Thursday, December 22nd
Our morning started with a debriefing session. We shared ideas, asked questions, and offered suggestions of ideas to implement. I asked questions about pharmaceutical allocation, insurance coverage, and patient knowledge of the healthcare process. In Peru, the only medications that require a doctor’s prescription are painkillers. Amoxicillin can be purchased over the counter from one of the countless pharmacies located on the street corners. This ease of access has lead to drug overuse, which in turn is causing multi-resistant strands of bacteria to evolve that are virtually impossible to treat.
This is where health education comes into play; it must start at the top of the ladder and trickle down. Government officials need to realize the flaw in this policy. Peruvian doctors need to understand the danger in over prescribing drugs to patients. Without understanding that bacterial strands can develop resistance to antibiotics, it seems like there would be no repercussions for giving out pills as if they were candy. Doctors also need to advocate for more restrictions on pharmaceutical distribution. Individuals need to be taught to take antibiotics seriously. They have a protocol that needs to be followed religiously. The health of the individual being treated is on the line. This was the case for the woman that, for whatever reason, did not receive a proper treatment plan for tuberculosis, and contracted bronchitis.
Thursday was a campaign for the men. Like Wednesday, we took glucose levels to test for diabetes, and psychologists were available for the men to speak to. A main focus point of the psychologists was promoting non-violent domestic behavior to the men. Unfortunately, only two men came into the clinic. This is understandable as the clinic was open from 8:00 am - 12:00 pm, so many of the men in the community were at work. After realizing this, we discussed options for more compatible clinic hours for the future men’s campaigns. Most men would be able to come in the evening hours; however, it is difficult to staff doctors during those times. The women in the community were also able to come in and speak to psychologists if they wanted to. The good news is that faces are beginning to become more familiar.
The clinic is currently putting an electronic system into place. This system maintains each patient’s person profile, triage results, and notes taken down by various doctors. On successive visits by a particular patient, doctors can debrief themselves on each patient’s recent medical history before a visit. Since the clinic was slower on Thursday, I spent a significant amount of time working with Omar as we learned how to efficiently use the system. It is a great asset to the clinic; the software was designed specifically to cater the needs of our clinic.
While Ramy had free time from patient intake, I noticed him taking time to teach a young 14-year-old boy English. This young boy is a face we see each day throughout our shifts at the clinic. Ramy has taken time to develop a personal relationship with the boy. It is essential to the effectiveness of the clinic for personal relationships to be formed with members of the community since they need to know us before they can fully trust us.
After we finished at the clinic for the day, we headed to Huanchaco, a 1 sol ($0.33) bus ride, from the clinic. Huanchaco is a beautiful beach town. For lunch we tried ceviche, a traditional Peruvian dish consisting of raw fish cured with acidic juices.
Once we finished lunch, we walked around the local shops before heading to our surfing lesson. We then headed out into the Pacific. This was the first time anyone in the group had ever attempted surfing (excluding our sand surfing experience on Tuesday). Surprisingly, we managed to get up on our boards and enjoyed the time in the water.
After our lesson, we found a local coffee shop and tried the infamous Peruvian desert, lemon pie. We then took the bus back home for dinner with our host families before taking the evening to ourselves to rest and recharge for Friday.
Friday, December 23rd
Friday was our campaign for happiness. This was a morning full of fun for the kids in the community. The parents that joined also seemed to have a great time interacting with their children and clinic volunteers in a positive setting. The event’s first speaker was a yoga instructor who discussed breathing techniques and releasing toxins. Our psychologists also came out to speak to the kids in a Q&A format about what success is.
During the campaign, Julia and I got to spend time speaking one on one with Lorenzo. I mentioned previously that Lorenzo is one of Katie’s best friends in Peru who went to college in the United States. He really cares about the health of his fellow Peruvians, so he spends a significant amount of time at the clinic.
I was curious to learn about his experience with healthcare in Peru. He explained that the lowest level of public health centers in Peru are “postas”. These facilities do not provide a great amount of care. However, he said that the doctors in postas are incredibly experienced. He attributed the doctor’s experience to the Peruvian’s habit of waiting until they have severe symptoms of disease to go to a doctor. Due to this pattern, the doctors in postas are accustomed to treating individuals with intense medical conditions.
Lorenzo said medications in Peru are not expensive. As I mentioned previously, no prescription is required, except in the case of pain medications. When asked, Lorenzo said it is usually not difficult to receive a prescription for a pain medication from a physician.
After the campaign, everyone headed home for some much needed rest. Immediately after having lunch, we all laid down for naps. Julia woke up with a fever, so Timothy, Grace, and the guys went to get her medicine. She took the rest of the day to recover. I stayed with her and caught up on reading and writing. After dinner, the group (minus Julia because of her sickness) went out to enjoy our Friday evening at the “discoteca”.