You can't use make because your version of Perl (and thus
MakeMaker) is configured for use with nmake. The Makefile
wants to use link but you probably only have ln. See
Re: Installing modules on Win32 for more
info.
So you don't need to use nmake, you need to reconfigure
Perl to use the tools that you have. The easiest and only
really supported way to configure this stuff is when you
build Perl. But you can probably get away with reconfiguring
by hand if you know what you are doing or don't mind
learning what you are doing by trial and error and occasional
research.
And, yes, you can probably use PPM because it sounds like
you have ActivePerl. But there are plenty of modules that
can't be installed with PPM because ActiveState hasn't
bothered to produce a binary distribution for them.