MEDLIFE

A strong sense of solidarity in poor communities can sometimes give rise to innovative solutions in the face of extreme hardship. One example: the case of comedores populares in Lima, Peru -- community kitchens that provide nutritious meals for everyone, and that also play an important role as a local gathering place. Anyone can eat at a comedor, but they are especially important for the most vulnerable populations -- namely children, the elderly, and handicapped -- who may not have the means to obtain a healthy diet. At the Comedor Hijos de Brillantes in Pamplona Alta, Lima, the handicapped and elderly get a free meal every day. For everyone else, it's just S/1.50, or 60 US cents.

Roberto Huayhuapuma Vasquez, President of the Association of the Disabled in Pamplona, recently invited the MEDLIFE team to visit the Comedor Hijos de Brillantes to learn more about their work and how we could help. Roberto, who was born with only one functioning leg, started the association for the disabled after facing discrimination and seeing the limitations it placed on others like him. "I realized that together we could do a lot to change the world for disabled people in my neighborhood," he said. "We are capable of doing much more than we are given."

The group began serving meals to the handicapped in the area two years ago, and has managed to accomplish a great deal with very few resources. They started out cooking on a wood fire; now they have a small stove, which prepares meals for about 50 people a day. Of those 50, about half eat for free.

The cramped shack that serves as a comedor is ill equipped for people with disabilities, with a dirt floor, narrow entryway, and no handrails. They're asking our supporters for help with improvements to the structure to make it more accessible so they can continue serving the population of men, women and children who depend on them. If you'd like to contribute to this project, donate to the MEDLIFE fund.

What is a comedor?

Comedores populares began informally in the 1960s and 70s as a survival strategy in the fast-growing pueblos jovenes, or urban shantytowns of Lima. Women came together to form neighborhood organizations, pooled their resources and collectively prepared and distributed meals to their families. As economic conditions worsened, their numbers exploded.

The comedor model of social organization found in Peru is a unique one. It started with grassroots action, driven primarily by women in the poorest communities. The introduction of the Vaso de Leche government assistance program in the 1990s, which guaranteed a glass of milk for children and pregnant women every day, was made possible by using the existing networks of comedors. The women leaders in the program gained organizational skills and experience that empowered them to fight for a more active voice in public life. Sadly, they also became targets of political violence by the Sendero Luminoso (Shining Path) terrorist group in the 90s.

Today, thousands of comedores populares are still active and vital to the growing populations in pueblos jovenes. Many are subsidized by the Peruvian government, which provides some raw ingredients in bulk, with some also receiving donations from church groups and NGOs. They are staffed in shifts by local volunteers, who receive food for their families in exchange for the hard work of preparing meals for large numbers of people. The network of women and men who run the comedors are important allies for MEDLIFE in the battle against malnutrition and other health problems, spreading the word about programs and resources to the entire community. They're often where we hold our preventative health workshops and public forums throughout the year, and sometimes even double as improvised doctors' offices at our Mobile Clinics.

Our latest educational workshop was located in a small community in the Nueva Esperanza area of Via Maria del Triunfo. MEDLIFE will bring a Mobile Clinic to this same community in March of 2013.

During the workshop, MEDLIFE staff members presented on a number of health topics, including the importance of psychological health and sleep, preventative tests for breast and cervical cancers, and nutrition. Along with our usual preventative health topics, we also touched on – for the first time – the important issue of property rights.

As many of our supporters know, MEDLIFE Peru works primarily with low-income, informal settlements established just outside of the city of Lima. Poverty, terrorism, and a lack of opportunities in rural Peru have prompted thousands of residents to migrate to these urban slums. As these communities become bigger, more established, and better organized, residents begin to move toward legal formalization of their homes and communal spaces.

Yet, the country has struggled in developing a comprehensive plan for urban development. With changes in government administration, treatment of informal settlements has varied widely. The involvement of several different agencies, sometimes with conflicting policies, also makes the process of legalization a murky one to navigate.

Santos Abad, a government lawyer, explained the basics of acquiring land title, highlighting the primary agencies involved in the process: COFOPRI (government agency that deals with property formalization), the municipal government, and – in some cases – the court system.

Abad outlined an important law called the prescripción adquisitiva de dominio. This law states that an individual may gain legal land title simply by possessing the land, peacefully and consistently, for a minimum of 10 years. The government's 10-year rule is a seemingly adequate amount of time for legal owners to reclaim their land or, if they wish, take squatters to court.

Community members listened attentively and immediately began to ask questions. In addition to general information about legalizing their property titles, many wanted to know more about the intricacies of sharing property. What happens when you share a home but are not married? How can parents ensure that their homes get passed on to their children?

Residents have voiced a need for more education, in order to better understand their legal rights. MEDLIFE hopes to begin including this type of training, focusing first on property rights, in our upcoming educational workshops.

Stay tuned for more information on important issues regarding land rights in Peru, coming soon!

Ashley attended a Mobile Clinic in Lima, Peru last month, and raised $2,345 through the 50:50 Campaign -- enough to cover her Mobile Clinic expenses AND sponsor a community development project! Learn more about how she did it in the interview below:

Tell us a little bit about yourself.
I'm a junior at the University of Delaware majoring in neuroscience and psychology.

How did you hear about MEDLIFE?
There's a chapter on my campus; I also heard about it from friends who had gone and recommended it to me.

What made you decide to do the 50:50 Campaign?
The trip was expensive, between the flight and the trip fee. I have a lot of friends and family that want to participate and help me with my goal of becoming a doctor, so I thought it would be a good way for me to get to come here, and for them to be involved.

How did you do it?
I wrote a little information on the campaign page, and basically sent it to everyone I knew. Slowly, people started sending me money and sending me emails saying "Congratulations, this is going to be a great trip and we just donated to your campaign." It was really nice to see how many people wanted to help me out.

What would you recommend to other people doing the 50:50 Campaign?
I would just send it to anyone you know. I sent emails to my family and friends, and put a link on my Facebook, and a lot of people clicked on it and donated through there. Some people might not be able to donate, but you may as well try, and even if they can't, I think that people would like to see what you're doing and read about MEDLIFE. It'lll just give everyone a little more information about the organization.

Now that you're here in Lima, what are your impressions so far?
It's good! I wasn't sure what to expect, but it's great so far. The people here are very nice, everyone's been really helpful.

What's been your favorite part of the Mobile Clinic?
I think the tour was my favorite part, because in the clinics you only see a small area, but in the tour you get to see so much and learn so much about the communities. It was really interesting when we saw the first MEDLIFE water project, and I was amazed that the money I raised could be enough to provide clean water for an entire community. 

Last Friday we visited the community of 8 de Diciembre for a seminar on various topics regarding preventative health care, as well as to hand out the Pap smear results for patients who attended a previous Mobile Clinic. The turnout was a lot bigger than we expected, showing us that this community is eager to learn about preventative measures they can take to help protect themselves and their families. From the moment we arrived we saw a very organized community; they had taken the time to rearrange the room to be able to accomodate all participants.


Biz Shenk, one of our MEDLIFE interns, gave a short presentation about mental health, which the community appreciated enormously. Several residents had questions regarding psychological health, but felt ashamed to ask them publicly; for this reason, MEDLIFE is trying to organize visits so that community members can meet one-on-one with psychologists. Two representatives from Manuela Ramos, an NGO that works to secure women's rights, also helped MEDLIFE Field Nurse Meri Lecaros present information about sexual and women's health. Among the topics addressed were how to recognize and prevent STDs, how to prevent cervical cancer, and how to do a quick breast exam to check for breast cancer. 

Although participants listened with interest to all of the topics, the one that seemed to interest them the most was malnutrition. Almost every mother in the room was asking for advice; they all wanted to give the best possible nutrition to their children. At the end of the seminar everyone was satisfied with the answers given to their questions, and confident that the information received was not just for them to keep, but to also be shared with others. This group's interest was so strong that they even asked for more meetings, and MEDLIFE plans to continue returning to the zone to provide information on additional health topics. 

Inge is a Communications Intern based out of Lima, Peru

This week, the MEDLIFE team completed our first staircase project in 12 de Junio, a community located right next to Laders de Nueva Esperanza, where we have already completed six staircase projects.

This particular project was organized for one of the community's residents, Carmen Solano, who is also a MEDLIFE follow-up patient battling breast cancer. Since 2011, MEDLIFE has been helping Carmen receive treatment for her illness, as well as helping to support her family while she is unable to work. Carmen has always shown incredible positivity in the face of her disease.

At the end of the week, two of the hardest-working students were asked to break the ceremonial bottle of champagne alongside Carmen, as part of the inauguration of the staircase. After a loud round of applause for the student volunteers, the students asked for an even louder one for the community.

"I will continue to fight against this disease, with more strength and without giving up," said Carmen. "Thank you for this beautiful gesture."

Read more and see more photos here.
 

Dr. Jose Luis Rodriguez joined MEDLIFE in 2010 as a general practitioner. He has always demonstrated a keen aptitude for patient care; just a few months after starting with MEDLIFE he began implementing new medical and educational programs for our Mobile Clinics. Now doctor Jose serves full times as our Medical Director, and is in charge of the supervision of all medical aspects of MEDLIFE´s operations. Learn more about Dr. Jose below:

Where are you from?

I am from Lima. I was born in Lima, but my father is from Trujillo and my mother is from the border between Chile and Peru.

How did you get involved with MEDLIFE?

Three years ago a colleague and friend named Iliana Rodriguez, who used to work here, called and asked me to fill in for an absent doctor on one of MEDLIFE's Mobile Clinics. So I agreed to help. This was in December, about three years ago. I came to the clinic and ended up helping for all five days and loved the experience; luckily, they invited me to come back for the next clinic. I was working as part of the Mobile Clinics for about two months when i first met MEDLIFE Director Nick Ellis, and he asked me if I wanted to work in a more permanent way, as a coordinator. I agreed and have been working here permanently since then. And that is how I got into MEDLIFE.

What do you like about working here?

First of all, as a doctor you have the call or duty to serve the community. Sometimes, our jobs don't allow us to help as much as we would like to, but in the Mobile Clinics you can really see how the patients are so grateful. Those kind of experiences make me feel that what I have learned is really useful, and that is very fulfilling.

Talking about good experiences, I also enjoy working with the volunteers. The students have their own personalities and they come full of excitement, wanting to help and to learn at the same time. I like watching them interacting with the patients, and I get the sense that they also appreciate the way that I work. Since the feeling is mutual, we generally make a good team.

What do you like to do in your free time?

I love dancing! That is definitely one of my favorite things to do. I also love soccer, and that's because I'm 100% a sports person.

Could you name some of the patients who made or make an impression on you?

There is one lady who comes from the sierra and lives in the community of Oasis here in Lima. The first time she saw me was the first time she ever saw a doctor; she hadn't been treated by a doctor in her entire life until that day. At the Mobile Clinic she was measured and weighed by a nurse; she then saw a dentist and general practitioner. She was very moved by the kindness we showed her and said she felt treated more like family than like a patient. She was so moved and grateful that she started crying, and I was thinking to myself, that i never understood how much we were really doing for our patients. That was a very emotional day.

We just recieved these photos from Ccaccaccollo, a community outside Cusco, Peru, where we constructed new bathroom facilities starting in August. The community has been putting the finishing touches on the project, and school director Maria Teresa Flores tells us, "The bathrooms look great, and the kids and I are very grateful to MEDLIFE for completing this project." 

Today we have some good news to share from Lima: after finally getting heart surgery on December 14th, Eloy Britto is back home with his family and on track to a full recovery.

Eloy is a quiet eight-year old boy who was born with Tetralogy of Fallot, a congenital heart defect that causes low oxygen levels in the blood. Symptoms include blue skin color, poor development, and episodes of exhaustion and seizure. In most cases, children with Tetralogy of Fallot undergo heart surgery at a very young age and can go on to live normal lives. Without the surgery, most patients with the condition will die before they reach the age of 20. 

Until a year ago, Eloy's family lived in Pucallpa, in the jungle region of Peru, isolated from any sophisticated medical care. His mother, Betsy, says she knew that he had a problem from an early age and tired easily, especially in the jungle heat. She describes how Eloy, who loves to play soccer, could only take a few steps, kick the ball, and had to sit down and rest. Last year, Betsy came with Eloy and his younger siblings to stay with a relative in the community of Virgen de Cocharcas in Lima. He was doing well in school, but he stopped going in the second grade after he fainted at school one day.

MEDLIFE has been following his case since last summer, taking him to various doctors' appointments and tests to determine if he could receive the operation that would save his life. Cardiologists expressed concern that Eloy could be too old for the operation; as his heart grew, his system had become accustomed to working the wrong way. But Meri Lecaros, MEDLIFE's field nurse, was determined to find a way to help him. In the meantime, we worked to improve his living conditions, including building a staircase next to his house.

In November, Eloy went to the hospital for a checkup, and seeing his condition had worsened, the doctors checked him in for an extended stay. They would try to help him gain weight until he was healthy and strong enough for an operation. Having never been to the hospital before, he was resistant to medical intervention; Meri recalls with amazement how it took several nurses just to hold him down for an injection. But he began to improve, and when we visited him there, the MEDLIFE staff was surprised to see how well he was doing. He was in a room with other kids around his age, and happily played and shared toys with them, smiling and talking more than we had ever seen him do before.

Meri found out about a program coming to the children's hospital in Lima -- a group of surgeons arriving from Spain to perform specialized operations only on the most serious and difficult cases. They would be in town for just one week, and there was a long waiting list. At this hospital, the patients' family has to secure the necessary amount and type of donated blood before the child can be placed on the schedule to receive an operation. We frantically searched for O-positive blood donors; in the end, one of our own interns, Inge, donated blood. Meri managed to intercept the doctors as they made their rounds and get their assurance that Eloy would get his operation before the week was over.

When Friday came, we watched as Eloy entered pre-op around 9:00 in the morning, and waited until he came out about eight hours later. The surgeons told us from the beginning that this surgery would be a complicated and risky one; it required cutting open Eloy's heart to place patches and widen a vessel to reroute the blood. Any miscalculation could mean cutting an artery and stopping the heart.

The operation went as expected, doctors told us, but Eloy was losing a great deal of blood and would be in great danger for the next five days. Meri was in the hospital almost every day during this time. At one point, Eloy had a heart attack and his system shut down completely.

"He was dead," says Meri. "We thought that was it, and just when they were disconnecting the machines, he took a breath by himself."

In spite of these scary moments, as he continued to recuperate, the difference was clear; post-surgery, Eloy's skin no longer had the blue tint, and he could walk around the halls of the hospital without getting tired. When Betsy arrived to take him home from the hospital after his two-month stay, she says he was waiting for him in the doorway with his toys and impatiently told her, "Let's go home now!"
Eloy's health is still delicate, and he needs a safe environment to ensure that he can continue to improve. But he seems to have made it through the worst of the danger now -- he's eating, talking and happy to be home playing with his younger sister and brother.

MEDLIFE will continue to support Eloy and his family through the recovery process. 

In today’s issue of El Comercio, Peru’s main daily newspaper, this headline caught my eye. It reads, “Only 39.6% of the budget allocated to healthcare was used in 2012.” Though it doesn’t have the answers, the article may provide some insight into one of the questions students always ask when they first see the communities where Mobile Clinics take place.

This week's Mobile Clinic in Lima is one of our biggest to date, with almost 100 volunteers from schools all over the United States. That means we can serve twice as many people with double Mobile Clinics and community development projects! The project this week is two more staircases in Laderas Nueva Esperanza, and as the student volunteers learned yesterday, building a staircase in a week is not easy.