I recently was writing a friend about some struggles she is having and through thinking about this conversation have begun to realize some sin in my own life that I have been avoiding….procrastinating, you might say ;)

“...it has been interesting (Im sure you can relate...) to be ripped away from everyone/the norm and start over on your own. Honestly this is my first time and I am struggling with it on several levels. i think my tendency to "stay busy" and not take time and create a space to reflect this past month has built up some tension inside..so im dealing with that. And am thankful that God is showing me these things so I can begin to work through them now!”


When we get settled into our daily routines sinful habits and patterns seem to blend in and sneak into our work and our relationships. In the past month and a half my life has changed in many ways….this has magnified some of the sins already in my heart that I have managed to conceal from myself or just pushed out of mind.
During my time here in Peru I have noticed my tendency to procrastinate and put off difficult tasks when I am not sure how to tackle them. Now to be fair a lot of these projects or tasks are ambivalent or lack a real timeline, but they are still things that need to be done. For example, working on the independent study course I am supposed to be taking, applying to different schools or writing to family and friends back home. Sometimes this even reaches into work tasks. I am in charge of starting a blog for the clinic and updating pictures. I have done this but am not sure what improvements to make or what to do next and so updating this just gets forgotten and put back on the bottom of the list of things that I need to get done. I am still quite functional and even have time to help others with things, but I have recently been feeling the need to address this issue honestly with myself. God has given me great gifts, responsibilities and opportunities…and I must be a good steward of all of those things. And I need to be consistent and intentional about that work!

The intern book this month “How People Change” spoke of how our actions and the responses that come out of the difficult situations or “heat” in our lives are really just reflections of the heart. I was reading Jeremiah 17 this morning and really thinking about this chapter. Here are a few verses:

5 Thus says the Lord:
“Cursed is the man who trusts in man
and makes flesh his strength,
whose heart turns away from the Lord.
6 He is like a shrub in the desert,
and shall not see any good come.
He shall dwell in the parched places of the wilderness,
in an uninhabited salt land.
7 “Blessed is the man who trusts in the Lord,
whose trust is the Lord.
8 He is like a tree planted by water,
that sends out its roots by the stream,
and does not fear when heat comes,
for its leaves remain green,
and is not anxious in the year of drought,
for it does not cease to bear fruit.”
9 The heart is deceitful above all things,
and desperately sick;
who can understand it?
10 “I the Lord search the heart
and test the mind,
to give every man according to his ways,
according to the fruit of his deeds.”

Reading this passage really reminded me of the roots of the problems I am finding myself in and that my actions and habits are not really due to culture shock or communication problems, etc. (Which are a definite reality and ever present temptation to blame!) But they are flowing out of my rebellious heart! However I find great comfort in the fact that “ God is our refuge and strength, a very present help in trouble.” (Psalm 46: 1)

In Jesus Christ, God has given us everything we need to overcome these struggles and addictions and patterns in our lives if we are in communion with Him and seeking His will. In spending time in reflection and prayer and with the help of the Spirit and with accountability from my brothers and sisters I hope to move forward through repentance and in faith that this is a situation that can change...now! ;)


10 “Be still, and know that I am God.
I will be exalted among the nations,
I will be exalted in the earth!”
11 The Lord of hosts is with us;
the God of Jacob is our fortress.
Psalm 46: 10-11

Pediatric campaign in Milagro Sector 6--Tuesday

Today we had another day of the Medical Campaign with the Norfolk, VA team! We were in Milagro once again but in a different sector, and operated out of a school ('colegio') called Circulio Solidario. We saw 80 kids and also had dentistry with our new Dentist from the clinic, Angel. He saw an amazing number of patients today..I know it was more than 40. Here are a few photos...

Although by the time I got the chance to get away from triage the day was winding down and things look deserted...but I assure you they were hopping earlier! And the free toothbrushes (and worm pills) were still a big hit!

From Trujillo July 2009

Cyntia helping in the dental area...

From Trujillo July 2009

My little friend, hehe. We were teaching him to count on his fingers

From Trujillo July 2009

From Trujillo July 2009

From Trujillo July 2009

From Trujillo July 2009

Pediatric campaign in Milagro Monday

Today began at 7 am this morning when I got up to be at the clinic for 7:30…we have a team in from Virginia this week and so our first day of clinic was in the barrio Milagro which is north of Wichanzao on the Pan American. The team has three pediatricians and one physical therapist so we were limited to seeing patients in those populations.

We were based out of a Presbyterian church of another Presbyterian denomination (interestingly started and currently pastured by South Korean missionaries) and saw 70 kids today. Everything ran smoothly but in the beginning we had some difficulty because most of the children that came didn’t have their parents with them. This is because they are all working during the day and usually the kids would be in school but of course the Peruvian schools are having a swine flu scare and just decided to let the kids out a few weeks early. We weren't sure how many patients we would have if we charged for the visits, because this is a very poor area so we saw the kiddos for free. We had a great turn out and had a lot of fun as usual with them...while they waited they got to color, play games and blow bubbles. Very cute!

We finished around 1pm and went to the church in Wichanzao for lunch (always a favorite of mine! The ladies at the church know what Peruvian food the Americans love!) I stayed around until 5 in the library where I have started to volunteer. The Wichanzao Church opened this library in May and I think it is quite the draw! There are always kids and teenagers in there reading, surfing the net or playing chess and checkers (first time I've seen that in Peru!) I will be there on Monday and Wednesday afternoons from 3-5pm. It is a great opportunity for me to get to know people in the community and talk with the kids, as well as read and learn about Peru. I will help keep it organized and help children with homework or projects, or just talk and hang out. The library is not huge, but it is definitely a blessing to Wichanzao and a great chance for me to get to know people in the community.

Also, on a more comical note I had a bit of an adventure in the collective on the way home. First of all there were 9 people in the car...I was in the back seat by the window when a nursing mother and her Mom got in with me. Okay, roomy enough until another man gets in the back too and so while squeezing in someone bumped the baby..which was by the way the healthiest (fattest) baby I have ever seen. In all seriousness though it really was a sight to see! Anyway...the baby is crying and so the mother starts to nurse her. Not out of the norm here at all, in fact hardly a day goes by when I don't see that, especially in the clinic. However, it is usually not in a car with 9 people, and inches away from my face! I mean literally....whew. Anyway I just had to turn my head and laugh, I love this place! Hah, not a day goes by without something like that happening. They say laughter and a good sense of humor is some of the best medicine for culture shock and homesickness...so I'll take all I can get!

Another day in the clinic

Every morning in the clinic before the day gets going all of the staff gather together in the waiting room for a devotional and prayer led by Percy Padilla, the Pastor of the clinic. Usually we are joined by one or two early birds to the clinic, but most people don't show up until it gets a bit warmer out. Well, Tuesday is the day that Dr. Mario (one of the Peruvian physicians) attends patients in the clinic, and he is quite popular with the people in the neighborhood so by 8 am our little clinic was full of patients! So everyone had to stand because we didn't have enough chairs...such a blessing to have a room full of people to hear God's word but not when there aren't enough chairs! When I first got here I wondered why some days the clinic almost seems dead and others it is just bursting. I quickly found out this has a lot to do with the physician that is attending patients that day--and Dr. Mario is a favorite. To get you up to speed there are several Peruvian doctors who work in the clinic during the week. Occasionally we have teams from the states in the clinic or a doctor will come for a week or two, but the day in and day out patient care falls mostly on our Peruvian doctors who can serve as primary care physicians (although this concept isn't widely practiced here--most people come out only concerned with immediate needs).







The last patient I triaged today was this elderly man from the Sierras who was a farmer (agricultor....paltas/avocados, manderinas, limon/lemons). He came in with a complaint of some chest pains. I was trying to take his blood pressure but the machine kept giving me an error signal, so I went and found a cuff to take it manually (*We only have two stethoscopes in the clinic so I use mine all the time..Thanks Mom!) I had a bit of trouble though because this guys pressure was through the roof! We had a good little talk afterwards while I was taking his medical history. He was born in the Sierras in Huamachuco and was about 78 (I think...he wasn't sure so I just kept throwing years out at him and he eventually decided on 1931!). He told me about the different places he had lived in Peru and things he had seen. He worked around Huaraz for a long time and told me about that area. I am hoping to go soon with some of the other interns....there is a good bit of climbing there and it is supposed to be beautiful. He said there is always always snow and ice, and bitterly cold at night but so beautiful. He also taught me my first bit of Quechua..bread (pan in spanish) is t'anta. I love talking with the characters that come in...so fascinating to learn from them and they have had some very interesting life experiences.

One Month Anniversary

So I never thought I would be able to admit this...but I am definitely feeling some culture shock after one month here in Peru. I was sick this past week (finally!) and I think that broke me, hah. I was in denial about it but I definitely miss everyone at home (the food too!).

I am starting to get settled here after a month. Well, at least I am past the point of being nonfunctional! The first week I was here I couldn’t get around by myself anywhere or go to the store and now I feel completely confidant in doing that. I’ve figured out how to cook pretty well on our little stove, and to wash clothes. Sounds easy, but it’s not! The washing machine doesn’t have water so you have to fill it up and watch it…refilling when necessary. Very time consuming!

Every week here has been completely different. My first week we had a medical campaign here in Trujillo, the second week was spent in the clinic getting to know everyone and how things work…checking out the neighborhood etc. Then the third week I was in Cajamarca, and now I am coming to the end of week four—a normal week in the clinic. This week has been great and has allowed me some time to talk more to Dale and Lora and reflect on what my role in the clinic will be this next year. A lot of things will be changing and I am trying to get oriented to the administrative and clinical responsibilities I may/will have over the next 11 months. On a normal day (I use that in the loosest sense here in Peru) I leave my apartment at 7:30 to be at the clinic for 8:00 and work until about 2:00. Most of my time thus far has been spent in triage with patients. If they are new I put together a new record for them and go through a few basic questions on personal and family history, etc. Apparently this is not commonplace in Peru…most people only come to the Doctor when they are sick to get medicine for their chief complaint and then they are outta there! So unless I explain why beforehand, people look at me like I am crazy when I start asking if they have diabetes, HIV (slightly taboo as you can imagine) or asthma. But once we get through the history I take vitals, weight, height, etc. and try to talk with them a little. Being in triage was definitely stressful at first, I had no idea how to ask these questions, how to spell names or street addresses or what to say but being thrown in and having to figure it out was the best thing that could have happened. It was quite humbling…and I have learned so much Spanish this way. It actually puts the patients at ease a little I think when I can ask them a question about my Spanish. It makes them feel like they are helping teach me and we both get a laugh out of it sometimes..either that or I just feel embarrassed and silly!

In the afternoons I read, do random things for the clinic (setting up a blog, photo albums, writing thank you cards) and I also try to study a little bit. This week I am starting Spanish lessons with one of the Peruvian SALI teachers—Rebeca. I’m reading a lot of books and lecture files online as well as watching videos on the internet to learn basic skills such as auscultation so when we go on house calls I can get an update on how the patient is doing. I try to get the Peruvian doctors to explain things, but we are not just faced with one language barrier but two! The Spanish is tough but when you throw in medical terminology sometimes things get lost in translation. But thankfully most of the words are very similar!

We don’t do house calls every day, however if we have a mother with a newborn, or an older patient who is not able to get to the clinic sometimes Dale Ellison (Peru Mission missionary who runs the clinic) and Percy Padilla (the Peruvian Pastor for the clinic…both awesome guys!) and I will go out and walk to Wichanzao or Clementina, Primavera, Los Pinos, Alberto Fujimori or some of the other developing communities where patients live. We visit for a minute, do a quick check up and then Percy will read an appropriate passage of Scripture (often a Psalm) then we pray. These visits are mostly pastoral in nature, so we can let them know we are checking up on them and looking out for them...it's a good opportunity to address spiritual and other concerns.
I really enjoy these visits, for several reasons but certainly because it brings an increased awareness of the raw reality of the ministry here in Wichanzao. Put yourself in my boots for a second on a sandy hill (a dune really) in Clementina: You are standing in front of two women and their children (no men sight)and their home…mostly made of sticks, woven plant fiber and cardboard (plastic or tin roof if they are lucky). The sky is dark grey and it’s misting…the fine, sticky kind. Percy is reading a Psalm in his strong quiet way and you are trying to listen to the Spanish but this thought keeps pressing into your mind of how when you leave everyone will just file back inside and sit…sometimes hungry, probably sick, and definitely, always dirty. And you know that at the end of the day you get to go home to a hot shower, electricity and good nutritious food…probably with desert. The only thing you have to remind yourself that you were even there is the sand in your shoes and a few black boogers from being out in the desert for an hour.


I feel like in my short time here in Peru I have seen medicine, hopelessness, poverty, faith and kindness in some of their purest forms. Don’t get me wrong I am probably making it sound terrible...but it is not all bad here and there is progress being made. The church here in Trujillo is living and active and growing. But there is so much hurt and worst of all loneliness here…the kids, the fathers working all day in their cabs or a dead end job, the housewives alone in the house, the elderly woman who lives on the street corner by our house.

“There is so much suffering in the world—very much. Material suffering is suffering from hunger, suffering from homelessness, from all kinds of disease, but I still think that the greatest suffering is being lonely, feeling unloved, just having no one. I have come more and more to realize that it is being unwanted that is the worst disease that any human being can ever experience. In these times of development, the whole world runs and is hurried. But there are some who fall down on the way and have no strength to go ahead. These are the ones we must care about.” –From In the Heart of the World by Mother Teresa

Christ served at every level of society and in many forms...but he always met the immediate needs of the people he was ministering to. He fed them, comforted them, healed them, gathered to talk and eat with them and then he preached to them. I think that as long as we are seeking to follow this we will continue to see the Church and Gods kingdom grow in this area of Trujillo. Please pray for the staff and missionaries as we witness to the lonely and lost in this community. It is our hope that we are lights of Gods grace in this neighborhood and that we will continue to be prayerful, conscientious, and consistent to that end.

Team from First Pres Jackson, Mississippi in Cajamarca

This past week I was in the mountain city of Cajamarca with the First Pres Team from Jackson, Mississippi led by Dr. Danny Story (who happens to be the father of one of my roommates Sarah Story, who is also here interning in Trujillo). The team was split up into dental, medical and VBS teams, and I worked mostly with the medical clinic inside the church. This team has been coming to Cajamarca for the past ten years and really had an incredibly organized system. For anything to go that smoothly you knew many years of trial and error (and a lot of prayer and planning) went in to getting ready for that week! We had a great week of clinic and saw 589 patients in medicine, and probably more…but that was the official number. I was in triage with two other nurses, Emily and Sarah Elizabeth and we each took vital signs and triaged up to 70 patients in a day. I really enjoy triage for several reasons, first of all you are the first person they talk to about their problems, which are often sensitive and personal, and I was able to show some compassion and provide some reassurance that they would be in good hands. Probably one of my favorite things I get to do in my daily work isn’t even related to medicine…I really just like to comfort people and touch them, put their shoes back on, hold their hands, talk about something random or make them laugh to get their mind off of their worries. I find that once people can relax they are much more open to being honest and bringing up real, deeper concerns. Also, on the practical side this was the best opportunity I have had to practice my medical spanish and (attempt) to translate. Its really out of pure necessity that you are forced to do this because there simply are never enough translators. So I was very grateful for the practice and I hope to be translating for the teams that come late in the summer...Although this week I felt completely inadequate, humbled and often frustrated with my lack of knowledge!

We saw a lot of arthritis and associated joint pain as well as infections, coughs, the flu and other common issues. For a number of adults we saw this was their first visit to a doctor. It never failed to amaze me to begin clinic at 8 am and triage a woman who was in for arthritis and joint pain (along with at least 5 other problems, and more if I would let her), yet when I asked her why her hands were dirty she told me she had been digging potatoes in the cold early that morning! (It is literally freezing at night in Cajamarca) To be first in line I know she was there at 6:30 am, so who knows how early she had gotten up to begin work. Peru is like that…all around are constant little reminders of how difficult life here is and the constant fight for survival.

The most common complaint was people just complaining of total body pain, especially their backs, which I didn’t understand until after the first day of talking with them about their problems and lifestyle and watching 4 ft tall women carry a load on their back that was bigger than they were. In the states I saw a lot of preventable issues revolving around hygiene, and although I knew diet and vitamin deficiency was a problem here I never really realized the effects it was having on people. A lifetime of hard, physical labor and a diet that doesn’t include much more than meat rice and potatoes makes vitamin supplements essential here and we always need more. In fact vitamins (pronounced something like bee-ta-meen-as in Trujillo) was one of the first words I learned in the clinic in Trujillo, and to my initial surprise one of the most often prescribed treatments. Back home if I went to the doctor with a serious complaint and he gave me vitamins…well, I would go find another doctor. But here this is a very serious issue that manifests itself in all ages and types of illnesses, and a deficiency is often the underlying cause of a problem.

In Trujillo (and I believe other large coastal cities), it is customary (and expected) to greet everyone in the room with a few words and a kiss on the cheek, and touch effectively establishes instant feelings of friendship and familiarity. After a few encounters I quickly found out this wasn’t so with the mountain people! They are much more reserved and less touchy…probably good from a health perspective! I noticed a whole lot of eyes on the ground this week too. The people from this area have a long history of exploitation by other people groups and are often stereotyped as uneducated laborers. But for me this week was the closest I’ve felt to home in a month! I was right at home with the cows and barbed wire fences and hay….the backdrop of the Andes wasn’t bad either until I thought about how far people had to walk to get somewhere. Another habit of the people in Cajamarca which I quickly picked up on and found very entertaining was their tendency to add “–ito” to the end of many of their words. It is more or less the equivalent of adding “little” to the beginning of a word. For example, one of the MDs was called “Doctorisito” by a lot of little sweet old ladies. Now how many American MDs do you know that like being called “little doctor”?! However this is certainly a term of endearment and only given with good connotations as far as I could tell. I got a lot of “jaaaa hermaniiiita….por favorrr” and “doctorisiiita” which I quickly had to correct with the equivalent of “Ahhh no sister…I am a..Ummm…little student!” This was all very funny to me until in the latter part of the week when an 84 year old woman with one eye, a cane, and no shoes called me "little sister" and cupped my hands in hers to tell me thank you for seeing her. That was quite a moment for me...especially when I looked at her address...she had walked for a few miles on rocky roads to see us that day. How humbling. That gave me much encouragement, two seconds earlier I was thinking how much my back hurt from craning over trying to listen to soft voices for 4 days. I felt pretty ungrateful and ashamed of myself...had to take a step back. Just another day in Peru, ha! I really enjoyed my time with this team, they were so supportive of each other and a joy to work with. I know they are a blessing to the congregation and community each time they come. They also left many things for the clinic in Trujillo, which we are very excited about!