June 3: 2nd day at Inppares

This morning I woke up feeling awful because I stayed out too late last night dancing. But I still got ready and got to work on time. This time I woke up with enough notice for a hot shower and it felt wonderful!

I spoke with a person at Inppares and she told me that it is fine for me to mention patient details on my blog or with my friends from the US. What is forbidden is to reveal details such as names, addresses, or information to anyone who requests it, such as a relative or friend of the patient.

That said, I was very impressed and moved by the first patient of the day. She was a 62-year-old woman who came in because she was worried about the bleeding from her vagina. She doesn't have a uterus becasue of a hysterectomy long ago, and therefore really shouldn't be bleeding past menopause. Turns out she had three sexually transmitted infections because her husband sleeps around without using condoms. Although she doesn't want to have sex with him, she and he consider it part of marriage duties. She was very uncomfortable telling Claudia that yes, she had had sex recently and when exactly it was. Claudia gave her a lot of verbal information about protection and how the diseases are transmitted, and got her the necessary consent form for an HIV test and a syphilis screening, because those were basically the only two common diseases she did not have. It was very sad to see this old woman who just wanted to be left alone sexually, coming in with three diseases and possibly even HIV. Claudia suspects she has cervical cancer because hysterecomies do not always remove the cervix entirely.

Another woman came in because she was pregnant and an HIV test is required for all pregnant women. However, she thought she really didn't need one, even to check, so Claudia had to tell her about the requirement for the baby's sake and give her more information in general about the disease.

In between patients, Claudia and I talked about all sorts of things. I taught her some Japanese, showed her the results of some contraception-related studies online (specifically male contraception ideas that will soon be on the market, I believe), and told her about the drug trade in the US and the problems on the border with Mexico. I showed her a webpage about salvia divinorum and the most recent study showing that immediate treatment of HIV with antiretrovirals can reduce transmission by 97% and improve the health of the patient (versus waiting until the CD4 count lowers and viral load increases, some years after infection). It was pretty difficult to communicate all of these things in Spanish, but I had to translate the websites so she could understand what I was talking about.

I saw a bunch of neat posters at the clinic in a flip-book: they had information about STIs with LGBTQ-specific photos and themes, and some with the same information for sex workers. Here are some examples:

"How HIV is contracted and how it is not."

"Rediscover the pleasure of safer sex. It's sex without penetration, with all the fantasies and erotic games that we think of."

"Not all of us men should have to be masculine, marry, and have children. We can construct a new type of masculinity, equivalent in value to that of the model society has imposed upon us."

"No one can deny you the right to walk through streets or plazas, discriminate against you, insult you, hit you, or arrest you for being who you are."

I wasn't feeling well from the lack of sleep and coffee, so Claudia let me go home from noon to 2:30 to sleep and eat lunch. I slept for basically the whole time.

Claudia finished her appointments at 4pm and since I'll be coming in on Saturday for a urology/prostate cancer screening from 9-1pm, I was permitted to leave early. Instead of going straight home, I decided to explore the area on foot. It's really beautiful here in this residential district. I walked to a small park and there were restaurants and little stores everywhere. Because I hadn't eaten lunch, I kept my eye out for some tasty and cheap food. Ceviche is pretty expensive compared to the rest of the food (14 soles vs. 5 soles, although 14 is still only $5).

I thought about buying some chifa (Peruvian-Chinese food served by Chinese people) but decided on some green tamales because I saw a cute sign that said, "Tamales prepared in this house! Ring the doorbell." They were only 1 sol each and a really cute old man slowly walked out to talk to me about them, so I bought two. They contained chicken and smelled incredible, but unfortunately were pretty spicy.

I got some flowers for my host family. :D

After doing some email checking online, I walked with Renzo to a really cool marketplace where we bought desserts and anticuchos. Anticuchos is a dish of cow heart that is incredibly flavorful. I'm not sure if I could eat the whole thing in one sitting because of all the richness. We also ate choclo, which is a type of corn but the kernels are three times the size of regular US corn kernels. It was delicious and of a similar flavor to the corn I'm used to.

For desserts, I tried suspiro limeno (Sigh of Lima?) which was like flan, sort of... but with fluffy whipped cream on top (except much, much lighter than whipped cream). I also ate leche asada (roasted milk) which was a lot more like flan. A little crispy on the top, though.

Then we walked all around the area and viewed a really big, beautiful church that can be seen from my window in the apartment. Here it is at night:

It's actually a lot of work to maintain this blog... there's so much to do here and so little time! I do actually miss my UNC friends a ton. I've gotten used to air-kissing everyone's cheeks but not used to the absence of my closest friends. I'm accustomed to spending a lot of time with guys who treat me as equals, and here it's sometimes hard to feel like I'm treated equally from males. Not necessarily as a romantic prospect, but as someone who needs the door opened for her which I would not always like in the US. Sometimes, sure. But I can really do it myself and I could use the exercise. :) I haven't been to the gym in weeks!

To end... a humorous poster I saw on the street. Peruvian politics has all kinds of corruption. Claudia and her friends discussed the Sunday elections and agreed that they can't trust either one of the candidates at all.