Saturday, June 5, 2010

Update

Due to a family health issue, I will be returning early to Seattle. I hope to leave you all with a small photo capture of Lima and some rambling thoughts at a later point. With love
m

Studying the sociology of sexual health in Lima, Peru

On my first day of work my colleagues told me that, in order to arrive safely, I would have to sprint the three blocks between the bus stop and the Barton health clinic in Callao, on the outskirts of Lima. I spent that day observing gynecological exams given to female sex workers from the neighborhood. For someone who usually gets queasy just seeing a q-tip change color as it´s dabbed, zooming in with a camera and watching cells in the cervix change color was pretty intense. The next day I observed the treatment for male patients, including one young man who tested positive for HIV, syphilis, throat bacteria, and a urine infection. We also advised a young man on which hormones might be most useful in becoming more physically effeminate. Next came a day with the clinic social worker, in which we talked with a 17 year old working in order to make fast money in order to pay for her father´s medical bills. Though prostitution is legal in Peru, it is only legal in government certified locals, for women over 18 years of age. A record of health checkups is also required. As an experience with reality it has been both shocking and also inspiring, if that can be understood.

The Barton clinic is working with the University of Washington to research HPV/HIV infections in the sex worker population of Callao, as well as looking at the effects of violence and pressure on incidence. Every afternoon the clinic provides free exams and treatment to sex workers from the neighborhood. Each patient also meets with an on site social worker. The clinic runs an outreach program using promoters, who bring in folks to the clinic, and site visits to local government approved brothels.

Every one who works here and who comes in have struck me as just lovely and incredibly strong. It´s been really marvelous, and I often wish that these doctors could see themselves the way I do, if only for a moment. 15 plus years in the clinic has made their work into a routine, as is the usual way of things. To me they are incredibly inspiring folks, doing work which I find to be immeasurably important and neglected, in an isolated corner of a huge city in the vastness that is Latin America... such programs are just such tiny specks in the face of social ills, or social change, or reality, however you want to look at it. But one thing I´ve learned this year is to really appreciate these bastions of health and constructive action amidst what can be very dismal or difficult spaces. And the whole system runs on paper and stamps! No computer database at all!

Of course personally my mind is all over stimulated with fantasies for the kinds of ways that I could intersect with this kind of work without becoming an MD toting doctor. Ideas of sociological studies incorporating oral histories, working simultaneously to empower and support these vulnerable populations (esp with the women) while working hand in hand with public health programming (which doesn´t currently exists) to form larger projects to improve living conditions etc. Projects dealing with drugs and homophobia, violence and pressure, antagonism towards immigrant populations, and so on. How exactly to get my hands on this sort of work and make it happen is still a mystery, but that´s part of what keeps me young and idealistic, no?

Also, June 2nd was international sex worker rights day! Which originated in France. I marched with a collection of sex workers and their supporters through downtown Lima, wearing a glittery mask and waving a little noise maker. Sort of a strange place to find oneself, unexpectedly. We were such a small group that it felt like the police were making more of a cage for us than a protective barrier... but I think it was good for the jarring of many Limeños senses, a good kind of message, and folks were generally pretty positive on the streets, if shocked. Of course the general sort of condescending humor directed at the scene was hard to counter. But still, I think visibility is important for the movement.

Lima in general is a strange place. It´s hard to remember that it´s a desert city on the edge of the sea, or that it´s old, or that it´s in an Andean country. I love my neighborhood. Lima sits along the Pacific ocean along a set of cliffs that drop off to beach access, and Barranco, my neighborhood, looks out over the water via a series of tiny alleys and bridges. People keep telling me to fear for my life in this city, but I feel pretty alright most of the time. I have a lot more exploring to do, and no time to see even a third of what I would like to in Peru in general, but so it goes. I went trolling through some museums- found an exhibit on the indigenous art movement and one documenting the times when the MRTA and Sendero Luminoso and the government created a state of civil war and mass deaths in Peru. Tried very hard to locate myself in time and space, remember how close all the Andean culture is both historically and geographically from here. I wish I had more time to be out of the city. I miss Bolivia.