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.

Andreas ...

We had a wonderful home stay with Udy and Waldo and the adult children who come and go from their home. Most especially I enjoyed visits from Anjeli and Andreas, Udy's grandchildren. Udy felt sorry for me not having any of my own, so insisted that I can share hers! We had many great meals, conversations and walks with Udy and Waldo. Udy is great at explaining things in Spanish so that you can still understand; it's like she plays charades, acting things out. And she took great delight when Pat would understand something before I did. Like many Peruvian families, Udy and Waldo raise guinea pigs (cuyis) which is a delicacy in Peruvian cuisine. But Pat and I couldn't manage to fire up to try it, and Udy was kind enough to wait until our departure to make it for the two French young men who were also staying there.

Anjeli and her papa Edward ...

"Mi hermana Peruana" ... my Peruvian sister ...

We said goodbye to Udy and Waldo and the community of Chimbote with sadness but with great hope that we will stay connected and return again!

A week in Bolivia ...

Our journey began with a dream and a plan, and when we had to book our around-the-world flights last fall, we chose LaPaz, Bolivia as a stopover before our volunteer work in Peru. We were not aware of how special Bolivia would be, and that we would meet someone with bigger dreams and plans...Dr. Jose Velasquez. I will introduce him and the organization Mano a Mano shortly.

But first, it was our close friends, Drs. Brooks Donald and Karen MacKenzie who introduced us to Bolivia. With their daughter Shannon, they have been involved with Mano a Mano for the past 9 years and told us their stories of the wonderful people, culture, and country. We gave a donation to a school they were helping build and it was our chance to see firsthand what they had been describing. Brooks sent a letter of introduction for us to Jose (perhaps overstating our importance), and suggesting a bunch of things we may want to do. For sure, we did receive the royal treatment, but realized that they treated all of their visitors and guests with the same gracious hospitality.

Bolivia by bus ...

We flew into LaPaz, a city built into a giant crater at an altitude of 3680 meters above sea level. The airport sits on a flat plateau above the city and the taxi ride into town was all downhill with lights of this city of 1.5 million dotting the hills and landscape. Despite our pre-med for altitude sickness, we both felt a little nausea with headache that soon passed. The next morning we boarded a bus to Cochabamba....over the hills and down the mountains. We had both read about the buses in Bolivia, although this one was comfortable and the roads were paved. I made sure Deb made the trip in fine fashion and my multi-drug regimen for nausea, frequent urination, panic, and altitude did the trick for her. After 9 hours, one pretty bad Jean Claude Van Damme movie and one flat tire we arrived safely in Cochabamba.

Minnesota healthcare professionals share their knowledge and friendship ...

Our next bit of good fortune was to be here the same week a group of physicians, dentist, nurses, psychologist, ER techs, firefighter, and PA from St. Paul Regions Hospital and other Twin Cities medical clinics were here in Cochabamba to present the 4th Acute Care Conference sponsored by Mano a Mano. We were tag alongs but really enjoyed meeting and hanging out with a great group of folks. It was especially nice to reconnect with Mary Margaret Conroy and her husband Tom. Mary Margaret is a neonatologist and pediatrician and my mentor during residency in the Twin Cities. She says she taught me all that I know about kids, and I think she may be right. We had lots of fun sharing stories about about families, kids, and mutual friends.

Women prepare for their community's clinic dedication ...

The morning after we arrived we all packed up for a trip to dedicate one of the medical clinics built by Mano a Mano. Our three jeep caravan drove further down the mountain valleys to Santa Rosa, a small village reached by a cobblestone road. The dedication was for the next morning, and under the direction of Jose and the other staff, we swept, drilled, lifted, hung, unpacked, washed and sweated to prepare the clinic for it's grand opening in the am. Opening a new clinic or school is a big deal for these small villages where families live in poor conditions. The whole village turns out, decorations are made, school children and elders gather, a formal program with the national anthem, speeches, thank you's, traditional dances, ribbon cutting, plaque unveiling, and confetti showering of the guests is joyously conducted. A large meal prepared by the villagers sent us off filled with food and appreciation for being part of a great event.

Bolivian schoolchildren ...

Mano a Mano ...

I was able to ride with Jose and ask him how this all became a reality. He learned his values of hard work and service from his parents who moved the family from a rural home to Cochabamba where their kids could get a better education. Back in the early 1990's, he had this idea of bringing necessary medical equipment and supplies from the US for the medical clinics he was working with. He asked his brother, a pilot in the Twin Cities if it were possible to raise some money for donations and supplies and send them to Bolivia. It was and he did and soon thereafter he helped create Mano a Mano, a non-profit with headquarters in Cochabamba and it's US affiliate in the Twin Cities. Their model was to create sustainable clinics and schools by partnering with villages and towns throughout Bolivia. The partnership required that the village and community contribute 30-40% of the cost of building, donate labor, food, and housing during the construction, and agree to maintain the building in the years to come. The government pays for the salaries of the doctors and teachers. With this model, their success has been phenomenal ......120 medical clinics, 41 schools, numerous roads and airstrips have been built throughout Bolivia. Mano a Mano also sponsors and requires continuing medical education of it's clinic providers, has a dream scholarship program for kids with financial needs, has it's own construction division and equipment for road development, continues to collect and donate medical supplies and equipment, and found that it was more cost effective to make it's own beds, windows, doors, and drapes for the clinics.

Dr. Jose Velasquez, a dreamer and a doer ...

As the week went on and we had further opportunities to meet more of the people at Mano a Mano, both Deb and I felt fortunate to meet such a dedicated group .....we found them all to be first class, genuine, value driven, mission focused, transparent, hard working,organized, and efficient. But most of all we liked them as people, and their dreams and plans have touched thousands of lives in Bolivia and the US. For additional info check out their website at manoamanobolivia.org

El Cristo de la Concordia ...

A trip to Cochabamba would not be complete without a climb to El Cristo de la Concordia, the largest statue of Christ in South America, on a hill overlooking the city and valley. We hiked up the 1349 steps (yes, Deb counted on the way down) to see the statue. It towers over you as you stand on the ground and watch the clouds float overhead against the blue sky. For both of us it was a special spiritual moment and prayers were said for all of the people in our lives, our blessings and faith. The inscription at the base says, "This is my commandment. Love one another as I have loved you." In all of our travels, we have surely been witness to the incredible love in the people we have met.

Bolivia's future ...

We celebrated the week with a big party at Mano a Mano's building and then were up early for our flight to Lima, Peru. It seemed only fitting that we were met by Andrea, a member of the Mano family who is a flight attendant. She also had a layover in La Paz and was there waiting for us. Her goal is to become an airline pilot....it seems like the dreams in Bolivia have been passed to the next generation.

Traditional dances at the party ...