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Historic flooding and mudslides have hit Peru bringing the worst destruction from floods in two decades. An estimated 70,000 people have been displaced from their homes along with an estimated 72 dead due to the natural disaster.
Referred to locally by the Quechua name of Huaycos, these natural disasters are a results of heavy rain brought on by the El Niño season in the Pacific ocean. The rains cause the rivers to overflow bringing floods to the normally dry desert coast of Peru.
The flooding has overwhelmed local water treatment plants and Lima, Peru’s capital city, has been without water for almost a week. The Peruvian government has issued a state of emergency around most of the country as floods and debris flow into the streets.
The rains are predicted to continue into April, bringing more flooding to the already affected areas. Areas with vulnerable access to water have been completely cut off from their normal supply. The aguatero trucks that normally suppply many of our communities with water have stopped visiting, and many supermarkets have completely run out of water. Tap water was not working in large parts of the city for up to a week, and receiving intermitent water in other parts.
Critical infrastructure has been damaged, the bridge that connects El Augostino y San Juan de Lurigancho collapsed due to the overflow of the Huaycoloro river, makes access to the district very difficult. Many other roads and railroad tracks have been completely washed away.
This week, MEDLIFE went to survey the communities we work with around Lima that have experienced flooding, to make a plan for immediate relief aid and possibly plan a development project for the future. We visited Chaclacayo, a district hit badly by the force of the Huaycos
In Chaclacayo, people are lacking basic necessities like food, shelter, medicine and water. People in the valley experienced flash floods after surges of water hit the Rîmac River. The floods swept away homes, railroads and roads in it’s path.
Those displaced by the Huaycos have been seeking shelter in encampments of tents provided by the municipality of Lima. Guadelope, a resident of Chaclacayo, has been sleeping in a tent with her daughter since their home was flooded. When asked what she needed most, she responded with food.
With forecasts of more rain, the situation is expected to worsen bring more huaycos to the already vulnerable communities.
We have started a fundraising campaign to go directly to communities affected by the flooding. You can donate HERE. During times of natural disaster, direct donations can have the most impact because the money is going directly towards supplies for victims to start rebuilding their lives like food, water and medicine.
In the hills, high above the city center of Lima, Peru, sits the community of Nadine. One of Lima’s Pueblos Jovenes, or young towns, people began to settle in the area in 2012 and now there is an estimated 350 families living there.
Lima is surrounded by informal communities, like Nadine, without land titles and thus without recognition from the government and legal access to public electricity and water. However, Nadine sticks out as a dramatic example of the city’s stark divide between rich and poor because it sits along what has been dubbed the “Wall of Shame”.
The wall was built about 30 years ago by those living below in the wealthier area of Santiago de Surco to divide themselves and their poorer neighbors. The wall has been covered by Peruvian media as well as internationally. The dramatic view from the top works as an all too provocative visual metaphor to the divide between the rich and poor of Lima.
Living up in Nadine means no access access to a public water supply. Fabiolo Rosales Bartolo, a resident who has lived in Nadine for 3 years says she pays around 200 soles, about $60 USD, a month for water for her family.
“We pay much more for water than people that live on the other side,” Bartolo said. “I have a baby and it lasts for a week, because I have to wash clothes, I have to cook.”
Oxfam estimates that those living without access to SEDPAL, Lima’s public water supply, pay up to 10 times as those with access, a case where it truly is expensive to be poor.
Life for residents in Nadine and communities like it reflects the informality of the town itself. Houses spring up on land not formally owned by those who live there. Water deliveries can be infrequent and unpredictable. Most residents make their money in an informal economy by selling goods and services on the streets.
In Nadine, this life is all lived with a view of the paved, tree lined streets of Lima’s wealthier districts. However, from below, you can only see a wall.
“Here we can to look at the other side to a comfortable life,” Bartolo said. “There is a big difference between the rich and the poor. The wall separates us from the people that have. More than anything it shows you the reality of our country,”
Dr. Genry Aguilar has been working as a doctor on mobile clinics with MEDLIFE for two years now. He practices medicine where he grew up, in the Andean city of Cusco, Peru.
Dr. Aguilar brings an infectious energy when he works mobile clinics. When talking with a patient, all parties are engaged, including volunteers. The conversations are in Spanish, apart from small asides in English to volunteers, yet volunteers are absorbed into Dr. Aguilar’s expressiveness and physicality when talking with patients.
When listening to a heartbeat, he will get volunteers on the stethoscope as well and have them listen for the murmurs and irregularities. Dr. Aguilar has found a way of caring for patients needs, while also teaching volunteers about the signs he’s looking for.
Dr Aguilar decided to work in Lima this week instead of his usual base of Cusco to see other sides of Peru.
We spoke with Genry Aguilar after a clinic about his experience working with MEDLIFE:
Can you tell us a little bit about yourself?
I am Genry, I am a doctor. This is my second time working with MEDLIFE. It is my first time working in a different place like Lima, I used to work in Cusco. For me, working in MEDLIFE has been a good experience, I have learned a lot. I have met a lot of people from different countries.
Why did you start working with MEDLIFE?
First, I have always the intention of helping those in need in any way possible. Medicine is a helping career. It is a career where we are here to resolve pain.
What value do the volunteers have in clinics?
They are very important, without them, these clinics wouldn’t be anything. They are youth with a great desire to help. It is indescribable, working with them, I have encountered a joy to help, to serve. To bear witness to the pain that often patients must endure alone, to make a child, or a person who is suffering smile. Health is the most important thing in life, along with education.
How does MEDLIFE work with the local system?
MEDLIFE works at the level of the ministry of health, the professionals are certified in this system at the same level as any Doctor that works in the Peruvian healthcare system.
What value do Mobile Clinics have for the communities?
This value, it’s not just an immediate value. The youth, who have come before, have left a big mark. When they see volunteers, the expect the best for them, from each one of them. Somone shows up, and the kids surround them. For sure, this is because of the impact of the positive impact of those who have come before. For you, it is a question of improving upon it. Make it better, so that this persists.
Marangu is a lush green rural Tanzanian town tucked in the shadows of the mighty Mt. Kilimanjaro. MEDLIFE conducted clinics there in 2016. Many of the houses were very poorly constructed and offered little shelter from monsoons.
One particular case was brought to our attention when during a mobile clinic, an 84 year-old woman wrapped in colorful cloth came in named Elianasia, nicknamed Bibi, and asked us for help with her bathroom.
MEDLIFE staff followed her through the jungle to see her bathroom. It was hard for Elianasia to walk so far, her leg was causing her pain. She lived all alone, all of her children had gone seperate ways and were not caring for her. Her husband died tragically in 1962. When staff saw the rest of her house, they were surprised she was only asking for a bathroom.
Her kitchen was a fireplace sheltered by some wood poles and tattered rags, the bathroom was a hole in the ground covered by a small wooden board, which was being slowly devoured by ants and appeared it may collapse into the hole next time it was used. She did not have a room anywhere that could provide shelter from the rain. During monsoon season, she slept on a wet bed and tried to cook in the rain.
"I will be very happy if you can provide for me a house where I can stay," said Elianasia. "I am praying for you, so that god may bless you in everything that you do, thank you very much."
In 2017 the project was completed, thanks to a generous donation from Goodlife Travels.
MEDLIFE founder and CEO Nick Ellis, MEDprograms director Angie Vidal, and MEDLIFE Tanzania Director Neema Lyimo visited and found Bibi living happily in her new home.
Water access is an issue that communities around Lima continue to face. Development in the slums of Lima happens backwards, in that people move in and then utilities like electricity and water are installed, often times taking years to get a steady access.
The best option in Lima for water is connecting to SEDPAL, the city’s water system, however, many of the communities MEDLIFE works with lack the property rights and thus the legal designation as communities and are not eligible for water from SEDPAL. Communities without access to the city water supply, rely on water tank trucks to visit and deliver water.
Without a steady supply, those living on the outskirts of Lima use tanks and barrels to store their water. Sometimes, the containers were used in the past to store non-potable water or chemicals. These containers also run the risk of contamination from bacteria as they are often not adequately sealed and reused without cleaning.
People will buy water directly from the truck and fill in water tanks to use throughout the days between visits. Fabiolo Rosales, a resident of Nadine, lives at the top of hill of her community at the base of a wall built to keep settlements from spreading onto private property. When looking over the wall, she sees the wealthier districts of Lima with access to the city water supply and the occasional swimming pool dotting the cityscape.
“We buy our water for 25 soles and we pay much more than people living on the other side,” Rosales said.
Rosales experience is not uncommon. Buying water from the trucks can cost up to 12 times as much as public water utilities. Along with the money, there is the time spent waiting for a water truck to come and the labor of carrying the water back home. The poor truly pay the most for water.
The problem Laderas de Nuevas Esperanza faces is the road that leads to the community, is narrow and dangerous for the large water trucks to drive up, so often they do not. MEDLIFE worked to build a water reservoir for the community to safely store larger quantities of water between the infrequent visits of water trucks. Residents worry though, that during wet winter season, the truck will not be able to make it up the road.
“The water truck doesn’t come here often. Sometimes we need to wait for two days starting at 5 am, all day long, waiting for the water truck to come,” Maria Salas, a resident and community leader in Laderas de Nuevas Esperanza said.
The next step in Laderas de Nuevas Esperanza is building a road. MEDLIFE aims to bring more stability in access to water in Laderas de Nuevas Esperanza. With a water reservoir more water can be stored safely and for longer periods of time. A road would bring more frequent trips from water trucks as well as greater access to the community for other services.
Last week was the start of MEDLIFE's spring clinic season with 41 volunteers from Queen's and Laurentian Universities of Ontario, Canada. Over the course of 4 days of clinics, the volunteers were able to serve 368 patients around Lima.
We thank all volunteers who came out to Lima for a week of learning and serving!
When running mobile clinics, MEDLIFE aims to provide people from low income communities with primary health care. Cost is a problem in access to health care, but just as important an issue is actually getting into the hospital.
It’s estimated there is 1 doctor for every 20,000 people living on the outskirts of Lima. The time that patients spend with a doctor is a rare moment to talk with a health professional. To give the best possible care to patients MEDLIFE uses doctors and dentists from Lima to staff mobile clinics.
Analida Palacios works as a physician at Clinica Oncologia y Radioterapia, located in the San Borja district of Lima. Her usual place of work is located in a wealthier district of Lima, where patients can afford to be treated in a private clinic and forgo the long waits for service.
She first heard of MEDLIFE through a co-worker who was working with the group. After hearing about the concept of the mobile clinics, she decided to join herself to provide basic healthcare and consultation to the people in low income areas of Lima.
“We bring medicine, we bring prevention with pap smears and breast exams,” Palacios said. “I think the population will be more prepared.”
Just sitting down and being able to talk to a doctor can be an invaluable experience for those who have little to no access to healthcare. It is not uncommon for doctors working clinics to meet with patients with health problems ranging from diabetes and breast cancer that have gone untreated for years.
Although, Palacios is not following up with the patient's herself, she is the first contact they have with MEDLIFE and sometimes, any health care at all. In the private clinic where she works across the city, Palacios is able to use ultrasounds and labtests to diagnose and treat patients. As MEDLIFE is travelling to different communities it is up to the doctors working the clinic to determine if a patient needs further attention, through conversations and basic health checkups.
“You can do the basic stuff, but you can also speak with the patient and the family,” Palacios said.
Palacios says she looks for signs that would point to a diagnosis while taking in what the patients tell her about their symptoms and lifestyle. If a patient needs further attention, they are admitted to the follow-up program, where a nurse working full time with MEDLIFE will accompany them to hospital and clinic visits to get the care they need.
“If we don’t come here with this type of medicine, nobody will,” Palacios said.
In the weeks following MEDLIFE’s mobile clinics, nurses are busy traveling door to door to patients homes to follow up with those who need further care after the clinics. This is the second step. After the medical clinic has come to the patients, the nurses will come to patient's home to talk more about treatments.
In the community of San Martin, Carmen, a MEDLIFE nurse, talks to an woman in her sixties through the door of her bodega. She had visited a mobile clinic in her neighborhood and this is her first meeting with a nurse to choose to become part of MEDLIFE’s patient follow-up program. Carmen explains her symptoms could be indicative of breast cancer and she should have a mammogram.
“What do I have to do?”, the woman responds.
It’s a valid question. MEDLIFE aims to break down the barriers to healthcare, the most obvious being the monetary, but long waits, transportation and A trip to a clinic or hospital can mean a day away from the responsibilities at home or work, a steep cost to those living in poverty.
Carmen tells her a MEDLIFE nurse would accompany her to visits and assist with paperwork. She decides to join the follow up program to get a mammogram.
Those living in the outskirts of Lima can have a long journey without paved roads into the city for an appointment.
For Luis Oyolo, a trip to the hospital is a family affair. Luis must use a wheelchair due to a fracture in his vertebrae. He typically has at least two family members accompanying him to visits, for loading in and out of taxis and navigating the curbs and bumps of Lima.
Many taxis will choose to not transport Luis due to the burden of loading and unloading the wheelchair. MEDLIFE is able to cover most of the cost of the taxi, but the cost of time used by Luis and family members spending most of their day in a waiting room is still there.
Luis waits anxiously with his father and brother for a consultation in the National Institute of Rehabilitation in the south of Lima. This is the only hospital with a rehabilitation program close to where Luis and his family live. The waiting area is full of patients, young and old, waiting for an appointment as well, most accompanied by family. When Luis is called in, they spring at their chance to talk to a doctor.
“I was first hospitalized in a hospital very close to my home, but unfortunately not all hospitals are the same,” Luis said. “I was in a hospital for 20-30 days, where the doctors did not come, they did not see me, they did not take care of me.”
Finding a hospital with the right care and ease of access for a patient is crucial for a long term solution. Although it is Luis says this hospital is still close to his home, making a physical rehabilitation program one step easier. Throughout his rehabilitation, a MEDLIFE nurse will work with Luis, helping to sort out the various papers and forms.
MEDLIFE can cover almost the entire cost hospital visits and operations, although even with funding, the daunting task of navigating the Peruvian healthcare system can keep those who need care out of hospitals and clinics. One of the most valuable services MEDLIFE nurses give to patients acting as a guide to the healthcare system and accompanying them to check ups and procedures.
Money is not the only barrier to healthcare. To fully address the problem of healthcare access in a sustainable way, local and personal difficulties must also be taken into account.
The inauguration was an emotional moment for everyone. Nataly would finally be able to support her family and care for her children. Her son lost his arm three years ago in an accident with a cane cutting machine (full story here.) Nataly's family went under financially trying to cover the cost of the medical bills from the accident. Nataly told us the best thing for her would be able to work close enough to her home to still care for her kids. One of the pillars of the MEDLIFE ideology is sustainable development and support, therefore, MEDLIFE made it our mission to make this hope of Nataly's a reality. The MEDLIFE summer interns from 2016 fundraised for the project, and last week we delivered the cart to Nataly!
MEDLIFE recently completed our second of two massive staircases in Ecuador, drastically improving access to the community of Llinllin Santa Fe. The path is used by the communities school children to get to school, and now they can safely descend the mountainside to their school.