DukeEngage | Duke Center for Civic Engagement

In a country such as Peru, it is fairly easy for a group of Duke students to
stand out as "gringos". Different skin tones serve as an easy marker of our
"outsider" status. Our reliance on the English language, and our difficulty
with the Spanish language, also indicate our foreigner status. And with some
of us, our height literally makes us stick out in a crowd. All of these
indications contribute to our status as foreigners so much that we are
bombarded with cries of "Cusco, Cusco, Cusco" by taxi drivers who see us as a
group of young Gringos touring the sites of Peru.

With our status as foreigners, Peruvians quickly identify us as Gringos, which
influences their actions towards us. In Huayllabamba, the second city which the
Duke health group is surveying as part of the water filter project, reactions
toward us, a group ranging from five through nine young Gringos depending on
the day, are not always positive. Some see our group walking door to door down
the street and retreat into their homes, closing the doors behind them, and
ignoring our knocks, even after seeing them enter their houses. Some answer our
knocks only to provide us with excuses such as not having time to take the
survey, or being occupied with drying their donkey. Some though seem interested
in our study, only to refuse their participation because we are not Peruvians or
government officials. One women proceeded to give us a 20 minute long rejection,
explaining the government’s failures in providing clean water and controlling
prices of petroleum and food products, stating multiple times that we should
not be doing our investigation without the government’s assistance, which made
me feel so unwanted that I felt like abandoning the project.

I do see though why some people appear to act a little cold towards Gringos, for
Gringos represent change. Rarely, if ever, do Gringos walk door to door simply
to chat with people. I have seen foreigners doing community wide campaigns
sharing their faith, which can be interpreted as "Change your religion." There
have been other groups analyzing a person’s health and hygiene and providing
him/her with medication and soap, telling them to "Change your health/hygiene
habits." In Huayllabamba, some volunteers from our NGO have already traveled to
the town to build new stoves for people for them to "Change their cooking." And
our group, giving surveys about a person’s water usage and hygiene habits and
promising them a filter capable of improving their water and overall health, is
essentially saying "Change your water usage." Although all of these things could
essentially improve a person´s life, we are changing aspects of their lives
which have been the same for themselves, for their parents, for their
grandparents and much longer. We are essentially saying "Change your culture."

Although our Gringo status does prompt some negative reactions, it also helps initiate many positive responses as well. While others may close and lock their doors when they see us walking on the street, some people in Huayllabamba approach us, at first only to talk and ask us where we are from and what we are doing in the area. After they learn of our project, they are quick to invite us inside their homes. Upon conclusion of the survey, they thank us immensely for taking the time to work on the city's water system and for interviewing them. Some offer us hot drinks or fruit, and one lady told me and another member of the Duke group to return to her restaurant and visit her. Additionally, some of them will actually tell some of their neighbors to take the survey, guaranteeing success where we were likely to have been rejected.

No doubt that a warm reception and much gratitude definitely boost our sense of accomplishment while the (sometimes harsh) rejections lower our self-esteem and sense of achievement. Despite the varying reactions we receive, which I believe are due to our Gringo appearance, we can only continue with our investigation knowing that everyone may not be willing to participate initially. If we persevere and ProPeru accomplishes everything the water filter project should, including the distribution of free medicine and water filters to those who seem really eager, we can only hope that others will eventually participate after viewing their more trustworthy neighbors.

As I cross the street, I see a black mangy dog with a dead bird clenched in its teeth by the neck. It is running at a quick jog towards a light blue painted hospital where, inside, the faculty practices with too few supplies, forgoing gloves for the addition of another stethoscope. Passing the hospital, I look ahead and see a mass of people walking down the street, one by one, two by two, with grimaces on their faces, forced to travel miles in the advent of a new strike which has disembodied the transportation system for the next two days. The sun is boiling and hot and relentless, and since I have forgotten to put on sunscreen, I will undoubtedly have red burns the next day.

Another day. I walk into a small house in a town called Yucay on the outskirts of Urubamba. The house itself is neat and simple—enough. I have arrived to install a new stove, simple as well, though more complex than its predecessor in that it contains a chimney instead of nothing. I am greeted by a small boy, around six or seven years old, with a smile on his face and a toy in his hand. Their kitchen is about the size of a dorm room, detached from the rest of the house, with old ashen remnants strewn about on a platform in the corner. Above the platform is a hole, a skylight, which has been used as a makeshift chimney minus the tubing to go up into it.

As I start to work, placing brick after brick in a preliminary pattern, the small boy comes and asks me my name. I tell him, and he tells me his, and then he starts to help me, handing me brick by brick as I need them. Far from shy, he begins to talk, quickly, about everything, asking me questions as his curiosity peaks sinusoidal, then retreating back into observations and monologues. I find it hard to understand him, as his voice is high and his speech erratic and rapid, but I understand enough to see that he does not suffer from some too early existential crisis brought about by western defined poverty in a house sufficient.

When it comes time to add the upper half of the chimney, I ask for a ladder. The boy brings me to his grandfather, and he, in turn, leads me to the backyard. There he has been growing alfalfa, which undulates wistfully in the slight wind from the north, and several trees of some fruit with which I am not familiar. Up along one tree, in the back, is a ladder, old and wooden, but in its place. Anything else would have seemed anachronistic.

I help the old man carry the ladder back to the house. Inside, as I nail the wires supporting the tubes into the wall, he tells me that he is ninety years old. I am impressed. He then jokes, after asking me how long the stove will last, that he hopes it will be his last. One could interpret this in two ways, depending upon his own level of pessimism, but in the environment it seems clear that his remark is pointed at the chimney. Given his good temper and amiability, the other seems nigh insulting. But it’s there.

When I finish, I am invited by the mother of the household to a small meal with the rest of the family. This is how they thank me. Not with words, but with action. I prefer it.

As we sit and eat, we talk. They ask me about the States, and I answer honestly. They seem happy with their new stove. They ask me if I learned to build them in my own country. No, I didn’t. I learned here. Do the people in your town use these stoves? No, not usually. Most families have stoves made out of metal, powered by electricity or gas. Oh. Silence.

When I leave to pick up a combi towards Urubamba, I shake hands with the men, including the boy, and kiss the cheek of the woman. Ciao. And then I’m gone.
 

As previously mentioned, the main aspect of my health program is the water filter project. The Duke group was originally assigned to work on the town of Huandar, about thirty minutes away from Urubamba. Huandar is a really tiny town, with only about 20 families, so we were able to complete the surveys and collect stool samples in about three days. This Thursday we will hold our educational health charla as well as distribute medication. We recently began surveying people in Huallyabamba, which I believe is the largest of the five cities incorporated into the filter project.

Before starting Huandar, our group spent a couple of days in two of the other surveyed towns, attempting to deliver medication to those who had given their stool samples about a month before. Nothing was really accomplished these days because it was next to impossible to find those who had been surveyed since no map, photo, or any form of documentation, besides a person’s name, was kept by previous volunteers. We were being thrust into half-completed projects and having little success. Although we had managed to complete Huandar, surveying the required number of houses, collecting and analyzing stool samples, and holding multiple educational charlas in Huallyabamba will be impossible for us to complete in our remaining weeks here, meaning that we will be leaving this town in the same semi-completed stage for future volunteers.

Although we have taken some steps to better organize the study, such as creating a map of the surveyed houses (sometimes including a description), the thought of not completing Huallyabamba is simply unpleasant to think about. Not completing the project seems very unpleasant to me (and I imagine to the other Duke volunteers) because failure to complete a project, one which has been given great importance, is very unnatural to us as students. And although we understand that the filters themselves are not yet ready, it is a little frustrating that we have to make people wait to receive this filter after already spending time explaining the importance of clean water to them, but not giving them the means to do so (not yet at least). I imagine some of them viewing us as nothing more than a bunch of gringos bringing our advice, promises, and medicine without actually giving the Peruvians we interview the power to improve their own health (with the delivery of a ceramic water filter).

Of course the language barrier itself presents a challenge in both capturing a person’s interest in the project (at which we usually respond with "medicamientos gratis para sus hijos"/ "free medication for your kids") and administering the questionnaire. In Huandar I spoke at the town meeting for less than 30s and helped with some surveys, so I was somewhat confident in my Spanish ability. All confidence I had though plummeted in Huallyabamba when I spoke in Spanish to an elderly man for about 3 minutes only to have him respond to me that he didn’t understand English and that I needed to talk to him in Spanish. Luckily I was able to find the whole situation quite comedic and continued explaining the project in my English sounding Spanish, but to no avail.

Every project has both its given set of problems and the potential to be much better. Although I will not be able to address either of those aspects during my experience here, I am aware that we are essentially laying the groundwork of what can become an amazing project. We can only hope that ProPeru and its future volunteers build upon both our success and failures (and actually install the water filters).
 

Three weeks since our arrival in Urubamba, Peru, we finally began working on the main project assigned to the Duke Engage health volunteers at ProPeru. Although we originally thought that our time here would be split between working in clinics, conducting health education classes, and working on a water filtration project, we learned that our main task would be focusing on the water project.

This water project would primarily focus on administering surveys concerning a person’s water usage, recent sicknesses, and willingness to participate in a study in which half of all participants would receive a ceramic water filter while the other half would be part of a control group and not receive a filter in order to see if the ceramic filter is successful in killing parasites. In addition, a main component of the project is collecting stool samples in order to analyze them for parasites and return with free medication if it discovered that the person does indeed have parasites. We are also responsible for conducting educational "charlas" or chats with those who participate in the study to better improve their hygiene habits so that we can ensure that the filter’s cleansing ability is not negated by a person’s self-contamination resulting from his/her own hygienic habits, such as not washing his/her hands before eating.

Before coming to Peru I knew that living any comfortable life in the United States could be considered as living a spoiled life when in comparison to the lives of a majority of others in the world. I had only thought though that my "spoiled life" resulted from various technologies, such as my Ipod or personal laptop, or from the opportunities afforded to me as a U.S. citizen, including an education at an institution such as Duke. Although I was aware of the great health disparities between the United States and most other countries, I never considered clean water as a contributing factor to my "spoiled life."

In the U.S. it is quite easy to devalue the concept of clean water seeing as how it flows out of thousands of faucets, whether in our homes, schools, restaurants, or any location/establishment. Not only do we have clean water, but have water enhanced with fluoride and other minerals, to improve various aspects of our health. Even with access to clean water, many of us still choose to purchase “cleaner” water, relying on water bottles to satisfy our need for fresh, pure, artesian, mountain, exotic, uncontaminated, (add more adjectives here) water. I live in a country in which there is no risk of obtaining a parasite simply from brushing your teeth; a place where the death of a child from constant diarrhea due to contaminated water is unheard of.

Unfortunately, Peru is a country with a drastically different water system than that of the United States. Most of the water here is contaminated with bacteria and parasites which are responsible for many sicknesses, sometimes fatal. We learned that diarrhea, resulting from parasite eggs or larva is actually one of the leading causes of infant mortality, and that parasites themselves are often responsible for anemia and malnutrition. I could share with you the details of the parasites that become worms which line your intestine and consume all of your food, or of those which actually travel through your bloodstream and harvest off of your brain, but I will allow you to conduct your own research on the nasty critters.

Part of the problem is due to the numerous amounts of people and animals who defecate in the street, which can eventually wash up into the water system. Most people however are unable to treat their water, not having the means to do so, or not seeing the need to do so for they consider this part of a normal life. Even those who are rich enough to treat their water often do so in a somewhat unsafe way, chlorinating or bleaching their water. The easiest method of treatment for most is simply boiling the water, but not everyone takes the time to do so.

It is easy to see then, the spoiled life which you and I live: one which not only includes the modern comforts of technology, but a life in which clean water is merely an afterthought. Clearly then installing aluminum lined ceramic filters which can kill most of (if not all) the parasites found in the water is a beneficial project for our group to undertake. During our time here though, we will not actually be installing any filters, as various prototypes are actually being constructed and tested to see which works most effectively, but we will focus on administering the surveys and conducting the charlas. This project however, definitely does not come without any challenges....................
 

I arrived in Urubamba, Peru expecting to immediately work with our partnered NGO, ProPeru, in installing and explaining water filters to people living in rural pueblos. Between the sixteen of us embarking on this Duke Engage experience, I never expected to completely eradicate water-dwelling parasites in a town, but I did expect to remain relatively busy at least attempting to do so. Living in the fast paced culture of the United States, one in which people drive, talk on a cell phone, change radio stations, and eat all at once in an effort to crunch time, I am used to having a variety of goals which I wish to accomplish daily, weekly, monthly, etc.

The Peruvian concept of time though, greatly differs from the one found in the U.S and translates into spending more time to do less. The phrase of “time is money” definitely does not apply here as it is not unordinary for a person to arrive an hour late to a meeting (or not show up at all). Time here also has greater importance in relation to people, with most shops, offices, and schools closing midday and reopening late afternoon so that people can return home and have family lunches. It’s also customary to not only stop and greet a friend/acquaintance on the street, but to have a decent conversation with them, regardless of how late you may be running to work or the amount of things you need to accomplish in those next thirty minutes.

As you may imagine, this concept of time, which devalues the amount/length of work, can be very frustrating, especially for a person like me, who mentally budgets out time for tasks during the day and expects to accomplish those tasks within a given time frame. For those of us involved in the health aspect of this Duke Engage project, our normal working hours fall between 9am and 1pm, giving us only four hours a day. This may be an acceptable amount of time if only the ProPeru staff had not acclimated fully to the Peruvian concept of time. It has been frustrating to come into the office and read journal articles about the filters we will (hopefully) install, or watch presentations concerning water quality in the area when we could have reviewed and learned this information prior to our arrival. Our group came to Peru expecting to work and wanting to help others, but so far it seems like most of our time has been spent in preparation of what is yet to come. Those in the Duke group which build stoves with working chimneys in towns where they still cook with an open flame in their kitchen always return home late, usually after seven hours of work, due to a culture of tardiness which seems to thrive here. As already mentioned, time spent in community/companionship with one another is given great importance, but I have still not fully acclimated to this cultural belief. During a “mini” project Saturday, which was to finish by 1pm, our group was required to stay longer after being offered a lunch by the community in thanks for working on the school. Many of us had made plans for what was to be a free afternoon, but found it necessary to accommodate our hosts´ request, wait for a lunch that was never to come, and completely disregard our plans in an effort to follow cultural norms.
 

This slower, differently valued Peruvian time system has definitely been the source of much frustration during my first 11 days here, but slowly I am trying to accept this new concept. I definitely do see the value of spending more time with friends and family, then focusing on my own goals or expectations for the next 7 weeks, but the difficulty of doing so is great. On the upside, I have much more time to reflect on my experiences here. I have taken an entire 11 days before writing my first blog post. 