As the taxi “merges” (read: changes lanes with zero consideration of the other vehicles in its path) onto the highway of sorts, I realize that everything I know about Lima and Peru after my first 10 days in the country will have to be amended. I’m jammed into the back seat with a fellow TB researcher and a nurse, another nurse in the front by the driver, ducking my head slightly to avoid a painful collision with the low ceiling at every bump in the very bumpy road. We’re on our way to the district of San Juan de Lurigancho, home to over a million residents in Lima, and the location of our TB study population. I’ve already been working for about a week on the project, but until now have mostly remained in my home district of Miraflores and at the University at which I’m working, an easy (hour-long) bus ride away. I have some vague idea of the rest of Lima, the sprawling slums and poor urban regions that comprise much of the 9-million person metropolis, but am not quite prepared for the poverty that faces me. I haven’t seen anything like this since a trip to Nicaragua 3 years ago, and not in the vastness that is Lima.
Today consists of visiting a few of the 34 health clinics serving the district and then attempting to find a few patients that have fallen through the cracks in a loosely-woven health system. In trying to find a few of these patients, we go through areas that are apparently too dangerous for me to bring along my camera, though they didn’t seem any different to me than the others. A few observations stick with me: the enormous number of sick-looking stray dogs that abound; the houses up in the hills that are built with scrap sheet metal, leftover pieces of wood, any material available; the tiny girl that peaks around the corner of the building at the weird tall white guy with a medical mask on. Addresses, if any, appear to be assigned at random (there aren’t streets at this point, we’ve climbed several hundred feet up into the hills), and written in chalk or sharpie. Today, we don’t find the patient we’re looking for, he apparently doesn’t live at this address any more. Maybe he moved somewhere else looking for work, maybe he died, there’s really no way to know at this point, and no way to ensure his continued TB treatment regimen.
Flying into Lima, most foreigners find a tourist-approved taxi company to take them straight to Miraflores, a fairly wealthy district within the sprawling municipality, where they’ll likely stay for the duration of the trip, possibly for a day or two before heading south to Cusco, Machu Picchu, and the rest of the “Gringo Trail” as one of my Peruvian friends dubbed it. They’ll experience great food, relatively low prices, and many American restaurants – KFC, Pizza Hut, McDonalds, Burger King, and Starbucks are all visible from the central Park Kennedy (named, of course, after an American president). Staying in a hostel, they’ll meet other travelers who speak English, visit bars frequented by other tourists, and generally have a good time, if a bit like any other international destination.
Not that there is anything wrong with this really – I did quite the same thing on my trip to Europe last year, spending a few days in each country, checking out the highlights before moving onto the next exotic locale. There are so many places in the world to check out, and sometimes we only have time to see the highlights before moving on. The issue comes when people think that their experience in the city was representative of how life really exists there. Before this trip to San Juan de Lurigancho, I’d had about the same experience in Lima. I knew that most of Lima wasn’t like Miraflores, but this distinction was more of an asterisk to my experience, an afterthought to the wonderful food, ocean vistas, and tourist-friendly coffee shops I had frequented so far.
But this trip to SJL makes me realize that there really are almost two Limas, the one curated for the wealthy residents and tourists, and the rest of Lima where most people wouldn’t normally visit. The first one, where I live and spend most of my time, is relatively comfortable, not that unlike life back in the states, and a good tourist destination. But it’s the second Lima, San Juan de Lurigancho and similarly poor, off the beaten-track areas, that I think I’m going to learn the most from.