I am so thankful for my time in Peru these last two weeks. I had forgotten the many challenges of living in a country where you can’t flush the toilet paper or drink from the tap. This was my second trip with Medical Ministry International – and my mom’s first. The trip was titled “Cusco Extreme”. I actually heard about it the last time I was in Peru and was intrigued. My work graciously allowed for me to take off for this specific time period. The team consisted of 3 Americans, 3 Canadians, and several Peruvians. We had a family doctor, a dentist, an LPN, 2 RNs, and my mom served as a general helper.
Before I go any further I’d like to paint a picture of the medical system in Peru. They have a national health care system with strict rules. If someone gets sick or injured regardless of severity they have to go to the local clinic which is staffed by a nurse or a nurse in training and no doctor to be found. The staff there decide if you “require” further attention and they write a paper to refer you to the health center. But at their discretion they can say “it’s just a broken clavicle, you’re fine”. At the health center they look at you to decide to either help you, send you home, or send you to the hospital. At their discretion they can say “it’s just a broken clavicle, you’re fine”. At the hospital they look at you to decide to either help you or send you home. At their discretion they can say “it’s just a broken clavicle, you’re fine”. If you made it through all the obstacles and they allow you to have surgery or other specialty you are now stuck in the hospital for days, weeks, or even months waiting for the promised medical care. During those days, weeks, or months you’re spending at the hospital you are unable to attend to your crops or animals and your family may starve while you’re waiting for medical attention. While there are “Emergency rooms” in the larger cities they can turn you away, require you to pay a large sum of money, or even close for a holiday or party!
One other key player is the pharmacy, you can walk into any pharmacy and they can “diagnose” you and give you all sorts of prescription medications without having to see a doctor – you can get sutures, lidocaine, parasite treatment, antibiotics etc. Unfortunately there is financial gain to be had if pills are sold as a result of the diagnosis which leads to some problems of inappropriately medicating. For example if you walk in complaining of back pain they may “diagnose” you with a kidney infection and start you on antibiotics when you probably strained a muscle in your back an ibuprofen would’ve been more appropriate.
In addition to all of these challenges you have the terrain of Peru where we were located: altitude of 10,000 feet, steep mountains, terrible roads, and in the rainy season all the dry dusty roads turn into mud pits. The towns we visited are so remote that they feel like the government has forgotten them. Healthcare services are far away so getting care takes time away from work. In addition the initial clinics may dismiss their complaints even though a real, treatable problem exists. As a result even though they saw a doctor they don’t have very much trust in the system. In fact we saw a number of patients who used us as a second opinion.
Our group hiked around rural Peru and held clinics in 4 towns (we planned to go to more but ended up doing an extra day of clinic in one town rather than 2 half days in other towns – apparently it’s difficult to round up ~10 horses to cart our stuff across the mountains).