1) What is your purpose? (25 words or less.) If you had to describe your calling in life, what would you say? What are you here to do? What gift is yours to give to the world?

My purpose is to lead and to heal, through work as a midwife, by sharing love and fostering transformations.

2) What do you love, and how do (or will) your actions demonstrate this? (250 words or less.) We at Gaia believe that following your heart is the best way to help the whole planet. What do you care about, and what do you most enjoy doing?

I love to realize my dreams and, through that process, inspire and empower others to realize theirs.  By journeying to Peru to learn Spanish and volunteer in a birthing clinic, I learned that I can achieve anything I set my heart and mind to.  With that epiphany, I fully embraced what I am here on earth to do and am walking the path of my dreams unwaveringly. 

I am here to make a difference in the world one birth at a time; here to empower women, families, and communities.  On this journey, I want to work internationally as a Nurse-midwife to bridge traditional birth practices with modern medicine.  Additionally, I wish to help preserve indigenous cultures and their immense wisdom. 

To continue manifestation of these ambitions, I am pursuing enrollment in the UCSF Nurse-midwifery program.  I have an interview on January 16^th and I will know if I am in the program in March.  In May, I will return to Peru for three weeks to work with and learn from a great Shaman, Don Americo, and an indigenous group, the Q’ero. 

By realizing my dreams, and inspiring others to do likewise, we are joining forces to create a sustainable, peaceful, and beautiful world.  In doing so, we give testament to “Si se puede! (Yes one can!).”

3) Write your ideal job description. (250 words or less.) Forget about job titles like 'doctor' or 'artist' or 'lawyer.' If you could get paid just to live, how would you spend your time? What would you devote your life to? What would your days be like?

Wherever I am in the world, I want to live amongst friends and in harmony with Pachamama (Quechua for Mother Earth).  Within this community, where one can just live without needing to work for money, I am the healer.  I hold the space for transformation; just as there is a time for sowing and harvesting, there is a time for life and death.  My friends come to me for healing and guidance.  From great teachers, I have learned to listen to the earth and find the natural medicines she provides for us; I teach my friends to listen as well.  I am a Shambhala warrior with fearlessness and gentleness radiating from my being.  I am a teacher and a student; a master in my own right.   I am a great and humble leader.  My life is devoted to love and freedom.  I am here to help other beings awaken and self-actualize.  Every day is a journey, an adventure down the river of life. 

The application for the UCSF Nurse-midwifery program required a goal statement and a personal history statement.  Even though I knew what I wanted to express, writing these two pieces took some time and processing.  To everyone who helped support me in this process, thank you so very much!  Thank you for helping me put into words what resided in my heart.

And, without further delay, here are the two pieces I submitted for my application...


Goal Statement:

As a Certified Nurse-midwife (CNM) and Women’s Health Nurse Practitioner (WHNP), I aspire to bridge traditional birth practices and modern technology while working with underserved and indigenous populations, both in the U.S. and internationally.  My mission is to provide quality health care to women in rural Siskiyou County, California, and in the Andean mountains of Peru.  To provide excellent care and be of greater service to these women as soon as possible, I am seeking advanced specialty preparation through the UCSF MEPN Nurse-midwifery and WHNP program.

I choose to be a CNM and WHNP because of the immense value the profession provides for women, families, and communities.  This fulfilling career path was clear to me after assisting underserved women at the Davis CommuniCare clinic, Sutter Davis Hospital, and in a government clinic in Peru.  I want to be of further assistance to women like twenty-year-old Nohemi Carhuani Ascue of Cusco, Peru who told me after I supported her labor and delivery as a volunteer doula, “I don't know how to thank you for all you have done for me.  You are truly an angel.  You are very good as a person and you will be the best as a professional.”  For Nohemi and others like her, I wish to be a phenomenal CNM providing excellent women’s health care and empowering women, families, and communities through the transformational and normal physiological birthing process.

As a CNM and WHNP, I will be part of the dynamic force of nursing professionals who work as patient advocates and health care providers throughout the medical field.  In numerous specialties and varied settings, nurses treat, educate, and provide emotional support to patients and their families.  Furthermore, nurses collaborate with other health care professionals to improve the health of individual clients and the community.

To the nursing profession, I bring initiative, dedication, compassion, emotional intelligence, orientation to detail, and strong communication skills.  From volunteering in the maternity ward of a Peruvian government clinic serving the poorest in the region, I bring a working knowledge of medical Spanish, an appreciation for the process of labor and birth, and experience with diverse groups.  From working as a white water rafting guide, I am calm under pressure and lead effectively in turbulent circumstances.  From transporting elderly and disabled paratransit passengers, I bring understanding and patience.  From living in a student governed cooperative, and serving as its liaison to the UC Davis administration, I bring extensive experience in group dynamics and in facilitating communication for consensus.

Upon completion of the UCSF Nurse-midwifery program in 2012, my immediate goal is to gain experience working with Barb Boehler CNM and her staff of midwives at Davis CommuniCare clinic and Sutter Davis Hospital.  With a target date of 2016, Ms Boehler has graciously agreed to be my mentor as I utilize her clinic model to bring nurse midwifery to Happy Camp, California, and the neighboring Hoopa Valley Indian Reservation.  By 2020, my goal is to have a midwifery center in the Cusco region of Peru which provides excellent maternal care in a way that preserves the traditions of the indigenous people, the Quechua.

I envision my goals being achieved through study at UCSF because of our alignment in dedication to increasing service to underserved women and families.  From being a volunteer doula working alongside graduates of the UCSF Nurse-midwifery program at Sutter Davis Hospital, and most recently at San Francisco General Hospital, I know I will be working with and learning from exceptional faculty and staff at UCSF to provide care for those who need it most.

Personal History Statement:

My decision to pursue a graduate degree in nurse midwifery stems from my childhood dreaming.  While growing up in the countryside of Mt. Shasta, California with a father as a Registered Nurse and a mother as a horse trainer, I dreamt of being a small town doctor, like Dr. Quinn Medicine Woman, who would ride her horse to treat patients and deliver babies throughout the countryside.  We didn’t have our own television, so weekly viewings of the Dr. Quinn show were possible only by driving into town to our grandparents’ house.  Since I lived 7 miles outside of a small town, imagining being a health care provider in a sparsely populated area was not difficult.  And riding horses to see patients in this day and age?!  For me the idea was not far fetched because I often rode my Shetland pony to the one room Buddhist school I attended, so riding a horse to see patients seemed quite plausible.  As you can see, my atypical childhood fostered creative thinking and dreaming.  Using Dr. Quinn Medicine Woman as an inspiration for my career choice may sound schmaltzy, but that’s how dreams are born!

 

With my dream intact many years later, I headed off to college at UC Davis aspiring to be a doctor.  After completing an internship at UC Davis Medical Center and doing several job shadows with doctors in Mt. Shasta, I realized that being a modern day doctor is certainly prestigious, but it does not readily embody the deep connection between physician and patient that I seek.  Still holding onto my dream, but unsure of my career path, I continued my studies in Exercise Biology at UC Davis.

 

As I journeyed through my college career, I expanded my horizons with many endeavors.  In the summers, I adventured down rivers as a raft guide.  During the school year, as a commercial driver, I transported a wide variety of passengers ranging from junior high school students to the elderly and disabled.  Along the way I met and worked with people from all walks of life.  I also learned how to think “outside of the box” while living in a student governed cooperative community at Davis.  Residing at “The Domes” were 28 graduate and undergraduate students housed in 14 separate dome structures.  What united us, despite our diverse backgrounds and eclectic interests, was a common goal- a community dedicated to sustainable living through consensus decision making.  In addition to living in the community, I served as liaison to the University Administration. 

 

After exploring many avenues, my childhood dream of being a rural women’s healthcare provider expanded to include working with underserved and indigenous peoples world-wide.  Last September, while expressing my dream to a family friend who is a nurse at UCSF, I learned of the nurse-midwifery profession.  I was elated to discover that nurse-midwives provide the model of healthcare I dreamt about as a child and that international work is also possible.  Because I want to work internationally and in poor, rural communities, my friend highly recommended the UCSF program.  Since that pivotal conversation, I have pursued my dream unwaveringly.

 

To begin my international work and to prepare for further academic study, I lived in Cusco, Peru from January through June of this year.  In Peru, I gained a working knowledge of medical Spanish by attending Spanish classes and volunteering in the maternity department of a government clinic.  While at the clinic, I often worked closely with the Andean indigenous people, the Quechua.  Their passion for life endeared them to me while their extreme poverty and high maternal mortality rate inspired me to want to help as a nurse-midwife.  In addition to working with the indigenous people of Peru, I aspire to bring midwifery care to the Hoopa Valley Indian Reservation located near Happy Camp, California.  While working with both indigenous groups, it is my intent to honor their traditions by sensitively bridging them with modern technology.

 

Thus my decision to pursue a graduate degree grew out of my original dream enhanced by academic studies and world travel.  While I may not ride a horse to reach my clients in California, nor ride a llama in Peru, I passionately strive to realize my dream of providing excellent women’s healthcare world-wide.

Upon seeing this clip on youtube, I purchased this documentary.  It is very powerful and it continually reinspires me to continue on my path to becoming a Nurse-midwife so I can return to Peru and be of service to her people. 

Please excuse my long hiatus from writing in this blog.  For awhile, I thought my sharing through a blog didn't matter and thus didn't continue writing down my stories and dreams for others to see.  However, thanks to comments made by friends through facebook about my pictures in Peru, I remembered that what I am doing in this world is rare; I am fully stepping into myself and embracing my path.  Since others may be inspired by what I am doing in my life and sharing in my writing, I am renewing my activity with this blog and will be sure to keep it updated.  It's good to be back in the blogging world and especially with the Gaia Community!  And now to catch up on the 6 months of life I have yet to inform you of.....

In June, my sister came to visit me in Peru and we traveled around the Cusco area for about two weeks.  Unfortunately, she was sick for most of the time.  We flew back to the States after Inti Raymi, the huge Inca celebration in Cusco on June 25th.  Our paternal grandfather passed away on July 2nd, so we spent time with our dad and helped with estate matters up in Mt. Shasta.  What a whirl wind all of that was!

At the end of July and beginning of August, I was in Winter Park, CO participating in the two week NLP Master Practioners Course.  Wow!  It was amazing!  Great teachers, such as Charles Faulkner and Steve Andreas, were there and the class participants were extraordinary as well. 

Along the lines of NLP, I also attended the Institute for Advanced Studies in Health (IASH) convention in September.  While there, I had the pleasure of meeting Carla Woody.  Carla is the founder of a non-profit (Kenosis Spirit Keepers http://www.kenosisspiritkeepers.org/ ).  Their mission is "to honor and preserve the integrity of indigenous wisdom and sacred cultural practices by providing cross-cultural exchanges, education, and community-building opportunities."  Upon meeting Carla, I knew it was destiny for me to participate in her 2009 trip to Peru to work with Don Americo and the Q'ero; trip information at http://www.kenosis.net/Retreats/PeruTrip.htm.  Since I want to have a birthing clinic in Peru and work with the indigenous people, this trip will not only benifit my soul, but will be imperative to my midwifery career and success in preserving the Inca traditions while bridging them with excellent healthcare.

In pursuit of becoming a Nurse-midwife, I have applied to the UCSF MEPN Nurse-midwifery program.  MEPN stands for Masters Entry Program for Nursing and is for students who have a BA or BS, though not a Bachelors in Nursing, and wish to become Advanced Practice Nurses.  It is a three year masters program.  The first year is an accelerated nursing program to become a Registered Nurse (RN).  Then, the following two years are more of a standard Masters program. 

In 2012, I will graduate as a Nurse-Practioner specializing in Women's Health and as a midwife.  The specific acronym for this professional title is CNM (Certifed Nurse-midwife).  As a CNM, I will be able to work in hospitals, clinics, and homes as well as work internationally.  I am just tickled that there is a profession that I am so passionate about and was born to do!  It has been, and will continue to be, an amazing adventure on this path to midwifery.

Currently, I am looking for work and, when I'm not applying for jobs, I am a volunteer doula for San Francisco General Hospital.  A doula is a non-medical birth assistant who offers emotional and physical support to a woman in labor and to those whom she wants present for her birth.  It is amazing to be a doula and hold a grounding space for the transformation of birth.  It is just incredible!

Tomorrow is New Year's Eve; I can't believe how quickly this year has flown by.  While this past year has been wonderful, I think this coming year will be even more exciting.  As you know, we have a new president and I am excited to see how he, and we, will transform this country. 

In my own life, there will also be many transformations.  I have an interview with UCSF on January 16th and I have the feeling a new job will come down the pike soon.  I will be sure to keep you up to date and I look forward to the sharing!

Definition of Midwife

A midwife is a primary health care provider whose services are guided by the individual needs of each mother and baby. Her abilities and knowledge are the health, physiology and effective care of pregnancy, birth and postpartum.

She acts in a humane, receptive, flexible manner, on the basis of evidence or practical experience. She is willing to update her knowledge continually while maintaining a practice of meticulous care with minimum intervention.

She acquires essential knowledge from other midwives through a variety of educational routes within a formal or traditional process, as well as by assisting with mothers and babies.

A midwife shares information with mothers, families and the community that may include her model of care, alternative health services, rights and responsibilities, wellness, preventive care, bonding, breastfeeding, child rearing and family planning.

A midwife provides care and oversees the health of women and their babies during the childbearing year and assists with birth. She may provide lifelong care to women. The midwife's practice is autonomous: she may offer her services at clinical facilities and in homes.

A midwife can identify health problems, knows techniques for managing emergency situations and has a plan to refer or transport, when necessary.

A midwife is acknowledged as a primary provider of maternal health services by the members of her community or by the country in which she practices.

— International Alliance of Midwives
http://www.midwiferytoday.com/iam/

It never ceases to amaze me how quickly the time flies by.  I've been pretty busy because I have clinic work 24 hours and class for 20 hours a week, though I am loving it.  I have been volunteering in the maternity ward of the Clinica Belen Pampa and I have already assisted in 14 births.  Each one of them has been amazing!  I am very fortunate to have this volunteer opportunity and I am so glad I have 2.5 months left working there.

This volunteer position was coordinated by the school where I take Spanish classes, Amauta Spanish School.  Jenna, the volunteer coordinator, has been amazing and I am so glad she could find the exact position I needed.  On February 28^th, Jenna and I went to visit the clinic to make sure everything was in order for me to commence work the following Monday.  I had my Curriculum Vitae and Letter of Intent, both in Spanish, firmly in hand.  She and I spoke with the head director and expressed that I needed a position working with partos (deliveries).  I explained that I will be applying to Nurse-midwifery school when I return to the U.S. at the end of June and need experience working closely with an Obstetra (which is the profession here most like Nurse-midwifery).  He easily confirmed that I could work in the maternity ward.  He even went so far as to show me the location and introduce me to the staff I would be working with.  When we left, Jenna said that was the most time she had ever seen a Doctor, especially the director, spend with a volunteer.  I took it as a very good sign!

That Saturday, I went shopping for the required uniform.  My uniform is green scrubs, a white lab coat, and white shoes.  I bought all of it in a little hole in the wall store; and I mean, literally, hole in the wall, which is very typical of the stores here.  Also, in the States, I am average sized in height and weight.  Here, I am fairly tall and have big feet!  I wear a size 8 shoe in women's, which is normal in the U.S.  However, they had to dig to find the one pair of size 8, white, hospital shoes. 

Anyway, my uniform for the clinic looks great on me and I pull off the professional look very well.  Also, none of the guys bother me with cat calls when I am in my uniform; hopefully it is because they have some respect for a medical person volunteering here.  If I am in street clothes, though, it is not uncommon for some guy to whistle or make a kissing sound, which is very unappealing.  When I am in my uniform, people often miss call me Doctora (Doctor).  I kindly inform them that I am a volunteer and am not a Nurse, nor a Doctor, though I would be glad to help them get what they need.  It was pretty cute a couple of days ago, though, when I got off the bus and two little girls in uniforms (by the way, all the children wear uniforms to school here) came running up to me calling out, "Doctora, Doctora!  Hola, Doctora!"  I spoke with them for a couple of minutes; before we parted I had taught them how to say hello in English and to give a high-five.  Being here, I now realize how trademark American a high-five and a thumbs-up are!

Clinica Belen Pampa is more of a small hospital than a clinic, though they don't do surgeries (which includes Cesareans).  It is a government clinic and thus attracts some of the poorest people in the Cusco region.  I am glad to have such a post because I would rather lend my efforts to the people who need my help the most.  The presenting challenge here is that some of the poorest people are from the surrounding country side and they only speak Quechua, the language of the Inka's.  Right now, I don't know any Quechua so my communication with them is none verbal; also, only a couple of the staff members speak Quechua.  Most of the patients speak atleast some Spanish, though, so I am not at a complete lose. 

My shifts are Monday, Wednesday, and Friday mornings (7:30am to12:30pm) and Saturday nights (7:30pm to 7:30am). My first day at the clinic was Monday, March 3^rd.  When I arrived, I introduced myself to all those whom I had not yet met.  I got the impression that, while they may have been a little shocked by my presence, since I am the only volunteer around (especially a white, blue-eyed, female), they seemed ready to accept my help and I felt included.  By the way, blue-eyes are very uncommon here.  One of the Obstetras commented on my eyes and said they are like the ocean.  She had only seen such eyes on dolls.  I think alot of other people woud agree with her, because I get a fair number of stares, especially from children.  I don't mind the stares at all; it is actually quite flattering.  Now, back to the clinic.

When I arrived, there was one woman in the Sala de dilatacion (labor room).  Her name was Carla and this was her first baby.  Her male cousin was in the room with her, which is the only time I've seen friends or family members in that room.  There are four beds for laboring mothers and family/friends are not allowed to enter for privacy reasons.  Her cousin didn't stay for long and Carla was all alone.  The staff members are very good with the medical portion of birthing and could use some improving with the emotional/psychological portion of helping the mother.  Carla was very soon in a position where she needed some human contact and reassurance, which is the case with majority of the women.  I found that the best thing I could do to help was to stay with her, help her breath through her contractions, and lend encouragement when she felt incapable of continuing.

Carla delivered a healthy baby boy!  After the delivery, Carla was transported to another room.  As the staff was taking care of her, they motioned to me to bring the baby.  "What?" I thought.  "You want ME to pick up the brand new baby?!"  I had never held a new baby before and it was the most elating experience!  No wonder these mothers cry out, "mi amor (my love)," when their babies are delivered and safely in their arms.  Every time a baby is born, it is so beautiful and magical!  I definitely look forward to having my own someday, after I am done with Nurse-midwifery school.

I had forgotten my camera that first day, so I returned the following morning.  Carla was so grateful for the visit and she kept thanking me for my help during her labor and delivery.  She and I took pictures together and cooed over her baby.  You can see the photos in my photo section.  I have also included pictures of all the other babies born my first week.  I won't be continuing to have a picture of each of the babies I help deliver, because the clinic can get busy.  However, I will do my best to capture some of the very special moments.

There are some women whom I connect well with and I am able to help a lot; there are other mothers who would rather just be left alone.  For all of them, I do my best to lend the support that they would like to receive.  There have been several women who are especially thankful for my presence and their gratitude makes all the work worth while. 

I received one e-mail from a new mother I helped and it made my heart melt.  This is what she said...

"...no se como agradecerte todo lo que haz hecho por mi, de verdad que eres un angel... eres muy buena; como persona y se que seras la mejor como profesional que Dios te bendiga siempre cuidate mucho y de nuevo gracias por todo... " 

If you can't read that, this is what I can translate from what she said and it conveys the main idea of her sentiments.

"...I don't know how to thank you for all you have done for me.  You are truly an angel...You are very good; as a person and you will be the best as a professional.  May God bless you always and take care of yourself..."

This statement is definitely going in my scrapebook!

All the births here are natural, which means no pain killing drugs.  I have incredible respect for all of this women because near to none of them ever scream and they inform me that the pain is horrendous. And even with all of the excitement after the birth, all of the women I have asked have said they don't ever want to have another baby.  "¡Que dolor! (what pain)" they say.  I do my best to be empathetic and compassionate while helping these women.  Because I don't have children, I really have no idea exactly what they are going through.  It is certainly an initiation into motherhood, which I imagine can be incredibly scary at times.  I do my best to help them progress on their journies and make the experience less of a trauma.

Here are some of the best things of the birthing culture here in Peru.  The actual moment of birth is called "dar a luz," which literally means "to give a light."  Also, every women is given her placenta so she can bury it in earth.  This is done to thank Pachamama, mother earth, for all that she has lent to provide this new life.  In return for her gifting, the placenta is gifted to her for her renourishment. 

Right now, the biggest challenge for me is trying to understand and communicate in Spanish.  Fortunately, I know enough of the medical side to know the big picture, but it gets really frustrating when I can't communicate well nor easily understand explainations.  The only major challenge in working with the staff is that they speak Spanish very quickly and the words are often technical.  I pray that I will learn at lightning speed so I can be of more help to them.  I am also very fortunate that they really like me and most take the time to help me with learning the vocabulary.

The best thing about volunteering here is that I am allowed to do things I could never do as a volunteer in the States, especially in the clinic/hospital setting.  I have taught new mothers how to breastfeed and I have never had experience in this before.  The first time I helped a new mother, I was just making educated guesses.  I was confident, though, and she trusted me; the baby latched on without a problem.  Good thing I was paying attention during my internship at the birthing center at UC Davis my freshman year of college. 

I have also started to make great friends with the staff members.  Güido, one of the Obstetras, has taken the role of mentoring me.  Today, he assisted me in gently pulling/guiding the delivery of the placenta.  Cool!  He will also be teaching me how to measure the dilation of the cervix.  This includes sticking a gloved hand up a woman's vagina and measuring with your fingers the width of the cervix.  (The cervix needs to have a dilation of 10cm before the baby can pass from the uterus into the birth canal).  Thank you, in advance, to all the women who will assist me in learning this skill and I hope to be as gentle as possible with each of you.

Clinica Belen Pampa is also the leading institution in the area for vertical births and other professionals will sometimes come to learn the method. Vertical births are done with the aid of a special chair/stool.  The Obstetra will catch the baby from behind the mother.  This seems like a great method.  The deliveries are usually quicker and the women say that it is easier for birthing.  However, vertical births are only done about half of the time and seem to be up to the judgement of the Obstetra on staff and not on what the delivering mother would prefer. 

Well, that is it for my first two weeks at the clinic.  Thank you so much for reading and sharing my experiences with me.  I miss you all and I hope you are all doing well.

Abrazos y besos (hugs and kisses),

Heather (also know here as Kristine or Kris, for short, because Heather is to difficult for the people here to pronounce; I don't mind so much, though I do look forward to being called Heather again).

Wow!  I can´t believe three weeks have flown by so quickly.  I realize it is about time I caught you up on my great trip to Puno with my host father, Jorge, and another student who lives in my house, Nienke.  I haven´t mentioned Nienke in my previous blog entries, so here is a little bit about her.

Nienke is about 6ft tall, dark-haired, dark-eyed, and is always in a great mood.  By the way, it is very challenging to be tall in Peru.  Most of the people are about my height or shorter.  They make things on the smaller side too.  For example, I can touch my ceiling without standing on tip toe; I am even considered on the bigger side of average and I am only 5'4".  Even though Nienke doesn´t physically fit comfortable here, she doesn´t seem bothered to be a good foot taller than everyone else.  Nienke is 19 years old, has a good head on her shoulders, and hails from Holand.  She has learned Spanish INCREDIBLY fast, which my family has informed me is typical of Holandeses.  It is common for Holandeses to speak 4-5 languages fluently.  There are a lot of people from Holand who attend the school and I feel like I am running through mud trying to keep up with them in Spanish.  Fortunately, Nienke and I are about at the same level, though she learned in four weeks what took me eight.  It is really great having another student in the house.  She and I help each other with sentance structure and translating while we have meals with our family.  Unfortunately, she leaves tomorrow to continue traveling in South America and I will miss her.

There are a lot of students that come through the school.  Most stay for about four weeks.  When you are here learning Spanish, four weeks feels like nothing.  I am one of two that will be staying a total of five months, which is very uncommon.  I only really get to know the students I have in my class, because the students come and go so quickly.  There are about five students per class and the classes change every week.  So, I have had the pleasure of meething, and have developed some great friendships, with people all over the world.  Though, our time together in Peru is often short lived; most head off to continue their travels or return to work/school.  Fortunately, I have befriended several of the Amauta staff and interns, who are more permanently here in Cusco.  I have also made friends with several of the locals, so I have some regular friends to hang out with.  O.k. now back to Puno.

Jorge, Nienke, and I took a bus from Cusco to Puno on Friday night, Feb. 8th.  We only took small daypacks for our weekend necessities.  Nienke packed the least and thus had the smallest bag.  For once in my life, I wasn´t the one with the most stuff.  Jorge took that title for this trip!  Before we left the house, I said, in Spanish, that he was the woman of the group and the whole family had a good laugh.  We took a taxi to the bus station, which was 3 soles (about $1) and the bus station was a good 7 minutes away from the house.  I am so glad that Jorge was with us at the bus terminal, because I don´t understand their system at all.  While we were waiting for our bus, I informed Jorge and Nienke that I drove a 40' bus for most of my college years;  they were shocked and impressed.  We left, without problems, at 10:30pm and arrived in Puno at 6am.  Traveling by bus was much like traveling by plane, though with a little bit more room.  Fortunately, I was able to sleep most of the trip, much due to the fact that I am a heavy sleeper and am capable of sleeping in contorted positons.  Nienke, however, did not sleep much. 

We had breakfast in the bus termininal, which was fairly good.  I had banana pancakes.  Yes!  Though, they don´t have maple syrup here, so I ate them dry.  Normally, we have bread and cheese for breakfast, which is actually really good.  Monica, mi mamita, also usually makes a fruit smoothy for breakfast.  The fruit here is incredible; so are the avacodos! 

After breakfast, we all went to use the rest room.  Like Norway, you have to pay for the public restoom, though it is much less expensive here.  However, if you want toilet paper, and have forgetten  your own, you´ll need to pay for that too.  (I don´t go anyway without my own toilet paper now).  The bathrooms were not very clean, which is usual for public restrooms here, and lacked toilet seats.  I have mastered the very ackward "hover and try on your life not to touch the toilet" maneuver.  Fortunately, the bathrooms in my house are clean and have toilet seats.  As of yet, all the places I have gone have had running water, which is not the case in the country.  I´m not sure what they do there; I haven´t noticed any visible outhouses.  Also, the toilet paper doesn´t go in the toilet; it goes in the waste basket.  This is such because they don´t have a good way to remove the toilet paper from the water system.  The water system here is very poor and not clean.  I am not sure of the exact sequence for the water system but, essentially, it is very important to boil the faucet water before drinking it.

It was about 7am when we left the bus terminal and went in search of a tour boat.  Puno is a city located on the shore of Lake Titicaca.  Lake Titicaca is the highest lake in the world at 3,800 meters (almost 12,500 ft) above sea level.  Most of the lake is in Peru and part of it is in Bolivia.  We finally found a tour boat and paid 30 soles (about $10) each.  The tour lasted all day, which is yet another example of how incredibly cheap most of the things are here.

The first place we stopped were the floating islands of Uros.  That´s right, they are actually floating!  The islands are made of reeds and have been around since the time of the Inkas.  There is an entire community that still lives on these islands and use the reeds for most of their needs.  The insides of the reeds are even edible; they taste kind of like banana, but less dense.  The community used to keep more to themselves, but now they are very tourist oriented.  Some people have referred to the islands as floating souvenir shops.  While it was great to see them, they were a bit too touristy oriented for me and I was glad when we continued on our way.

Our second stop was at the Island of Taquile.  It was beautiful!  Lake Titicaca is huge and Taquile was more in the middle, so it felt like it was more in the middle of a sea rather than a lake.  The water was so blue; it was one of the most beautiful sites I have ever seen.  The pictures really don´t do justice to portray how breath taking it was.  I felt like I could have been in Greece and yet it had its own unique special beauty, unlike Greece.

We walked from the shore to the town along a rock path for about a mile.  Along the way, we were offered Muña, which is a delightful herb.  We would crush some of the leaves and inhale their essence to help remedy the effects of the high altitude.  At lunch, I had Muña and Coca mate, which was the best tea I could ever imagine. 

We had lunch at a restaurant over looking the water and mountains in the distance.  We ate with the other people from the tour at a large table shaded by a refreshing white sheet that gentle rippled in the wind.  It was all very picturesque.  We had fish that were freshly caught from the lake and they were mouth watering. 

It was time to leave all to quickly.  I could have stayed at this tranquil island for several more days just inhaling the harmony and simplisity every part of the island invited me to embrace.  However, it was getting late in the afternoon and the waters get too chop for safe travel the later it gets.  Also, we were expected at Jorge´s brother´s house for dinner.

We made it safely to Jorge´s brother´s house, which was beautiful for Peru standards.  It was three stories and had mostly hardwood floors.  Peruvians, in general, are pretty poor.  They get by using things that just get the job done.  I don´t think I have been anywhere here that would be up to U.S. building code standards.  Life is more raw here; it is more passionate and somehow more real.  People don´t take things for granted.  Most are so happy when they can have a good meal, good health, and a safe, warm place to sleep.  They aren´t preoccupied with a lot of the superficial things that seem to be predominante in the lives of most Americans.  While I will enjoy the creature comforts of being back in the States, I think I will really miss the culture and the people here when I leave. 

Jorge´s brother and his family were extremely hospitable and I felt very welcomed.  Nienke and I shared a bed because they only had one extra room for us; sharing was not a problem.  Lucky for Nienke, I no longer kick in my sleep.  Puno is usually very cold from the wind off of the lake, but it was warm this weekend.  So, we slept comfortable and for about 10 hours, since we were both exhausted.

Sunday morning, we had breakfast with the family and then went into town to see the festivities.  This particular weekend was carnival, which is the reason why we had traveled there.  Carnival is a huge celebration, for what exactly I never really found out.  But, the people dress up in elaborate costumes and have parades through town throughout Sunday and Monday.  They would dance non stop; I don´t know how because it was sunny and hot.  I was tired just walking.

The other distinct thing about Carnival, besides the costumes and the dancing, is that it is an opportunity to have water fights.  Water fights had been going on for several weeks and were linked in celebrating this particular event.  The objective of the water fights was to get members of the opposite sex as wet as possible.  I didn´t mind so much when I was playing along too, but boys or men took immense pleasure in getting me wet, especially when I didn´t want to be wet.  Espuma, this horrible, soapy, foamy substance shot from an aerosal can was also used to tag members of the opposite sex.  I hate espuma with a passion!  While water was predominately used in Cusco, espuma was the weapon of choice in Puno.  Nienke and I couldn´t go anywhere without getting sprayed with espuma.  The worst thing was that we couldn´t do anything about it, besides hide.  We were both very anxious to get back to the house after having dinner in town. 
 
A side story about water fights in Cusco...the first day that Nienke arrived was the biggest day for water fights in Cusco.  Practically the whole city was playing.  Nienke had to go to the school in the afternoon for the tour and I offered to accompany her.  There were tons of people playing in the Plaza de Armos; it was like walking through a war zone, only with water and espuma.  It would have been a lot more fun if I had wanted to get wet.  While walking together, Nienke and I were approached by a young man who took great delight in welcoming us to Cusco.  "Hola chicas, welcome to Cusco," he said as he sprayed us with espuma.  Nienke and I ran, but it was pointless.  There was nowhere safe to run too.  The water fights were also not contained to one day, much to my dislike. 

Another time, Nienke and I were walking together to an internet hub near our house to download pictures.  We both had our electronics with us and were ongaurd to hopefully avoid potential attacks.  Unfortunately, there was a group of young men who spied us.  Nienke ran and half of the group ran after her.  She finally stopped, indicated she had a camera, and pleaded for them not to get her wet.  They totally attacked her with water ballons.  The rest of the gang, that had stayed to attack me, stood ready to bombard me with their balloons.  I stood my ground.  Every aim they took missed me, but I was pissed.  I think they could tell from my face and the fact that I was starting to run after them very quickly.  They spun around and took off.  I don´t think they are used to girls willing and ready fight back because I have never seen a group of guys here turn around and run after attacking a chica with water or espuma.  I don´t know what I would have done to them if I had continued pursuing them, probably nothing.  It was worth it just seeing them run from a girl.  Yeah!  Take that!  

Anway, back to Carnival at Puno.  The weekend went by very quickly with the lake tour on Saturday and then the parade festivities on Sunday.  Sunday night, we took another bus trip back to Cusco.  I was very glad to be back in my bed by 4am Monday morning for a few hours of sleep before getting ready for school.  Enjoyed everything about the weekend, except for the espuma.  

¡Hola todos!  ¿Comó estan?  (Hello everybody!  How are you?)  Lo siento (I´m sorry) I haven´t written in ages.  During the week days, I have been spending 6 hours a day in Spanish class and my weekends have been spent renewing my EMT (Emergency Medical Technician) certification on-line.  Today, I completed my last hour of on-line testing.  Yeah!  Now, I just have to send off my paperwork for processing and will hopefully receive my new EMT card within a month.  So, why am I renewing my EMT?  Well, I need to have it current for the job I want at UCSF Medical Center when I return in July. 

In order to renew my EMT, I had to complete 36 hours of on-line continuing education (CEs).  Eeeks!  I had planned on completing my renewal before leaving for Peru, but I was busy getting ready to leave the country for 6 months.  So, before leaving the U.S., my friend, Dave, printed off all of the EMT chapters and put them in a huge 2" binder.  Having the chapters in hardcopy has been extremely helpful.  I haven´t had to spend as much time on the computer, which costs about 1.5 sols ($0.50) per hour.  I know, that isn´t too expensive, but it adds up really quickly.  Thank you so much, Dave! 

Fortnately, which I didn´t realize at first, I didn´t have to read every chapter.  Thank God!  That would have been ALOT of reading.  Each chapter was assigned hour credits and I received the respective hours of credit after completing an on-line exam.  So, I would read the chapters in my room and then take the tests at the internet hub next door.  The people who run the internet hub know me really well!  I love the internet!  I would definently have a hard time living without it.

While it was a lot of work, I did enjoy some of my time renewing my EMT.  I realized that I really miss studying the human body.  The EMT chapters helped me be a little closer to the medical world, which was sometimes a relief after a long week of Spanish.  I also love medical vocabulary; like this word, borborygmus.  Borborygmus is the churning sound your empty stomach makes when you are hungry.  I love it!  Crazy words for silly bodily functions! 

Now that I have been out of school for 8 months, I am starting to miss it.  I am so glad I studied Exercise Biology at UC Davis.  I absolutely loved it!  Yes, I am technically in school here learning Spanish, but it feels so different.  I miss the world of medicine!  I look forward to working at UCSF Medical Center and commenzing the Nurse-midwifery program at UCSF.  I think I will feel more at home here once I start volunteering at the medical clinic.

So, now that my EMT work is complete, I have time to update my blog.  I have so many wonderful stories to tell!  They will have to wait until tomorrow, though.  I am about to have dinner with my host family.  Then, I am going to buy some chocolate cake and celebrate!  Yeah!  I am so happy I could kiss everybody!