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Elberta Malpartida met Isabelle at a festival for the Virgin Del Carmen, a Christian saint that is widely worshipped in Peru and Colombia. In the 40 years since their meeting they became very close, more than just friends “we became soul sisters, truly friends, real sisters,” Isabelle said.
One day, Elberta showed up at Isabelle’s doorstep with nothing but six buckets, two dogs, two turtles, $150 and of course, her stamp of the Virgin Del Carmen that she carries with her everywhere.
She had no money, no other belongings besides the clothes on her back, no explanation and nowhere to go. What was a sister to do? Isabelle took her in
Five years later, Elberta is still living under the care of Isabelle and her daughter. Isabelle is happy to care for her, but a string of unfortunate events for Isabelle and her daughter Judith along with the deteriorating health of Elberta since her arrival, has made the burden of caring for a dependent too much to bear.
Elberta is nearly crippled with Arthritis. When Janet and I visited for patient follow-up, it took her a couple minutes to walk across the room and take a seat on the bed. She had a perpetual look of pain on her face, grimacing, wincing with each small movement. Like a kind of tick, she continuously puckered her lips, opened and closed her mouth, making a light but audible smacking sound.
The only cognizant thing she said the whole time we were there is that she feels lots of pain. At one point she tries to grab something from a bag of knick-knacks a few feet away. It requires a huge amount of effort for her to reach across the bed and bend over the few feet to grab the bag. She doesn’t seem like she can do it, and realizing the extent of her disability I grabbed it for her, but she just discarded it- like she had forgotten or never had a need for it.
Janet and I sit down. We don’t need to ask Isabelle any questions, it all comes pouring out of her, like she has been dying to tell “The story of the grandmother who was abandoned,” as she called it, to someone for a long time. What follows is the story as she told it.
Elberta didn’t used to be poor, she begins. Her family wasn’t poor either. She used to have a nice house in Villa Maria, where she met Isabelle. Her husband made them sell the house and move Quilmana, an area south of Lima. They bought a nice house with a beautiful garden abundant in fruit. When Isabelle used to visit, she would return to Lima with a basket full of fruit. Things changed.
Elberta’s husband died.
At this point Elberta was struggling with old age and could barely take care of herself. Living alone was no longer safe, she had no children to help care for her. She had few assets other than the house she lived in. She subsisted primarily on fruit from the garden. Sometimes, she would fall in her house and it would take two or three days for someone to notice and come pick her up.
Eventually, Elberta decided she was going to sell the house in Quilmana, and move to Huanuco, where her sister Elaria lived. Could she stay with Isabelle for a couple of months? After which, she promised, she would go to her sister’s house in Huanuco. Isabelle of course said yes, but she pleaded with Elberta to not sell the house, “money runs out and we don’t know what’s going to happen in our lives. At least you can rent your house,” she told Elberta.
Nevertheless, Elberta sold the house for $2000 and asked Isabelle to come get her in Quilmana. Isabelle sent her daughter Judith to get her. When they arrived in Villa Maria, Elberta’s plan was to use the money to open a grocery store in Huanuco. Isabelle tried to convince Elberta to buy a woodhouse in the hills of Villa Maria with it, but she was set on her plan. She was also spending it little by little on basics like food. She went to Huanuco after less than two months had gone by and lived there for awhile.
However, when her family realized she was running out money, and the grocery store hadn’t panned out, they bought her a bus ticket back to Lima, and sent her off. That’s when she showed up at Isabelle’s door with nothing but $150, two turtles, six buckets, two dogs, and nowhere to go.
What was Isabelle to do? She took her in.
“We took care of Elberta because we are humans and we need to have charity. We feel compassion but we don’t have support enough to give her. But thanks to god at least we have something to eat. I have been alone for 24 years, I got divorced, and I have been fighting since then, but I haven’t abandoned myself,” Isabelle said.
Elberta started living with them in 2000, they took care of her on their own until 2015. When Elberta arrived both Isabelle and her daughter were working, Elberta was too old to work. As time has passed, things have gotten much harder for all of them. Isabelle was fired from her job when she got severe bronchitis. So Judith has to support Isabelle, who is now 70, along with Elberta. Judith is a teacher. She teaches classes at a church during the day time, and does office work in the afternoon and evenings.
It is not just food and shelter that Elberta needs, but healthcare as well. Elberta fell and broke her hip. She was unable to walk and was perpetually in severe pain. She lay in bed suffering all day, waiting for an operation, which Isabella and Judith eventually saved enough to pay for, with some help from insurance. Then, right before the operation Elberta fell again and broke her hand. All the money they had went towards basic care for this injury, and Elberta wasn’t able to have the surgery.
“I said lord why is this happening to me I’m going to put this in your hands because I have no idea where I’m going to get money,” Isabelle said. “My daughter has her own children and now the bill the light and the water bill is due. Then I saw the statue of the Virgin del Carmen, which is actually the one that Elberta has devotion to for the last 40 years. And after I pledge to the virgin and the lord, Elberta started walking again. It was a miracle of the lord.”
Elberta walking was a great relief to them, as they did not have a dire need to pay for the surgery, and did not have to carry he everywhere. But their relief was short lived.
Life kept beating them down; Judith had a heart attack.
While she recovered quickly was able to resume her role as breadwinner, the strain of the situation was clearly weighing heavily on her.
“All the expenses come from us. Sometimes my daughter tells me, what happens if Elberta dies, how are we gonna have a funeral. I always tell her don’t worry, if you worry you’re going to have another heart attack. The heart attack happened just two months ago. That’s why I don’t want her to worry. And what happened next, I had a stroke. I just laughed,” Isabelle said.
Now Isabella can no longer do even the work she was doing after she lost her job; making lasagna, rocoto, and rellenos to sell on the street, because the stroke impaired her motor function. At least she recovered enough to take care of Elberta and her grandson while Judith is at work.
“I got to the market I buy groceries, because I don’t have anyone to get them for me,” Isabelle said. “My daughter works all day. I have to run, I have my grandson I have to take care of too, I don’t have time for Elberta. I’m tired, but I make her food. I don’t have time [to give her enough attention] so she feels abandoned. That is why she had the crisis three days ago, crying like a little girl, saying she doesn’t have anyone. ‘I don’t have anyone, I don’t have anyone to talk with,’ she said. Every time I see Elberta cry I say don’t worry god is not going to leave us.”
Isabelle must do everything for Elberta, she can do hardly anything on her own. Basic things, like finding diapers for Elberta, can quickly snowball into a struggle under the strain of poverty. Isabelle goes to a local church to beg for diaper donations, but she can’t always get them. Whether or not she gets them- just this task can take up a good part of a day’s time and energy for Isabelle.
Just leaving Elberta alone in the house is sometimes a problem.
She is not of sound mind. One time she escaped the house, and for hours no one could find her. Thankfully, a neighbor found her wandering around in the rain soaking wet and returned her. Sometimes, she will grab her belongings and tell Isabelle that her dead husband has arrived; he is calling her and she must go. Elberta paces the house, speaking, muttering to herself all night -or perhaps to visitors only she can see, like her dead husband.
“My biggest fear is if something happened[to us] she is not going to have anything,” Isabelle said. “Thank god now I recovered and can take care of her in the house. What I want to ask is for you to help me with her because she doesn’t have anyone. We may be poor, but she at least she has bread for her mouth. If there is not enough[for her], we will eat [mine] it together,” Isabelle said.
They would love to continue taking care of her, but their budgets are stretched to the limit, and they have significant health problems as well. They have tried taking Elberta to an Asylum, but they would not take her in. The asylum told them that they would not accept Elberta because Isabelles house is made of concrete, and if Isabelle could afford to take her in 5 years ago, she must have the resources to take care of her. Isabelle has tried visiting Elberta’s sister Elaria to get help, but she will not help them. She has tried calling Elberta’s nephews, who hang up on her when she mentions Elberta.
She has to care for Elberta on her own.
MEDLIFE is working to get Elberta into the pension 65 program, a Peruvian government program that is very difficult to apply for that gives money to the elderly poor, much like social security in the U.S.. Pension 65, however, is specifically for people who were generally to poor throughout their lives to pay in.
MEDLIFE nurse Janet went to the municipality and walked them through the paperwork every step of the way. This money would enable them to put Elberta into a home where she will be cared for, or just lighten the load for them. Pension 65 is a slow bureaucratic process. It is often too difficult for those who need it to navigate on their own and wait for. It will be months before we know if they get in. Hopefully, it will allow for a new beginning for Isabelle and Judith, who have put everything they have into caring for Elberta for so many years.
When we met the students and teachers from the Galte, Yagachi school in Riobamba, Ecuador, their classrooms were deteriorating. Thanks to successful fundraising campaigns led by MEDLIFE at Wayne State University, MEDLIFE-Ohio State Chapter and MEDLIFE at UGA, we worked with parents, teachers and community leaders to build new classrooms for the school. The new classrooms will provide a safe and comfortable learning environment to ensure that the kids at the Galte Yagachi school receive an education with dignity! Watch the video here.
Yesterday, I tried surfing for the second time here in Lima. This time was marginally better than the first, thanks to some calmer waves. For a coordinated person, surfing is a tricky skill to pick up. For a slightly klutzy person, as many of my friends would classify me, surfing seems near impossible. The first time I went, my friends and I took a much too quick lesson then struggled barefoot along the rocky beach to the water and into the surf. The further I paddled out into the water, the stronger the waves got. It wasn’t long before I was bracing myself at the sight of the larger oncoming waves. They would come, flip me off of my board, and send me tumbling in a whirlwind of water. During these more violent waves, I couldn’t tell which way was up. All my senses were assaulted by salt and water and noise and force. The only thing to do was let the wave take you and wait for it to spit you out, all while hoping your board didn’t hit you in the head and you had enough air in your lungs.
Out there in the ocean, struggling to get back on my board before the next wave came, I was struck by a feeling that I do not often have: a lack of control. I couldn’t stop these waves, I couldn’t get a break from them, and I was completely at their mercy. It was a scary feeling. Unfortunately, this lack of control is a feeling that many people experiencing poverty have constantly.
On a patient follow-up visit to a very marginalized area recently, I was confronted with this problem in an unforgettable way. While waiting outside a small bodega with MEDLIFE staff for a follow-up patient, we encountered a woman who had come to wait for a phone call on the bodega’s phone. Upon closer inspection, this woman’s body, especially her eyes, were tinted yellow. Alarmed by this, the doctor asked if she needed medical care. She said no, but explained what had led to her appearance. Years ago, she had problems with her gallbladder, and had gone to the hospital to get it removed. Shortly after, she began turning yellow. When she went in for a scan, the medical professional had told her that she was missing a kidney. The woman was shocked – she had never had problems with her kidneys before. The MEDLIFE doctor told us that the surgeon for her gallbladder surgery had probably taken a kidney to sell. I knew organ trafficking was a problem here, but it had never before presented itself to me in such an apparent way. This woman must have felt so betrayed by the breach of her trust – an unfortunately not uncommon feeling towards medicine here.
Later, we heard more about the woman’s story from a neighbor. She had seven children. The oldest was 20 years old, while the youngest was 1 year old. The woman, with jaundice and missing a kidney and gallbladder, was probably not in the best health to be carrying children. The nurse commented that she needed to be on birth control, or to tell her husband to stop getting her pregnant. However, family planning is not often a process that most women here are involved in. Some women try to hide birth control use, or but many simply do not use it and then find themselves with many children, often not by their own choice. Finally, according to the neighbor, one of her daughters had stopped growing at age 6. She was now 11, and unable to walk. The doctor hypothesized that her daughter probably had polio.
I was speechless after hearing this woman’s story. She had gone through organ trafficking, had many kids in an area that was extremely affected by poverty, and a daughter with polio – all of which could have been prevented. How little control she must have felt over her situation, when wave after wave of negative circumstances hit her and her family. These events in her life were effects of a larger, very complicated system.
Working in the pueblos jovenes of Lima has illustrated to me the complexity of poverty. It doesn’t just come down to not having a job. It’s the political issues that lead people to mistrust their government, which has a history of violence and lack of support for its people, whether that’s by not providing electricity or denying land rights. It’s the economic issues that force people to leave their farming lifestyles and move to a crowded shantytown. It’s the social issues, like sexism and violence in the home. More than anything, it’s a lack of control over one’s situation.
When I was surfing, I knew I could make the decision to get out of the water whenever I wanted. Getting out was the only way to avoid the waves. However people here and marginalized populations around the world can’t simply leave their situations. That’s where MEDLIFE comes in. We’re working to help these people get out of their oceans of poverty, and onto more stable ground. I’m sure the woman we met felt little control over her situation. I want to change that and in working with MEDLIFE, I feel like I am – little by little and patient by patient. My experiences here are formative and everlasting. I know that I will leave this internship at the very least with a slightly better knowledge of surfing, but mainly with the desire to continue helping people affected by poverty leave their oceans of disadvantage and gain some control.
Back in 2014 we blindly followed Carlos, MEDPrograms director of Peru, up a number of stairs to reach Julio’s home in the hills of Lima. This was the first time we were all meeting Julio. Compared with the homes of other patients we visit, Julio’s home is situated at one of the highest points on the hills. We knocked and entered into a small, seemingly cardboard room consisting of a single bed, a chair, and Julio's few personal belongings.
Julio sat in the chair as we piled in to speak with him and hear his story. On first appearance it was not obvious what his ailment was, but he and his mother seemed so sad, and the mood was somber. As Julio began recounting his story, we quickly understood why.
Julio is twenty-six years old, and until several years ago, he was able to lead a relatively healthy life. Though living in poverty, he was in good physical condition and rarely had any health problems. Then, when Julio was eighteen, life as he knew it was turned upside down. Julio developed excruciating back pain that worsened over time, eventually preventing him from walking or moving his legs on his own.
This crippling problem has inhibited Julio from leaving his small, one-room house for eight long years. Upon hearing this, even Carlos, who has been with MEDLIFE since 2010, was taken aback. We had not previously known the gravity of Julio’s situation, but he was clearly in great need of help.
Julio’s mother, sister and nephew live in a small home situated just up the hill above Julio’s room. As Julio cannot lift himself up, they assist him with everything. There is no running water in the home so he has to bathe outside with the help of his mother and sister. His mother explained that she is constantly worried about Julio because he cannot take care of himself; for years he has been dependent on her, a single mother. “I am the mother and the father,” said Julio’s mother.
It has been exceedingly difficult to care for her family. She supports three children, and her days are often split between taking care of Julio and for her one-year-old grandchild so her daughter can work. She burst into tears at recounting their situation and admitted the one thing that would transform their lives. “I just want Julio to be able to walk. That is the most important thing, for him to have his life back.”
Although Julio is educated, his condition prevents him from working and therefore from making significant contributions to the family’s income. Despite the obstacles presented by his illness, Julio is able to earn a little money by sewing sweaters. Each sweater is sold for the equivalent of $1 each, and on average, he can sell three sweaters per day. With such little money, the family has a difficult time trying to make ends meet. With no funds for a medical appointment or an easy way to transport Julio down the hill, despite his symptoms persisting for eight years, he has never been able to manage a visit to the doctor. He had no idea what was causing his lower body paralyses.
In June 2014, Julio’s mom heard there would a MEDLIFE clinic in her neighborhood in Pamplona Alta. She attended the clinic to ask for some long awaited help. The doctors at the clinic coordinated with Carlos to organize a follow up visit to meet Julio and figure out how MEDLIFE could best help him. After finally meeting Julio and learning about his condition, it was an easy decision to make: we needed to get him to hospital to see a doctor and find any possible cure for his debility.
Carlos informed Julio that he would finally be seeing a doctor. Instead of excitment, at first, Julio panicked and said that it would be impossible to get him there; he was nervous to leave his house. Carlos assured him we would be there every step of the way. Together, with one person supporting him on either side, we assisted him down the stairs from his house, down the hillside, all the way to the hospital, and then back home again.
A couple weeks later we repeated the routine for Julio’s follow-up appointment. For our second visit with Julio, he seemed less nervous to be helped down the steep steps and more eager for the trip to the doctor. In the car on the way to the hospital, Julio appeared to be in amazement with his surroundings; he captured the view out of the car window on a camera phone, seemingly to hold onto a fleeting moment.
Since our preliminary visit Julio has seen a doctor several times, with MEDLIFE always escorting him from his house to the hospital and back. It often takes an hour just to go up or down the hill to his home. After so long, his doctors were finally able to provide a diagnosis. They believe Julio’s immobility is due to an inactive muscular neuropathy, for which he will undergo intense physical therapy.
Although the initial cause of Julio's pain is still undetermined, doctors concluded that, due to some mysterious ailment eight years ago, he developed proximal myopathy in his upper and lower limbs. A diagnosis for the root cause of Julio's problem is underway. In the meantime, doctors hope that with the right treatment and physical therapy Julio may be able to walk again and return to the life of mobility that was taken from him years ago.
After years of isolation and sadness, Julio lost hope that he would ever lead a normal life again. But now, he is overjoyed about the possibility of having his independence back. He is ready for the road to recovery. In April 2015, Aaron Sandfield, a former MEDLIFE intern, donated the funds necessary to improve Julio´s living condition so that it would be easier for him to travel to his physical therapy sessions. MEDLIFE has taken him to all of his consultations and appointments, helped get his physical therapy paid for by SIS, renovated his house and built a staircase leading to it. His prognosis will be known after five weeks of physical therapy.
We are very hopeful for him.
Director of MED programs Carlos Benavides stood on a steep dirt path in Paraiso, a community where MEDLIFE has never done a project before. It was daytime and the deplorable living conditions in the pueblos jovenes were in full view.
When MEDLIFE enters a new community, it is often necessary to start from scratch. Sometimes people have never heard of the organization. MEDLIFE may not have any contacts with the leaders of the community, if there are any. So how does MEDLIFE get to the point where a specific problem is identified, and we have engaged with the community enough to organize a community meeting?
Often, engaging the community starts in the simplest way possible: visiting the community, approaching people in the street, knocking on doors, explaining to them what MEDLIFE is, and listening to their needs.
Carlos was in Paraiso on one of those preliminary visits. He was scouting out the dirt path for the construction of a small stair-case. It will benefit many families, but MEDLIFE is making it primarily for a specific patient, known as Pompinchu, a famous comic with osteoporosis and a broken leg. He can only walk with a walker, and MEDLIFE is trying to make the walk up the hill to his home safe for him and his neighbors.
No one said hello on the walk up to Pompinchu’s house, it was up to Carlos to take the first step and engage the community. “Do you know what MEDLIFE is?,” Carlos asked over and over. The response was always no. He would stop them, explain what MEDLIFE is and why MEDLIFE wants to build a staircase in the community. Then he gave them his card, asked them to spread the word about the project and help organize a community meeting. Hopefully they would actually call.
Next, he went to speak with the people who would be directly impacted by the project.
Pompinchu’s house is in the middle of a row of shacks mostly constructed out of wood and corrugated iron siding on a steep hill; I wonder how they don’t slide off.
Carlos knocks on a neighbors door. A middle-aged man answers, and Carlos asks him what he thinks of the staircase project. Would it benefit him too? Is there a real need for it?
The neighbor replies that the need for a staircase is great when it rains a lot. “When the land is wet, it is like soap,” he said. “It is always a problem for my family too. There have been enough accidents here.” MEDLIFE will have to get rid of some of the plants in the path that he has planted. He doesn’t care, but it is important to bring up these sorts of things with community members who will be directly affected by a project.
Carlos asks him to talk with other people in the community to help organize a meeting to discuss the project. He agrees and takes the card.
The row of shacks that the staircase will lead to sits beneath a concrete two-story home that towers above the shacks surrounding it like a bizarre monument, a constant reminder that another life is possible here. The shacks would shock most people who have never visited a slum while the two-story home would not look out of place in a lower middle class neighborhood in the US.
Carlos pauses, looks up at the large home and begins to talk about why it is so important to help a community to self-organize. It was as if he was trying to answer the obvious question that enters ones mind when wealth and poverty are so sharply contrasted: why aren’t people helping one another more within the community? It is clearly possible for people to work together to make life better for the community and for every living in it- but it hasn’t happened.
“The problem is self-organization, communication; [getting people] to come together and work hard is quite difficult,” Carlos said as he glanced back up to the concrete house above the row of makeshift shacks.
“For example you see that two-story house- there are the socioeconomics of life. He stayed here and progressed here. People don’t organize themselves well so we need to help them, motivate them, and say to them that it’s oneself who changes their own life. We make staircases, plant plants, paint them, make handrails, everything, everything we do, it is just in five days and here it is –a great staircase.”
All it takes is five days of people working together to make a long-term impact on the quality of life of the community. While MEDLIFE pays for building materials, designs projects, and brings volunteers to help with some construction, it is ultimately the community that actually builds most of the staircase.
Before we leave Carlos tells Pompinchu’s neighbor again to please call and tells him that “we can build it if there is not a problem mobilizing the community.”
Later that day he headed to another community, 15-A1. MEDLIFE has already built a staircase and held clinics here. Here the community is engaged and organized. They already helped MEDLIFE build a staircase. Now, MEDLIFE is working on building a water pylon, so that the community can have access to cheaper water, and so they don’t have to carry water bucket by bucket up the steep hillside to their homes.
The difference between 15-A1 and is immediately apparent. Everywhere we go people stop Carlos to thank him for the staircase, discuss working on the water project, or to just say hello. The people in 15-A1 already know about the development projects happening in their town; Carlos doesn’t have to tell them about the water pylon. Many of them tell Carlos that he can count on them to be there to help construction.
A pregnant woman holding a crying baby stops Carlos to tell us how hard it is for women with small children to carry the buckets of water up the hill, how she doesn’t want her children to have to drink water full of dead flies and fungus.
This community is engaged and rallying around the project, and things are happening. A community meeting is being organized by several contacts who came to meet us and discuss the project.
But it takes time to get to this point. It starts small. It starts with getting a few people in a community like Paraiso to spread the word and work with MEDLIFE to make a project happen.
At the bottom of the hill Carlos hails a moto-taxi, he knows the driver. He mentions how difficult it is living without any light in the community he lives in that is visible through the moto-taxi window on the adjacent hillside. “This town needs lights, this town needs water, it is different everywhere,” Carlos said.
Carlos tells him he will talk to some people; maybe MEDLIFE can do a project to put lighting in his town.
I look across the bustling city of Lima, Peru to the distant lights shining on the steep hillsides, which are crowded with small, tin-roof-covered houses. The imagery of the green light from the novel The Great Gatsby and the faint sound of salsa music from a radio in a nearby house coalesce into a moment standing atop a hill in Pamplona Alta.
I distinctly remember my first visit to Pamplona Alta, one of the communities on the outskirts of Lima where thousands live in a reality of no formal property rights, no easy access to clean water or quality health care, and extremely few financial resources. MEDLIFE was hosting a mobile clinic, and I had the opportunity to observe a physician that day. I noted the differences in his communication style compared to the physicians I had shadowed prior. It was clear that he invested extraordinarily in the wellbeing of each patient, making sure to explain his thought processes and detail preventative measures going forward. There is always a tendency to rush through patients, but he was pleased to take the time to answer all the questions each patient had. We may have stayed an hour or two later that day, but he realized that his time was a small price to pay for the health of another. I have shadowed numerous physicians in the U.S. and abroad, and the genuine concern that he possessed for his patients stands out to this day.
This theme is reaffirmed and apparent each day I work as an intern. Whether he or she is a community health promoter, director of MED Programs, Volunteer Affairs Coordinator, operations specialist, or fellow Volunteer Affairs intern, every person I have met who works with MEDLIFE is truly empowered to proactively make a difference. Here at MEDLIFE, this means furthering the mission of partnering with communities to provide improved access to medicine, education, and community development to low-income families across the globe.
The magic of MEDLIFE is in the organization’s ability to empower the individuals with which it interacts. It is empowering students in MEDLIFE chapters across the U.S., Canada, and Puerto Rico to organize mobile clinic trips and learn more about the root causes of the inequalities in health that exist. It is empowering others to realize that their opinion matters and that they can make a difference, in their recognition that there are many people in this world that need organizations like MEDLIFE to keep working to help them. By attending a community meeting last week, I learned that one of MEDLIFE’s greatest achievements is empowering the communities with which it works.
A community meeting is an essential meeting that occurs several times before beginning any work on a development project and before mobile clinic logistics are solidified. The other interns and I, along with Sr. Carlos Benavides, MEDLIFE’s Director of MED Programs in Peru, walked into a meeting where 50 to 60 community members had already gathered, some sitting and some standing, to listen to us speak about MEDLIFE.
We had come to outline a proposal regarding a partnership and staircase project with that particular community. As with any MEDLIFE staircase project, we would provide the construction supplies if the community members agreed to work together and alongside us by preparing the site for several weeks before students arrived to cement and decorate the staircase. One must look closely at the consequences of this decision. Imagine a (common) situation of subsistence living, where each day’s wage is solely used to purchase food for that person’s family for that day, a situation that is especially difficult for single parents. By participating in the project work, individuals forgo their income for an entire day or two.
After Carlos spoke, he asked the community to explain why they wanted staircases. Several men and women stood up and articulated that the steep hillsides were dangerous for the old, the sick, the pregnant, and the young. Each person, without fail, mentioned that these projects were not for them; the projects were for the future wellbeing of the community.
After successfully organizing one project in unison with MEDLIFE, the community and its leaders are better equipped to address other projects that will perpetuate the wellbeing of their community.
The selflessness clearly portrayed that night, and many other instances throughout my experiences as a MEDLIFE mobile clinic participant and intern, continue to empower me. I am inspired to become a competent, empathetic, and effective physician based on my experiences with the people in Lima and Tena. I have learned that each person, no matter his or her cultural, political, or socioeconomic background, has a fascinating life story to tell, and one must simply ask the right questions in many cases.
The Pueblos Jovenes are not an easy place to make ends meet. Residents face long commutes to work and markets, and a long trip up the hills to their homes. The cost of water is many times higher than in the US, and of course, residents earn a fraction of the US minimum wage.
Yet at the age of 73, Javier Soltero was still able to continue his work as a painter and live alone. Until one day, when he was working with some wall tile, he cut his finger.
Yes, there was blood. He was surprised, the cut rattled his nerves. He was shaking a bit afterwards- but that was it. He didn’t think much of it. He didn’t go to a doctor. It was just a cut.
The thing was, his nerves never steadied. His hands didn’t stop shaking; they started shaking more.
Flash forward three years to the age of 76, Javier cannot work, and he cannot live alone.
He lives in his son’s home, with only the many cats that reside there to keep him company while his son is at work. He hardly ever leaves the small one-room building.
Parkinson’s disease has radically altered his life; he can no longer care for himself. His son must care for him, as well as find the money to pay for expensive medication to help control and slow the advance of the disease.
He walks slowly, with the rigidity and stooped posture typical of the disease. His hands perpetually shook as he answered the MEDLIFE nurse’s questions, but he answered them, as he is still in the early stages of the disease. The cognitive decline and difficulties with motor function have not progressed to the point where this becomes a huge challenge.
Cognitive decline typically becomes severe after 10 years with the disease, and most patients are completely dependent on caregivers after fifteen. The timeline varies from patient to patient, but the disease inevitably progresses.
Javier has had the disease for two years, and already, it has taken a lot from him.
“Working, normally, I was always working. But in the two years with this (Parkinsons), it has stolen my strength. Even when walking now, it is not the same (as before the disease).”
He cannot paint anymore, or do other work, because his hands shake too much. Javier doesn’t like to leave his house; he said it is so difficult that it is impractical and makes him feel ashamed of his disabled condition. He also has osteoporosis, and a fall caused by the inhibited motor function typical of Parkinson’s could have serious consequences.
When a friend told him about a MEDLIFE clinic happening in his community, he made it out of the house and got help.
MEDLIFE has paid for three months worth of medication for Javier. This will help control the disease, slow its progress, and take some pressure off of his son.
“When I take the pills, I feel better. Sometimes, I can even move my hands,” he said.
Cecilla Rubinos went to the doctor because her throat was so sore she couldn’t talk. When the doctor tilted her head back to examine her throat, he noticed something else.
“Haven’t you noticed your forehead,” he asked her. There was a large abnormal bulge in it. She had noticed, but she didn’t know what it was, and neither did the doctor exactly.
“I was worried because I didn’t have any money to go to the hospital and have tests done,” she said.
She has a large tumor in her forehead. She needs an ultra sound to find out what she needs to do next.
So she met MEDLIFE nurse Jannette in front of an altar in La Ciudad de Dios (the city of god), a district in Lima, to go to an ultra sound that Medlife paid for- she doesn’t have to worry about paying for the tests on her own now.
MEDLIFE nurses often accompany patients to clinics and hospitals for a variety of reasons, but primarily to assist them in understanding their illnesses, and in navigating the tedious and complex Peruvian medical system. It also helps ensure that they make the appointments, and follow through with important next steps afterwards.
Cecillia, for instance, previously believed that the bulge was caused by bone growth, and that the bulge would cause her to lose her vision. However, none of this has been confirmed by credible testing or medical personnel.
Cecillia said she is happy that Janet accompanied her to her appointment because it helps her to understand her condition. She also has trouble navigating the city alone- she rarely leaves her small community or home.
She said she is not worried about herself, but about what she will do with her young son, Leonardo, who she carries from the altar to the clinic. “If I get an operation, who will take care of him?” She said.
Her husband works all day, and her son, 18 years old, works all day as well. He is trying to save money to go to college one day. Cecillia hopes he can leave home soon. “Life is not easy, life is hard,” she said. “ He is a man, he needs to learn that.”
When the test results come back, Ceillia can trust MEDLIFE to help her choose the right steps to take towards recovery.
Thick fog hovers below. The grandiosity of the hills sends shivers down my spine. Looking into the distance sends me into a whirlwind of emotion, the view is simultaneously the most beautiful and horrific thing I had ever seen. I find myself squinting, desperately trying to find the endpoint of the shantytowns that run up and down the hills before me.
I’ve been in Lima, interning for MEDLIFE, for almost two months now. The shantytowns never seem to end, the number of patients pouring into the mobile clinics accumulates, and the white-board for follow-up care patients fills itself everyday. The task begins to seem intimidatingly big and impossible to complete. Despite these discouraging initial thoughts, working with MEDLIFE has altered my perspective in the best way. The small steps we take as volunteers, interns, leaders and health care professionals changes lives in big ways and remarkable progress has been made. Writing about my experiences over the last few weeks seems near impossible! It feels tremendously difficult to begin to find words that match the emotion I feel and to eloquently explain how life altering medical, educational and developmental projects can be, and have been, in the lives of our patients. It is one thing to hear of poverty, and another to hear people's stories while sitting in their living rooms.
Living in Lima has taught me to never expect things to be on time. My housemates and I all know better than to assume we will be leaving for a patient follow-up visit with one of our field nurses at the scheduled time. One must factor in at least twenty to thirty minutes later than said departure. This easy going and laid-back culture I find myself in is, once you get used to it, a very pleasant change. Having said this, the opportunity to go on these patient visit, has taught me that they are well worth the wait. They all begin similarly: a bus ride. Or make that multiple bus rides, “moto taxi” trips and train journeys. Upon arrival to a very impactful visit I went on, our field nurse Janet, like countless other times, pulls a patient’s chart out from her MEDLIFE draw string bag and takes us up and down the hills, through unpaved roads and unmarked homes. How Janet finds the address we’re looking for, perplexes me still. I make it a point to stop and breathe. I find myself having to do this multiple times a day.
After a few knocks at the patient’s door with no answer, Janet moves into phase two: “señora!” she screams. “Señoraaaaaaaa!” Audible footsteps appear and a shabby door on loose hinges swings open. We are invited in by an elderly woman who, I learn soon after, was diagnosed with diabetes at one of our previous mobile clinics. Some of our initial concerns are raised very soon into the visit. Her home’s infrastructure is shaky and the dirt ground is exposed. The makeshift walls let in beams of light. They create a display of rays that pierce through the dark, damp room in hundreds of directions. These issues only add to our patients existing health concerns. Another big concern is her diet. As we converse, she begins to tell us what she eats on a daily basis. Having a grandmother at home who has been diabetic for years, I know that our patients’ list is worrisome. Her diet consists mostly of carb filled and starchy foods. These products are usually cheapest and most filling, something desirable in a context of poverty.
Janet decides that it would be a good time to take our patient’s blood sugar level. The first test shows a blood sugar level of 320 mg/dL. A normal sugar level for someone with diabetes should be anywhere between 100 mg/dL to 140 mg/dL depending on food intake. This initial test seems very high, so Janet does another reading about ten minutes later: 435 mg/dL. Tension rises in the room and I am told that our patient is at very high risk of experiencing serious and irreversible damage to her body. High levels of glucose act as a poison, damaging the body’s pancreas, kidneys, heart, arteries and nerves. Through the quick-paced Spanish, I decipher that, if her glucose level is not lowered, we will have to go to the hospital immediately. We wait three more minutes and test again. This time, the machine reads a glucose level of 512 mg/dL. Before anyone can say anything else, we are gathering our patients’ belongings and bringing her to the nearest hospital. Access is limited; we must get a taxi, as ambulances are expensive and unreliable. There are six of us including our patient, without any time to waste, we cram ourselvesin and head towards the closest building with insulin. The most disappointing and eye opening experience of that day was once we arrived at the hospital, we were told by two hopeless looking patients, that the emergency room was closed. This seemed absurd to me, how can an emergency room be closed? We speak to a doctor and he delivers us the worst news thus far; they don’t have insulin.
This story represents an example of lack of access. This is an arbitrary concept that includes poverty, injustice and deficiency. It was an overwhelmingly sad way of, for me, actually understanding what lack of access meant. It meant that our patient was not able to control her diabetes due to lack of access to a healthy diet, healthy living space, and tools to regulate her disease. It meant that our patient couldn’t always get to a hospital, and when she did it meant that there was a lack of resources such as medications and staff. By some twisted way of faith, MEDLIFE was present that day, and was able to help that patient. She eventually got brought to a much larger, and further away, institute that did have access to insulin, and is doing well today.
Being able to put my experiences of this internship in order in my head has been most challenging. Being able to a part of an organization that sustainably changes lives has been incredible. Being able to live in a city in South America has been exciting. Being able to share this experience with other interns and volunteers has been life changing. I leave this internship with an exhilarating motivation to take on whatever life has in store for me and to boldly plunge into helping end global social injustices.
Are you a dedicated MEDLIFE chapter member who is looking for a way to become more involved in MEDLIFE? Applications for the MEDLIFE Student Advisory Board for the 2015-2016 school year have now opened!
Joining the MEDLIFE Student Advisory Board (SAB) is a great way to get more involved with the organization, take on more responsibility, and work towards future career goals.
“Members of the Student Advisory Board are some of MEDLIFE's most dedicated volunteers,” said MEDLIFE's Expansion Associate Kendra Downer. “They are on the ground at universities interacting every day with the people that make MEDLIFE possible: our chapter members.”
MEDLIFE is currently looking for applicants with expertise in the following areas:
“MEDLIFE hopes to expand to over 300 chapters, and with the SAB advising new and existing chapters on important chapter issues,” said Kendra, “we hope to see all MEDLIFE chapters reach their full potential.”
This is what Student Advisory Board Member Leema John, who was part of the SAB for the 2014-15 school year, had to say about her experience:
“The SAB work that I took part in was a mix of many things,” Leema said. “During the first semester, the focus was on chapter management, which was conquered as a team. Each team member focused on a particular area of MEDLIFE and chapter development, I helped chapters in New England and Canada with fundraising efforts.”
Later in her work with SAB, they switched their focus to expansion. “I would reach out to high schools and universities both near and far that did not have MEDLIFE chapters,” she said.
Leema’s advice to prospective applicants was this:
“I would stress the importance of clear and effective communication (as the majority of it is not in person) and flexibility, as the SAB program is continually evolving to reflect the needs of MEDLIFE's growth as an organization.”
Leema stresses that she got a lot out of the hard work she put into her time on Student Advisory board; it taught her skills that she sees as crucial to her professional development and to employment after college. “As a busy college student, the SAB team taught me to manage my time well, communicate effectively through impersonal platforms (phone, skype, email, etc), and develop a sense of accountability to both my SAB team members and chapters. As a member of the SAB team, I had the opportunity to work with students that were very diverse, but linked by dedication to the MEDLIFE mission.”
Working on the SAB also led Leema to further opportunities for professional development. Leema initially joined the SAB as a launching pad to get to the MEDLIFE summer internship that she had her eye on since she first got involved with MEDLIFE as a freshman. “I figured that the SAB was the middle ground between the position that I had held in the past, and what I aspired to obtain in the future,” Leema said. “It seemed like a great way to get further involved in an organization that I truly felt passionate about.”
In the summer of 2015, Leema traveled to Lima, Peru as a summer intern in the MEDLIFE Department of Student Affairs. Two of the other 2015 summer interns were also on the SAB board before they got the internship.
Get in your applications here as soon as possible! They will only remain open until suitable candidates have been found.