June 18, 2012
(PHOP has arrived in Chincha this week and we will be posting
updates from both Chincha and the Sacred Valley. For more information on
the addition of the Chincha site to PHOP, click here.)
So, you may wonder, what would a pediatric sleep doctor from
Cleveland Clinic possibly be doing on a medical mission to Chincha, Peru?
Well, begin with an in-flight emergency at 2
a.m. involving an adult sickle-cell hypertensive patient turned
hypotensive patient over the Atlantic and follow it up with 24 patients on day
1 at the Peruvian American Medical Society (PAMS) clinic!
The PAMS clinic is the brainchild of cardiologist, Dr. Anibal
Zambrano and colleagues from St. Louis. With his lovely wife, Kathy, by his
side he is part of a tireless and dedicated team that has built this clinic an
arid earthquake devastated area of Peru. The clinic brings much needed
medical relief to its people.
The clinic itself is impressive with 2 floors of clinic and lab
space, including endoscopy and EKG rooms. Here primary care physicians trained
in pediatrics, internal medicine, and Ob-Gyn rub shoulders with specialists in
GI, nephrology, dermatology, neurology, radiology, and cardiology on any given
day.
Partnership with the Cleveland Clinic and Case Western Reserve
University this year meant that CCLCM- CWRU had the opportunity to expand the
increasingly popular PHOP mission from the very rural location tucked away in
the mountainous Sacred Valley to the small urban township of Chincha.
6:00 a.m. Alarm bells signaled the Cristoforus Colombus
Gran hotel as Chincha was stirring awake. We began with breakfast at 7
am. Then into the honking traffic it was as our cabs weaved their way
to the clinic. Half-finished houses, rubble by the street sides, and unveneered
office buildings bespoke of the toll the society here has paid to the quake.
8 a.m. The clinic starts with a welcome by PAMS. Volunteer
physicians from Washington University in St. Louis and University of Florida as
well as local docs made up the team.
12:30 pm . Lunch was called. We were thankful for a break.
Miscommunication-- the pediatric area was told 6 unexpected walk-ins had just
arrived from an orphanage. Lunch would have to wait!
5:45 p.m. The 2 pediatric stations saw 55 patients
with diagnoses ranging from undiagnosed asthma in a teen to folate deficiency
to suspected sexual abuse in a 4 yr old. Of course, there was the expected
vitamin A deficiency, malnutrition, chronic cough, TB exposure, and helminthic
(worm) infestations. In total, hundreds of patients were seen today at the
clinic making it a very busy day.
7 pm: A cold shower in the mild Peruvian winter! Brrrr! The
hotel just could not keep up the warm water supply this evening as scores of
tired volunteers decided to wash away the day's grime all around the same time.
Makes one really thankful for the wonderful life we enjoy back home!
7:30 pm. A wonderful teaching session by Dr. Walden of St. Louis
on H. Pylori and other GI ailments underscored the vastly different approach to
GI diseases in Peru vs. USA. Training in an approach to common ocular
conditions and eyeglass fitting at the ophthalmology station followed.
10:55 pm. Just got back from a late dinner and now blogging! No
sleep here guys!
Jyoti Krishna, MD - Pediatric Sleep Medicine, CCF
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