Cusco, Peru
We spent a week in Cusco, Peru, which is high in the Andes mountains at 3,500 meters (about 11,500 feet). We took the bus overnight from Lima to Cusco, which takes 22 hours of travel, along the coast and then winding up through the mountains. I started to get altitude sickness on the bus ride and was very ill for three days afterwards, barely able to get out of bed and unable to eat or drink. We took the plane back to Lima, which took 45 minutes (!). So my advice is to fly into Cusco, and then plan to rest for a couple of days before descending to Machu Picchu. Once I felt better, I would get winded walking up stairs or a steep hill.
Cusco is a lovely city, old architecture in the cathedrals, churches, and Inca stonework everywhere. Cusco was the capital city of the Inca empire when it was thriving, but the Spaniards did their best to level the buildings and enslave the Incas. Now Cusco is one of the most heavily touristed cities in South America. You cannot walk in the city without being beseiged by local merchants to sell things, everything from alpaca scarves and hats, sweaters, to jewelry and everything else imaginable. Only a very few beggars were in the streets, however, and most people are very friendly. It is a very safe city and tourists can walk the streets all evening after sunset to see the beautifully lit main plaza and buildings.
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