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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.
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.
Mauricio Parra is a 22-year-old Colombian native who recently came down to do a summer internship for MEDLIFE in Lima, Peru. Here he writes about his first two weeks on the job:
Stepping outside of the Jorge Chavez International airport, I was instantly welcomed with an array of white and red flags. Coming to Lima as a summer intern for only six weeks, I knew that my time here was going to be slightly limited. Nonetheless, I haven't let it bring me down one bit. By keeping a positive outlook, taking things slowly, and focusing on forming meaningful life experiences, I am determined to do as much as I can to help take MEDLIFE to the next level.
During this past week and a half of exploring the beautiful city of Lima, I have seen first-hand why it is knownfor being full of life with its amazing history and strong cultural heritage. However, not too far from the striking heart of Lima lies a different, intriguing story that often goes unmentioned and ignored. Directly across the window of my room, I can see in the distance the sandy, desolate hills of urbanized slums known as Pamplona. It is the first thing I see when I wake up to go to work, and the last thing when I am collecting my thoughts to go to bed, so consequently, I have found myself wondering what deeper story is behind all of this.
My first trip to Pamplona was with Carlos, Director of MEDLIFE Peru, and Tim, a visiting architectural student. Carlos and Tim showed me around Pamplona, especially the parts of the community where MEDLIFE is planning to construct community development projects. I already had a previous idea of the staircase projects that MEDLIFE provides and I understood the notion behind them, but I was instantly caught off guard by the abundance of stairs MEDLIFE has actually built. Moreover, understanding how they can be useful based off a picture, and physically experiencing why they are needed, are two entirely different things. It wasn't until I had to walk up and down the steep and dangerous hillsides, admittedly almost falling several times, that I truly grasped how vital a simple set of stairs really are. Frankly, I feel like I have been taking them for granted my whole life.
My first welcoming from the people of the community came with bright smiles, firm handshakes and soft hugs, and was followed by a glass of the delicious Peruvian soda, Inca Kola. Even after having visited other impoverished parts of the world, it still continues to amaze me how the people who have the least always end up being the most generous.
My most recent visit to Pamplona was to do a patient follow-up visit and to present a nutrition education workshop with Carolyn, another MEDLIFE summer intern, as well as several other staff members. Having already done it in the past, Carolyn felt calm and collected regarding all of our material as well as what to expect. I, on the other hand, spent all morning analyzing every last bit of information and anxiously waiting for the time to head out.
When the time finally came to give our presentation, walking in to the packed room took me completely by surprise. Aside from making it slightly more intimidating, it managed to show me the genuine desire of the locals to come out and learn more; something that I rarely see back home in the US. The doctors spoke about important health-related problems specific to Peru, such as obesity, breast cancer and cervical cancer, and the women seemed very receptive to everything they heard. Soon after, it was my turn. I took a small sip of water, looked up at the audience, and presented everything that I had been reviewing over and over. As it turned out, the presentation went much better than I expected! Looking back, it was silly of me to have been worried at to begin with. I was able to get several laughs out of the audience, and whenever we asked a question, there were always several community members willing to respond. Afterwards, Carolyn and I helped weigh and measure everyone to get their BMI number and give them an idea of how healthy they are. Speaking with the various Peruvian women, I found that our difference in cultures was no barrier to our ability to connect and laugh together. They all kept a cheerful, optimistic spirit while joking around about running up and down the stairs each morning to shed a few pounds. Each and every one thanked me for coming out, and welcomed me to come again for more presentations. It is safe to say that the workshop was a success.
Overall, while my time here in Lima has been somewhat brief, I already feel like I have learned a lot about what MEDLIFE does between Mobile Clinics, and what it takes to be an intern. I am still very curious to learn more about the Peruvian culture, try different foods, meet more people, and visit new places, but most importantly, I am very excited to see what else I can accomplish in the next month. I have realized that the more informed I become and the more passionate I grow, the more hopeful I am that before I leave, I will able to look out and across my bedroom window and feel proud knowing that I have made a difference.
Summer Intern Carolyn Adam writes about her experience planning and delivering a presentation on nutrition in Lima, Peru:
I can't believe I have already been here in Peru for almost two months. The beginning of my trip was such a blur as I went straight from my last final of the semester to the airport the next day, and then the participants for the first Mobile Clinic of the summer arrived in Peru two days later. After seven weeks and four Mobile Clinics I can say I am pretty comfortable in my role as a MEDLIFE intern. Then there are those times when I am not so confident, like on June 27, when some of the other interns (Savannah and Maureen) and I presented on general nutrition tips in a health workshop in Pamplona.
We had put together the presentation after interviewing women on their family's eating habits during the previous week's Mobile Clinic. The presentation focused on feasible changes families could make in their diets to become healthier. These recommendations included trying to only eat one carbohydrate source with each meal (instead of eating both rice and potatoes, which is the norm in Peru); increasing the amount of lean proteins, such as fish and lentils, in their diets; and trying to cut down on the amount of unhealthy snacks they buy during the day (something I am definitely guilty of).
The girls and I had worked hard on our presentation, but I was still nervous about making diet recommendations to a group of people I didn't know, especially in Spanish! Out of all the interns, I can definitively say I have the least experience speaking Spanish, having only taken one semester of Spanish over a year ago. I was afraid no one would understand what I was saying, or worse, I would freeze up in front of the 30 people that attended our presentation if I could not think of the word for something.
I could not have been more wrong. The community members were so welcoming and gracious and actively participated in our presentation. At the end, the girls and I passed around a healthy "bocadito" we made that was a fresh vegetable mix, and everyone really enjoyed that. My favorite part of the experience was after the presentation, when everyone wanted to find their BMI. We had brought scales and measuring tape, along with BMI charts, and explained how BMI can help gauge whether or not you are at a healthy weight. The community members who attended the workshop were so proactive about weighing and measuring themselves, and then learning how to read the BMI chart so they could be more informed about the state of their health.
For me, the most rewarding part of being a MEDLIFE intern is interacting with the members of the communities we work with. I love that I keep getting opportunities to grow and do things that I would never have done before, like giving a health presentation in a (very) foreign language. I can't wait to see what the rest of the summer has in store!