Politics . . . not as usual in Peru

The Presidential race is heating up. Officially, the Peruvian elections are held on April 10 - but there is a few days when the ballots are counted and the results stream-in (remember this is a vast country with very isolated communities in the jungles and high mountains).

Okay, drum roll please - the results are very interesting to say the least. Remember, in order for an outright winner to be announced, one candidate must gain greater than 50% of the general casted votes. So really, it is impossible for an official winner to be announced from the general election. Rather, the top two vote getting candidates go to a run off. And, the suspense is building . . . those candidates, at this point, are likely to be . . . Ollanta Humala and Keiko Fujimori (See: http://www.livinginperu.com/news/14628).

This is a really big surprise. Up to a month ago - Toledo was drawing the greatest favor. I have been saying all along - just wait for the last week of the campaign, Ollanta and Fujimori will come on strong. Come on strong they have. Currently 86% of the ballots have been counted and Humala is in with almost 32% of the votes and Fujimori has a distant second place vote getting at 23.2%. Third place horse in the race is PPK at 19.2%.

Famed Peruvian Noble Laureate Mario Vargas Llosa has gone on record as saying the match-up between Humala and Fujimori is "no less a choice between AIDS and terminal cancer" (I will let you decide who is what). Not exactly flattering words from a person of such distinguished prose.

Stay tuned - the race is far from over. One thing is, however, for sure - the Peru of the future is going to be different. The politics of Humala are not the politics of Garcia or Toledo. His nationalism agenda will inevitably lead to a different political ideology. Equally, Keiko is a political unknown and has a lot to prove for her very young age.

Whatever the outcome, the people of Peru have spoken and demand a change. The trickle down, so earnestly promised by previous administrations, has yet to come to fruition. A new political machine will need to meet the demands of the people living in the Los Cerros. Whoever wins the run off election on June 05 will need to be more observant to the 40+% of the Peruvian population that still lives in abject poverty.

The future has a lot to tell. Stay tuned.

Andina Fundraiser 2011

"A Bridge to Change Benefit Dinner" at Andina Restaurant

You are invited to join HBI for a Fundraising Celebration! Please be our guest on Monday May 9th & Tuesday May 10th, 2011 for our second annual "A Bridge to Change Benefit Dinner." HBI facilitates sustainable improvements in individual and community health through collaboration with existing resources. Come see how you too can Build Bridges of Collaboration, while enjoying the warmth, familiarity and contrasts of Peruvian cuisine and culture, hosted by Andina Restaurant.

Each night will begin at 6pm with a Peruvian Pisco Sour (non-alcoholic beverages also available) and "bocaditos" (small bites) to welcome you. Dinner will begin at 7pm and will encompass 5 flavorful courses of Peruvian inspired, northwest influenced dishes. All of which will be accompanied by specially paired wines.

• Vegetarian options will be available for each course, please let us know in advance
  

From the beginning of the cocktail hour through the completion of the 3rd course we will hold a silent auction. This will be a mixture of items brought back directly from Perú, along with items donated from the local community. Throughout the meal, we will share stories and pictures of our projects over the last year. If any past volunteers are interested in sharing their HBI experience, please email us at info@hbint.org .

Proceeds from this event will facilitate HBI as we Train, Consult, Deliver Care, and Connect Resources to some of the most impoverished people and underserved healthcare providers and organizations in Perú and beyond.

Where: Andina Restaurant: 1314 NW Glisan St., Portland, OR, 97209

Dates: Monday May 9th & Tuesday May 10th

When: 6 pm ~ cocktails and passed "bocaditos", 7pm ~ 5-course dinner with specially paired wines

How Much: $150 per person (including gratuity) ~a portion of each meal is a tax-deductible donation~

Reservations: There are a limited number of reservations available for each night. Please contact us at Info@hbint.org with the following: 1) night you will attend 2) number of guests 3) any important dietary restrictions Andina should be aware of 4) a contact phone number where we can confirm the reservation.
You can also call Benjamin Grass to make reservations - tel. 608 354 7567

Tickets: Seats for the event can be purchased in two ways:

• Send a check $150 per person to HBI, PO Box 8813, Portland, OR 97207
• Go to the HBI website and enter the events page. Please specify in the "purpose" box: Andina Dinner, along with the night you will be attending.

We look forward to seeing you at this Second Annual event. We promise you will not be disappointed.

Stirring the Pot

Photo: Poster announcing the sessions. I love the logo and design.

Photo: Speaker presenting her session.

Photo: The edifice of the Ministry of Health - a beautiful old building in Lima.

Yesterday afternoon HBI was invited to present to the Peruvian Ministry of Health. Our invitation was in association with a series of "charlas" or talks that the government convened to advance international collaborations. The speakers for the sessions were the Brazilian Senior Secretary of International Relations, a former head of the Peruvian Ministry of Health who now runs an NGO that works around the world, the director of a blindness prevention program in Peru (HBI's very own Dr. Daniel Bueno Rojas) the head of the United Nations HIV/AIDS program in Peru and HBI. Needless-to-say, it was quite an honor.

Each organization was provided a 20-minute time slot to talk about their work and propose ideas for greater collaboration and in-roads with underserved communities. All of the speakers that presented before me read from prepared statements or delivered standard PowerPoint presentations about their work and visions. I decided to do something a little different.

I think I might have ruffled a few feathers. I could not help myself. I couldn't darn well neglect the pink elephant in the middle of the room. I spoke "passionately" (as a person in the audience told me after the event) about the need for delivering services and advocating for political change that embraces a "pro poor" agenda. I talked about the divide that exists between the "haves" and the "have nots" in Peru. I challenged the Ministry of Health to develop programs that better trained Peruvian physicians and nurses to work with the poor. I encouraged the investment in training opportunities that teach Peruvian providers to understand the influence of long term trauma on the lives of people living in extreme poverty. I encouraged the development of a government mandate to ensure all Peruvians have access to healthcare services.

In the end, the bulk of my talk was about recognizing the responsibility that we all have to ensure that every child can grow up to realize their dreams. I ended my talk by telling the story of Alejandro Toledo - a man who grew up in extreme poverty and became the President of Peru. I told the hundred or so people gathered at the event that President Toledo's story is the story that every child should strive to conceive. I said that the dreams that allowed President Toledo to become the leader of Peru, are the same dreams that will bring an end to poverty.

Given the tense political climate in Peru - my use of former President Toledo as an example of the direction the Ministry of Health should head, may have been a bit too strong. Oh well, if nothing else I sure stirred the pot and got people thinking.

As we were getting ready to leave the conference a woman came up to us in the hallway. She said that she really appreciated what we had to say. She said that HBI's emphasis on ensuring that everyone has access to the highest quality health services was very inspiring to her. She told me that she felt more people needed to hear this message.

I can't end this Blog update without thanking Billy Greenman for his time, energy and expertise in acting as an interpreter for my talk yesterday!

You can't change the world

Photo: My office in Lima; sweetheart, please note the water bottle.

"You can't change the world. No one has that much power." It took a long time for the sting of those words to wear off. When I was much younger I thought I could actually change the world. I was convinced that if I worked hard enough I could make a lasting impact. Then, one day, someone said these prophetic words to me. I think they were just trying to correct the shallow thinking of a naive young man. They really caused me to think.

I don't think I can change the world anymore . . . I know I am changing the world! No not in the arrogant, the world revolves around me way; but rather, I know that simply living my life is changing the world. By making the choices we make everyday, by committing to spend our time and energies in the way that we do - we are changing the world. Our impact, however great or small, changes the world whether we recognize it or not.

The real challenge is to live a life committed to making choices that hold the opportunity to diminish poverty, to assure health, and to value all life. My challenge is to make choices that recognize the great disparities that exist in the world and accepect the great impact of my choices. Because, whether I like it or not, my choices help to change the world everyday.

I had a conversation the other day in which someone asked me if I thought helping one person held the potential to make a difference in the world. My answer was a resounding yes. A "yes" for so many reason.

We can't know what happens to our "gifts" when we give them to others. We can't fully know the impact that helping others has on us. We do not know what happens when we help others to reach their goals or to build a life they desire. There is a multiplying factor. A sort of cumulative effect when we all start directing our choices toward a bigger change.

Am I going to change the world? Certainly not by myself - but most definitely with the help from all of us working together.

2011 Arequipa Healthcare Conference

Photo: Post-conference speakers dinner.

Photo: The beautiful campus of our host site, Catholica University.

Photo: Dra. Natalie Gehringer and our wonderful interpreter Ms. Nancy Talavares.

Photo: I don't think the problem of attendance was related to the size of our poster.

It is Sunday afternoon and our conference has come and gone.

The conference this year was a mixed blessing. On the shinning side, we had an amazing team of North American and Peruvian speakers. Their depth of knowledge about pediatric respiratory illness was amazing. Not to mention the time, energy and expense they all took to be a part of the conference and this learning opportunity. HBI owes them a great deal of gratitude. We are proud to be affiliated with such amazing people.

An area that we continue to struggle is conference participation. We had so much hope that we would sell out the conference this year. Our goal was to fill the main conference room - a plenary audience of almost 300 people. Well, we fell far short of this number. In fact, we ended up with a total enrollment of under 60 attendees.

The professionals who attended the conference were very engaged and enthusiastic about the material being presented. In a post conference evaluation, the vast majority of attendees ranked the experience as "exceptional." The question we are all left with is . . . if people enjoyed the conference so much, why are the attendance numbers so low?

We can't judge the quality of this experience based on our attendance. Rather, I am very optimistic for the future of our conference because of the enthusiastic conversations that took place over the two days. We discussed advancing the "humanitarian efforts of Peruvian organizations," reviewed critical care guidelines for pediatric respiratory illnesses, and engaged in practical skills building sessions. In fact, the whole experience was very collegial.

Our next conference is scheduled for September. We are already starting the planning. I am certain we will apply the learnings from this conference. Heck, even if we helped only one physician or nurse gain the skills they need to better serve the patients they work with - the conference was a huge success.

Not a recommended travel itinerary

When choosing travel plans, there is great wisdom in giving yourself plenty of extra time for connections, inter-flight rest, and transfers.

I, unfortunately, rarely (oh, scratch that . . . never) follow these precepts. I was in the Tampa, Florida area yesterday presenting at a homelessness service providers conference. I finished my last presentation at 3:40 pm and rushed out of the conference facility to drive the 60+ miles to the Orlando International Airport to catch a 6 pm flight. And yes, I had a rental car to return and was bound to run into commuter traffic in the Orlando area at 5 pm.

The drive was the most uneventful part of the past 24-hours. This is stating a lot. Those of you who have driven in central and south Florida know that the highways are analogous to NASCAR racetracks. Ever car speeds up to your bumper and then slingshots up the road as if they are in the "flag lap."

Okay, so my flight from Orlando to Seattle started banal enough. I was buried in work and typing away at my computer. That is, until I heard a request for a doctor to help in the rear galley of the plane. Wanting to help my colleagues who most assuredly beat me back to the galley, I walked to the small crowd gathered in the portion of the plane usually only frequented by the flight attendants. When I got there I learned that I was the only physician on the plane and the two flight attendants who were simultaneously talking with medical support on the ground and attending to a young woman in acute abdominal distress. They were more than happy to have me step in and take over.

It turned out that she was suffering from acute gastroenteritis that was compounded by flatus in the large bowel. In plain speak - she had a lot of gas. The two hours that it took to finally provide her some relief were very exciting. The flight attendants and the tower continually asked me if the plane needed to be diverted to get her immediate evaluation and the poor young woman was in a great deal of discomfort. In the long run, she was scared, in a good deal of pain from the pressure in her abdomen and really just needed a little simethicone (Gas-X) and a helpful ear to listen to her concerns. All ended well.

I arrived in Seattle at 10 pm PST (three hours ahead of the eastern time zone I had been operating in for the past couple of days) and was greeted with a 2-hour lay-over before I could catch my flight to Portland. The flight got delayed. I finally arrived in Portland after 12:00 a.m. on Wednesday morning. By this point, I had been up for 21-hours.

I quickly rushed home and jumped into bed to hug Lee and Alex for all of about 3 hours. I was picked up this morning at 4:30 a.m. and caught the 6 a.m. flight to San Francisco. This is where I currently sit as I type this blog update.

My next adventure is a 9-hour and 30-minute flight from SF to Lima. I arrive a little after 12 a.m. on Thursday. After collecting my bags - I will have a 4+ hour wait before I can catch my last flight of the trip to Arequipa at 6 a.m.

Okay, here is the Pièce de résistance - I arrive in Arequipa around 9 a.m. on Friday and have until 12 noon when the conference starts. Oh, and Karen and I are the first speakers of the conference. Let's hope I can get a little sleep before the conference - or I will be working on energy fumes. Yikes.

The lesson for this story . . . please don't model your travel plans on my very frenetic wanderings. I don't think my itinerary is a very healthy approach.

4th Annual Conference

We are gearing up for our Fourth Annual Arequipa Medical Conference and Training Symposium. The following video will air on public TV stations in the Arequipa area for the next week. Keep your fingers crossed that we get a record turnout. Our goal is 275 people!