Arequipa Public Health

Every two days Layne has to see a doctor to get her leg surgery checked. She’s not supposed to walk on it much at all so we are not wandering around doing interesting things. 

I walk Rusty, we sit and read, Layne with leg up, we cough in alternating barrages as we struggle to get over our head colds. What a pair of crocks we are.

It’s not actually not bad sitting in the sun with Rusty snoring in the tall grass heads in Kindles so we make the most of it, like CNN proper retirees. 

I am getting a little restless as my cold is giving way finally and I am starting to feel actively human again, so I’m planning a photo walk with my camera to spend some time not feeling completely stationary. 

It’s an odd thing about making a journey with a goal even with an open ended timeline in that the compulsion to move is always in my mind. I like being a nomad and I don’t like seeing GANNET2 gathering dust in a campground. But we’re in a good spot for what needs to be done. 

Yesterday we had to show up at the public hospital at 9am to have the surgeon inspect the site of the skin cancer removal. After a delay as we waited among the crowds of applicants for medical attention the surgeon cleared the wound and changed the gauze and pronounced it excellent. The pain has been far less post surgery than in past operations Layne has been through. 

But the public hospital - oh my. People line up outside some doors and crowds gather around others as though besieging them. The pressure in the staff is unsustainable and the stress shows. The staff are efficient, short tempered and firm in holding back the begging petitioners waving paperwork through the gaps in the doorways.  

It’s horrible to jump lines, to get picked out by the surgeon and watch the eyes follow your gringo back. It would be worse to have to join the petitioners as we just aren’t used to pleading for our lives. We’ve lived with decent health insurance, we have expectations even here in Peru where we paid cash, four months of minimum wage, for service. Want to know what it feels like to be the richest patient in the corridor? Come here for a check up. 

We have another appointment Wednesday for another check up, which may or may not be here or at a clinic. 

It was a relief to get to the sidewalk and wait for the Uber. I keep thinking about getting a terminal diagnosis here. It wouldn’t be like the attention I got at Jackson South in Miami with my city insurance. 

It may be a hospital but it is also an economic opportunity. 

I need to photograph something pretty for a change. In a week I fly to Miami. It will be interesting to photograph the Overseas Highway again. That will be a change. 

Recovering In Arequipa

So what do you do if you get sick and you…you live in…a van? You recover or die I guess are the only two options. And if you plan on recovering having another person to help out would be useful. I rather failed there, because as Layne prepared to have surgery on a big black spot on her leg I came down with something that felt like Covid. I tested myself and it wasn’t but I was knocked flat.

The owner of our campground kindly turned us on to a skin doctor in town and we Ubered to see her in her office at the San Juan de Dios private hospital. It took her five seconds to establish Layne had two skin cancers that needed to be removed. The one on her arm was no big deal but the one on her leg looked more involved. She said neither had the characteristics of serious cancers (biopsy to follow of course). 

Then she set us up with an appointment with the surgeon and told us she was transferring our $26 consultation fee to his office as she hadn’t really done anything. That blew us away there and then but there was more. 

On the streets of Arequipa life went on as normal and we had this surgery appointment hanging over our heads. 

Our travel plans were on hold until we knew what exactly was going on here. We have permission to be in Peru until October 10th so that isn’t a problem and down south it’s still winter barely moving into Spring so we are in no hurry to travel to Patagonia just yet. 

On the other hand I do miss driving and seeing things but this is an excellent place to stop. The weather is perfect in dry season, sunny day follows sunny day with cool nights and no variations. 

It wasn’t an easy time for Rusty who kept finding himself closed in the van when we had to take an Uber to get another medical appointment. We’ve tried leaving him outside in campgrounds but he howls miserably at the gate so putting him in the van is the best answer. He sleeps and it’s where he knows he belongs. 

Before the surgery Layne had to meet a cardiologist to do some tests to make sure she was safe to receive a local anaesthetic  and that was one more appointment. The ability to speak Spanish is very helpful as English is not readily spoken in Peru. The surgeon had some English but we understood each other in Spanish. He explained we could have a small cut for no scar or a wide cut which would heal more easily but would probably leave a scar. He illustrated it thus: 

Last time in the US Layne got a very small cut and it took months to heal and very painfully. Layne opted for the long cut which would allow skin to be folded over the wound making recovery simpler and faster. His patience explaining this stuff was remarkable. 

The fee for everything including an overnight stay for observation, with a crappy breakfast (below) and follow up visits totaled $1200. Not only was that affordable (for us, not necessarily for your average Peruvian) but Layne got excellent care. The surgeon checked her wound and rebandaged it the morning after, the nurse handed him the gauze but he applied it. I’ve never seen that in the US. The long wound was already less painful than Layne’s previous surgeries. 

We have follow up visits scheduled with doctors checking the wound every couple of days to ensure nothing goes wrong. In the US when Layne complained of pain the medical center assured her over the phone that it would pass. It did but it took six months. 

Back to the van with me enfeebled by my cold and snuffling. A wheel chair to the curb where an Uber awaited.

The first follow up was in a public hospital and we got to see free medical care in action for people who couldn’t afford a $26 dollar fee. It was crowded with huge lines of people standing in vast crowds outside each door to admissions or consulting rooms. 

Again the doctor herself checked the wound and put fresh gauze on it and gave us instructions for applying antiseptic over the weekend.

I tried to snag a photo of the crowds and failed rather dismally but it did not look like fun getting an appointment  there. 

Layne was walking well and we stepped outside to wait for the Uber. 

One weird thing was the street filled with funeral parlors. Judging by the cab loaded with new coffins for delivery business must be brisk. 

And if we feel the need we have a design specification to convert our Promaster into a hearse complete with hooks to hang wreaths off the roof:  

And we got a ride home to GANNET2 and Rusty in a Jet Tour X70 a Chinese SUV you’ll never see in the US. It looked like a regular car to me but what do I know? 

We both have felt the level of care throughout this business has been excellent though being able to speak some Spanish, and medical terms are tough, has been very helpful. Laynes recovery is going so well I have tickets booked to fly to Miami on the 10th of September. A four day flying visit to Key West  for a new driver’s license. That trip will cost almost as much as Layne’s surgery. And we could still afford another $26 consultation fee if we had to. We are the lucky ones.

Sins Of The Flesh

I have been unable to post these past couple of days owing partly to my own suddenly poor state of health, inasmuch as I have a rather debilitating head cold. With Layne having surgery for two skin cancers my timing could not have been worse.

Happily all went well though they kept Layne in overnight just to make sure the wounds start healing properly. They were very thorough before during and after the skin cancer surgery at Clínica Florez in Arequipa. 

Rusty went looking for Layne when I came home to feed him but settled down patiently as I came and went during the operation Thursday evening. He is a good and patient dog. 

She should be home today and if needs be we can rent a room here for her at the campground’s hotel. I meanwhile am coughing and spluttering and slowly recovering. It’s been a bit rough one way and another.  

Cooking Class

Rusty and I walked Layne to her cooking class Monday morning. I have no patience for cooking so I do the washing up. I enjoy seeing clean plates appear in my hands from a soapy mess especially when we have unlimited water at a campground sink. 

Rusty took a long circuitous walk home and I followed on the end of his leash. Past the Chinese car dealership that has moved..,

And along the riverfront which we cannot actually access because there are walls everywhere. 

Another breezy hot perfect sunny day at the campground at Las Mercedes Hostel. A Kindle and a chair. 

Layne meanwhile was playing with fire. 

And producing piles of spicy Peruvian food, bell peppers stuffed with spicy ground beef…

And a pile of potato avocado and shrimp. She brought home samples and they were quite delicious. 

They also made Peruvian ceviche with the big soft corn called “choclo.”

21 Germans showed up all at once at the campground in a rolling hotel. They travel with bunk beds in the bus, cook their food and spend three weeks together. 

Layne got friendly with the leader/driver/cook who works twenty days on and twenty days off and said he might be organizing a trip to Ushuaia at the southernmost tip do he might see us there…the occupants were a mixture of all ages and quite friendly though they were gone in 36 hours.   

We left Rusty at home aboard GANNET2 and took a stroll into the Plaza de Armas, the main square, which was concealed by the Spanish as it was where they drilled their soldiers in public. Nowadays it’s where lovers and families and street food sellers gather. 

We bought some chicken tamales and some beef skewers with potato grilled on a  street corner. We take street food home for dinner many evenings. 

We aren’t alone in thinking Arequipa is the prettiest town in Peru. 

And at 7400 feet is quite breathable. 

There is a bar nearby called the Pisco Museum so after we collected some cash at the ATM we stopped by and tasted four different Piscos which is the national firewater of Peru. 

Pisco is a grape distillation which if it were French might be called brandy or if it were Italian, grappa. They grow eight different varieties of grapes in Peru and make brandy from all of them. It’s known as Pisco for no known reason, possibly from a Quechua word meaning “a pot” but it became known abroad because barrels of the stuff were exported to Spain from the port of Pisco which we drive past on the coast, and which has nothing to do with the actual production of the spirit. It’s a bit like Tupelo honey coming from Tupelo blooms and not from the Mississippi town of that name. Robert our guide:

Pisco is about 42% proof and I actually enjoyed it more than I appeared to. 

Then she told me to smile. 

This is a slightly perfumed sipping Pisco that I quite liked. 

And so home to bed. No worries walking Arequipa by night.