Mari y Tanta

Lima lies in a coastal desert where it never rains. Its only moisture comes from the fog that constantly enshrouds the city. Affluent neighborhoods, such as Barranco and the aptly named Miraflores, send water trucks up and down the boulevards, watering the flowering trees and shrubs that splash riotous color onto the misty grey backdrop. Behind high stucco walls and stout gates, fortunate residents live on quiet, narrow streets, streets that feel familiar to traveling Norte Americanos. Tucked away in a lovely home in Barranco lives Mari Solari, as she has for the decades during which she has amassed one of the finest collections of first quality Peruvian handicrafts in Lima, if not the world.
 

(photo courtesy www.expatclic.com)

Mari buzzes in her guests and offers a warm personal welcome into her exquisite gallery, Las Pallas, but also her home. She allows them to enjoy her extensive personal collection of artifacts in the living room and her sunny, verdant atrium before beginning a narrative tour of the public space of her gallery. Her accent and appearance reveal her origins in North Wales as she shares a personal story that she calls “classic. I fell in love with a Peruvian man, moved here and just never left.” She offers her customers not only a fascinating education from an expert but also personal stories of her wide-ranging travels across Peru and the artists she has been encouraging and buying from for decades. A picture emerges of the complex relationship she has with the first people of this country but also the market she operates within. She takes nothing on commission, preferring to purchase and resell a collection that must now represent an investment of hundreds of thousands of dollars. She admits that other resellers have moved toward encouraging their artisans to produce goods ever more in line with what easily sells in North American and European markets, but this has not been her bent. Her choice to work to preserve and promote the finest handcrafted work made in Peru is, she admits, hopelessly traditional. The artists whose pieces she markets and her local and international customers, many of whom have been loyal to Mari for decades, are grateful for her passion.

Joined to Mari by an equally passionate commitment to her work is Tanta, a health promoter for Socios En Salud in a neighborhood to the north, Carabayllo. Here, the air is filled with choking dust, not gentle fog. The flower-arched boulevards have been replaced by boulder-strewn paths winding up treacherously steep hillsides. Visitors are struck by a similarity to the landscape of the moon. This peri-urban slum is home to 200,000 people, over half of whom are unemployed. The merely poor live at the base of the mountain; the poverty and misery intensify as the altitude increases meter by meter. At a community center about halfway up the hillside and in tiny, two-room clinics dotting the highest tiers, Socios En Salud has been serving the people of Carabayllo for 18 years. SES is the Peruvian sister organization to the Boston-based non-profit Partners in Health and was founded to focus initially on the needs of patients with multi-drug resistant tuberculosis. The keystone of the Socios program, as with other PIH sister organizations in Haiti and Rwanda, is its cadre of community health workers, of which Tanta is a proud member.

Tanta’s story begins with ten years of untreated maxillary cancer. A complex tangle of factors prolonged her suffering: absent, inadequate or inaccessible health care; societal machismo that meant her husband would not allow her to talk about her “private” health needs, much less ask for help; the crushing demands of raising her family in a resource-poor setting; and the other far-reaching effects of extreme poverty dominated by hopelessness. Finally she was connected with Socios En Salud and her life was forever changed. Socios arranged and paid for treatment at Lima’s cancer specialty facility. Tanta was cured. She was then invited by SES to join in its work. She received extensive training and is today one of its proud community health workers.

This health care model as originally designed by Partners in Health provides for medications, primarily for TB and HIV/AIDS, to be delivered to patients in their homes by the health promoters. Now, Tanta says, she only does that if people are too sick to go to the clinic to receive their meds. Her main jobs currently are case finding, being the eyes and ears of Socios in her community, providing educational opportunities for children and social and emotional support for sick people. She knows her neighbors well and can convince a mom to seek care for a child who appears malnourished. She visits and encourages patients on long or lifelong treatment regimens such as for HIV/AIDS. Her compelling personal story, tireless dedication, professional skills and courage to speak truth in difficult situations are tools that equip her to perform a job that transcends all the others, that of role model for the women of Carabayllo. Here is a woman who is recovered from a horrific illness, a rare and remarkable success story. Here is a woman who patiently but persistently negotiated with her husband first to ask for care and then to become a trained, respected worker in the community. Here is a woman who embodies the work of the most famous and well-respected model for not only multi-drug resistant tuberculosis treatment but for an entire system of health care delivery to the sick poor across the world.

I’m such a fan of this program and these health promoters that I just had to ask for a photo with Tanta. As she finished the question and answer session with our group, I jumped up and tried to establish quickly some rapport with her by shaking her hand and stating slowly “I am a nurse, enfermera.” For about the millionth time in my life, I realized as the last word left my mouth that I had unintentionally done the opposite of what I had meant to do. I had probably created a barrier by referring to a medical hierarchy I’ve always ignored and frequently forget exists. The tone of her voice as she answered instantly acknowledged then obliterated that divide. In a clear proclamation of our sisterhood and her unmistakable pride, she smiled and said “Estoy una promotor de salud.”

Two women. Two passions. Two ends of the spectrum of Peruvian life. I am left feeling grateful for the opportunity to meet them both.