Floating reed islands, Colca, Quinoa

Heron contemplates own mortality.
Floating village, Uros.
The floating island's edge and boat made also of totora reeds.
Heading into Colca Canyon.
Quinoa growing.

Home solutions, funerary chullpa, alpaca

Playpen at farmer's home in Puno. Add sheepskin liner and child.
Homemade remedy for backpain and rheumatism - snake oil.
Uninhabitated island (tour guide said something about wild boar, foxes and snakes). The views from the Lake Umayo Peninsula, where Sillustani, are my favorite in all the year's travels.
1 month old alpaca. David Bromwich and Gautum Siram, this is for you.
Funerary chullpas built for nobility, from the Incan period, but from another culture, the Colla. The carved stone block structures, reaching as high as 12 meters, are supposedly much more sophisticated than anything the Incans built. Complete family remains, along with food and objects, could be stored inside. There are tiny crawlspace entrances facing the east on each tower, that were supposedly sealed immediately after burial.

The Colla spoke Aymara (the language more associated with Bolivia, as opposed to Quechua) and were warriors. They became the southeastern part of the Inca empire.

More photos from Puno and Colca

Mirador (scenic overlook) with statue of Manco Capac, apparently synonymous with lover's lane. Miranda, from the Puma Mirador, in front of Lake Ti Ti Ca Ca - Quechua for gray or stone Puma. Not titicaca, but ti ti ca ca in quechua.
Uri - " did you really get the condor in it?!!!" From Colca Canyon.
Cuye (guinea pig) topiary. University Arequipa.

Arcoiris (rainbow), Amantani.

was at ethics conference mon. tues.

Some random photos on return to Lima

Friend and lifelong extreme headstand competition, Anthony Broadman, sends this along from greater than 14000 feet. The sierra in California?
Totora reeds and headstand on the floating reed islands of Uros on Lake Titicaca. 3800m (less than 14000 feet).
Anne, Uri and Miranda on the non-floating island of Amantani - after hiking to the temple of Pachatata.
Answering questions at the CERI in Arequipa - from March 16th entry.

The best photo from the last three weeks. stone arch, man and mule, lake titicaca, wheat. Amantani. More photos to follow.

Puno - beautiful!

Took a wet freezing cheap 6.5 hour (ok miserable) bus ride to Puno from Arequipa for a breathless reunion at 3800m with Uri and Miranda around midnight.

This morning climbed to a few miradors and after hearing Puno was not much to look at from several people, was surprised at how beautiful it is, nestled between mountains at the mouth of the lake.

In the afternoon we went to Sillustani - where there are tall incan funerary columns -and passed some of the most beautiful landscape I have seen here in Peru. Lush and mountainous, lake shimmering from every angle. You can see the weather approaching from a distance.

Miranda and Uri had a fantastic time in Cusco- witnessing their continued eccentric inexhaustible excitement about the cuyes (guinea pigs) and all the camelids today is great. Very fun to be together.

Had tasty trout and pejerrey (king fish?) from lake Titicaca tonight for dinner.

Tomorrow morning we get on boats to spend the night on some islands.

Will have many photos to show later.

Llama Sneeze Run

Took some great windy dirt paths along the river, and saw the llamas. Saw one start and do something that looked more like a sneeze than spitting.

Also saw a huge old tortoise, sheep and ostriches. All in the Selva Allegre park.

Got the Arequipan specialty Queso Helado (literally Cheese Ice Cream, or just Cold Cheese) on the way back. Sounds unappetizing perhaps, but tastes fantastic.

¨MODS implementation: a convoluted mess¨ now titled ¨MODS implementation: an extremely long convoluted mess¨

I think it's going well.

An extremely excited friend congratulated me yesterday after reading the ole blog on finishing my project - let me clarify: The project is no where near being done!

St. Patrick´s Day in Arequipa and Rules for Running in the Urban Granja at Altitude

Rules for Running in the Urban Granja at 2200m

1. Do not, under any circumstances *, attempt to keep up with a running partner who has run 5 marathons.
2. Types of excrement to avoid: cow, sheep, goat, dog, comments of construction workers
3. Kohn for uphill segments: “I cannot induce pulmonary edema with exertion.”
4. If no rabies vaccine, let sleeping dogs lie.
5. Give wide perimeter to llamas. They spit. (Okay, so we didn’t see any llamas today. Tomorrow’s run. They do spit.)
6. Enjoy: terraced green chakras with farm animals feeding amongst growing maize in the middle of a sandy white stone city against a backdrop of snow capped mountains.

* including your running partner arriving from sea level yesterday and you having nearly two weeks to acclimatize

*especially the morning after St. Patrick’s day

As a half blood, I may have been the most Irish person in Arequipa yesterday. Irish heritage did not stop many Peruvians and a few Englishmen from celebrating at Arequipa’s Irish Pub. Flaherty’s served up pisco sours and Arequipena beer with so much dye my lips and tongue were still green this morning. (I did ask for “Lo mas verde que tiene.”)

Am skipping going to Cusco with Uri and Miranda in an attempt to write a paper draft this weekend. Motivation to make efficient use of my time, but so far am at draft #1a with meta-title ¨MODS Implementation: a convoluted mess.¨

In the corner of the apartment where I am working, that there are many bees pollenating the very pretty lima (tiny little lemons, I think) tree outside the window.

Chilly here. wool sweater and scarf weather when the sun´s not out.

a satisfying day

The data got cleaned, the graphs were made, Dave arrived in plenty of time, the talk went well.

Even better, there was no going home to pass out from exhaustion afterward....as the last case of the CERI - the committee of MDs which reviews MDR TB cases - was presented, Uri ran out to check his match results and got his first choice for residency: Montefiore. Hurray!

Dave took us to a very celebratory, very memorable lunch. Uri and I agree; my boss is the best.

We even managed to get a little work done before Dave caught the plane home.

curious pitstop #2 and data marathon

At 5.30am, this sign seemed funny. this yoghurt shop had the nicest roadside bathroom in all of my travels in Peru. Panamericana Sur, arequipa to Camana.

bleary eyed from data entry and cleaning. uri has been helping too. think it will come together. Am only missing questionnaire number 87 of 803, my stapler and photocopies from two of 45 centers. Given my track record, this trip (sunglasses 2x, camera, binder of data - all found) I think these will all emerge. de la sol has been keeping me going. have also been listening to bacilos, columbian group introduced to me by sergio - for tb data entry, what could be more apt? arequipa is sandier than i remember - layers collect on my computer in hours. the high altitude desert apparently includes the city. still really like it here - lots of character

yo hablo espanol

Gave a 45 minute talk today in Spanish about MODS, the collaboration to implement the test here in Arequipa, and the preliminary results of my data -despite incredible pre-charla anxiety, I think it actually went well. Only one of the 23 nurses who are the heads of the TB programs throughout the department of Arequipa fell asleep.

Am preparing the rest of my newly acquired data for Thursday and then am off to travel next week with Uriel Felsen and Miranda Von Dornum - both boldly missing THE MATCH on Thursday at Sinai but making up for it by heading to Macchu Picchu Sunday.

I´ll probably catch up with them at the highest navigable and best named lake in the world: Titicaca.

Uri arrived just in time, late saturday night, to be my epidemiological knight in shining armor and help me figure out how to label axes in powerpoint.

Am excited about the project these days - many good things all at once here in Arequipa.

40 in 3.5

Have visited 40 health centers in 3.5 days to clean data and get some more information. One final visit this afternoon.

Skipped Puesto de Salud Quilca in Camana because it was a half hour drive on a sand road the rental car couldn´t handle.

Puesto de Salud El Toro in Islay, the other center from whom we have data but didn't visit has to be reached in the rainy season by climbing across some kind of rope bridge because the river is too high. Wasn´t happening with the data binders in tow.

Was a productive and fun road trip, this time with a young Peruvian MD, Sergio, who was the ideal person to have on board.

Preparing now for a talk monday on the test and the data we have to date.

Back in Arequipa

Got here safe.
Mountains covered in snow which is nice.
Busy.

Want to be a clinical researcher?

I'm told the average lifespan of the NIH research career is 7 years or 1.5 grants.

(But that the curve is bimodal with some winning many many grants and some only one.)