Llamas, alpacas, vicuñas, and the Apache Mountains are known as a few of the natural beauties of Peru. Many tourists come from all over the world just to try a tender alpaca steak or get their hands on the extremely fine fibers of a vicuña sweater. However, hidden behind Mother Nature's gifts are poverty and many Peruvians in need of medical care.
Being a recent medical school graduate, I wanted to put my 4 years of medical school to the test and do what I always dreamed of: helping those in need. Fortunately, with the help of Medical Ministry International, I had the opportunity to go on a 2-week medical mission trip to Arequipa, Peru.
After 14 hours of flying and an overnight layover, I landed in Arequipa. The moment I stepped foot out of the airport, I was immediately taken away by the beauty of three volcanoes: Chachani, Misti, and Pichu Pichu. Once we arrived and settled in at the hotel, we were fortunate enough to have 2 days to rest and explore as "tourists."
A few days later, it was time to put my game face on and start taking care of patients! For the first 3 days, we went to a small village called Socabaya. We set up our temporary clinic in the village's YMCA building. I was amazed to see at least 50 patients waiting outside the building. They were from all age groups: seniors, children, pregnant women, and young adults.
The next clinic site was in a small town called Pedregal, which is located 2 hours from Arequipa. Once we arrived, the reception that we received was breathtaking. We were greeted by a standing ovation. This was also my favorite locationbecause it was the busiest and a unique setting. We had at least 75 patients lined up and waiting for the team to arrive. We were so busy that we had to set a limit of 100 patients that day, and chose to return 2 days later so that we could accommodate those patients we had to turn away. The unique setting was the town's local museum-which happened to host not only mummies but also displays of several animals preserved by taxidermy, including foxes, squirrels, and birds-was the only place that could accommodate the patients. It is not often that one can say that he or she has practiced medicine alongside mummies and preserved animals!
In the last week, we had to wake up at 3:30 a.m. to travel 4 hours to a city named Condoroma, which sits approximately 16,000 ft (4800 m) above sea level. I remember shivering on the bus and seeing frost forming on the window the moment we arrived. It was at least 10 ºC! We were wearing only scrubs and light sweaters. As a result, the thin air and cold temperature made it a tough environment in which to work particularly as there was no heating system in the school where we were working. One of our nurses developed headaches, nausea, fatigue, and shortness of breath with an oxygen saturation in the low 80's which we diagnosed as acute altitude sickness. Luckily, we had an oxygen tank and enough acetazolamide and dexamethasone and her symptoms improved with treatment. I managed to keept warm by taking quick 5-minute "sunbathing" breaks after every patient encounter. At least I got my healthy dose of vitamin D! I have a tremendous amount of respect for the local Peruvians who battle the cold temperatures and thin air every day.
The last 2 days of our mission were spent at a small church in the town of Ciudad Blanca. The first day ran very smoothly; we had three doctors, one of whom brought ECG and portable ultrasound machines. These came in very handy, as I was able to diagnose a patient with atrial fibrillation. The ultrasound machine was useful in ruling out serious abdominal pathology. I had many patients with gallstones, as identified by ultrasound. Fortunately, Medical Ministry International was running a surgery mission in the upcoming weeks, so we were able to schedule many surgical procedures. One of our doctors was able to diagnose abdominal aortic aneurysm, which wouldn't have been accomplished without the portable ultrasound machine.
The last day of the mission was the most challenging for me. One of the doctors fell ill, so I found myself having to manage 28 patients. This was a first for me. I felt I was able to get a glimpse of what it would be like working as a resident. Another challenge that I had to face and overcome was working with translators. Spanish is the most commonly spoken language in Peru, but Quechua is also spoken in some regions. Hence, I had to work with two translators at once, translating English to Spanish, Spanish to Quechua, and vice versa.
One of my favorite rituals on the trip was after setting up our equipment at each clinic site every morning, our team and patients would sing a popular Spanish song "Alabare." The singing brought us closer to the patients and set the tone for each day. Each clinic site followed a similar structure for providing medical care. At first, the patients would register and then be triaged by the nurse. Every clinic would have at least two examination rooms, one dental room, and one eye examination room. Once patients were examined, they would go to the pharmacy to collect their medications. Finally, patients would go to the integrated health department, where they would receive donated gifts and information on how to take their medications and attend lectures covering common medical problems, health promotion, and prevention strategies.
Our team of health care professionals was able to provide medical service in the following disciplines: general medicine, obstetrics and gynecology, pediatrics, optometry, and dentistry. By the end of the mission, we had seen a total of 1043 patients: 553 in general medicine, 313 in optometry, and 163 in dentistry. We handed out 1532 prescriptions and 215 pairs of reading glasses or sunglasses and performed 108 laboratory procedures, and 900 patients received health education.
Overall, I am so grateful for this amazing opportunity! Peru offers diversity and endless exploration for tourists, and the scenery is absolutely stunning. The local Peruvians are very friendly, and their food is delicious. Being a recent medical graduate, I had the opportunity to diagnose, manage, and treat my own patients under the supervision of a physician. As a result, I was able to prepare myself for residency in North America. I would definitely go back to Peru just to relive this experience in the future!
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Bikraj Chohan |
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