Peru 9

This post is about our time at Machu Picchu and Cusco. This first picture is of our view of Machu Picchu just before we left. We had some rain on the day we were there, but it cleared at the end of the day and this picture shows how Machu Picchu sits in the clouds.

This picture is from the top of the mountain behind Machu Picchu. We were able to climb this mountain and it gave great views of the ruins below.

This picture is from the three window temple. This is one of the more famous areas of Machu Picchu.

The next picture is from Saqsayhuaman, the ruins that sit just outside of the city of Cusco. The stones here are enormous and perfectly shaped and placed. The entire structure is in the shape of a lightning bolt.

This picture is Qoricancha. This was originally an Incan temple and the Spanish conquistadors built a church on top of it. You can see the ancient building style under the more colonial style.

This last picture is a view of Cusco from one of the mountains outside of town. A storm was coming in, but we were able to walk back to town before getting soaked.

Peru 8

This post is about the day that we visited the Sacred Valley. It is the area between Cusco and Machu Picchu that has many ancient Incan cities and ruins. This first picture is from our first stop where we fed llamas and alpacas. This picture is of Angela feeding a llama.

The next picture is from Pisac, one of the ancient Incan cities. This picture is from the main religious area of their city.


These 2 pictures are from Ollantaytambo, the next set of ruins that we visited. It is easier to see in these pictures the amazing stone work. Many of the stones were as large as this one that Chuck is beside and fit together so perfectly that there was no mortar!

This picture is from Chincheros, the last town that we visited. It is famous for its old church and also the ruins. The sun was setting and this made the ruins even more beautiful.

The last picture is of Salkantay, the largest mountain in the region at over 20,000 feet. It was rainy at times during our day, but the sky cleared and gave us a perfect view of this impressive peak.

Peru 7

This first picture is of a Quechua woman working in her corn field with the beautiful snow-capped mountains in the background. This field was 1500 feet above the town, but at least it was flat. So many of their fields are on sharp inclines mainly because there is very little flat land here to grow crops. This only adds to the already difficult work.

This picture is from Angela examining a young local boy with his father. He had fallen on his arm 6 days ago and had received an ACE bandage from the local Peruvian clinic and instructions to see a Pediatrician. It took them a few days to make it to Diospi Suyana, but he was found to have a displaced radial and ulnar fracture. It is different being in a place where 2 broken bones is not an emergency and it takes 5 days for you to come to the doctor.

This next picture is of Chuck bringing a patient back to the exam room in the "consulta". As we have mentioned before, the patients often arrive the day before to get a ticket to see the doctor and then wait patiently until it is their turn. We also wanted to tell you about an interesting patient we saw yesterday. She is a 47 year old lady with significant swelling of both of her legs for 6 months. We did a full evaluation and found that her kidneys ok. Her thyroid, although not normal, is likely not the problem. Her heart was large on xray, but her echo was ok and her ekg was ok. A rheumatoid factor was sent (we are not sure why exactly), but was very positive. She does not have rheumatoid arthritis, but may in fact have lupus as the cause of her swelling and joint pains. She is going to come back in a week for more evaluation. It is truly a blessing to have the ability to do lab testing in a area that is so otherwise remote.

This picture is of the chapel where the morning devotional time of prayer, singing, and a message is done before the clinic day. On this day, one of the local hospital workers was speaking about his experience with God.


The last two pictures here are of local people that we have seen around and near the town of Curahuasi. The people here are kind and grateful for the care that Diospi Suyana is providing. The first guy is a local farmer who we have seen multiple times on short hikes around the town. Despite being 75 years old, he can hike much faster than us. The funny story about the last picture is that Alex and Chuck were hiking up one of the smaller mountains near town yesterday late afternoon when they passed this group of people. They saw Chuck´s camera and were asking him to take a picture of them. It turned out to be a great shot!

Peru 6

This photo is of the hospital pastor. Every morning before clinic we have a time of singing and a short message from either a staff member or the pastor. The pastor is then available all day to pray with patients and families or share the gospel. He is fluent in both Spanish and Quechua and thus can share with them in their native language.

We thought we would tell you about some more of the interesting patients we have seen in clinic lately. This photo is a picture of Angela obtaining a skin scraping. This 8 year old girl came in with a diffuse pruritic hyperpigmented rash over her entire body after taking a trip to the Amazon jungle. We scraped her skin to look for a fungal infection, but instead found that she had diffuse scabies after looking under the microscope. Apparently (per some of the doctors here) it is not uncommon to see severe scabies infections even in immunocompetent patients.

This next photo is a chest CT of a patient we saw with Alex Brunner. This is a 30 year old woman who came in a few months ago complaining of cough and fever. She had been told she had pneumonia about 10 years ago, but was otherwise healthy since. On physical exam she had significant crackles with inspiration. A chest xray was concerning so we got a chest CT scan. Her CT scan is quite abnormal and it is currently being read by a radiologist in Germany.

This last picture is of an elderly lady who came in with complaints of abdominal pain. She then mentioned that she was diagnosed with Addison´s disease in Lima a year ago. She was started on prednisone at that time. Thankfully she had continued to take it on a daily basis, but she had very little understanding as to why she was on the medicine or for how long she would need it. The concept of chronic medical problems is not well understood by people here. They often ask for a cure and they frequently need education about continuing to take medications and their importance.

Peru 5

This post is dedicated to our weekend hike to the Incan ruins at Choquequirao. It was an intense hike that took us over 45 miles. We descended from 9500 feet to 5000 feet and back to 10,000 feet and that was just the way there...we did the reverse on the way home! We did have a guide and 2 mules that helped us carry all of our camping gear. The first picture above is of the majority of the ruins. It is a massive site and is still being actively excavated. Very few people go to this site each year and the day we were there, we were the only ones. There is no road, no electricity, and no running water and obviously no easy way to get there.

This picture is of Chuck in the main plaza of the ruins just as we arrived after already hiking 4 hours that day and climbing over 3000 feet. These ruins are often compared to Machu Picchu. They are more rustic in architecture, but a much larger site most of which is still unexcavated.

This is Angela sitting on a bench on our last day of the hike. It was in the morning and we had a magnificent view of the snow-capped Andean mountains all around us.

This picture is of Chuck at an overlook at the Choquequirao ruins. This gives an idea of how high the ruins are. When we were hiking, crossing the river below was the midpoint for the way there and the way back.

This next picture is of the clouds rising from the valley at sunrise on our last day on the trail. Not a bad view coming out of the tent in the morning.

The last picture is of our campsite one of the nights on the trail. As we were walking back after seeing the ruins, our guide had set up our tents and there was a rainbow over the farm where we were sleeping. Pretty picturesque. All in all this was a difficult hike, but well worth it.

Peru 4

This first picture is the view from one of the exam rooms. Not all the views are this nice, but we get to use this room in the afternoons! Not bad. The next picture is of Angela helping cast a young boy´s leg. He had a tree fall on him and broke his tibia badly, but his fibula was ok. Martina John is also in the picture. She and her husband Klaus John are both physicians from Germany that founded this hospital. They worked for many years to raise money for the hospital and it has been open now for 1.5 years.

The third picture is of Chuck doing an abdominal ultrasound on a patient with right upper quadrant pain and concern for gallstones. Chuck was able to find the gallstone that was causing the pain and now she is seeing the surgeon about a possible cholecystectomy. There is a German internist here who is skilled at doing ultrasounds and has been teaching us how to do them as well. Chuck has mostly been doing abdominal and renal ultrasounds, but may start trying cardiac echos soon!

The last picture is of the local church that we have been going to. It meets in a garage at night and there is only room for about 40 people, but as you can see there are people standing just outside as well. Most of the population here does not go to church. Some are catholic, but mostly in a cultural sense without any true belief in God. This church is an example of a place where people have come to find hope despite many hardships that they face on a daily basis.

Peru 3

This post is from our weekend activities. The first two pictures are from the market here in the town of Curahuasi. The first one is of a traditional Quechua woman who was doing some shopping for the week. Most of the items for sale are produce that the farmers bring from the campo. Angela is in the second picture buying some onions from a local woman. There is a daily market in town, but the Sunday market is by far the largest. We bought our fruits and vegetables there this week.


The next two pictures come from a hike we took on Saturday morning. We woke up at 430am and and started a tough hike. We passed some of the local people later in the morning that were working in the fields. These are the typical patients that we see in the clinic, so it was interesting to see where they live and work. The picture above is of a young Quechua boy in front of his family's house. They live alongside their animals - cows, horses, chickens. The next picture is of us with Amy Morton and Alex Brunner. Amy is a midwife from Vanderbilt that also goes to our church in Nashville who is here to work at the hospital. Alex is one half of Alex and Laura Brunner who we mentioned before, but are the physicians who are here in Curahuasi for 2 years to work at the hospital. If you look closely at Angela´s foot, you will notice that her left foot is shoeless. After hiking 1.5 hours, we had to cross a river. We all took off our shoes and tossed them to the other side first, but Angela´s toss over was more of a toss up and into the river. Chuck walked in the river for an hour to find the shoe, but it was washed away. So Angela had to triple sock and hike back 1.5 hours with no shoe! Another one of the hospital workers has let Angela borrow some hiking shoes now. Thanks to Petra.

The last picture is of Chuck showing Laura Brunner how to make popcorn on the stove. This is an important picture because it is the one and only thing that Chuck will ever be able to show Laura how to make. She is an incredible cook here with very limited resources and the Brunners have been kind enough to host us for at least one meal every day.

Peru 2

We have been working at the hospital in Peru for going on 2 weeks now, and are really starting to get the flow of things. The first picture above is the view out of the front door of the hospital which overlooks the surrounding mountains, which obviously are beautiful. The second picture is the waiting room of the clinic area, or consulta. Patients must come beforehand (usually the day before) and get a ticket in order to have an appointment with one of the doctors. They then wait until their name is called.

We wanted to tell you briefly about 2 interesting patients we have seen. One was an 8 year old boy, whose mother came in because she was concerned about how he was walking. It was not clear what the problem was until the exam. His calf muscles were hypertrophied and he walked with a lordotic gait. It turned out that he had a fairly advanced case of Duchenne's Muscular Dystrophy. The next case was a 13 year old boy whose father was concerned that when he was angry, his face turned blue. On exam, this child was markedly cyanotic, with clubbing of his hands, and had an O2 sat of only 77% on room air. He most likely has a progressing congenital heart defect. We referred him to a cardiologist, but the nearest one is 3 hours away and the family is uncertain if they can afford to go. Although Peru does have some national healthcare there are very limited resources for patients like this that have chronic and such serious diseases, especially the Quechua people. They are the descendants of the Incans, but are now the poorest people group in Peru.


The next 2 photos are during a hike we recently took that has views of the surrounding mountains. It is the rainy season here, but fortunately it usually rains at night and the days are beautiful. These pictures are an example of the amazing landscape in this region. Although there is marked poverty here, these people also have this beautiful reminder of God's awesome power in front of them daily.

Peru 1

We made it safely to Curahuasi, Peru and are getting settled in to working at the hospital. The top picture is a picture of the front of the hospital. The name of the hospital is Diospi Suyana. The building was completed 1.5 years ago and has been open since then. There is an outpatient clinic area and a hospitalization area. There are also multiple operating rooms. We have seen some interesting cases so far. We saw a case of likely leishmaniasis, many patients with parasites, tuberculosis, and more common things like gastritis and arthritis. This morning we helped with a young child who had a bean stuck in her ear. (that was one malo frijole!).

The second picture is a view from the top of a mountain looking down on the town of Curahuasi. Our town is at 8700 feet and we hiked the Mirador to a height of over 10,000 feet. It gives an incredible view of the town and surrounding mountatins. We were really tired at this altitude at first, but have gotten more adjusted to the limited oxygen!


The last two pictures are from our weekend in Cusco. Alex and Laura Brunner (friends and physicians from Vanderbilt who are working here for 2 years) took us with them on their weekend trip to get supplies and enjoy the beautiful city of Cusco. The plaza is incredible at night.

We have enjoyed the start of our time here. Our spanish has been pushed to its limit, but Chuck is getting better and Angela has been able to communicate pretty well. Please continue to pray for us and our time here that we would be a help to the full-time physicians here and that we will begin to have a better understanding of where God is leading us to serve in the future.