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MEDLIFE have been working in the community of Laderas for nearly five years now. As well as running educational workshops and mobile clinics in this community, we have also been heavily involved in constructing projects here. Over the past year, we have been working on a project to constuct five staircases in this community which is located on a steep hillside. We completed the majority of these staircases with the help of volunteers from our mobile clinics but the last staircase, which we finished last week, was left to staff and interns. Here are a few photos from the week:
We look forward to continuing to work with Laderas in the future and have already started making plans for potential future projects in this community!
There is a custom in Peru to keep a human skull in the home as a way of protecting the family and warding off evil. On Wednesday 28th September, MEDLIFE patient Delia Martín brought out the skull which had been protecting her home and presented it to a group of MEDLIFE staff and interns. She told us that she wanted us to take it as she felt she had reached a stage where she no longer needed the protection.
Delia has been suffering from Caroli syndrome since she was a young girl. This is a rare congenital disorder of the intrahepatic bile ducts that can lead to high blood pressure and, in severe cases, liver failure. Delia is a mother of five and her symptoms have left her unable to hold down a stable job. Her husband works long hours running a workshop from the house. However, this means Delia is left to care for the children alone and has no way to get money in to support her family.
Over the past few years, MEDLIFE have been supporting Delia though her treatment and helping to make sure she has access to all the medication she needs. Recently, the MED Programs department started a project to fundraise to bring a sandwich cart to Delia to help her to have a more stable employment. Thanks to the money raised by North Oconee High School we were able to go to Delia’s house to deliver the cart on Wednesday 28th September.
A group of MEDLIFE staff and interns got in a truck with the cart decorated in balloons and drove it up to Delia’s house. Delia was so grateful for the cart and explained to us how it felt. “First (MEDLIFE nurse) Ruth arrived telling me to come outside, saying ‘we have a surprise for you’. So I went outside and suddenly out in the street I saw the car with everyone in it and the sandwich cart. In that moment I was so excited, I don’t know how to describe it. It was a very strong feeling.”
Delia welcomed us all into her house and started using her new cart immediately. We were lucky enough to be her first ever customers, receiving delicious hamburgers stuffed with lettuce, cheese and chips! Before we all left, Delia addressed us as a group, she said “I don’t know how to thank you all for what you have done for me. I want to thank everyone from the NGO MEDLIFE from the bottom of my heart for helping me through every stage of my illness. I have no other words except that I am so grateful to everyone that has helped me and I hope that you all continue to help people like me.”
MEDLIFE was introduced to the community of Union Santa Fe in 2012 by the leader of a neighboring community, located in the heart of Pamplona Alta, one of the most impoverished areas of Lima. Union Santa Fe may not have any public spaces, road, electricity nor water access, but they did have one very important thing, the desire to work together to move forward as a community. As soon as Director of Projects Carlos Benavides saw this, he immediately began working with them on a staircase in 2012.
“Before having the staircases, pregnant women, the elderly and children of the community struggled to walk up the dusty hill which became especially dangerous in the rain,” Casani said, a Union Santa Fe community leader. This first project was the beginning of a close and productive relationship between MEDLIFE and Union Santa Fe.
Four years later in September of 2016, we have completed 15 projects with them, and brought two Mobile Clinics and two educational workshops to the community. We are currently planning a project that the community has long needed; road access to the community.
The road will take these sections of road and pathway, turn them into driveable roads, and connect them to another road that leads to the bottom of the hills.
The new road will be connected to the road seen in the bottom of this photo, and allow easy access to main roads nearby.
The benefits of a road go far beyond the obvious; the ability to drive or take public transit to your home. Many of the shanty towns like Union Santa Fe are not recognized as legitimate communities by the local government, and are thus cut out of access to public utilies. If the community is accessible by road, then Luz Sur, the public utility that provides electricity in that area of Lima, will be obligated to install electricity as well as public lighting in the streets of the community. This will also make the electricity in their homes cheaper. Sedepal, another public utility, will also obligated to install a drainage system that will drain excell water runoff and can be used to install plumbing.
In this part of Lima, many communities get their water from privatized water trucks that drive around and sell water. With the new road, the trucks will drive into Union Santa Fe up in the hills, and residents will no longer have to walk down the hill and climb back up with heavy jugs of water.
Like many of Lima’s informal shantytowns, getting and keeping land titles has been extremely difficult for Union Santa Fe. “15 years ago everything was just dirt paths, a few houses and the pig farm,” Carlos said. “The people here built all of this in fainas (community work days.)” As urban areas became increasingly crowded, the people who now live in Union Santa Fe and other settlements like it throughout Lima, decided to climb the hills and stake out a plot of land to build a home of their own on.
However just because someone built a home doesn’t mean they own the land its on. Entire communities sprang up on land for which they lacked land titles. There was a legal process to aquire land titles, but for that the community needed infrastructure.
The staircases had helped move Union Santa Fe closer to their goal of getting land titles, but it wasn’t enough. When Casani, a community leader in Pamplona Alta, asked MEDLIFE founder and CEO Nick Ellis for a road, Ellis quickly agreed because the community signed a document promising to finish construction by the end of the month and because of the dedication and commitment he had seen from Casani and the whole community in the past.
Once the road is constructed community of Union Santa Fe will have land titles, access to electricity, plumbing, and easy access to their homes. Perhaps most importantly, all future projects will be much cheaper and easier to complete because construction materials and equipment can be easily transported to the construction site by motorized vehicles.
Casani and the people of Union Santa Fe were very grateful, “ [MEDLIFE] is the only organization that we have encountered that consistently brings rapid and immediate social help,” said Casani.
On Friday 9th September, we held our first PAP smear educational workshop. MEDLIFE has been carrying out PAP smears to test for cervical cancer since some of our earliest clinics. However, recently our nurses have noticed that many women have not been benefiting from these results as they have never been educated on how to read them correctly. Women who were being given normal results were worrying that they had cancer as they didn’t know what a positive or a negative smear looked like on paper.
Therefore, the MEDLIFE nurses have been collaborating with obstetrician Zaida Lara to design a workshop that goes hand in hand with giving out the results of the tests. The first of these workshops took place in the community of Kawashi, Villa María del Triunfo where Zaida, along with MEDLIFE nurses Ruth and Carmen, talked the women present through reading their results. Zaida explained to the group what a positive result would look like compared to a negative result and what the different types of abnormality could be. For example, she explained how a result that showed up as being ‘abnormal’ could be anything from a yeast infection to an early onset cancer.
The woman who attended the workshop were clearly pleased to hear this news; “as soon as I opened my result I began panicking, having someone to talk through it with me and explain every step made it that much easier,” one woman told us. The workshop also meant that the women were able to talk to the nurses about their individual results and what the next steps would be. For the first time, they were able to act immediately if there was something wrong with their results and know the exact course of action to take. Furthermore, it allowed us to quickly and efficiently get the patients who need more help into our follow up program.
So far, MEDLIFE has treated hundreds of patients who have been diagnosed with abnormal PAP results and helped with 20 cancer diagnosis’. Hopefully, with this new way of delivering information, we will be able to help even more patients to get the treatment they need.
Over the last few decades, Peru has seen mass migration into Lima which has led to huge numbers of people gaining land through squatters rights and setting up unstable, poorly built homes to enable them to live in the country's capital. Since the 1970’s, migration to urban centers has been a huge problem throughout South America and has let to the construction of Brazil’s favelas, Argentina’s villa’s and the pueblos jóvenes that we see in Peru. MEDLIFE’s architecture intern, Edinson Aliaga, explained the effect that this dramatic urbanization had on Lima: “There was an area that was created for urban expansion in Lima, but they didn’t expect just how many immigrants would be coming in.” This extensive migration and the unprecedented number of people moving into the urban centre, led to people grabbing land where they could and constructing quick temporary structures to allow them to gain land titles on unstable terrain. These badly constructed houses left the residents susceptible to illnesses and infections from the poor living conditions and other structural dangers due to the unstable nature of their homes.
In more recent years, there have been many housing projects and design programs developed across South America that attempt to deal with the growing issue of social housing in the slums. Alejandro Aravena is a Chilean architect who this year was awarded the Pritzker prize for a social housing project he developed in Iquique, Chile. The Pritzker is the Architectural equivalent of the Nobel Prize and is generally awarded for design ingenuity and projects that are considered to be ‘momentous’ works. Therefore, the seemingly unimpressive social housing project that Aravena won it for, came as a surprise to many in the Architecture community. However, in reality, Aravena’s project was more than just a social housing scheme, it was a piece of architectural innovation with Aravena’s desire to tackle Chile’s social housing issues at the heart of it.
Aravena’s idea to develop a sustainable housing model, shaped to the needs of the poor, is something MEDLIFE is currently investing in with its own housing projects. MEDLIFE’s new architecture and civil engineering interns, Edinson Aliaga and Raul Huapaya, have been working closely with Carlos Benavides, director of MED Programs Peru, over the last few months to expand MEDLIFE’s work in the field of social housing. Many of the illnesses and health problems we treat come as a result of the poor living conditions and lack of basic resources, caused by the structures built after migrating.
Aravena’s project ‘half of a good house’ was developed after similar issues of migration and centralization had arisen in Chile due to sudden dramatic urbanization. The idea behind the project was Aravena challenging the thought that the public money received to improve the living situation of many impoverished Chileans could either be used to build many low quality houses or a few high quality houses. Aravena instead presented the idea of creating a secure, sturdy structure which could then be expanded on relatively cheaply by families in the future when the time came- essentially half a good house. “Aravena is something of a pioneer in this field of social housing.” Edinson explained, “He was one of the first people to think about social housing as a way for the poor to be able to have stable, comfortable housing at an affordable cost. He came up with the idea of developing a house after it has been built, thus giving people a stable foundation which they can then expand on if they want to. Essentially meaning they could put in more bedrooms, a small shop, anything they need, knowing it’s on a stable structure.”
Creating houses with stable foundations and basic commodities has been a large focus of the work of the MED Programs department over the summer. Edinson and Raul have been working on developing plans that are similar to Aravena’s in the way that they have the option to be expanded on but are also designed with the individual in mind. The department has already undertaken two housing projects for MEDLIFE patients Santusa and Soledad and are looking for ways to further incorporate Aravena’s philosophy of ‘half of a good house’ into future projects. “These houses can really cost anywhere between $7,000 and $10,000.” Raul said when talking about how the housing projects are funded. “So Santusa’s cost one price, Soledad’s will cost a different price. Soledad’s has two floors which obviously will cost a little more but it will be a smaller house.” Both these houses have been constructed with the possibility of expansion either upwards or outwards and both were designed with various structural elements taken into account including location, terrain and ‘cultural elements’ such as the number of people who will be living there. “The houses we build have to be both secure and practical with everything that the person needs thought about. That includes a bathroom, a bedroom, and a living space. All these things have to be done within a structure that has been thought about for Peru and for Lima where we find many earthquakes and other structural issues” Raul explained.
The idea of these houses being built “with everything that the person needs thought about” is the main focus of MEDLIFE’s social housing project. As with Aravena, we want to be able to provide the communities we work with with the same safe quality of housing as the rest of Lima and not just give them something cheap and comfortable because that is the easiest way. However, we also want to make sure that these houses are suitable for the individual both in terms of space and structure, dependant on the location. Previously, the issue of social housing has been addressed with a ‘model home’ approach, essentially designing one practical living space and putting that up wherever a house is needed. However, Edinson explained how this approach is not really feasible. “The problem there is that no one is thinking about the individual. They’re just thinking about making it simple. 20-30% of the terrain around Lima is not recommended to build on in these areas but people don’t know about this. Really, no buildings should be being constructed on this land but if they have to be built, they have to be built well. So that’s the first thing, you have to think about the foundations of the house dependant on where it’s being built. Secondly, you have to think about the actual individual. For example, Santusa had a single floor to her house because she is living alone. Soledad’s house however, had to have two levels so there is room for her and her son. So that’s another thing to think about.” Making a blanket design of a ‘model home’ isn’t feasible because whilst it may serve well for one individual living in one place, it will not be safe or comfortable for a different individual.
Part of the MEDLIFE mission is working together with community members and patients to give them what they need and what they ask for. We are committed to seeing this through with our housing project in constructing sustainable, stable homes for those patients in need. Santusa and Soledad were both one off cases where the individual was in desperate need of a house which we then constructed to according to their personal needs. However, MED Programs have more recently been talking about developing a happy medium between Aravena’s ‘half of a good house’ theory and our own belief that the individual must be taken into account. On a recent visit to Urucancha, a remote community in the uppermost hills, Carlos Benavides began discussing plans with the community leader of designing a ‘model home’ specifically for that community. This would essentially mean that the structural elements could be taken into account as all the houses would be being constructed on the same terrain and the cultural elements could be covered by the possibility of expanding on the solid structure. Raul explained a bit more about how this ‘community model home’ would work. “We would make a plan for a ‘model home’ that would meet the cultural and physical requirements for that community. We would then help with and supervise the construction of two of three homes with the help of community members. So, everyone then knows how to build this ‘model home’. The idea is that it’s an easy and repetitive way of building so we can get enough materials for however many houses the community needs and then after having help with the first few, they can build the rest by themselves. However, this will only work for this community. As Edinson said, when you go to a different community with a different terrain, it’s a completely different world. For example I would never design and build the same house for someone living in Surco as I would for someone in Villa Maria del Triunfo and it works the same way amongst the communities.”
The possibility of creating ‘model homes’ for communities is still very much in the planning stages but in combining what we have learned so far with inspiration from other projects like Aravena’s, the direction for the housing projects is becoming increasingly clearer. We hope to be able to continue to work with Edinson, Raul and Carlos to develop this project even further in the future.