Living it up in Lima!

Mmmm Inca Cola!

The Country Club
Yesterday, the extended Arambulo family and Theo and I went to the "Country Club" in el campo (the mountains). It is about an hour east of Lima in the mountains in a suburb called Chosica. The people who live here are quite poor and the houses are in various stages of construction. Some have roofs, others don't. Some have bathrooms and running water, some don't. Some have cement floors, others are just dirt. They get around by mototaxis (very few people own cars) or by combi (large van) or micro (larger bus). There are people who sell their goods in the markets but they carry their good in carts on side of the major highway where the trucks, cars, and buses drive and it's very dangerous. There are "guard dogs" that roam the street or live on the roofs and very few security guards like in my neighborhood. What I love about these neighborhoods though is that you will always find kids playing on the dirt soccer field in the center of every community. I love it!

We arrived at the Club around 7pm and it was beautiful! You could see the moon and some stars. The lights from the houses in Chosica on the hills. The Club is a large private resort with small bungalows, eight swimming pools, a small zoo (with "exotic" animals - cows, horses, deer, rabbits, swans, peacocks, llamas, macaw, parrots, toucan, goats, and a few others), a mini golf course, restaurants, and more. The kids loved it! Theo got to have his first official swimming lesson by yours truly (once a certified YMCA lifeguard and swim instructor) and he was AWESOME! He swam after his water toys for 20 minutes, kicking his legs and reaching for the toys. I dunked his head under a few times and we sang "Motor boat" and "Wheels on the bus". I figure he'll be the next Michael Phelps! I can't wait to bring him to Minnesota this summer to swim in Auntie Annie's pool and at the lake! I did a good job of keeping him out of the sun and applied a lot of sunblock but forgot to reapply on myself and so I'm a healthy shade of pink at the moment. Hopefully it will turn to tan by the time I return to all my pale co-residents in the hospital in two weeks :) 

The front patio of our bungalow in the Club.

The Arambulo family walking to la piscina (the pool).

The view from our bungalow of other bungalows and the surrounding mountains.

Victoria and Fatima in the pool with Theo and his cool kid shades.

Theo swimming after his toys. He's a natural!

My little swimmer!

He loves the water (and chewing on toys)!

After swimming - hanging out with abuela (grandma).

Lima, written by mommy.
For those of you who don't know, I lived in Lima, Peru, from August 2009 to June 2010. I was on a scholarship from the National Institutes of Health to do research in between my 3rd and 4th year of medical school at the University of Minnesota. I am now in my second year of residency at the University of Washington and am in the Global Health Pathway. I am allowed three months to travel abroad and do clinical work and/or research during my training. I decided to return to Peru since I was familiar with the city and had developed good relationships with some of the researchers here and I was familiar with the city and customs here.

This week has been amazing! Not only do I get to spend a lot of time with my son, Theo, whom I haven't seen much since being back at work (where I work about 80 hours per week over six days), but I also get to see all my old friends from Peru. Theo just turned seven months this week and is sitting up all by himself. He rolls over very well now but hasn't started crawling quite yet (thank goodness). He has a great temperament and is very easy going. He loves all the attention from all the people who come visit us everyday. There are six of us staying here but I think there are at least 10 people that come over on a regular basis and they fall in love immediately. I think it is because of his big beautiful blue eyes and blond hair (a VERY rare combination in South America) and probably because he smiles and laughs for them and you fall in love instantly.

The Arambulo family is very generous and is allowing us to stay in their house/condo in a suburb of Lima called San Borja for free. It is a very safe neighborhood and we have a security guard for the building (most buildings do) and there is a swimming pool. There are sidewalks and a large park nearby that we go to as well. They have a maid and her daughter, Yani, is our nanny. She is in her early 20s and is on summer vacation (the seasons are opposite in the Southern Hemisphere) from school. It takes them nearly two hours to get here everyday by bus because of the traffic (they only live like 15-20 miles away).

There are a few things that I forgot about living in Peru. First, the toilet paper does not go in the toilet but rather in a small basket next to the toilet. It's taken me a few days to get used to that.
Next, you cannot drink the water. As I learned many times before, unless you want to have diarrhea you should only drink bottled water and no ice. I still brush my teeth with the faucet water and I'd drink a Pisco Sour or two with ice but that's it.
Third, "Peruvian time" is at least 30 to 90 minutes later than they say. If you have a meeting at 11, it will be at 11:30 or noon. I forgot this as I try to be punctual ("Early is on time, on time is late" they say...but not in Peru!) I've now adjusted and to be honest, I never really know what day or time it is.
Fourth, safety is always a concern. "Should I get in this cab?" Generally old men taxi drivers are safer and I also have some "personal taxi drivers" too that I can call. "Do I want to take X (camera, wallet, sunglasses, etc.) with me in case I get robbed?" "What is the minimum amount of money I need for the day?" Luckily I am used to this and I trust that where we are living is safe to leave my passport, wallet, computer, video camera, camera, jewelry, etc. I tend to take buses because generally they are safer because there are more people but sometimes I get frustrated because they take FOREVER to get anywhere and I'd rather pay the $4 for a cab rather than $0.50 for the bus and save myself 30 minutes or more but it's a calculated risk getting in a cab alone.
Last but not least, I forgot how wonderful the people are here. Everyone has been so warm and welcoming and eager to meet Theo. I feel like I am at home. I think it is a lot easier as well because my Spanish is much better (when I arrived in 2009 I only knew a handful of words as I had studied French in college).  My vocabulary has exploded this week [mostly with baby-related words - chupete (pacifier), biberón (bottle), babero (bib), cuna (crib), manta (blanket), coche (stroller), silla de auto (carseat), juguetes (toys), etc.] and I feel much more comfortable having conversations with people.

Work
I had low expectations for this trip from a research perspective because I knew I only had a month and two of the large cohort studies on risk factors for cardiovascular diseases were still collecting data and will not be completed until the end of this year. However, I feel very fortunate that I am here this week because a very prominent researcher from Johns Hopkins, Bob Gilman, is also here and very interested in collaborating with me on various projects on diabetes. In addition, Jaime Miranda and Antonio Bernabe-Ortiz, whom I worked with previously, are also eager to collaborate on their cohort studies. I have had many meetings this week and I also set up a rotation in a very busy emergency room as well. It is one of three hospitals in the city that has an intensive care unit. I start on Monday and I'll definitely have stories to report next week!

Thanks for reading! Miss you all!
Love,
Katie

Hospital de Emergencias Casimiro Ulloa - the hospital where I am doing my rotation in Miraflores.

Jose Lopez - a Fogarty scholar with me from 3 years ago who is now a Fogarty Fellow studying tuberculosis!

The field site at San Juan de Miraflores in the neighborhood of Pampas.

The trabajadores - the field workers in the office.

The view from the top floor of the office in the neighborhood Pampas.

The roof of a house in Pampas

Julio, a Peruvian doctor, and two of the field workers, and I after are long walk up the hill and around Pampas.

The main street in Pampas out the bus window.

The traffic in Lima - mototaxis, buses, cars, taxis - and now a train that is actually working (it used to just be tracks when I was here before).