Home again ...

"The real voyage of discovery consists not in seeking new landscapes, but in having new eyes." Marcel Proust

A few weeks early, we found ourselves traveling home to help Pat's family care for his mom, who was diagnosed with a brain mass and needed surgery and rehab care. Bernice is an amazing 90 year old mom, grandmother and great-grandmother who came through her surgery well and is receiving wonderful rehab care in Grand Rapids, Michigan. We are so grateful for the time we were able to spend with her, and to be honest we must have been ready to come home because we hadn't yet planned our Galapagos Islands adventure. It will have to wait for another time ...

So we've been thinking about how to put these five months in perspective, to sort through the images, experiences and relationships we have had so that we won't forget or lose sight of things. Which called to mind Proust's quote ... perhaps the best thing that happened over the past six months is that we have begun to look at the world differently. Whether in northern India seeing displaced Tibetans struggle to save their language and culture, or in Africa as children and their families struggle with poverty and illness and educational barriers but still retain their smiles and joyful dispositions, or in South America as committed and tireless citizens work to provide better lives for their communities, we see ourselves as connected and involved. We have been so blessed to have walked a while with these people, and we will hold them in our hearts forever.

We aren't really so different after all. Our countries look different, we look different, our language and customs and faiths may be different, but we all seek peace and joy in our lives, and we all love our children. In Grand Rapids, Michigan, Bernice was surrounded by her children and grandchildren as she faced this surgery, and a few days later welcomed her 15th great grandchild, Brady Haarman, into the family. And in so many parts of the world, generations work and live together in a life long struggle to thrive amid so many obstacles. Family, and the importance of connections between people, are the same the world over. If we understand that, how can we not live in peace?

So with these "new eyes", here are a few things we hope to see as we return to our lives in America:

- More possibility than worry in every day.

- Opportunities to simplify our life, so that we will have more to share with people in other parts of the world who ask for so little, but can really use the help.

- Valuing the connections that have made our life so meaningful by taking more time with friends.

- Continuing to trust that our adult children, who survived (possibly even thrived?) without us for six months don't need for us to waste energy worrying about them.

- Taking care of our bodies, and remembering that the carbs we crave don't have feelings and won't be hurt if we refuse to eat them. We have both lost about 25 pounds with eating less and walking several miles a day, and we feel better than we have in many years.

- Chances to thank our employers, patients and coworkers for allowing us to go "walkabout", because now we understand how really badly we needed the break.

- Ways to challenge, each and every day, the message brought to the American people that we are better off not caring about the world around us and isolating ourselves and our vast wealth rather than sharing our concern, compassion and abundance.

- Time to appreciate each other and the relationship we have together. After six months, it's nice to realize that we are both a bit sad to have to share each other with others again, and that we never had a day where we were sick and tired of each other's company. It is a wonderful thing to be married to your very best friend.

Who knows, maybe "walkabout" is also in how you see it. Maybe every day, when worry and anxiety and feeling overwhelmed and frustrated and over responsible start to creep up, we'll be able to sit back, take a deep breath, close our eyes and say "for the next five minutes I'm going walkabout to Zanzibar ..."

The Sacred Valley of the Incas ...

We were scheduled to depart from Cuzco at 4 pm on Saturday June 4th, which is defined in my mind as a "travel day". Pat has been hoping that after five months of international touring I will loosen up a bit on this, but on the day of departure from someplace, I generally want to get to the airport or bus station early (ie three hours or more) and do nothing that might jeopardize a timely departure. So despite his hope otherwise, I resisted his idea to hire a taxi Saturday morning to take us through the Sacred Valley visiting historical sites and villages where Peruvian artisans dye alpaca yarns and create their beautiful rugs and clothing. "What if we get a flat tire?" I protested, but he was sure we had plenty of time.

So the taxi arrived, and Pat said "Como se llama?", and the guy answers "My name is Achilles". What? Are you kidding me, as in the weak ankled Achilles? Off we went, with me muttering "This is not good". We drove off of the highway, through farm roads more stone than dirt, and about an hour into the drive Achilles pulled over and said "It'll be just a minute while I change the flat tire."

Pat didn't bother to tell me that the spare was not in the best condition, and I didn't bother to ask what we would do if we got another flat.

Achilles got us through the Sacred Valley where we saw a natural salt farm and some of the most spectacular mountains, valleys and Incan ruins

of our trip. We made the bus in time ...

Cuzco and Macchu Pichu ...

We flew back to Lima and then took another 24 hour bus ride, this time through the Andes to the ancient city of Cuzco. I was particularly happy that most of this ride was after dark, so we were unable to actually see the mountain roads we travelled on. We arrived safely and our hostel was very nice.

We took the train from just outside of Cuzco to the city of Agua Caliente, at the entrance to the Macchu Pichu national park area. From there it is a 2 hour hike up the mountain to the "lost city of the Incas". It is amazing to see the Incan architecture and landscaping, with brilliant green grass under blue Peruvian skies. A beautiful walk there and back, and then took the train back to Cuzco.

Hola, Chimbote!

We flew from La Paz to Lima, Peru, and spent one night in a hostel there before boarding another bus to Chimbote, the site of our next volunteering experience. We walked off the bus just after 7:00 pm, and were met by one of the members of the parish who said the van which would bring us to our home stay was coming. The other thing greeting us was a very bad odor from the factory across the street which makes fish meal.

A few minutes later, a van pulled in and we loaded into it. The guy driving introduced himself as "Juan" and said he was in a hurry to get to mass; when we pulled into the church parking lot, he jumped out of the van in his full priestly garb and ran into the church to lead the service. It would prove to be a fitting welcome to the ways in which people working in Chimbote are always multitasking and collaborating to serve the people of this impoverished community.

Our Host Family ...

It's amazing how first impressions can change; that first night we saw dirt roads and hundreds of stray dogs, very poor homes and rather barren hillsides. But from the time we were dropped off at the home of Udy and Waldo Palacios de Santos, we saw smiles and warm welcomes and a desire to share the Peruvian culture with us. The rooster next door who crows every night from around 4:00 am until 7:00, the man pushing a cart of vegetables through the streets while speaking into a loudspeaker "verduras, verduras" became expected parts of our days. And by the end of two weeks, we would no longer be surprised by the kisses and hugs of these warm and appreciative people, who give so much more than they ever expect to receive.

Father Jack Davis, an ordinary man doing extraordinary things ...

We came to Chimbote on the recommendation of our friend Mike Sullivan; the Parish Priest, Father Jack Davis, was a classmate of Mike's from St. John's. Jack has been in Chimbote for 30 years, and makes yearly trips to his hometown of Devil's Lake, North Dakota and other places all over the US to raise donations for projects in Chimbote. And what they have done is impressive. We visited workshops where the local people make furniture, housing projects for people with handicaps, a program for assisting women and children and a maternal child health and delivery center. Chimbote also has the first Hospice in Peru, and Pat will write about our time volunteering there and the great staff and patients and families we met.

Dignity, respect, love and service ...

It is hard to imagine that 2 weeks of one's life can lead to a lifetime of valuable memories. But that is exactly what Deb and I experienced with Hospicio Santiago Apostol affiliated with Fr. Jack's parish in Chimbote. Our goal was to evaluate the program and provide helpful suggestions and ideas for the continued success of the program. At our closing session we shared these thoughts and praised the staff for their dedicated service...mission accomplished! What happened in between is the story that's worth telling.

Sister Juanita and the Hospicio Team ...

Sr. Juanita Albrecht was at the very first meeting to discuss the idea of a hospice service back in 2002, and has been it's inspirational leader, accomplished administrator, and master designer of a wonderful residential facility and outpatient program from the beginning. The mission of hospice is to give care and support to families and patients dealing with terminal illness, with special attention to the values of dignity, respect, love, and service. Muerte con dignidad ..death with dignity, is the most important goal.

The Hospice Team ...

When Deb and I first walked from the dusty street and through the gate into this hospice facility, we both felt the peace, tranquility, and comfort of the surroundings. A beautiful green space, flowers viewed from every patient room, a vegetable garden in back to provide nourishment, and many birds made it ideal for patients and families. The staff were welcoming, interested, caring, fun, and worked well together as a team. We split our time equally between inpatient and home visits. We also had the pleasure of working directly with Dr. Cinthia Bocanegra, the hospice physician. Cinthia was knowledgable, caring, interested in new ideas, and understanding in her explanations despite the language barrier.

Home visit with a sweet señora ...

Actually, I think that communication is the most important skill in doing hospice work and if I had to rely on my ability to speak and understand Spanish, we would not have accomplished what we did. Deb to the rescue. She was terrific as my interpreter as well as a great comfort to the patients we saw. It was fun to work as a team and support each other.

It's hard to imagine how attached you can get to patients, families, and staff in just 2 weeks, but we did. Elizabeta was a 7 year old admitted with terminal lung cancer. Her young mother was in the room with her other child, a 16 day old infant, when we first met. Elizabeta had been diagnosed at age 2, and now was terminal after all treatments were not effective. Deb held the infant as we explained the situation to Mom and recommended pain medication for comfort. We revisited several times over the next two days meeting extended family and friends. Elizabeta was comfortable and asleep when she died on the second day, her little hand resting on the open bible and her head covered with a bright Peruvian hat.

Pedro and Juan ...

Pedro (pictured above)was in hospice because of a very large pressure ulcer over his lower back and a fever. We saw him frequently and enjoyed his great sense of humor and New York golf hat. He said we should just take him home with us to the US in our suitcase....no problem if he couldn't fit, he would just cut off his arms and legs. We gave advice about wound care and the good news is that he will likely be discharged in the next week. We'll both miss his humor.


Juan had been at hospice for some time with pulmonary fibrosis. Unfortunately, his condition declined as expected and all appropriate treatments for his disease were being tried. We asked him about his goals and he stated he wanted to be comfortable and not struggle to breathe. We taught the staff about the use of morphine for shortness of breath and helped them transition and accept his wishes that he not go back to the hospital. When we were leaving he had declined further but thanked us for making him more comfortable and tranquil.

Roseta ...

And finally there was Roseta. We saw her at home. She had a large external thyroid cancer and is not expected to live very long. She was not eating much and had become weaker and thinner. We didn't have much to offer in terms of changes to her treatments, but we both sat by her side on several visits holding her hand. She is a beautiful woman who looks you straight in the eyes, smiles and then has a healing touch of comfort. We came to comfort, but in Roseta's case, we both felt we were the one's being comforted.

This was true throughout our stay in Chimbote. The people we met were poor, but rich in love, spirit, and reaching out to us. A memory and lesson that will stay with us always.

Sister Peggy's return to Chimbote ...

Father Jack is a real character; watching him is to see tremendous energy, enthusiasm, and love for the people of his parish. They line up outside his office to see him, most with questions, blessings to request, or crafts which they want him to buy. And he can't seem to say "no". Neither can Sister Peggy Byrne, the Irish Nun who has been in Chimbote for almost as long as Jack. He tells the story of a time he bought something from someone, donated it to a parishioner to sell, and Peggy showed up wearing it the next day, having bought it from the parishioner. Jack tells a great story, and remembers to the year when things around the city were built or blessed. It was a visible sign of the love of the community for Sister Peggy the the night she returned from the United States where she had surgery a month ago, the parishioners lined the streets of Chimbote hand in hand to welcome her home.

Father Jack and Sister Peggy ...

A sweet little boy named Bryan ...

In addition to the needs for improved health care and elder care in Peru, we were struck by the lack of mental health resources for people. Medications for depression and anxiety are not prescribed by primary care providers as in the US, they are only prescribed by psychiatrists. There is one adult psychiatrist in Chimbote. Therapy resources are scarce. And the closest child psychiatrist is in LIma, which is 7 hours by bus from Chimbote. The mother of a boy with ADHD heard that I work in child psychiatry, and asked for help with her son, as his medication was not working. I spent some time talking with them, but in the end, it's hard to help them when they have fewer resources available and the cost of travel to a provider is prohibitive. While most Peruvians believe that education is the way out of poverty for their children, the children who have learning and behavioral challenges are at great risk of never completing school. Below is a picture of this little boy, Bryan, and his mother.