Quichirragra & Chinchao

Photos: 
1. Beautiful view of the hillside fields from Quichirragra.

2. Some of the baby quilts made by our friend in Lima that she requested we take "someplace where they are most needed."

3. Hermana Merrill with the roll of "napkins" at our breakfast table.  
4. Eating a breakfast of cuy.  
5. Beautiful children at Quichirragra.  
6. Hermana Merrill with some of the children (and a portion of the donated clothing in packages behind her).  
7. Happy grandmothers waiting for some of the donated clothing.  
8. Arrival in Huánuco.  
9. The Huánuco airport terminal.  
10. At the health post in Chinchao.  
11. Rob finally caught a fish (rainbow trout) along the highway to Chinchao.  
12. Mary along the highway to Chinchao.  
13. They raise hydrangeas in fields up and down the mountainside along the highway. Many of these plants and flowers are raised for export.  
14. They refer to the buses that transport live fowl as "chicken buses".  These caged chickens came from the "chicken bus" and were transferred to this "chicken motorcycle" for transport to a remote village in Huacaybamba province.  This couple consented to a photo when Mary requested it.
15. We saw these musicians transporting the harp along the road between Huaraz and Huacaybamba (the long, rough, dirt road). I can't even imagine how he can ride like this without dropping the harp.
16. Heading down the stairs from the Health Post at Chinchao to get back to our vehicles.  
17. An adobe home adjacent to the health post at Chinchao. The reddish/pink flower in the foreground is about the size of a beachball. The mountainsides are covered by dense vegetation reminiscent of the Hawaiian Islands. Much of the steep hillsides are under cultivation.

This week found us traversing the rough road from Huaraz across the Andes Mountains to Huacaybamba Province (Huánuco Departamento) again. This time, due to prior rains and road damage, the journey took us eight hours, six of it on the dirt road. This is the same rough road described in our post of November 8 and this was second visit Monday afternoon to the health post at Quichirragra as well as meetings Tuesday with community leaders and health directors at the Health Center in Huacaybamba, the provincial capital.

We traveled with a team of two specialists from Church Headquarters in Salt Lake City from the welfare department. Brother Steve Dobb oversees Area Initiatives throughout the world and Dr. Archibald leads the medical committee. They came at our request to assist us in determining how the donations of medical equipment that had been made to remote health posts could have the greatest possible impact to benefit the health of the communities that are very isolated, and to identify the most pressing health challenges seen in these areas. They will take this information back to headquarters to share with their committees as the Church continues its Humanitarian efforts.

We were able to have a detailed conversation about the greatest health challenges they faced and identified what they had done already to try to address them. We then talked with them to identify what additional resources they were aware of, including other non-governmental organizations (NGOs) that were working on these or similar problems who could be potential partners with whom we can work. The major problems identified were maternal mortality and morbidity (which means death and other bad outcomes to pregnancy), medical emergencies, and chronic malnutrition in children.

Many of the maternal problems stem from the great distance that must be traveled to get to the health post (the health clinic) and the fear that many have of going there. Home births are common and when a complication arises with delivery (primarily bleeding issues) before the mother can receive care it is already too late. The ultrasound and other equipment donated can help to diagnose potential problems before they become an emergency and provide enough time for the patient to get to a higher level health center (four hours away on very bumpy roads) or hospital (in Huaraz at the end of the rough road that took us eight hours to come in on and which is sometimes impassable).

Out here, when someone with a medical emergency is referred to a clinic or hospital with more advanced facilities, many patients refuse to go and often times stay home and die. Some of this may be due to economic and travel distance concerns. (Having traveled the road twice now, we understand why people could be reluctant to make the journey and can only imagine how it would be to travel it in the midst of a medical emergency.) Those who experience an emergency many times do not survive the journey across the Andes, either.

Malnutrition is a very complex issue here in that it involves agricultural, economic, cultural, behavioral, and other factors. No one factor is key and so solutions are not simple. Because of the complexity a solution would of necessity involve other churches, governments, schools, health personnel, non-governmental organizations, and LDS Charities. All would need to work together to address the problems and arrive at solutions and that would take time because of the long-standing behavioral, economic, and cultural components of the problem. We indicated that without other partners we would probably not be able to be of much help with this challenge.

We were honored guests for breakfast the day after our arrival and had our first meal in Peru with cuy (guinea pig), a local favorite. This humble room is the dining room, and laundry room, the outer area of the bathroom and probably the living room and has a dirt floor, but the people are generous in sharing what they do have.

When we touched down Monday morning at the airport in Huaraz where we were to meet our ground transport, we were surprised to also be met by the stake president (ecclesiastical leader) of Huaraz who had been notified 10 days earlier that we were coming and could take some donations of clothing from his stake members to Quichirragra, where there is great need. He had a truck full of donations that they had collected and sorted in this short time. After filling all available space in the van that was taking us to Quichirragra, Huacaybamba there were still a dozen large canvas bags full of donated clothing. We quickly made arrangements to have them sent as cargo in a bus that would leave later that day for Huacaybamba where we could pick them up the following morning. I was touched by the magnitude of this donation, made by people who have very little themselves, for people they had never met across the Andes Mountains. The clothing was  clean, nice clothing sorted by size and carefully packaged with like items.  Both giver and receiver were blessed by this outpouring of generosity.

Tuesday afternoon we left Huacaybamba for the now all too familiar road back to Huaraz where we arrived well after dark and spent a short night prior to our early flight back to Lima. From Lima we flew to Huánuco where we spent Wednesday night. Thursday morning we were up early and on the road by 6 a.m. to conduct a similar visit at the health post in Chinchao, several hours from Huánuco.    
As we left Huánuco Thursday morning for Chinchao it was raining. This is the first time we've really seen rain since our arrival and the "selva" or jungle starts just east of Huánuco and we were heading east. Our drivers to Chinchao performed as if they were in a Formula One race with traffic moving in only one direction (which distressingly it wasn't--it was two-way traffic with lots of curves on a mountain highway) and we somehow made it to Chinchao without becoming victims of high-speed vehicular trauma.

At the health post in Chinchao, we met with medical staff and the director of the regional health care network as well as community members. While the medical issues were very similar to our visit earlier this week, this community had much greater success with patients accepting referrals for high-risk deliveries. Though some communities were five hours from the health post, identifying high-risk pregnancies was part of what they did very well. A significant reason for their success is the fact that there are two women (nurse and birth attendant) who have worked here for 18 and 20 years respectively and have developed relationships with the women who have confidence and trust in them. At 36 weeks of pregnancy, those with high risks are sent to the hospital in Huánuco, and they have developed this as a community expectation that has led to a great reduction in maternal death.

In our discussion about the issue of malnutrition they were able to identify a potential partner that is working in another nearby province with some success. We have worked with this organization elsewhere in Peru in different types of projects, and now will make contact with them to learn more of their nutrition project which sounds similar to some of the food production projects we are involved with. There is a possibility we can work together to forge a solution for a few more people in these Andean communities.

As we drove back to Huánuco we looked to find a place to eat a late breakfast. None of the available options seemed reasonable (and the Peruvians with us felt conditions at the establishments were too "sketchy" for safe eating). Along the way back to the airport, we passed a restaurant that served really fresh trout. We stopped which gave Rob a chance to get his hands on some rainbow trout which made him very happy, even if it wasn't on the end of a flyline.

Thursday afternoon we flew back to Lima where our team had another visit scheduled in the airport to meet with the director of a health post to discuss similar issues and explore potential solutions. Our visitors from Salt Lake City then caught a flight to Quito, Ecuador where Friday they were to travel and visit another remote health center where medical equipment donations were made this year. We hope that this visit will provide a greater understanding of the nature of our donations and the needs we are trying to address, and we hope additional training or other solutions can be found to improve the health outcomes of these remote communities and the beautiful people who live there.

We were happy to sleep in our own bed and to be back at the office after being gone for nearly two weeks and to start on the tasks and projects that awaited our return. As always we are staying busy and are thankful to be here serving our fellow man and our God.