MEDLIFE

Although our staff members, doctors, and student volunteers conduct Mobile Clinics that last one to two weeks, the preparation for these clinics begins well in advance. MEDLIFE Fund Project Director Carlos Benavides visits several different communities, assessing needs and attempting to pinpoint locations that will serve the greatest amount of patients. Carlos also looks for a "compromiso" from the community -- a commitment to collaborate with MEDLIFE by providing community support and local labor. Community leaders also pledge to publicize the dates of the clinics and clinic services to the members of their neighborhoods.

Three to four weeks before the clinic date, another meeting is held with each community to share our plans and to receive questions. This meeting serves as an opportunity to speak about common health problems, to inform the community about our Mobile Clinic process, and to explain the types of services we offer.

In preparation for our most recent Mobile Clinic in Lima, Peru, MEDLIFE staff members held a meeting with the community of Villa El Salvador to present information about our diagnostic screenings (breast and cervical cancer) and dental services. Check out our before and after photos below!

MEDLIFE staff members meet with the community of Villa El Salvador in preparation for an upcoming Mobile Clinic:

Photos from a subsequent January Mobile Clinic in Villa El Salvador:

Education is an integral tool for improving the overall health of communities and promoting healthy lifestyles; likewise, it is a core component of MEDLIFE's work in Latin America. Our most recent educational workshop in Peru focused on nutritional problems that plague the communities of Pamplona Alta, such as anemia, infant and child undernutrition, and the risk of parasitic infections. This workshop combined MEDLIFE's resources with those of a local leader, Sara Torres, who helped organize and run the event.

We first met Sara on a Mobile Clinic in her community of El Trebol. Sara runs a comedor, or community kitchen, which receives formal government support through subsidies on specific food items. We learned that not only was Sara already providing low-cost meals to members of her community, but she was also passionate about educating them about the importance of a well-balanced diet. Together, we developed a workshop to teach tips for battling malnutrition, including how to use a somewhat surprising ingredient  -- chicken blood -- to combat anemia.

Watch the video below for highlights from the event!

According to the World Food Programme (WFP) in Peru, "approximately 11 million people (38%) do not cover their minimum daily calories intake (2,100Kcal)." The WFP also notes the importance of using sangrecita (chicken-blood pudding) to prevent anemia, and has published a cookbook of over 40 household recipes containing sangrecita. More on the WFP program can be found here.

On a recent mobile clinic in Lima, an interested student asked me what I knew about the state of sex education in Peru. Her interest was piqued by the video she had just watched in our education tent, one which attempts to underline for our patients the often misunderstood connection between the sexually transmitted Human papillomavirus and cervical cancer. My answer was that there was none.

During mobile clinics, female student volunteers often express shock that many of the young mothers they help to treat -- some arriving with two to three fidgety children in tow -- are frequently around their same age, if not younger. This polarization of lifestyles is for many of them one of the more impacting moments of their volunteer experience.

In a hunt for more tangible statistics, I began doing some research. Study after study corroborated a bleak picture of increasing STD transmission in Peru and other parts of Latin America, especially in large urban areas. Factors included risky sexual behavior, limited condom use, and a fundamental lack of education. The same misconceptions and cultural barriers that MEDLIFE encountered when first offering free Pap smears in Pamplona, discussed in detail in this blog entry, reappeared in my research. When it comes to information about safe sex, it seems that many communities in Peru were just never given the tools needed to identify the risks of STDs or to understand contraception options.

On a cold and misty Thursday afternoon, after an exhausting day of stair-building during our engineering brigade, I headed down the muddy slopes of Pamplona Alta alongside a few other MEDLIFE staff members towards a surprisingly clean green building, just a few minutes from our work site. 

This was one of the nearly half-dozen Wawa Wasi centers in Pamplona Alta – low cost daycare programs where children under four years of age from low-income families can spend the day while their mothers are studying or working outside the home. Wawa wasi is a Quechua phrase meaning "home for infants." The program was founded in 1993 as a collaborative effort between the Peruvian government and UNICEF to alleviate the dire needs of the increasing number of families living in poverty. For a nominal cost, children are provided with two full meals a day and are instructed in a number of subjects such as basic hygiene and early education.

We were visiting this particular Wawa Wasi in the community of Mirador Dos to give a presentation to local mothers on basic hygiene and prevention of parasites. Stomach and intestinal parasites are rampant in Pamplona Alta due to exposure to contaminated water, food, and even the dirt in which children frequently play. Although we had expected to have somewhat of a larger audience, we were pleased with the ten or so parents who turned up. I began by asking the mothers how many of their kids had ever had diarrhea (although children worldwide frequently get diarrhea, it is a common cause of death in developing countries). Seeing an overwhelming number of hands go up, I clarified some of the common causes of diarrhea in developing countries, such as ingesting contaminated food and water. We then covered several essential points concerning hygiene, such as hand-washing and how to prevent transmission of contagious diseases.

This week, the Save the Children Federation (SCF) – an international organization that enforces children’s rights in developing countries – released a report on so-called ‘healthcare deserts.’ The term is akin to others used in the development world to describe areas devoid of resources (e.g ‘food desert’); SCF defines a ‘healthcare desert’ as an area where a child “has not received any of the six routine immunizations, including diphtheria, whooping cough and tetanus, or received medical treatment or advice for diarrhea.”  

According to the report, at least 40 million children live in such healthcare deserts, lacking access to health care workers and medications for easily preventable (but often fatal) diseases such as diarrhea, pneumonia and malaria. SCF's study focused on 25 countries throughout Asia and Africa, naming India as the country with the most children in need. Yet, curiously, India’s economy has grown in recent years. What’s more, the child mortality rate has decreased globally. We look, on paper, like we are generally on target to meet the Millennium Development Goal of reducing -- by two thirds -- the under-five mortality rate.

Cervical cancer is the most frequent cancer contracted by women in Peru. It is the number two cancer killer of women in Ecuador; in the USA, it doesn't even crack the top 10. Women in Peru and Ecuador are 3-4 times more likely to be diagnosed with cervical cancer than women in the USA. The likelihood of mortality exacerbates the problem: the mortality rate for women in Ecuador and Peru is 5 times higher than for women in the USA.

The statistics explain enough: cervical cancer is a big problem in Peru and Ecuador. What is MEDLIFE doing to stem this epidemic?

Offering free pap smear exams. The Pap smear is a screening test that detects warning signs of cervical cancer and pre-cancerous changes in the cervix. It is used extensively worldwide, and is generally recommended that women ages 18 and up receive an annual test. MEDLIFE hires a gynecologist or nurse-obstetrician to conduct pap smears during our Mobile Clinics. The exam is performed on site in a private gynecology tent, and the samples are analyzed at a local laboratory the following week. Individual results are then delivered to our patients by MEDLIFE patient follow-up coordinators.

Reaching women in need. Hiring a gynecologist is easy -- getting local women to show up and take the test is the real challenge! There are many financial, educational, and cultural obstacles which prevent or discourage women in Ecuador and Peru from receiving regular Pap smear exams. MEDLIFE removes many of these barriers by physically bringing the Mobile Clinic directly into communities and need, and be offering the exam free of charge. On all Mobile Clinics, MEDLIFE conducts an educational program aimed at explaining the how the exam is conducted and enlightening women as to its importance. In the past two years, MEDLIFE has provided Pap smear exams to approximately 2000 women in Peru and Ecuador.