Meet Juan*

In the district of Pisac, approximately 150 people inhabit the small mountain town of Ccotataqui. As our bus pulled up the bumpy dirt road into the courtyard of the school where we would hold clinic, a local official announced our arrival to the town via megaphone. While we set up our supplies for clinic, a crowd of women and children began to accumulate. We triaged these patients in order of their arrival, and sent them on to see the doctors. Although the line was long, we triaged effectively, and the physicians and their assisting medical students worked efficiently to keep patients moving through. However, around noon a group of men showed up from the fields. Their leader, Juan, explained that they were on lunch break from working in the fields, and only had an hour before they needed to get back to work. After a moment of deliberation, we decided to let this group cut the line. Although it seemed unfair to see these workers before the women and children who had been waiting all day, we knew that if we didn’t see the workers now, we would not be able to help them at all.

While filling out his triage form, I learned that like many of his fellow farmers, Juan suffered from the occupational hazards of lower back pain, eye pain, and a pterygium in one eye. When I asked the standard question <<Cuando fue la ultima vez que vio a un doctor?>> (when did you last see a doctor?), he responded <<nunca>> (never). After having his vitals taken in triage, Juan had an interview and an exam with a physician and medical student. He was then referred to the physical therapy station, where he learned back exercises, stretches, and practiced appropriate lifting techniques to reduce the strain on his back. Next Juan moved on to the eyeglasses station, where he was outfitted with donated sunglasses to protect his eyes during his long work days in the fields. Not only will these sunglasses help reduce the burning and tearing he experienced as a result of sun exposure, they will also slow the growth of his pterygium. After completing his circuit through our clinic stations, Juan thanked us earnestly for the sunglasses and advice. By working efficiently for the rest of the day, we were still able to see all of the patients waiting in line. Juan and his fellow farmers were so thankful for the chance to visit our clinic on their brief lunch break, we were happy to have been able to help them.

*Names changed

When looking for a place to begin about this small town that we visited called “Ccamahuara”, I instinctively look to Google to get a background about the village. As I’m writing this, there are only a few hundred results on Google that briefly mention the town. Ccamahuara is a tiny village located about three hours away from the town of Urubamba where we were based. Because of the remote location of the town, the inhabitants spoke primarily Quechua (known as Runa Simi to the people who speak the language).

This was one of the first days that we interacted primarily with the Quechua people of the Andes in Clinic, and so, we relied very heavily on our translators. Roughly 95% of the population of the town spoke Runa Simi with only five percent having an understanding of both Spanish and Runa Simi. Because of this, we were left at a standstill for the beginning of the visit. Then, a very kind woman named Susana arrived. She had come with her mother and child, who came with similar symptoms, and desired treatment. Were it not for Susana, I feel that we would still be in those mountains. With an understanding of both Spanish and Runa Simi, she helped us see patient after patient after patient. She selflessly stayed there the entire duration of our visit solely to help us.

I learned so much about her. Originally, from Cusco, she came back to the town and had been living with her parents to take care of them. She taught me about languages of the Andes, the customs of the people around the area, and her life, hopes, and dreams. It was an absolutely wonderful experience and probably one of the best experiences I had in Perú. Despite being very busy the entire day, we laughed so much! Before she left, I asked her to say goodbye. She found me before the group left; we hugged, took a photo together, and I thanked her for all of her work. She was, after translating all day, practically a physician, I told her. Before she left, she showed me the little white house where she was living and told me to come back and visit. I hope that one day I’ll be able to return to Ccamahuara to see her.

Meet Luz!

Hi my name Luz* and today I got to visit the PHOP clinic in Huandar. My mom brought me with my older sister and younger brother. They are both sick with the flu, so we got to the clinic early. My two siblings and my mom answered lots of questions and each got a form with funny words on it. We went to see a very nice doctor, Dr. Bhardwaj, who looked at my brother and sister. I answered as many questions as I could for them. After they were done, they got toothbrushes! I really wanted one! 

We waited around the clinic while my mom was seen by another doctor. I helped my brother and sister pick out really cool Toms shoes. I really wanted the shoes and the toothbrush, so I went back to the line and got a piece of paper too. And, school let out at noon, so all of my friends came to the clinic too! We all sat in a line and watched Dr. Bhardwaj examine patients. 

She had a helper named Devlin. I sounded out her name from her ID badge with the pretty picture. Devlin put medicine on the teeth of one boy in line. He sat on a chair in front of her and laid his head in her lap! I asked her if I could get some too. She said anyone between 6 and 12 years old, so I told her the ages of all of the kids in line. Since I am ten, I got some too! I sat on her lap and watched her make funny faces as she painted on the medicine with a little blue brush. It tasted bitter, but I didn't complain. Afterwards, I got my purple toothbrush and a new pair of shoes. I am so happy!

*names have been changed

Meet our hosts in Pisac!

Pisac, noted for its bustling markets and echoes of pan-flute music along colorful streets, is a village in the Sacred Valley within the province of Cusco, Peru. It also houses the Asociacion Winaypaq Pro Desarrollo Humano, an association to promote health, education and culture within the Sacred Valley headed by Dr. Morales. Dr. Morales has graciously been our main contact in Peru since 2010. His passion for the Sacred Valley has mobilized health care providers in Peru and abroad to meet the health demands of its residents. On our first clinic day in Peru, we journeyed from Urubamba to the Centre de Salud in Pisac to learn more about the local population and the health challenges they generally faced.

At this health orientation, Dr. Morales and host of other physicians welcomed us and echoed our hopes for further cooperation and continued development of the project. Their hospitality shown in the warmth of their greetings, the colorful welcome banners and local variety of refreshments. Our kind hosts debriefed us on their expectations for this year’s patient profiles and clinical exposure. An obstetrician, hospitalist and nutritionist all explained the ongoing issues their patient confront and the ways in which the public health care legislation has attempted to address these concerns. We learned that all pregnant women receive free health care, which includes dental care and nutrition in addition to the general follow-ups with moms. And while trained mid-wives can attend to normal deliveries, they must refer complicated pregnancies outside the Pisac district.

We were informed of the ways in which public health officials are targeting parasitic infections in children and the challenges in treating adult patients who can’t afford to leave work for a doctor’s visit. Compounding problems and critical conditions are often the only reasons adults tend to see physicians and often times these conditions are beyond treatment. Additionally, we were given a brief overview of the cultural myths that have  dominated the region and the ways in which they affect health care. For example, congenital anomalies are often attributed to evil forces (soka or macho). Moreover, Dr. Morales explained that a lot of medications and healing traditions rely on the quality of the food they are supplementing their treatment with. Foods and drinks are inherently “hot” or “cold,” the quality of which is not dependent on the physical temperature of the food. Hence, physicians are advised to tell patients to consume whatever they believe is best for the illness because an incorrect recommendation can debase the physician’s credibility in the eyes of the patient.

After the orientation, the rise in energy level of our group was evident and we were more than excited to start our first day in clinic on Tuesday (6/11) in a beautiful village called Huandar!  Please stay tuned for our series of “Meet the patients of the Sacred Valley and Chincha.”

The date is set! 

Please join us for this year's "A Taste of Peru" Gala on Saturday, April 13th from 5-9 pm at the Cleveland Skating Club. The Charity gala will benefit the medical missions trip, as part of the CCF/Case Western Global Health Initiative, to improve the health of people in the Sacred Valley & Chincha Peru. Join us for great Peruvian food, crafts, ethnic dances and Latin music!

To purchase tickets, please click here!

2013 Applications!

We would like to announce that the application for this year's trip is now open!

We encourage all those interested to apply.  If you missed the informational meeting, please email us at the address below for a brochure.  Important details of the trip are summarized below. 

The general application is due December 14th at 6pm.

You can access the application here:  PHOP 2013 Application

If you have any questions/concerns, please direct them to phopoversightcommittee2013@case.edu

Saludos!
PHOP coordinators 2012

Trip Information:
-          Trip dates:

o   Sacred Valley: Jun 10^th – July 5^th , 2013

o   Chincha: June 24^th – July 5^th , 2013

o   2, 3, or 4 week options for students

-          First meeting dates (times and locations TBA):

o   November: 15^th and 28^th

o   December: 12^th

-          Application information:

o   Deadline for general applications: December 14^th

-          Requirements:

o   Spanish fluency (can be a beginner actively working on improving Spanish!)

o   Attendance at bimonthly meetings

o   Participation on planning committees

-          Approximate cost: 
          o   $1500 for 2 weeks, $2500 for 4 weeks (with potential partial reimbursement for student 
                               participants)