PASEO Program Adventure—Day 17: El Porvenir y Trujillo, Peru

This morning (Monday—yes, still behind), I completed my final observation at another school in El Porvenir. It was definitely an interesting experience because the school I observed is a Catholic school (considered more private than the others), as opposed to a national school (or public school, which is what every other school I’ve observed so far is considered). Since students from the secondary school were on a field trip to local historic sites for the day, I was only able to observe students in primary school.

Upon speaking with a local social worker, I was informed that there is a lot of crime among the students, including extortion and theft. When I spoke to the director of the school, she mentioned that a lot of the children have difficulties at home that influence their behaviors, including lack of parental support and/or parents having to work long hours, leaving their children unsupervised upon returning from school. This recurring theme seemingly continues to make its way into every school that I observe. There are so many challenges that these children face both inside and outside of school, but especially once they leave school grounds each day. The risk factors are substantial, and we have to focus on fostering more protective factors in order to provide these children with substantial support so they can have the futures they deserve.

In the afternoon, we had our weekly meeting with a group of local women and family members in El Porvenir that I briefly discussed last week. Each week, two students from the program are responsible for teaching the group members relaxation and emotional regulation techniques for them to utilize at any given moment and teach others in their community. This week, one of the other students and I were in charge of working with the group members’ children—some of whom have physical disabilities and/or difficulties with motor skills and/or verbal communication deficits. We had each child write their names and draw something that corresponds with each letter of their name. The creativity and abilities in these children are truly incredible.

After our group, we went back to Trujillo for our Psicología en Peru course. Tonight, we focused on statistics within the country, all of Latin America, as well as throughout the world. When we look at a global scale, depression happens to be the most common mental illness. However, in Latin America, only five percent of the adult population reportedly suffer from Depression. According to the NIH, “In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.” If so many people in the United States alone have experienced depression, why is the percentage so low in Latin America? It’s because so many people do not seek or receive mental health services. This number is merely what is reported.

Among so many other challenges, stigma is the biggest problem pertaining to bringing attention to mental illness in Latin America, and especially Peru due to discrimination against mental health. If you seek any type of help or treatment, you’re considered “weak” or “crazy.” You’ll likely be asked, “Are you weak? You’re not strong enough to deal with this?” Alongside stigma, shame and misconceptions about having a mental illness come into play as well.

Even if we were to put stigma aside, psychoeducation is another challenge. If someone does in fact have a mental illness, many times, they’ll go to the local clinic with the belief that it’s a physical illness as opposed to a mental illness. In a perfect world, hypothetically speaking, of course, let’s say that someone does in fact go to the hospital for an issue pertaining to their mental health. As I mentioned the other week, you would have to wait days in the hospital before getting an appointment, and when you finally do get one, your appointment would only last a few minutes, and would consist of being asked a few “yes” or “no” questions to determine if you have depression.

There isn’t enough time to converse with the patient, so the odds of someone actually getting the help he or she needs and deserves are slim to none. But first, you’d have to overcome the stigma and shame in order to even make it to this point. And you’d have to hope that your family wouldn’t abandon you due to shame as well. Now if you want to talk about services, there is about 1 psychiatrist per every 300,000 people in Peru. If we were to look at another country, let’s say Colombia for example, there, you would find 2.1 psychiatrists per ever 10,000 people. Pretty significant difference, right?

The following statistics have been taken from Según el Instituto Nacional de Salud Mental (INSM) (2014): Nearly 5 million people (11.8%) in Peru suffer from some type of mental illness. 700,000 out of 1 million Peruvians suffer from depression, while 200,000 out of 1 million Peruvians suffer from some type of anxiety disorder. Less than 4 percent of these individuals receive services in specialized centers. Why, you may still ask? Fifty percent of such individuals believe they can overcome their mental illness on their own. Thirty percent don’t believe in treatment, and thirty percent don’t know where to go to receive services. (Yes, the percentages overlap.)

This is why education is so important. We must spread the word about mental health because until we can do so, millions of people will not receive the necessary services they require.

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Day 1 in Cartagena, Colombia Continued: The Walled City and Iglesia de San Pedro Claver

After seeing Las Bóledas, we drove further into the Walled CIty. One of the first things we noticed was that many houses had little knobs on the corners of their roofs. Years ago, if you were Catholic, you would put these knobs on your roof for witches to fly over your house. If you didn’t have it on your roof, it meant that you were not Catholic and since you were most probably considered a witch, you were taken into the inquisition.

Every year on September 26th, there is a competition to see who has the nicest balcony in the Walled City. For this reason, almost every house we saw had beautiful gardens on their balcony, and the reason being, the winner of the competition doesn’t have to pay taxes for an entire year. If you were to buy a new house in the Walled City, you must restore it or the government can seize it and sell it to someone willing to make the necessary renovations.

The Inquisition took place here in Cartagena during 1610 and lasted for 201 years. If you were not Catholic, you were considered heretic and would be brought to the building pictured below where you would either be tortured or killed. Either way, all women were brought here and were weighed because you could only weigh a certain amount depending on your height. If you were deemed “too skinny,” you were considered to be a witch with the capability of flying. If you were deemed “too fat,” you were considered to have the devil in you. Additionally, if a woman thought her husband was cheating on him, she could go to someone she thought was a witch and ask her to do a prayer for the husband to be faithful. If the husband was in fact faithful, the woman would be brought in and punished by having her breasts removed. If the husband’s behavior didn’t change after the prayer, it was assumed that he was still unfaithful and he would be brought in and punished in the form of having his testicles removed.

As we continued walking, we came across what translates to “Bitterness Street.” This street received its name because during the inquisition, two men were being walked toward their hanging and as they reached the end of the road, one turned to the other and said, “This should be called Bitterness Street.” Apparently, ever since then, the name remained.

The next building we saw was one in which the Spaniards would use as the main building to bring all of their merchandise into the Walled City. The square itself is called Custom Square because this building is where customs once was. Hangings during the Inquisition took place here as well.

The last sight we saw as we walked around was the Iglesia de San Pedro Claver, or the San Pedro Claver Church, started by a Jesuit priest who helped the cause of the African slaves. He was called the Patron Saint of Slaves because he dedicated his life to helping the slaves. This is the only church in Cartagena with indoor balconies, and back in the day, the rich people would sit upstairs and the poor sat downstairs.

As the evening tour of the Walled City concluded, my mother, sister, brother, and I ate dinner in at Porton de San Sebastian, which is a restaurant that has a beautiful story behind it. Before owning her own restaurant, the owner would cook meals and give them to local workers in the city who didn’t have much money as a token of her appreciation. Someone wrote about this quality of this woman’s food and the premise behind what she was doing, and eventually, the writer’s review helped build up enough of a reputation for her to open her own restaurant. When she did open her own restaurant, she continued her tradition by closing her restaurant off one hour each weekday during lunch hours for local workers. The food was incredible and knowing the story behind the restaurant and its owner made the meal that much more enjoyable.