The bus finally arrived at 4:30 for the “4-hour” bus ride to a clinic in Espinar. Unfortunately, our huge tour bus had to ford a couple rivers, sketchily pass several oncoming cars on narrow mountain roads, and carefully cross some primarily wooden bridges, among other questionable acts for such a large vehicle, which ended up taking 6 hours. (We did get to see a huge herd of llamas though – a major win for the day.) We were supposed to start at 8, but didn’t arrive till after 10. Luckily there wasn't a long line of women waiting. Sarah, Chelsea, and I set up rather quickly and got started with Dr. Ferris without breakfast. We had a steady flow of women till 3pm, so my hunger pangs were only a slight hindrance. We ended up seeing about 190 patients total - not a bad day, considering some of the campaigns earlier in the summer only had ~70. The drive back seemed just as brutal, but I slept through most of it. We got back at 10pm and grabbed hot showers before passing out. Long day..
Monday, July 11th, 2011
[list of number of patients in each department at the hospital]
Shortly after waking up, I was told that we’d be touring Regional Hospital at 1pm. We started on the 4th/ top floor and worked our way down. Scott was our Santa Claus and carried the big trash bag of toys and stuffed animals for the kids. They absolutely loved him. Oddly, they seemed equally thrilled by the toothpaste and soap we were also giving out. The hospital looked dirty and old, fairly similar to the one in Argentina, although much larger. Not a place I’d want to have any sort of procedure done. I wouldn’t even want to stay there overnight for that matter. Every floor had creepy Jesus shrines in the hallways. You really can’t escape Him here, even if you wanted to. Old Jesus pictures that look like they were made in the 70s are EVERYWHERE: cabs, bus windows, bathrooms, around people’s necks, in the clinics we visit on campaigns. There were sweet murals on a couple of the floors though. They were awesome, minus the fact that some scenes on pediatrics floor mural seemed slightly inappropriate for children under the age of 18. Not to mention this mural was done by a pediatrician. Among others, we saw some cute newborn twins with a poor mother who had no other family and was on the verge of tears, a few kids with burn wounds, and old dudes with unknown issues. Hospitals are gloomy places, but the smiles on the kids’ faces helped alleviate some of the newly-induced depression.
After the tour, we checked out a market that was more for the locals than tourists. First, we went though the meat market, which was absolutely grotesque. Forget the chicken legs and pigs’ feet sticking up in the air; the horse head sitting randomly on a stool with its tongue out; a cow (?) liver laid out nicely in an attempt to look appetizing (seriously, who eats that??) – the most appalling scene of the day was a woman hacking away at a cow’s head with a machete, totally unphased by the identical looks of horror on 10 gringo faces. Sharpened the blade, back at it again. Derrick snapped a pic, and we moved on to the happier land of fruits and vegetables.
There were other shops of random kitchen utensils and appliances, TVs, and kids toys. David and I decided to share a bistek, egg, and fries, which I’m surprised I could even stomach after witnessing such a horrific act on that poor cow head earlier. I debated a fresh glass of juice at another station, but Sarah told me I’d be an idiot to drink that. I think my body has been doing well so far with all the new germs I’ve introduced. I do feel that I’m pushing my luck though, considering Dr. Ferris shudders every time I tell him I tried more ceviche. Whatev, I have cipro to save the day should anything happen…
We went out again, despite clinic opening at 8am the next day. After happy hour at Paddy’s Pub (oddly from 10-11pm or something), Derrick, Carolyn, David, Sarah, and I ended the night at a bar claiming to have a Radiohead cover band, but of course they played one Radiohead song, followed by a lot of Nirvana, Pearl Jam, Blur, and everything but Radiohead. Fairly uneventful, minus the flock of at least 15 elves that came and tore up the dance floor and the bar counter. Kind of hilarious.
Tuesday, July 12th, 2011
Clinic was slow today, as usual. I saw a colposcopy, which basically just involves finding the cervix, dabbing vinegar on it, and looking for white patches that indicate potentially precancerous areas. I also assisted on an endometrial biopsy on a woman with a stenosed os, which required injecting lidocaine to numb the cervix, dilating the os with gradually widening spikes, then sticking a skinny tube up the os to collect a good bit of the lining of the uterus. It looked pretty painful, but some women have cried over a pap, so I’m not really sure how bad it really is.
Wednesday, July 13th, 2011 Urubamba: chutiqui calcon ikita!
Today began a 3-day run of campaigns. The drive to Urubamba was absolutely incredible. Perhaps I'm a little biased because I love South America so much, but Peru is absolutely beautiful. We made a stop at one point along the drive where there were ruins on a hill to the right; to the left, there were huge, snow covered mountains with a valley below buried in a thick blanket of fluffy clouds. The city was nicer than the others we’d been to – lots of restaurants, parks, and paved roads, although skinny - perhaps too skinny for the 2 large vans we were in. Outside of our “clinic,” there were palm trees in the park with more snow on mountaintops in the background. Not often you see that.
Our space was similar to a church gym with a stage. We set up curtains across the stage to separate 5 “rooms,” each less than 6 feet wide. Ours had a delightful vintage-looking poster of Jesus looking down on us.
The main floor was for registration and watching a video on what exactly a “Papanicolaou” was. This video (done by an MCG medical illustrator) turned out to be incredibly helpful. Since our tables didn’t have stirrups, we had to have them put their feet on the backs of chairs, which made things a little more complicated. Many of the women had never had the pap experience before, so the video helped cut out some time explaining the process. Not to mention Dr. George, the doctor Sarah & I worked with, spoke great self-taught Spanish. She’s a 50-something surgeon who has decided to do another residency to get certified in family medicine – interesting change of heart. She was very energetic and taught us a new way to do breast exams, so hopefully that helps. Unfortunately, many of the women spoke Quechua, and in these cases, there’s not much more we can do than use charades-esque motions and brute force to get them to do what we want. I have managed to learn about 3 phrases, one of which is the title of this post: “take off your underwear” – and probably the most crucial!
A few more doctors and nurses have joined CerviCusco for the next week, so we were fortunate to have experienced docs to explain stuff to us (and of course double-check some of our paps and questionable breast exams).
After a delightful lunch of grilled trout (not chicken!!!) and fries, we hung out in the park for awhile till our vans arrived for the ~1.5 hour ride back to Cuzco.
Thursday, July 14th, 2011 – San Salvador
Today’s campaign was at the Centro de Salud in San Salvador. Amanda & I worked with Dr. Bob, the eccentric once-ob/gyn doc who now works for Kaiser Permanente and has a sweet handlebar moustache. We were lucky to have the OB room, complete with stirrups and a big standing light. Nothing too eventful happened, but it did get a little hectic at times and we ended up seeing over 200 patients. After the last patient had been seen and we packed up our stuff, the mayor of the town met us outside with his paparazzi. He expressed his gratitude for this first-ever event in his town, hoping that we would come back again next year.
We had a bistek lunch at a restaurant with a nice view of the Urubamba River before heading back.
Friday, July 15th, 2011 - Pomacanchi
The last campaign was in Pomacanchi. I’m not sure what the building was, but we ended up setting up curtains in a large room to make 4 stations. Sarah, Amanda, and I worked unsupervised for most of the day. Again, fairly uneventful, but Amanda did find a breast lump in a 19 year old that we then referred to the CerviCusco clinic for a biopsy.
Saturday, July 16th, 2011
Today was a big day at the clinic! We watched Dr. Bob do a pelvic ultrasound for an ovarian cyst in a young woman; more colposcopies; Dr. Ferris perform a loop excision (LEEP); and Dr. George perform her 2nd cervical biopsy.
We also had the first patient to ever get a pap using the SurePath liquid-based method in Peru, given to CerviCusco through a $1 million grant. Kind of a big deal, as indicated by the numerous pictures we got of the situation. Hopefully she understood the magnitude of this event and didn’t just think we were creepsters. The fancy new machine came in a few days ago and is supposed to be far superior to the traditional method we’ve been using. Exciting day for CerviCusco, indeed.
Later that night, Sarah, Derrick, and I booked our trip to the jungle, then ate at another Ferris favorite: Cicciolina. I ordered a tender filet of alpaca that came with roasted tomatoes and fried mashed potatoes. Delicioso!
We also ran by the botica/farmacia to find some meds for this bug I’ve had for a couple of days. I hate to be a whiner, but the incredible amount of dust this city has managed to stir up coupled with the unforgiving dry air has been a force my little throat and sinuses just could not take anymore.
It’s hard to believe that all our medical stuff is done now. It’s sad in a way, but I am super pumped about our plans for the upcoming week: Machu Picchu, Punu/ Lake Titicaca, Arequipa to see the Colca Canyon, then to Manu for the JUNGLLLEEEE!! I’m excited that David will be joining Sarah, Derrick, and I since he found the yellow fever and typhoid vaccines (for ~100 soles total, by the way. Ridiculous, considering Sarah and I paid well over 4 times that in the states…)
Time to get some much needed rest...
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