it on 30 min before a shower, jump in the shower for 5 min before it runs out, wait another 30 min for the second person to shower, etc. We also hang our laundry to dry on clotheslines - no dryers.

It is an interesting, and humbling, thing to meditate on the differences in living standards between a "moderately poor" country like Peru and the US. Here I am living in fairly pituco* surroundings, among the upper echelons of society (and indeed, to be a gringo or foreigner here is to be automatically regarded as a VIP... hmm disturbing), yet I can't get over my nagging cough and I'm freezing all the time. And no matter how much money you have, you can't escape from frequent outages of power and water.

I've had the chance to get to know people from a variety of social classes here. Some are university students who wear nice clothes and have some disposable income, but live at home, only get running water at certain hours of the day, and can't find a job. Many more are from poorer neighborhoods, living in ramshackle self-built adobe houses with tin roofs and gaps in the walls, and the humblest of accoutrements. And then there are the street boys I first met in 2004, who were from the poorest and most troubled of homes, and spent most of their time on the streets, dirty and hungry and high.

It is humbling to actually know some of the billions of people who live on a few dollars a day, living on rice and potatoes and a few vegetables (meat's a luxury too!), constantly vulnerable to being wiped out by the sudden cost of a hospital visit or a defaulted loan or a husband leaving them. However, short of these extremes, it is also oddly liberating to realize you CAN live on much less money, if you are willing to give up some creature comforts and "luxuries", and rely on your friends and neighbors a little more than we like to do in the States. Doesn't Shakespeare (and the Bible) say somewhere that both wealth and poverty are dangerous, and it's best to live somewhere in between?

All I know is, living with less comfort, less control, and less water pressure has made me realize how much I take for granted (and how much energy I consume) at home.

*see my post of Sept. 2





My new 'hood
















A typical neighborhood for much of Trujillo

Another Musical Interlude (with Dancing!)

While in Lima for a conference (which I will write about in a future post), I wandered into this National Marinera competition in the Parque de la Exposicion. These couples were doing the typical dance of Trujillo & the North, "marinera". I think this part of the competition was the adolescent division...

Getting Sick in Peru is a Bad Idea (but also, of course, much more likely to happen)

I've officially been sick for over a month. I don't think I've ever been sick this long before. But I started having a fever and congestion on July 31, the day I got back from Santiago. I went on blowing my nose non-stop for two weeks, and have been coughing for about three more. Even yesterday I had to cancel 3 engagements to stay in and sleep.

I know my mother is reading this, so just to clarify (and make her feel better), it was never very severe. In fact, I've been up and about for most of the past few weeks, it's just that I've needed more sleep, lots of medicine, and the people around me have had to put up with a lot of unpleasant nose-blowing and coughing. I've also spent what in Peruvian terms is a fortune on health care. More specifically:

s/130 - two trips to the Clinica Sanchez Ferrer
~s/180 - lots of antibiotics, decongestants & cough medicine
s/140 - chest & sinus x-rays

That is 450 Peruvian soles, or almost $150. In US terms that's not bad for 2 trips to the doctor, X-rays and a bunch of drugs, especially when you consider that I don't have health insurance. (All I have here is "travel health insurance", which costs about $60/mo and covers things like emergency surgery or evacuation of my remains to the US.) But given that a typical Peruvian office worker makes about 20 soles a day, it's kind of a fortune. Thankfully, I have learned many valuable things about health care in Peru for the next time I am sick:

1) Don't go to the pituco doctor

Pituco is my favorite Spanish slang word, because it sounds exactly like what it means: uppity, chi-chi, well-moneyed, generally of/ about/ for the upper echelons of society. Anyway, I decided to go to the Clinica Sanchez Ferrer, located in an upper-middle class neighborhood called California, which is the nicest clinic in town, thinking I would get the highest level of care. In other words, I went to the pituco doctor.

Well, I don't know if it's just because I'm an extranjera (foreigner) without local health insurance, but they took one look at me and decided to charge me an arm and a leg. The first time I went they prescribed me expensive penicillin shots and brand-name drugs; when I balked at the price and asked for generics they begrudgingly wrote me another prescription at a quarter of the cost. The second time they misdiagnosed me with a urinary infection and prescribed me a really expensive antibiotic with no generic substitute; only after I bought it (at $2 a pill) did my nurse-practitioner friend in New York tell me it was basically the same thing as the first antibiotic, so I actually should not take it anymore or risk developing an antibiotic resistance.

So much for quality care at a top clinic. I finally went to our mission's clinic in the pueblos jovenes*, and the doctor who volunteers there regularly chided me, "So you thought you'd go there just because it looked pretty?"

2) You don't need a prescription for anything.

Literally. You can go to a pharmacy and get any antibiotic, painkiller, brand name or generic, that you like. In fact most people don't go to the doctor for this reason: they can just go to the pharmacy, describe their symptoms, and get the drug right away. This may seem a little scary, but given that most doctors here would just prescribe you antibiotics anyway, there's not much difference. And most Peruvians can't afford to develop addictions to painkillers or meth, so fortunately regulating that is not an issue...

3) The possibilities are endless... so don't worry about it

What I mean by this is, there are so many exotic bacteria and unknown environmental factors here in Peru that people generally don't feel well pretty often. Couple this with the absence and/or exorbitant costs of more advanced medical equipment for tests and diagnoses, and you'll find that people generally don't bother to find out exactly what it is they have. Unless you really need hospitalization, you just go on getting rest or drinking tea or trying your guessed-at pharmaceuticals until you're well.

Anyway, I am still coughing some, but at this point I've consulted with several legit American & Peruvian doctors (all associated with the mission) and am assured it's nothing serious, just a virus or lingering cough. I can also empathize a little more with the billions of people, both in the US and abroad, for whom top-notch health care is out of reach, and who have to manage without it as best they can.

(*see definition in my previous post)