What do children do in your country?

Photo: Martin enthralling the boys

Photo: The MIMDES program is located in the back of a busy market

Photo: The entrance into the program

Photo: Singing a song in the hopes of getting an extra slice of cake

Photo: The children introducing themselves and telling us about their work

Photo: Our introductions and Q&A session

Photo: The sign that introduces the program at the front door

"Do children in your country work?"

We were invited to a street youth program this morning run by the Peruvian Ministry for Woman and Social Rights (MIMDES). The program is a prevention and education project for children who spend everyday with their parents working in the markets and on the streets of Arequipa. There are currently three geographic areas of operation - the three principle street markets in the city - with Saturday and Wednesday activities.

Staff (a psychologist by the name of Marcos and Martin and Mariam - both Social Workers) from MIMDES provide an environment and an opportunity "for children to be children." As Marcos told us, many of the children who spend their days working in the markets or on the streets side-by-side with their parents "lose their childhood." One of the programmatic goals of the program is to allow children the opportunity to play, laugh and engage in child-centric activities.

Today, during our visit, there was a cake, cookies and a small celebration; for what, we don't know, but it was fantastic to be there. We were treated as special guests and invited to play with the some 20 children gathered at the "party." To start our time together, Marcos invited the children to ask us questions or tell us a little about themselves. The children took full advantage of their opportunity and asked such marvelous questions as, "Why are you bald? Why are your eyes blue? What language do people speak where you are from?"

One-by-one they went around and told us their names and what they did for work: Kevin sells fish with his mother, Wilson sell clothing, Mary Luz sells chocolates, Jessica helps her mother to deliver water, Stephanie is a meat cutter. Children, some as young as 5-years old, work side-by-side with their parents to eke out a small wage. Many, not all, attend a small school that is open in the market area. Most, dream of something so much more.

At one point in our visit, a little girl asked Martin, "What do children do in your country?" He was uncertain how to respond. He told her that they went to school and that they played. She asked him if children in [our] country worked like she did. Martin later told me that he was uncertain how to respond to her question - for he did not want to offend her. He did not know how to tell her that children in the U.S. spend their days playing and watching television. He did know how to tell her that children are allowed to be . . . children.

As we were getting ready to leave, the children came up to say goodbye. One of the boys, having been fascinated with the pictures I had on my iPhone of Lee and Alex (my wife and daughter), said "please give my best to your family." Wow, here is a child who spends day after day working in an impoverished market for little to no pay to help support his family - and he sends his best for my family. I was floored.

We are not certain what next steps will unfold with our new partners at MIMDES - but we are certainly looking forward to helping to build bridges for their programs and the wonderful work they are doing for children living in such desperate circumstances.

Please don't make Peru look bad

"You have got to write a book," I said to a colleague of mine last night over dinner at one of my favorite restaurants in all of Peru (Don Tito's Pollo a la Brasa). "Your story is too important and people need to hear it."

My colleague thought about what I said for a few minutes; and before he could respond, another Peruvian colleague of ours said, "but please, please doctor - don't make Peru look bad."

I thought about his statement a lot last night and this morning. I thought about what he meant by it. I wondered if the truth is ever a bad idea.

This morning I decided to go for a long run (I am suppose to run a 50km trail race next weekend and I am woefully out of shape). Running along the beach I came across a old man lying on the shoulder of the road. He appeared to be at least 70-years old and was barefoot and very disheveled. His clothes were dirty and torn and his feet had a thick layer of callous that comes from walking barefoot for a long period of time.

I had planned to run along the beach and then up through the neighborhoods of Miraflores, San Isidro and Magdalena back to the Formation House where I am staying. In total, I anticipated my run to take a little over 2-hours. In preparation for the heat (it is summer in Peru and Lima is enveloped in a thick, steamy curtain of clouds) I had taken 10 soles with me. I fully anticipated that this would more than meet my needs for calories and liquid replenishment.

I ran upon my friend about 40-minutes into my 2-hour odyssey. I could not just run past him. I had to do something. So I gave him my only money. I asked him (in my very broken Spanish) if there was anything else I could do for him. He said "pray for me." I told him that I would and went to continue on my run. He stopped me, grabbed my hand and said, "you are the only person who has stopped to help me - thank you."

I do not write this story to make Peru "look bad." I know that homelessness and poverty are far from unique to Peru alone. Rather, I write this story to say something that I think really motivates all of HBI's work in Peru.

We believe that we have an obligation to be continuously open to service. We believe that no one organization can serve all of the needs of a people, a community or a country. We believe in partnerships and collaboration. Our intention is never to "make Peru look bad." Rather our focus is working with marginalized and disenfranchised people and communities to effect permanent changes in health.

My mind is racing right now. I can really see a great deal of potential for partnering with organizations in Lima to help the homeless that live along the Costa Verde and other isolated pockets in the city. I can really see a great deal of opportunities for us to work with Peruvian organizations to meet the needs of people experiencing homelessness and make "Peru look good."

More to come . . .

Alto Cayma - Slow and Steady

It does not matter how often I come back to Peru and the community of Alto Cayma - I really just can't get enough of the people and the beauty that is the Andes Mountains.

Today is Sunday, a traditional day of rest and recuperation in most of the world. Yet, in the Pueblos Jovenes of Alto Cayma, people are busy with work. In fact, the work never really stops for the people of this area.

Many of the extremely impoverished communities will have 7-day work weeks. This morning for example, there was a steady stream of people walking down the only paved street in Enace (Enace is the name of a Peruvian government owned construction company that built a large housing project in the Alto Cayma communities in the mid-1990's; the details of the Enace project is the stuff of political legend and is far too complex to mention in this post; if you follow the URL hyperlink of Enace - you will be directed to an interesting article dating back to 1999; the people of this sector of Alto Cayma collectively refer to their area as "Enace" - even though the construction company and the houses they developed have long since departed.) toward the more "developed" sectors of Alto Cayma (Alto Cayma is a very typical Pueblo jovenes - in that there has been years and years of "invasion" into the area; and as time passes and people become more established in their lives, they are able to leverage more economic opportunity for themselves and their families). I asked my friend Adon where everyone was going - as it seemed strange to me to see so many people out and about on an early Sunday morning.

He told me that people were headed down the hill to the houses of the "more established" members of the Alto Cayma community. He told me that they were going to work in the morning hours - helping with cooking, cleaning, laundry; and then, in the evening they would track their way back up the long hill to perform all of the same chores in their own homes. I asked him if people ever get a chance to rest - he laughed and said "when we are dead."

And so goes the lives of people living in desperate poverty - each day is a set of challenges that many of us never have to consider. Each day can be filled with the challenging scenarios of how to get their basic needs met. Yet, in spite of this constant struggle - the people are vibrant with life.

Yes, poverty is all around - and yes, this poverty can (at times) seem a bit overwhelming. And, there is hope. The one thing we can never loose sight of in the work that we are doing is the hope. The hope that people all over the world share - that tomorrow will be "better" than today.

This week HBI will be helping to organize and facilitate a 3-day staff retreat in Alto Cayma. Our goal is simple - to help the Mission of Alto Cayma continue to bring hope to people living in extreme poverty. People with so much hope - that their optimism is infectious. People who have so much to teach us about the true blessings of life.

Team Peru: Arequipa

The Team Peru crew is settled in to our new surroundings in Arequipa. This is a dramatic contrast to our previous week - where we suffered through cold showers and hectic days. In Arequipa, the team will be staying at the wonderful Casa de Margot Hotel and enjoying a schedule that is a lot less demanding.

Yesterday was our first full day of work with a number of different activities. We had a group working to complete the "re-assessment" phase of a previous community research project from 2008 (The PACE Study), a group working on the installation of a water filtration unit at an orphanage in Alto Cayma, a group helping with the daily operations of the Mission of Alto Cayma (working in the feeding program that delivers 650 meals each day to the most impoverished members of the community, making home visits with the Social Worker, helping with child care in the Day Care Center, and working in the "brick and mortar clinic") and a group working on a few special construction projects.

One project that HBI will be supporting, but due to time constraints unable to particpant directly with, is the remodeling of a "house" for a very impoverished family in Sector "11 de Mayo" in Alto Cayma. The family, a mother and her four children (the father left a long time ago), currently lives in a one room stone hut with no water, sewage disposal or electricity.

We will be working with Father Alex Busuttil and the Mission of Alto Cayma on a remodel of the home to include a small kitchen area, a concrete floor and an upgrade to the walls and roof to better protect the family from the cold winter nights of the southern Andes. In addition, the collaborative efforts of our two organizations will purchase beds for the family - as they are currently sleeping on mats on the floor.

Stay tuned to the HBI Blog for updates and photos of the remodel.

"Being" vs. "Doing" - The Gringo Dilemma

Yesterday I did something very unique. Something I hardly ever do – whether or not I am in Peru or the U.S.

Yesterday, I sat in a park and watched people. Okay – truthfully, it is not that simple. In all honesty I was waiting for a meeting that was suppose to take place at 2:30pm in a part of Lima that I do not normally go. As it turned out, my colleague never showed up. As such, I got to spend a delightful hour watching people go about their lives.

I was in the burgeoning middle class neighborhood of Magdalena; a Lima neighborhood situated on the coast just next to the popular tourist spots of Miraflores and San Isidro. The breeze was light, the sun was bright and the temperature delightful - the perfect summer day in Latin America.

Yesterday, for a couple of short minutes, I saw Peru not as a project to develop or as a program to facilitate – but as a place where I truly feel at home, a place that is deeply seated in my heart. Grandfathers and grandmothers, business men and business women, mothers and fathers, children and adolescents – everyone was just living their lives. It was amazing to stop, even for just an hour, to really observe the flow of life for the average Peruvian.

So much of my time is consumed with meetings, projects and the standard “hurry up and wait” phenomena. In fact, as the “golden” thirty minute mark (Peruvians are notoriously late – and it is customary for people to arrive for meetings 30-45 minutes late) came and went and my appointment had still not shown up, I started to experience agitation – thinking to myself, “there is something more important I should be doing than just watching people walk by on this beautiful sunny day.” I felt an internal pressure to go and “do” something to fill my time.

Father Alex regularly talks about the importance of “being” vs. “doing” – and how often North Americans are consumed by the “do” at the expenses of truly experiencing the events of life. He will tell the groups that we bring down to Peru from the U.S. and Canada – “please allow you’re self to just “be” for the time you are here. Please let yourself be moved by the experience of “being” with people and witnessing their daily struggles, triumphs, dreams and desires.”

I think it is easy for people who have busy (half of my “busy-ness” is self imposed) lives to fool themselves into thinking that we do not have time for “stillness.” We are always thinking about the next item on our “To Do” lists or planning for our next event, program or project. This “busy-ness” fills our lives. At times, this busy-ness distracts me from what is really important – relationships . . . people.

Yesterday I sat in a park and watched people go about their lives –and it reminded me why I feel so committed to the work that we do. My quite time sitting on a park bench in the Plaza Magdalena reminded me why I feel so passionate about the “William’s” and “Ines’” of the world. Yesterday I fell in love with Peru all over again – just by being!

Community Assessment Survey

The University of North Carolina -Wilmington students have arrived in Peru and the real work for the survey project is about to begin.

On Monday night we conducted a three hour orientation and mock-survey practice session (very similar to the one we put together for the interpreters on Saturday). The 27 nursing students, faculty and distinguished dean of nursing were enthusiastic and ready to learn. One of the real joys of the work that we do is getting to create meaningful programs and projects with smart, young, eager health care professionals. Their excitement to fully immerse themselves in this new world of Peru is contagious.

For many of the students, this is their first trip outside of the United States. They are wide eyed and ready to catch the day by the tail. Good – because we have plenty of work in store for them. The actual survey collection will not begin until Wednesday. We have decided to conduct a convenience sampling survey and set-up data collection in football pitches or open spaces in 9 different areas in the Alto Cayma community.

Some of our data collection will be in locales close to the mission clinic and the social service operations of the church, while other data samples will be collected from newer “invasion” areas with little to no access to utilities – let alone healthcare or social services.

The primary goal of the survey is to assess healthcare utilization patterns as well as objective and subjective barriers to healthcare in a series. More specifically, the survey will gain information regarding perceived access to healthcare, awareness of area clinics and charity care resources, emergency department use, and perception of their own health, including medical, dental and mental health issues. The survey will also evaluate participants’ feelings on the medical care and treatment they are provided.

In gathering this information HBI and our collaborator the University of North Carolina Wilmington, hope to better understand the behaviors of the people living in the communities of Alto Cayma. We recognize that the data sets generated from this research project are not generalizable to broader peri-urban populations – and we feel confidant that this project is a paramount venture into creating more sound scientific examination of the lives of the people living in extreme poverty in Latin America.

Creating Community

It is such an honor to be asked into the home of a friend and be treated with respect and admiration. It is even more amazing to be welcomed into the home of a person you hardly know and become the guest of honor. Such was the case for our team in Lima at the recent Baptismal services for one of the special people to HBI.

As is the tradition in Peru, when a child is to begin an important phase of their life or accept an important transition – two people are jointly selected to act as the “Padrino’s” for that child. The Padrino (Godfather and Godmother) is a special person in a child’s life – as they act as a confidant, a mentor and a supportive influence . . . not too mention they provide the financial support that is a customary responsibility (as many people who request Padrino’s for their children are without the financial means to be able to put on the parties or the events that are customary for the occasions).

Reverend Patricia Blanchard and I were asked to be the Padrino’s for a beautiful young girl who is part of a special program operated in collaboration with HBI and the Anglican Church of Peru. Ines is a four year-old child with a debilitating skin condition that leaves her in near constant pain. Pain that often left her unable to walk and writhing with every bite full of food. We all knew this sad truth, and our goal for this special day with Ines was to shower her with love and affection.

The ceremony was absolutely beautiful. Ines was fully in her element all decked out in her new Baptismal outfit. The pink bows in her hair made her look like a little doll that had been pulled right off the shelf. The service was a full mass and involved a group of about 30 neighbors and well wishers who had all come on this Saturday afternoon to honor a young lady whose life has been anything but simple or easy.

Standing in the thatched roof church with its uneven dirt floor – made the experience even more impacting. Here, in one of the poorest Pueblo Jovenes in Lima, was a true expression of the power of love. We collectively were united in our hope for this beautiful little girl – and the promise of a future that was relinquished of suffering.

Following the ceremony our team was invited to the home of the Ines’ family. There, we were treated to an amazing meal straight from the earth. The meal was an ancient tradition from the Sierra called “Pachamanca,” or offering to the earth god. The banquet, a bounty of yuca, corn, legumes, potatoes and every type of sweet potato you could ever think of – was extracted from an open pit dug into the earth and covered with rocks that had been heated in a searing fire.

Buried in the center of the pit was a large pot filled with chicken and herbs. This was a meal like no other. The food was carefully removed from its terrestrial oven and lovingly served to our “team of honor” plate by plate –

no, make that . . . heaping plate by heaping plate. We were humbled by the generosity and care that this extremely impoverished family put into creating a truly memorable celebration for their cherished daughter.

It is an amazing experience and a great honor to be a part of the life of such a beautiful little child. By the end of our incredible meal we all felt a collective sense of tremendous gratitude for a family that sacrificed so much.

Valle Sagrado Outreach - Photos

Photo: The Playground

Photo: A case conference

Photo: The walk home

Photo: Waiting for the doctors

Photo: Dental care

Photo: Dr. Juan - a true healer

Photo: Nurse Karen and friend

Photo Credits: All of the photos posted in this BlogSpot are courtesy of an HBI volunteer Daniel Bachhuber. Daniel is working in Peru through the month of March and will have frequent photographic updates posted to his Flicker site at: http://www.flickr.com/photos/danielbachhuber/

Daniel is an extremely talented young man with an amazing ability to capture the true essence of a situation in his photography. HBI is very proud to partner with Daniel on a variety of collaborative projects.