Peru Health Outreach Project

* Meet Ana 

The day is winding down at about 3:00 PM. Triage is taking its last few patients before packing up the scales, tape measurers and blood pressure cuffs. Their assembly line of first eliciting chief complaint, taking patient vitals, and then measuring their heights and weights is winding down after a barrage of incoming patients. Up in the mountains, we generally receive an initial wave of mothers and their toddlers and infants in the morning, shortly followed by a stream of school children leaving class a little after noon with men leaving work at their tale. But at around 3:00 PM, we politely begin telling patients that there is no time for them to see the doctors. Being so high in the mountains requires that we leave around 3:30-4:00 PM so that we don’t make the treacherous descent down the mountain back to Urubamba in the dark (it’s unsettling enough in broad day light). 

 

However, a mother and her daughter are slowly making their way to the clinic as it’s closing. As our members prepare to tell them that they have unfortunately arrived too late, they note that they 18 year old daughter’s eyes are swelling with tears, her skin dry, scaly and cracked. Her expression is a reflection of the physical and emotional tension wrought on by a dermatologic disease externally manifested. As we bafflingly stared, we could not determine whether she was tearing because her eyes were also afflicted by the skin condition or because the social isolation due to her appearance was emotionally frustrating. Although our doctors could immediately identify her situation as Psoriasis with super fungal and bacterial infections, the people of Ampay only knew this skin condition as a congenital abnormality. On our first day of clinic, Dr. Morales explained that the congenital abnormalities, as explained traditionally by the people of the Sacred Valley, are understood as evil forces manifested in human disease. This evil spirit can impregnate a women which leads to an abnormal child. Our experiences in clinic did not reveal whether these beliefs and sentiments are strongly prevalent in the community at present. But regardless of such religious and traditional beliefs, stigmas associated with physical diseases are continuous throughout various cultures and ethnicities. And it was clear that this girl was a victim of such stigma. She was prescribed steroids, antibiotic and antifungal medication. When I asked the attending how this patient’s condition would be had she been born in the United States, the doctor informed me that her condition would be no where near what it is now. Perhaps a bit of dry skin, but their would be no lacerations that pierced her hands and feet and no scaly plaques that single her out in the community. 

*Names changed