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Nandini Razdan recently returned to the US after completing an internship with MEDLIFE in Lima, Peru, and is now applying to go to medical school. Read more about her experience with patient follow-up in her Intern Journal entry below.
Over the course of routine patient follow-up appointments, I had the opportunity to meet a very special patient named Eduardo. We met with Eduardo's mother near his house in an extremely dusty and desert-like community on the outskirts of Lima. While walking to their house, Eduardo's mother took the time to stop, pick-up, and drag a large piece of cardboard all the way to the front of her house, where there was already a growing pile of trash. I later found out that selling recyclables was the primary means that Eduardo's mother earned money, as most of her time was spent caring for Eduardo.
We entered the humble dwelling and made our way to the bedroom that Eduardo and his mother shared. Before embarking on our journey to Eduardo's house, I had failed to ask MEDLIFE doctor, Dr. Jose, about the patient's condition and history. My jaw gaped open and my breathing stalled as I entered the bedroom and saw what seemed to be a breathing skeleton.
Eduardo had the misfortune of developing Cerebral palsy (CP) as an infant. Cerebral palsy is a group of non-progressive conditions caused by damage to the motor centers of the brain. CP causes physical disability in human development, primarily concerning bodily movement. Limited movement leads to limited activity, which can be accompanied by lack of sensation, sight-based perceptual problems, communication problems, and sometimes impaired cognition. In the unfortunate case of Eduardo, he choked on a small piece of food as a baby, and for an extended period of time was unable to breathe. The hypoxia caused cerebral damage, and from then on, his life would never be the same. Eduardo is now in a near vegetative state -- unable to talk and minimally able to move. The years of lack of movement have caused his body to become deformed; he is all skin and bones with no muscle or fat to be seen, and his hands are completely bent forward due to lack of usage over the years. He is unable to speak and his inability to control his bowel movements forces him to wear a diaper. Eduardo does have some level of remaining cognitive perception. He smiles when he is happy and whimpers when he is sad. He recognizes his mother and is able to understand basic conversation, even though he is unable to respond.
Eduardo's story really hit home for me in various ways. I had an older sister who for ten years of her life was also in a vegetative state, but due to a genetic disorder, not Cerebral palsy. Living in the US, my family struggled with dealing with my sister's condition, but still had access to some of the best home-care possible for her from the first day of her illness. My sister had a comfortable hospital-style bed, a state-of-the-art wheel chair, access to any medicine she needed, and nurses at her bedside day and night. Eduardo had a simple bed with a quilt and few pillows, and a second-hand wheelchair that looked uncomfortable for his bony body and that caused his feet to drag on the floor.
The purpose of our visit to Eduardo was to give him a nebulizer treatment because he was having trouble breathing. As I held him in my arms during the treatment, I looked above and saw a roof full of dust, which clearly was not helping his breathing. Had we not come to bring the treatment, Eduardo's mother would not have been able to afford paying for the treatment in the hospital. My sister's illness was incurable, but CP has the potential to be prevented from worsening through years of care and therapy with specialists. With the lack of resources living in poverty in Lima, Eduardo's family had little to no chance of accessing the specialists needed to prevent his condition from developing as it had. When MEDLIFE first met Eduardo several months ago, extensive damage had already occurred and follow-up treatments were limited.
Eduardo's mother told me about Eduardo's history, and I was shocked to find out that the small body I held was that of one who was a whole year older than me! I thought Eduardo was no more than 10 years old, and he was actually 23. Two things struck me with this new finding; firstly, how much life and will to live was in this human to have made it to 23 years in such a physical condition? Secondly, I noted how different our lives were despite our similarities in age -- simply due to fate. I am a 22-year-old enjoying my time in Peru and trying to add to my experiences in order to enhance my career. Yet this 23-year-old was simply trying to live another day and breathe a bit better. Furthermore, Eduardo's mother told me that Eduardo's father had passed away from liver disease just two weeks before, making her the primary breadwinner. Eduardo's father had been an alcoholic, and one can imagine that the stresses of poverty and caring for a handicapped child contributed to his drinking problem. Also, she had another daughter who was 16 years old, but who lived with another family because she was unable to take care of both Eduardo and her daughter. Had my own family been in this family's position living in poverty in Peru, I could have easily been that daughter who was forced to live with another family because my own could only take care of my sister.
Dr. Jose has been taking care of Eduardo for two years, visiting him whenever he needs medicine or when he is sick. A few days after my first encounter with Eduardo, I accompanied MEDLIFE nurse Ruth Varona to take Eduardo to the hospital because he potentially had pneumonia. Being seen by a doctor in Peruvian public hospitals can be a very lengthy process. It took approximately six hours for Eduardo to finally be seen by a doctor in the emergency department, yet nurse Ruth stayed and waited with Eduardo and his mother the entire time. Eduardo might not have access to the home care that he deserves, but having his devoted mother by his side at all times and MEDLIFE doctors and nurses ready to help are the only reasons I can think of for the smile on this fighting 23-year old's face.
As a student at Florida State University, Mauricio Parra-Ferro founded a MEDLIFE chapter at his school and spent a summer interning in Lima, Peru. Even after graduation, he remains involved with MEDLIFE's work, and came back to Lima for a week this March to help out at a Mobile Clinic. Now back in the States working as a biology teacher for underserved middle and high school students and preparing to go to medical school, he took some time to reflect on his visit with us.
My involvement with the MEDLIFE Florida State University chapter has made it very near and dear to me, and seeing how much the chapter's expanded this past year makes me both amazed and extremely proud. With its 47 students, FSU comprised approximately 80% of the March 11-15th Lima Mobile Clinic. However, it was the combined effort from all of the universities which made the clinics and development project so successful.
Throughout the week, I spoke with several of the students to discuss their opinions on global health, the most memorable experiences, and what they hoped to get out of the trip. I was very pleased upon hearing the responses. Everyone seemed to understand the importance and necessity of real sustainability, and they appreciated how MEDLIFE always aims to create this through improvement of the local infrastructure, and through consistent patient follow-up. Moreover, rather than only focusing on their own experiences, they would often talk about the patients they saw in the various stations, the communities they visited, their admiration and respect for the MEDLIFE staff, and the reoccuring issues they were exposed to.
While several people came prepared, having learned various Spanish phrases and studied the Peruvian culture, I feel confident that everyone managed to leave with an altered perspective on life. The educational and eye-opening experiences which MEDLIFE provides gives participants the opportunity to expand their knowledge and subsequently be better prepared to serve others in the future, especially those who live in areas of extreme poverty.
In conclusion, my time helping run the clinics was everything that I hoped it would be and more. It was extremely refreshing to visit and work with the old MEDLIFE staff, people whom I consider family, and I loved meeting and getting to know the new members of the team. I sincerely appreciate having had the opportunity to be welcomed back to the communities to interact with residents, and help make even the slightest bit of impact on their lives. I have come to realize that throughout all of my volunteer efforts, especially the ones through MEDLIFE, while giving back to those who need it the most is undoubtably a rewarding feeling, it will always leave you feeling like you want to come back and do even more.
MEDLIFE Ecuador Intern Pedro Gonzalez writes about his relationship with a special patient in Riobamba:
I have experienced a lot of meaningful events during my stay here in Ecuador. I have helped follow-up with a lot of patients and worked on multiple community development projects. None of them has had a bigger impact on me than the day I met Leslie Salambay.
Leslie is a one-year-old girl who lives in the community of Calancha in Ecuador. She had the misfortune of being born with her right ear completely sealed and is currently at risk of losing her sense of hearing if it goes untreated. I met this adorable girl one day at the MEDLIFE Ecuador office in Riobamba. I heard her laughing from the other room and had to came out to meet her. She is a ball full of joy -- as soon as she saw me, she wanted to play with me and I ended up taking many pictures with her.
I asked Martha, our director in Ecuador, if I could be present during her whole treatment processs and she gave me the OK. Since then, I have been with Leslie during all of her appointments. It has not been an easy ride. Some of the tests needed for Leslie's treatment have been postponed because the staff in the hospital have not been careful enough to schedule a correct time for her; mistakes like this happen at public hospitals all the time. It's frustrating when you want to help someone but it's made difficult by poor administration of practices. As always, I am a positive person and try to get the best from each experience. I have used this time to bond more with Leslie and her family, and enjoy her laugh.
Leslie is always accompanied by her mother on these visits. One thing that I value about Leslie's mother is how caring she is for her child. She is always there and really attentive towards her daughter. It reminds me a little bit of my mother. I don't want the smile of this little girl to ever disappear. I know that I will keep working hard to make sure Leslie receives all of her treatments so she can live a normal and happy life.
Rachel Goldberg came to us fresh out of the University of Virgina to intern with the Communications dept. of MEDLIFE in Lima, Peru for a full year. Now, after her first month on the job, she writes about her experience working in the field with our patient follow-up coordinator, Meri Lecaros:
When I came to Lima to start my year with MEDLIFE, I knew I would be dealing with a level of poverty that I had never seen before. But knowing something theoretically and experiencing it firsthand are two very different things, and in the short month I've been living in Lima, I have already learned a lot. As the communications intern, I came here with no background in medicine, but I discovered there is a lot more to MEDLIFE's work. The problems we encounter every day in the field are part of a larger system of social and economic inequality that only gets worse over time. When you don't have the basic resources, infrastructure and education, healthcare becomes much more complicated. I am always struck by the empathy of the MEDLIFE staff as they work to respond to the whole problem.
For the past few weeks, I've been going with Meri, MEDLIFE's field nurse, to visit a patient named Eloy, an eight-year-old who was born with a heart problem that limits the flow of oxygen through his body and gives his skin a bluish tint. He needs an expensive operation that could save his life, but as I discovered when I visited, that isn't his only problem. To reach his home, we first had to take a cramped combi, a small public transportation van, from the edge of town up into the hills until the bus couldn't go any further, then climb up a steep and slippery dirt road until we reached another hill that looked like a pile of rocks. Eloy's house was perched on top. His mother, Betsy, came out to greet us, picking her way through the rocks as Eloy followed, stopping every so often to sit down and catch his breath. Thankfully, MEDLIFE is now working on a new staircase project next to his house.
After noticing that Eloy was small for his age, Meri has been visiting each week with a bag full of nutritious food. But she wanted to find a more sustainable solution, something that would allow Betsy to provide for her children even when she wasn't around. So I went with her as she talked to the president of the local comedor, or community kitchen, and worked out a deal: Betsy could help prepare food there, and in exchange take home meals for her and her children. As soon as it was agreed, Meri walked up to Betsy's house to tell her to bring her pots and pans and get to work. We watched as Eloy, a quiet kid and a picky eater, sat down and devoured the menu of the day.
As Meri said, "It feels good to know that we accomplished something today that will continue even if we leave some day." I hope that I too will be able to make some kind of lasting change this year, however small it may be.
Ecuador Summer Intern Amrita Athwal is now back in her hometown of San Diego, California after her eight weeks abroad working with MEDLIFE. Before she left, she wrote about her experience and the impact it made on her:
On our first day of work we spent nearly an entire day on a bus! It took four hours from Riobamba to Quito to pick up the students from the airport and then another seven hours from Quito to Tena. Along the way I encountered some of the most beautiful scenery I had ever seen. Working with MEDLIFE for three years now, I thought I knew the ins and outs of this organization and exactly what to expect while working out here. However, I had only experienced working with MEDLIFE in Peru and had never visited Ecuador. After getting to Tena I was so thankful to be placed in such a gorgeous country and to be given the opportunity to experience a new style of life. Every person that we met treated us with such compassion and kindness. The patients were so grateful to have us working in their community. Tena is very small, and the communities we visited were consequentially smaller than what I had expected given my previous experience in Peru. However, this wasn't a bad thing; it gave the clinics a much more personal touch and I could really feel the impact of our aid. The local authorities were so grateful in one particular community that they actually invited our entire clinic over for dinner— that was an experience that I will never forget. They shook all of our hands and gave awards to students who demonstrated exceptional work.
Both in Tena and Riobamba my favorite aspect about the Mobile Clinics was surprisingly not the health services provided, but the hygiene projects we carried out. For several days I volunteered to chaperone the students and worked alongside them as we toiled under the beating sun to build new bathrooms for the communities. Being from Southern California, I acknowledge that I come from a privileged lifestyle and am not used to the strenuous labor needed to mix cement and sift through sand to build a bathroom with my own two hands. Yet, somehow I did it and loved every moment of it.
In Tena there was an elderly woman with her nose completely deteriorated and discolored. I talked to her and learned that she had nose cancer for eight months now and none of her children would take care of her. This had to have been one of the most emotional moments for me -- to see someone in such extreme pain not have access to any sort of help. My heart went out to her, but I was so happy to be a part of an organization that was able to actually do something for her. She saw all the doctors and shortly after was admitted to the hospital for treatment. Just helping that one person made me feel like I was actually doing something, and that somehow, I made a difference in the world.
Overall, I can honestly say that I have loved every moment of my eight weeks in this country. My involvement with MEDLIFE will continue as I resume the position of Student Advisory Board West Coast chair, and I'm very excited for all the future impact I can make. I am now fully aware of exactly what is going on in both Peru and Ecuador, and cannot wait to come back here. My heart is and always will be in the beautiful country of Ecuador.