June 26, 2012
We started off this week with a tour of Chincha given by one of the nurses at the clinic. An excellent tour guide, she truly made us feel like we were seeing the city--open markets, lunch at a mom and pop restaurant, wine tasting, and visiting the home of the patron saint of Chincha.
Monday, however, marked the start of another clinic week. We are running with a diminished crew, as many of our friends--physicians and students alike--left on Saturday. (And they are sorely missed!) Luckily, more people from Cleveland came to join the Chincha clinic, allowing us to set up a new station for physical therapy and to continue seeing patients in internal medicine, dermatology, and for metabolic syndrome screening. Despite our diminished numbers, we still had a multitude of patients. One of our most popular stations, eyeglasses and vision screening, saw 65 people today, which is the average for that station.
Most of the cases that I’ve seen in Chincha are what you would expect in every outpatient clinic--upper respiratory infection, gastritis, back pain, etc. A few cases have truly stuck out to me because they are so preventable. One toddler was diagnosed with possible cretinism due to hypothyroidism that could have been reversed if she had been screened at birth. Another woman appeared with a mass in her neck, which was most likely a goiter due to iodine deficiency. In addition to these cases, we also found it difficult to prescribe medications since we were unsure of what was available in the other pharmacies in Chincha.
I spent Monday working with a Peruvian pediatrician, who had been practicing for more than 40 years. She was easy-going with her patients and understood cultural practices that helped her to establish rapport with the parents. For example, she emphasized to me that patients in Peru expected a prescription even if it was just for a viral URI and she would occasionally prescribe Paracetemol (Tylenol) or even antibiotics to pacify the parents. She also knew that Peruvian mothers would often apply their saliva to a ganglion cyst, a remedy that often made the problem worse. A strong believer in the mind-body connection, she advised parents to reduce stress in their children’s lives. Calling herself “medicina antigua,” she preferred to mix Peruvian beliefs with modern medicine. Although not necessarily adhering to current treatment guidelines, this made her more effective at building rapport with the parents and watching out for the well-being of her patients.
And she truly does care for her patients--this is a belief that everyone at the clinic shares. One physician takes the time to converse with each one, asking about their jobs, how much they earn (28 soles for an entire day of work?!), and comments familiarly that they need to lose weight. Some of the nurses will point out when patients are especially poor, hinting that I should treat them particularly well. Another physician paid for a patient’s biopsy herself so that the patient would be able to obtain a diagnosis. Patients reciprocate by ending appointments with a hug and a kiss on the cheek. It’s these gestures that render the Chincha clinic a community.
Sandy Sun, MS3 CCLCM
We started off this week with a tour of Chincha given by one of the nurses at the clinic. An excellent tour guide, she truly made us feel like we were seeing the city--open markets, lunch at a mom and pop restaurant, wine tasting, and visiting the home of the patron saint of Chincha.
Monday, however, marked the start of another clinic week. We are running with a diminished crew, as many of our friends--physicians and students alike--left on Saturday. (And they are sorely missed!) Luckily, more people from Cleveland came to join the Chincha clinic, allowing us to set up a new station for physical therapy and to continue seeing patients in internal medicine, dermatology, and for metabolic syndrome screening. Despite our diminished numbers, we still had a multitude of patients. One of our most popular stations, eyeglasses and vision screening, saw 65 people today, which is the average for that station.
Most of the cases that I’ve seen in Chincha are what you would expect in every outpatient clinic--upper respiratory infection, gastritis, back pain, etc. A few cases have truly stuck out to me because they are so preventable. One toddler was diagnosed with possible cretinism due to hypothyroidism that could have been reversed if she had been screened at birth. Another woman appeared with a mass in her neck, which was most likely a goiter due to iodine deficiency. In addition to these cases, we also found it difficult to prescribe medications since we were unsure of what was available in the other pharmacies in Chincha.
I spent Monday working with a Peruvian pediatrician, who had been practicing for more than 40 years. She was easy-going with her patients and understood cultural practices that helped her to establish rapport with the parents. For example, she emphasized to me that patients in Peru expected a prescription even if it was just for a viral URI and she would occasionally prescribe Paracetemol (Tylenol) or even antibiotics to pacify the parents. She also knew that Peruvian mothers would often apply their saliva to a ganglion cyst, a remedy that often made the problem worse. A strong believer in the mind-body connection, she advised parents to reduce stress in their children’s lives. Calling herself “medicina antigua,” she preferred to mix Peruvian beliefs with modern medicine. Although not necessarily adhering to current treatment guidelines, this made her more effective at building rapport with the parents and watching out for the well-being of her patients.
And she truly does care for her patients--this is a belief that everyone at the clinic shares. One physician takes the time to converse with each one, asking about their jobs, how much they earn (28 soles for an entire day of work?!), and comments familiarly that they need to lose weight. Some of the nurses will point out when patients are especially poor, hinting that I should treat them particularly well. Another physician paid for a patient’s biopsy herself so that the patient would be able to obtain a diagnosis. Patients reciprocate by ending appointments with a hug and a kiss on the cheek. It’s these gestures that render the Chincha clinic a community.
Cleveland pride!! (Spelling CWRU in front of clinic)
Sandy Sun, MS3 CCLCM
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