Sunday, May 08, 2005

i am posting something i wrote for international womens day! i had hoped it would end up in our local paper, but it seems they are not interested! oh well, one attempt at rejoining the world, sort of! and since in my blog i can write anything i want and "publish" it, here it is. and of course its dedicated to juanita and all the women in sipascancha. i remember once, i think gregorio telling me just to believe others from faraway knew they were there was important.
its wordy, i am too wordy! but i hope whomever stumbles on this will read it through and be able to put themselves there.

International Women’s Day 2005
Sipascancha Alta, Peru’
I met Juanita on a Monday morning, one year ago on International Women’s Day. She was unaware of the day or it’s significance, but it was her 39th birthday. She lived in la Comunidad Campesina de Sipascancha Alta, a small village of 90 families and 300 children situated in the mountainous Andes, where I had provided health care services during my yearlong stay in Peru. We had just arrived that day after our three-hour journey from Cusco, my home base. On the bus, Adella, one of the teachers, mentioned it being International Women’s Day. I hadn’t remembered it until then.
Heading to the Sacred Valley, I thought of the past orderly, civilized and sanitized celebrations in the United States that had acknowledged women of the world and how far I was from that. Peruvian music blared. I watched the young girls and women crowd onto the bus, spilling over into the aisles, thinking they were likely unaware of what day it was either. The young girls were in their uniforms, giggling, shy, and thankfully still in school. The old women were in their traditional clothes, aprons, and their hats, dirty and bent, sitting atop their heads and long, damp, braided hair. They boarded the bus with bundles on their backs, and a bucket in one hand and a plastic shopping bag in the other, all of them still hard at work. The young mothers, also in their traditional clothing, climbed aboard with their youngest tied to their backs in the colorful and worn mantas and their toddlers in tow, all looking as presentable as possible. Their big innocent eyes quietly studied me aboard their bus from Cusco to Pisac.
In Pisac, the teachers, local campesinos and myself, some 30 people, quickly filled Francisco’s van. He would take us to the village another hour and a half up into the mountains. Scrunched and bent over, I ate my warm bread from the local panaderia, and passed the bag around. Amid all the people, scratchy music, jokes and laughter, I watched out the window, passing the simple adobe homes, women washing their clothes in buckets outside, and children waving to us as we went by. As we climbed further into the mountains, the Andes spilled out around us. They seemed to go on forever.
Adella had accompanied Juanita that morning since she only spoke Quechua and did not read or write. Juanita had just told her she was pregnant, perhaps 9 months. She came to her because she had noticed again her ankles and calves were swollen, that her headaches were worse and that at times she was dizzy and her vision blurred. She was very tired and had difficulty doing her daily work of tending to her potatoes, her few animals, her children and elderly mother, whom she fed and cared for by subsistence farming.
Juanita’s clothes, while traditional, were torn and dirty. Beneath the layered and worn skirts, she did not look pregnant. She had not told anyone and of course had not received prenatal care. She told me her story, seemingly unaware of how horrific it was. This was her 13th pregnancy but she had only three living children, a son, 16 and two daughters, 6 and 10. She lost seven children within their first year of life, and twice she had fallen and suffered spontaneous abortions.
The father of all of her children apparently lived with her cousin and had other children. There was a suggestion of violence, as when she has had contact with him, he showed up unannounced and drunk to the small dirty, adobe shack she called home.
I was shocked to see Juanita’s weight of 114 pounds. When she took the layers of clothing off, I could see how small she was. Dirt was ground into her feet. Her skin was dirty and blotched, and beneath her lower eyelids, the tissue was white instead of pink. She was swollen in her face and up to her knees. Thankfully her blood pressure and pulse were normal, in spite of the signs of anemia and preeclampsia.
The tiny baby’s head was palpable and situated low in her abdomen. I could hear the heart tones and counted 156. On International Women’s Day, I was witnessing first hand the stark contrast of Juanita’s life to my own. And I feared she was in danger of developing preeclampsia and would have only me if she were to actually go into labor. and this would be just a snippet of her life that i have entered and would eventually walk away from.
In the small clinic in Sipascancha Alta, there was little to work with, basically boiled water and common sense. I had located the village and the people working there with a small locally based Catholic project, Cristo de los Andes, through a friend in San Diego. The Catholic Medical Mission Board paid me a small stipend and sent various supplies. When I had arrived there, 9 months prior, it was a dirty and abandoned building. Old discolored medicines were in the cabinets. There was not much the project could afford in terms of supplies for the clinic. The money they had went to the building of greenhouses, small schools, and latrines, and to the development of their local market of potatoes and artesania. Their project was for the benefit of the 300 children who lived here in abject poverty.
Sipascancha Alta was both beautiful and ugly. It sat at approximately 13,000 feet in elevation. Two large greenhouses bordered what was the center of the community. The rundown adobe buildings, many with broken windows, housed the primary school, community kitchen, clinic, storeroom, and workshop. A humble small church sat across from the clinic with locked doors. The Andes rose up all around us and were dotted with small, square plots of potatoes and randomly placed adobe huts. Tinny, Peruvian music blared from 5:30 AM until dark from the unpaned windows of the houses on the mountainside. Footpaths strewn with animal dung and garbage ran through the village, and the only road in and out was narrow and treacherous. Dust was everywhere during the dry season and it changed to mud during the rainy season. There were a few Eucalyptus trees and below, near the creek, pine grew. Early each morning, the villagers and their animals walked, sometimes ran the trails to work and to allow their animals to graze. The children came for school, milling around where the teachers and I lived.
There was always a scent of the burning Eucalyptus, it being the only fuel the campesinos had for cooking. There was not enough to burn for heat, so the adobe huts were very cold. Fire pits were in the homes, they had dirt floors, sleeping areas and no furniture except perhaps a bench. Outside children played in the midst of animals and dung, some barefoot, some wearing their traditional sandals. They were all dirty; the boys often in donated western clothing, the girls in a mixture of the traditional skirts and hand-me-down sweaters pinned together. Many had round bellies full of worms, and red, snotty, chapped cheeks from the ongoing colds they quietly suffered in the extremes of temperature. Their eyes were big and innocent, and their smiles and laughter inextinguishable. The few crying little ones were immediately scooped up and consoled by their mothers or older siblings.
When I arrived nine months ago, Adella, Pavela, and I had cleaned the clinic space from top to bottom with cold plain water, rags and a broom. It was dusty and dirty, and full of dead bugs. There was minimal light, no heat, and a stopped-up sink. We had a small pot to heat water. I stocked all I had into the available cabinets. Weekly I purchased medicines in the local pharmacies of Cusco. This was thanks to a small savings, my monthly stipends, and the generous donations of friends who were aware of what I was doing.
But, all I had for Juanita were vitamins with iron.
Adella and I knew she needed to go as soon as possible to Colquepata, three hours away by foot, where there was a Centro de Salud and doctor. We explained to her the seriousness of her condition; especially given the fact she estimated she was 9 months pregnant. We told her that the baby could die and she also. I asked her to put her feet up and rest when she could, to not eat as much salt, realizing the whole time that this would be nearly impossible for her to follow.
She shed no tears, showed little emotion, and no fear. I could only hope she accepted the fact she needed to seek more medical care than I could provide. I cried when she left, embarrassed and ashamed of what I had previously thought about the concept of International Women’s Day.
We went to Pavela to ask that a van come and transport Juanita to Colquepata as soon as possible. There were no cars in Sipascancha, only broken down bicycles, or horses. There was a telephone 2 miles away to call down to Pisac for a local van. But it would cost 30 soles, or about $8.50 each way. Juanita had no money, and she would have to leave her family for an unknown period of time, possibly until she gave birth.
The president of the village was made aware of the situation. A community wide meeting was held that day to expose the father’s behavior of all these years. It was decided that his responsibility was to pay the cost of the transport. While pleased to see him exposed, I was shocked that $17 could be suggested as this man’s entire responsibility.
The remainder of the day, the village was abuzz about Juanita. While the teachers and I were eating our lunch of a traditional soup, I listened, hearing what we often hear in the states when a woman has been abused. That she was stupid, and that she had asked for this. Some laughed.
There were many times during my work in Peru I was left to accept what was, and to recognize I was the outsider and did not understand the workings of a society such as this. I said nothing until I could contain myself no longer. In my best Spanish, and in halting breaths, I simply said that no woman asks for this hell for herself, or her children, here in Peru or elsewhere, and that I could find nothing funny about what Juanita was going through.
The next day Juanita came up to the clinic. The van was waiting in the area usually reserved for soccer games and the weekly market. She was as emotionless as the day before. Her blood pressure was higher and she was swollen up beyond her knees. Her head was aching. She had the same worn clothing on from the day before, and carried nothing with her. We went out to the van. Gathering around were the villagers. I realized what was going on once we neared the crowd.
The father and cousin of Juanita were having a physical fight over a small bundle. She was angry and he was meekly tolerating her yelling at him while they had a tug of war over their money wrapped up in a dirty piece of a blue plastic tarp. The villagers gawked. The administrator was trying unsuccessfully to call halt to all of this. The president joined in. Not only were they fighting, it seemed everyone was yelling, all while the villagers gathered and stared.
Juanita seemed unaware of the ruckus she was the center of. All I wanted was to be on our way, and to know she was in the hands of a physician. I walked out and said it was urgent that we leave. I was yelled at and told this was about responsibility. I was asked if I would then pay for this trip, because someone had to. I paid. We left for Colquepata. No one spoke. We arrived to the Centro de Salud. It did not take long to leave her in the care of the doctor. We got back in the van and I felt the tightness in my throat and my eyes well up with tears. I stared out the window. I don’t think anyone knew why I was quietly crying.
That night, I went to the clinic to put things away and clean up. I was still crying. Gregorio, a health promoter, seemed more worried about me than Juanita. I walked down to my room and sat outside in the cold under a perfectly clear star filled sky. I prayed, vowing to never let this day go by without remembering these people, and Juanita’s story, all told without emotion or recognition that anything was wrong.
The next morning, the president and the local representatives came to see me. Yes, they had been worried about me. I told them how sad I was to watch the leaders yell as the villagers watched, all with no apparent concern for the danger Juanita was in. I asked them if their dream to improve the lives of their children included that of their own daughters. Polite as usual, they apologized profusely. But did they truly understand? I don’t know.
Juanita returned to the village still pregnant. She apparently was off on her due date. She could not afford to stay there. A few weeks later she delivered her little daughter in her small shack with the help of her son. We were not there.
Adella, her mother, Josefina, and I went to visit her when the baby was 3 days old. We walked into the dark dwelling. It smelled of old blood. Juanita was feverish and weak, barely looking the same to me as she did while pregnant. The baby was wrapped in a dirty blanket and sleeping next to her. She cried telling us her baby did not carry the name of her father.
When we held the child and opened the blanket, she barely stirred. The tiny thing weighed maybe 4 pounds. She was difficult to arouse. I noticed how the skin beneath her knees just hung from her. She was dry as a bone and her umbilicus was dirty and yellow. She had not yet been bathed. Juanita said she did not nurse often and she herself was not well. Her son and mother were taking on the work of the animals and potato fields. She was otherwise alone with her younger children. We had no medicines that would help her.
Josefina sent Juanita’s daughter for ortiga, or stinging nettle. Josefina assured me if she could bathe in the ortiga, it would cleanse her and rid her of the infection. We took the baby to the clinic to bathe her while her daughter prepared water for her mother’s bath outside. The little girl never cried as I washed her in the warm water.
Josefina, Adella and I later sat quietly outside the clinic. Adella clutched her own son, Daniel. None of us knew what to say. We went to the storage area and gathered up food to bring to Juanita. We found eggs, canned milk, canned fish, grains, and vegetables from the greenhouse, normally intended for the children of the village. I instructed her son and older daughter that their mother needed to eat at least three times daily, to drink boiled water and teas and to bathe daily in the ortiga. She was to wake the child often to eat and otherwise rest.
Weekly we saw Juanita and her baby, whom she named Laurita, after me. It was an honor, but truthfully, I already felt an overwhelming responsibility to this little angel! Her mother had recovered and the small child gradually filled out. Juanita would bring her to me every week for the remaining months I was there. I spoke to the little doll in English and carried her everywhere with me, in her Peruvian hat, dirty swaddling, and a rag between her legs serving as a diaper.
The family brought me sacks of potatoes every time they saw me. It was their only way of repaying me. It was obvious that to do this was more important to them than my own instinct to graciously refuse. I was asked to be the child’s godmother. I have taken that spiritually on, as I had to leave before a baptism could be performed.
Gratefully, Adella writes me of the village and little Laurita and her family. Since returning to the United States, nothing here seems as important to me as it once did. Each day, each of us, unconsciously takes so much for granted. Juanita cannot begin to grasp such possibility. Daily in la Comunidad Campesina de Sipascancha Alta she simply puts one foot in front of the other and survives. Let us remember women like Juanita, and their daughters, this International Women’s Day and everyday.
You can contact Laurie for more information about her work in Peru at