Tuesday, January 22, 2013

Maximo Nivel Health Campaign

A couple weeks ago, we participated in Maximo Nivel´s health campaign, organized by our volunteer doctor, Dra. Mildred. Also with us, were 14 pre-med undergrad students from LeHigh College in Pennsylvania. This health campaign involved going to rural towns and impoverished Cusco neighborhoods to set up a clinic and conduct full-body assessments, and provide meds or referrals to local Peruvians without health insurance.

On the first day of our health campaign, we took a bus to the small town of Ancahuasi in the Sacred Valley, about an hour away from our headquarters in Cusco. We set up the clinic behind the town hall. Since Shelby and I were the only registered nurses in our volunteer group, Dra. Mildred assigned us to teach and help our pre-med volunteers with assessments. To cater to the amount of people we were going to be seeing, Dra. Mildred had us divide a full-body assessment into 9 stations: 1. height and weight, 2. pulse and respirations 3. temperature, 4. blood pressure, 5 & 6 eyes, ears, nose, throat, 7. lungs, 8. abdomen, 9. extremities (arms and legs). Since a basic full-body assessment is not taught during pre-med undergraduate education, Shelby and I almost felt like chickens running around with our heads chopped off to help our fellow volunteers get accustomed to their stations, and to act as translators, as well. After a little while they got the hang of their jobs. Shelby and I continued to translate and answer questions and act as second opinions to any abnormalities seen or heard. It was refreshing to know that we still know our stuff and were able to explain the pathophysiology behind disease processes. Thank you, Univeristy of Portland.

Dra. Mildred
The most exciting part of the day for me was getting to assist Dra. Mildred clean and redress a burn wound on a little girl´s arm. I´m weird and really like treating wounds. The gnarlier the better. We gave her mother more medical supplies and taught her how to continue changing her dressings at home. On that first day we saw approximately 150-200 patients. We arrived back in Cusco at about 8pm and I was tuckered out.

On day 2 we travelled even further into the Sacred Valley, for a little over 2 hours, to the even smaller town of Limatambo. The drive was long and snaked through the mountains, but the town and its view of the valley was absolutely beautiful. We set up clinic in the town´s theater. It reminded me of my elementary school´s multi-purpose room. That day we were expecting to attend to over 300 patients. Having had one full day´s experience with their body assessment stations, our pre-med volunteers were ready to work and seemed more confident. Again, Shelby and I acted as translators and helped any station that needed help. For example, if one station was getting backed up, we´d help them with their assessments to keep the people traffic flowing. The most interesting cases I saw that day were: an elderly man with ascites from alcohol-related liver cirrhosis and congestive heart failure and kidney disease, and a woman with a massive abdominal aortic aneurysm -I could feel its pulse through her abdomen. Most of the patients we saw had arthritic pain and the common cold. After seeing 305 patients, we got back to Cusco that night at 9pm, even more exhausted than the day before. It felt good to be exhausted from working hard, though.

Day 3 was a more relaxing day. We went to one of Cusco´s many neighborhood clinics, aka Centro de Salud. This one was the Centro de Salud Santiago. Our mission for that day was nutrition education to mothers and their children. We made educational posters to show mothers what they should feed their children from the ages of 0-5 months, 6-8 months, 9-11 months, 1-2 yrs, and 3-5 yrs. Additionally, we cooked these foods to show them examples and have them and their children try samples.

Mothers and their children learning about proper nutrition
Malnutrition is a big problem in Peru. It doesn´t help that global demand of quinoa, a native staple here since pre-Inka times, has driven its prices through the roof (it currently costs more than chicken), and now the poor can´t afford to buy it. I don´t even want to get started on the domino effect it causes on the agriculture of other foods commonly eaten by Peruvians. Like in many countries, it is generally cheaper for the poor to eat junk food. Malnutrition-related anemia is rampant among the impoverished children here. The community clinics are adamant about preventing and correcting malnutrition and anemia. The foods we cooked as samples were affordable and easy to prepare. Although it may not sound appetizing here is what we cooked to battle against malnutrition, and particularly anemia for children 1 year old and older: pureed chicken liver scrambled with eggs, green onions, and chopped carrots, deep fried as an iron and protein packed omelette. Note: limeade, simply made with water and 4 limes and a little sugar, is especially important to drink when eating liver in order to help your body absorb the iron.

Trying out our nutritious food samples
On our fourth day, we drove to the outskirts of Cusco, near the airport, to set up a clinic. This is the only neighborhood in Cusco that does not have a government-run Centro de Salud. They didn´t even have a building big enough to host the clinic. We literally moved the furniture out of a family´s living room and used it for our lung and abodmen assessments and pharmacy/doctor consultation. We set up a long tent just outside for the first 6 assessment stations. Neighboring families donated their tables and chairs to our cause. It was quite literally a community effort. Since our space was so minimal, we combined some of the body assessment stations together to avoid unnecessary people traffic through and between the tent and living room. Thankfully, we had another registered nurse from England, and 3 nursing students join our volunteer group. Their skills noticeably helped the flow of the clinic. We attended to 110 patients that day.

The week of the health campaign was busy, but incredibly refreshing to get to work hard to help people who don´t have any sort of health care. Dra. Mildred is absolutely amazing. She organized the week with the people of each town/neighborhood. Apparently Maximo Nivel hosts 3 of these health campaigns per year. Hopefully I will still be around for the next one.

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