Friday, June 22, 2007

Health is money

I've seen two very different worlds related to sickness in the past week and a half. Catherine and I went to the Clinica Stella Maris, a first-rate, first-world, modern and clean and highly professional cross between a doctor's office and a hospital, to get ourselves checked out for parasites. Ever since February we've both had recurring stomach problems--Catherine gets sudden and intensely miserable bouts of diarrhea, takes medicine, gets better, feels fine, and then does it all over again the next month, whereas I never feel quite as bad as she does but almost never feel completely normal either. Sister Teresa said she had parasites for two years once before she realized there was a pattern to her stomach issues and got analyzed. So that's what we're doing. The clinic is over an hour away on the bus, but it's where the sisters go, and as soon as I got there I knew it was worth it to go somewhere really trustworthy. The doctor was very kind, very professional, and acted like he had all the time in the world to talk to you, which was a welcome change from some doctors in the US. (Of course he doesn't do appointments, he just takes people as they come, so after the hour-plus bus ride we had to wait an hour and a half to see him... the good side and the bad side of the Peruvian approach to scheduling.) He even pronounced my name correctly and knew a few English words (like "bloating") to help me describe my issues. Going to the doctor in a foreign language, especially for stomach/bowel issues, means a whole set of fun new vocabulary words!

The doctor's visit was 50 soles, or about 17 dollars; the analyses all together are about 255 soles, or 85 dollars. My insurance with Notre Dame Mission Volunteers is going to reimburse me for most or all of this. Once they get done with the analysis we'll see what parasites we have and then get rid of the pesky little critters.

All this is unbelievably different from what I've seen when accompanying the parish health committee to visit the sick in our pueblo and take them communion. A few women from the parish spend their Thursday afternoons doing this, and the houses they visit range from modest to very poor. Yesterday's patient was a thin old grandmother with doubled-up hands, maybe from arthritis or something like that. She could sit on the edge of her bed but couldn't walk. She wore a hat because she had recently shaved her head to get rid of lice. Her house wasn't really a house at all: she had a little room like a shed, with a lightbulb overhead and cloths shoved into the gaps between the tin roofing and the walls, and a few yards down the hill was another bigger shed that I didn't see inside. A wooden board fence with a swinging door went up the hill to the right of both, and inside it was a sort of yard area at least partially roofed over. (The roofed part that I saw inside may well count as a legitimate house around here, because even nice houses in Lima sometimes have little areas open to the sky above, or whole back walls missing where a room leads right into a backyard. It never rains enough or gets cold enough here to make people seal themselves off completely from the outdoors.) The yard seemed to be where the woman of the house, the patient's daughter, did cooking and laundry. There was laundry strung up on lines everywhere, and farther up the hill a few old couches and bicycles lying around rusting outside. Here and there piles of stones outlined the paths where the daughter and the granddaughter and the dog walked back and forth through their home.

The grandmother, Señora Rosita, was very lucid and in pretty good spirits; her sister-in-law was there visiting her too when we arrived. Her sweet 7-year-old granddaughter hung around in her doorway keeping the dog out and singing songs with us. The daughter was a well-built woman in her 30's who came out from doing her laundry to talk to us. When Señora Rosita complained that she never brought her to church any more, she said firmly, as if she had been over this a million times to different visitors, that she would love to bring her mother to church, but she has no time. Every day she gets up at 3:30 in the morning to cook and take the food to the market to sell by 6 am. After selling all morning she comes back and does house chores and cooks for the family. If she doesn't do all this, she said, "what am I going to give my daughter to eat? The truth is, I'm a single mother. If I don't sell, what am I going to give my mother?" But even after telling us all this, she stayed to listen when the woman I was with told her about a special Mass for the sick, and asked when and where it was just in case she might be able to take her mom. She left us to go back to her laundry with the air of someone who knows her job and is going to do it.

The family seemed to get along well and be more or less in good spirits. The little girl goes to school and she could read the song book I had with me. So they're getting by from day to day. But what killed me was that Señora Rosa told us about the herbal soup she makes to help the pain in her bones, because they can't afford the medication she used to take. "Three for five soles, señorita! It's expensive!" Three for five soles is fifty cents a pill. Fifty cents a pill, if she takes one per day, is one hundred thirty-two dollars and fifty cents a year. After she said that, I had a surreal sense of not understanding the world I was in. The fence, and the dog, and the shed with the grandmother's bed and her wool blankets to keep warm, the strung-up laundry, and a couple of flies buzzing around the door--and more than feeling sorry for them, I felt a confused sort of anger. I didn't get it. Why don't they get a real house? I found myself thinking. Why can't they go get their grandmother some pills for God's sake? It's so easy! You just walk down to the pharmacy and get them! I had an urge to shove a couple hundred dollars into the daughter's hand, wordlessly, not as if it meant anything, but because it meant nothing--because the pile of dollars sitting in my bank account suddenly seemed so worthless to me. Here, just take it, I would say with a look. Your mother needs pills? Buy her a whole year's worth of freaking pills, they're only fifty cents each! How about a real roof for Grandma? I'm not looking to be your benifactress or anything, it's just that it's so simple! Where I come from you just take your money and go buy what you need...

In the face of fifty cents a pill, I don't know what good it really does for me to teach a little English here. (I have taken a "break" from my Communication classes because I had no clue how to teach Camus's The Stranger, and decided I would rather spend my time on other activities than try to design and teach a high school literature curriculum in a foreign language with no control over what texts are read and no guidance from more experienced teachers. Pati understands perfectly and gave me an open invitation to come back whenever I like or not at all. She is a very sweet, generous person.) Who knows whether my efforts will actually improve the lives of any of my students, especially when the progress is so slight and slow, and the ones who say they are interested in more intensive tutoring never show up when they say they will. Maybe they will make a little progress, but after this year (or next), I will eventually go back to the US and leave them. Going to the US is something many people here would like to do, but few can. But for me, it's the easiest thing in the world to go back home--to flash my passport and skip through customs and immigration to a life in abundance where everything I could ever need is always there for me. It seems a little wrong to do so while Señora Rosa is still living in her shed.

I want to swear that I will never look at a $20 bill the same way again. But I probably will, in the future, go back to seeing it as a coffee and a movie instead of a week's worth of dinners for a family.

...in other news, my fourth grade chorus cheers me up every time. They are so cute and they are singing so well.

Friday, June 8, 2007

Things you can do, and things you can't do

I haven't seen the new Pirates of the Caribbean movie yet, but lately I keep thinking about a quote from the first installment. Johnny Depp says to Orlando Bloom, while the latter is hanging precariously off the side of the ship: "There's two kinds of things in life: things you can do, and things you can't do. Either you can accept that your father was a pirate, and a good man--or you can't. Now, I can let you drown, but I can't bring this ship back into port all by me onesy, savvy?" As far as I know, my father was never a pirate, so that part of the speech has little bearing on my life. The last sentence, though, is how I've been feeling lately about several of my projects here, particularly Communication, and I'm discovering that a big part of the international volunteer experience is figuring out the difference between the things you can do and the things you can't do, and then learning to live with that.

For those who don't speak Captain Jack Sparrow, "all by me onesy, savvy" means "all by myself, got it?". The more I come to understand how Fe y Alegría works and what it needs, the more I realize that the things I would really like to do for these students are impossible for me all by me onesy to accomplish. What the students need is an English class that teaches them to really use the language instead of just memorizing phrases. What they need is a Communication class with a planned syllabus, where they are informed well ahead of time of all their assignments, where they are taught first to write paragraphs taking evidence from the text to answer a question and then to put those paragraphs together into essays, where they have homework that asks them to think instead of just to fill up their notebooks with summaries of each chapter they read. What they need is a real music teacher who would know how to coordinate the various vocal and instrumental talents of the students into a well-organized group or two. In other words, to truly fix the things I'm working on would take no less than three full-time teachers doing their jobs impeccably. Essentially, what the students really need is... not to need us.

But they do need us. However frustrating it is for me to look at this school, analyze where it is now, come up with some changes that would be essential to giving these students an excellent education, and realize that those changes are impossible, the immediate reality is that this year I can help a few students move a little closer towards that excellent education they aren't getting. Instead of patching up the leaks in the boat, we're bailing. Not a permanent fix, and by itself it won't bring the ship back into port, but it helps a little in the meantime. It's hard for me to work this way because I've always been a big-picture person. When I do things, I really do them, and I'd rather do one thing well than many things poorly. I get stressed out when (for example) I realize that the kids aren't going to have their reading questions for Monday because both they and I have just been given Monday's reading on Friday, and I can't demand that they take a quiz on the reading because I wasn't given the opportunity to tell them that there would be a quiz, so Monday will be yet another day of nobody having read and me not knowing what to do with them--in short, when I can't make the class "work." And I think, I can stop doing this if I want; I can walk away, dedicate myself to English classes instead, and let these students "drown" without something solid to hold onto in this class; but I can't fix it alone because I'm not the teacher. But then the next week I do manage to give them questions, and we talk about the setting and plot and start analyzing the characters, and they have fun re-telling Treasure Island from John Silver's point of view, and it's so clear that they need what I'm doing that I really want to continue.

So it turns out that much more difficult than either letting them drown or bringing the ship back into port all by your onesy is doing neither: staying with it even though it cannot ever really "work," learning to live with doing something halfway because halfway is better than nothing. A very difficult lesson for me. But this whole world of Peru is full of things that are different than I'm used to. Less academia, more cooking and cleaning; less news from the US, more freedom to be Catholic without the difficult politics of Christianity right now in America; less structure, more flexibility. Peruvians in general are not as stressed as Americans, and I'm trying to learn from them to just live with a little failure.

Meanwhile, my English groups are more or less under control, and by the end of the year if nothing else I will have taught "to be," the question words, and adjectives for describing people to every student in 9th and 10th grades in this school. It makes me laugh that I usually have class in an auditorium with holes in the roof where birds fly through, and my dry-erase board has stains on it from bird poop (so far I myself have been lucky). My fourth grade chorus is absolutely darling and often the highlight of my week. They are learning to sing in tune and working on doing rounds, and I hope to take them to a city-wide arts festival in November where they can perform and listen to other student groups! Some of them are so unbelievably excited about singing, they always yell "La señorita de canto!" ("the singing teacher!") whenever I appear, and they give you kisses on the cheek to say hello and goodbye. The secondary chorus has issues with showing up when they're supposed to, so I may be cutting out the Thursday rehearsal in order to accompany some of the parish women in taking communion to the elderly--something I have done once and am interested in doing more. The only other news lately is that Peruvians are constantly having parties. Last week was our friend Sara's birthday, Sister Denise's goodbye dinner, and Sister Magda's birthday all in one week. All the ice cream and cake is probably not good for me, but the celebrating sure is fun.