Day 20 – Opportunity: We took a day off but are back with Day 20. The following story comes from HBI’s Medical Director, Dr. Bob Gehringer. Enjoy!
Dr. Roberto Tarazona, my HBI colleague, and I finished a newborn resuscitation workshop for neonatal nurse specialists in Ica, about 5 hours south of Lima in the coastal desert. Given my aversion to overnight buses on bad mountain roads and my tendency toward motion sickness, I opted for a car and driver to get to Ayacucho, a moderate-sized city in the Andean Sierra, where we had another training event.
It was a good decision, given a highway of curves and switchbacks for much of the way. Upon leaving Ica in the morning with Luis Antonio, a lovely young man from nearby Pisco (and yes, the city from which Perú’s signature jet fuel alcohol gets its name), we zoomed north on the smooth new four-lane highway while listening to classic rock, past huge agribusiness fields of grapes, cotton, asparagus, mangos, olives, and avocados. Desert sand irrigated to a lush green, as long as the shrinking Andean glaciers hold out in the face of climate change.
Upon turning east, the fields became smaller, and the contrast of patches of green field and desert sand was stark. As we ascended, the vegetation turned to cacti and small shrubs. As we passed multiple slot canyons with dry boulder-strewn arroyos, the highway had frequently constructed dips to allow water to flow across when the arroyos quickly became pummeling streams.
Our vehicle for this high Sierra adventure? An older Nissan with duct-taped front fenders and a cooling system chose this day to die. Our engine overheated for the first time at 13,200 feet, and as we pulled to the side, radiator boiling and steaming, a bored-looking tethered donkey stared at us listlessly while music from the car played, “Put me in coach. I’m ready to play, today…” You can’t make this stuff up.
After scrambling down a boulder field to find water in a tiny stream, Luis refreshed the boiling radiator with dirty water strained through a rag. We repeated the process three more times before cresting the continental divide at 15,600. Four more stops across the altiplano and the down slope, adding four hours to our anticipated six-hour journey.
We passed herds of alpacas, llamas, and even scattered wild vicuña, the world’s softest and most expensive wool. There are rock corrals and fences all over up here. Who would hand construct a rock fence at least a quarter mile long at over 15,000 feet up a steep mountainside almost to the top of a peak? I have no idea how people survive here.
Once we crested the continental divide, we started the long descent – and this is where the road started falling apart, victim of frequent freeze-thaw cycles, yielding massive potholes and occasional fallen rocks in the right-of-way. More slow going, passing trucks in low gear, but finally down to the tree line, and the city of Ayacucho coming into sight.
Ayacucho was the epicenter of Peru’s internal war in the 1980’s and 90’s. Thousands of people died and disappeared by the army and the Sendero Luminoso guerrillas, and hundreds of thousands were displaced to the cities to seek safety. Now, Ayacucho is a center of Peru’s cocaine trade, and we were checked twice by police along the highway.
Over ten hours after departing Ica, we made it to Ayuchuco. Tomorrow, I have another day-long workshop supporting the regional newborn resuscitation teaching program and our two local College of Nursing of Ayacucho trainers as they train colleagues. It is an interesting adventure and an excellent opportunity to make an impact.