Never knowing what to expect!

I never know what to expect in any area of my life here except perhaps for the unexpected! The arrangement with my host family is that I eat meals with them so I eat what’s put before me. And fortunately most of the time I like the food here especially since there are fishermen in the family. One day this week, my host brother brought me fresh cerviche with something he called pupa and described as a large squid with tentacles full of teeth that can pulverize your arm. Today, there is no water except for a bucket from a neighbor’s house. You never know when the water tap on the front porch will start to trickle and the family mobilizes to full the water tanks before it turns off.
The same is true of working here. Today I went to the clinic to work with the obstetriz (equivalent to a nurse midwife in the US). She asked me to do nutritional counseling with prenatal patients which I did for about an hour when no more patients were coming to the door of the room I was using. I went out to find the obstetra had left for the capitol city in the ambulance with a patient. I had a meeting scheduled with someone else in ½ hour so I stayed around but the meeting never happened. I’m never sure whether I misunderstood or plans changed.
Then this afternoon I went back just as the health post doctor was doing routine checks on the older adults. He asked me to do nutrition counseling with them so impromptu, I met with about 20 older adults and inquired about their nutrition, encouraged them to increase fruits, vegetables, milk and decrease salt and sugar. This was a great learning opportunity for me as I bumbled through with my weak Spanish bolstered by their graciousness. As is often the case, they were teaching me about life here which is indeed quite difficult. Most of the people I talked to didn’t have money for canned milk, fruit or yogurt. And the idea of vegetables includes yucca, potatoes, sweet potatoes and more potatoes with occasional carrots, beets or peas. And of course there was the 84 year old man who talked so fast I understood only a few words but did understand that he wanted to dance with me and would like to have a woman to hold. All I could do was laugh and make a quick decision that any kind of talk about nutrition with this guy was really out of the question!
Sometimes I just don’t have any frame of reference for the lack of resources. The health post doesn’t have any more water than the rest of the town which means there are no hand washing facilities in exam rooms or staff bathrooms. The dentist has a water barrel and pitcher for hand washing. People do the best they can with what they have so I look for the strengths. The staff is caring and proud of their work which includes a lot of education around prevention. Several days a week, I’ll be working house to house with a health promoter. The health promoters here are often nurses who live in the community and know every family. The privacy mandated by HIPPA is a long, long way from Peru! Every house has a metal plate with the number (not the address but the house number). The health post has records of who needs vaccines, who keeps water tanks covered to prevent breeding of the mosquitoes carrying dengue, etc. I was encouraged to take photos of families after I interview them and jumped through my hesitation to find that most people wanted their picture taken. Next week, I start doing formal interviews and keeping data with the goal of interviewing 100 families by the end of February. Most of my questions involve nutrition, water sources and whether the house has a latrine, toilet, or the family uses the open fields.
So I start most days with some kind of plan and a LOT of flexibility for the unexpected!