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Ceverina, a 70-year-old woman in Lima, Peru, used to live alone in a deteriorating shack that could collapse inward at any moment. One of our MEDLIFE interns, Molly Trerotola, fundraised to remove Ceverina from the dangers of her deteriorating house and build her a new home. Check out the photos taken throughout the project!
We want to thank our Chapter at McGill University for their amazing support to the local comedor "Fe y Esperanza". If you want to read more about this comedor's story you can click here. Follow the timeline to see how this comedor was built!
MEDLIFE Nurse Janet pounded on the flimsy metal door to the small house and waited- No response. She tried again. Nothing. “Señor!” she yelled. “Hola Señor! Estamos con la organización de MEDLIFE.”
It is hot, the sun is shining for the first time in weeks. We wait. She tries knocking again. Where were they?
We were looking for a teenage boy who had come to a Mobile Clinic complaining of respiratory issues. MEDLIFE doctors had told him he needed to get tested for Tuberculosis. Had he? We didn’t know.
Tuberculosis is a highly contagious and often deadly lung infection that is rapant in the Pueblos Jovenes where MEDLIFE works and disproportionately affects people living in poverty worldwide. It spreads quickly in enclosed areas where one is in close proximitiy with an infected person. For example, the interior of the combis, small crowded busses used to get around Lima, are ideal for the spread of Tuberculosis. Many buses even have signs asking passengers to keep windows open to stop the spread of Tuberculosis, but oftentimes they still remain shut.
The infection can remain dormant for months or years in someone’s lungs before becoming active, contagious and symptom causing. Symptoms can begin mild, but typically progress to lethal if active TB is untreated. MEDLIFE doesn’t offer Tuberculosis testing onsite at clinics both because it is difficult and because all public hospitals offer free testing and treatment centers.
If this boy we went to find really did have active TB, he had could have spread it to his entire family and countless other people by now if he hadn’t started treatment.
Janet sighs and begins asking passerby for the family’s wherabouts. Eventually she discovers that the boy’s mom runs a fruit stand in a nearby market. We walk up the stairs to the top of the hill and find the market. We eventually find her surrounded by piles of grenadilla, mandarinas, and pineapples in her stand. The boy’s mom has no idea who we are- immediately the lines on her face deepen and take on the shape of concern and sterness that only the face of a worried mother can have.
Her son hadn’t told her anything about visiting the MEDLIFE clinic. He hadn’t told her anything about possibly having TB. “Vamos!” she said and we took off towards the house. She was sure he was there, and she was going to find him.
We hadn’t come to give him treatment or pay for it. He could get that for free at public hospitals. We had come to make sure he was getting treatment, following proper precautions to avoid spreading the disease, and was following the directions with the antibiotics. The only thing MEDLIFE occasionally pays for is medicine to help with the stomach issues some patients experience when taking TB medication, to make compliance with the treatment more likely.
If a patient begins taking the antibiotics and then decides to stop before finishing all of the medication, the TB bacteria can become resistant to the antibiotics and the disease can begin progressing again. If this happens, they will be spreading a strain of TB that has adapted a resistance to that antibiotic. There are many strains of antibiotic resistant TB now, and some are very difficult to treat because they are resistant to many different antibiotics.
The situation we were in was making it obvious why it was necessary to actually visit TB patients and make sure they are getting proper treatment.
We put on our masks outside the house to avoid becoming infected if the boy did indeed have TB, but the mother, she didn’t have one. As his mother storms in shouting his name he sheepishly comes out of the back of the house sporting a mop of disogranized hair, a white t-shirt and pajamas. He looks like he just woke up to his worst nightmare. We must have been very intimidating, showing up in surgical masks with his unhappy mother.
He remains quiet as Janet and his mother explain the situation. You could have cut the tension in the room with a knife. Janet questions him about how he has been feeling, each question ends in a debate between him and his mother over to what degree he exhibits each symptom. The mother seems to think he is downplaying his symptoms and has been sick. The boy says that he simply forgot about it and is fine.
A friend of his who has TB had been coming to the house for months so they could study together. Their pile of books was sitting on the table as we spoke. His friend had told them he wasn’t contagious since he had been taking the medication long enough, but if he had decided to stop taking the medicine because he felt better, or forgotten too many doses, he could have become contagious and passed anti-biotic resistant TB to them.
That is the problem with trying to control the spread of TB in places like the pueblos jovenes; lots of people with weak immune systems living in close proximity to one another with a lack of education and many barriers to access healthcare are extremely vulnerable to the spread of TB.
TB is not just a problem in Lima´s Pueblos Jovenes, but all over the world. In 2013, 9 million people around the world became sick with active TB and there were around 1.5 million TB-related deaths worldwide. The rate of TB has been declining around the world and in Peru due to efforts from governments and international health organizations, but is still a significant problem. In Peru, the per capita rate of active reported TB infections has declined by about 72% between 1990 and 2013, according to the World Health Organization. 67% of patients who began treatment were treated successfully.
No one knows how many people have latent TB since those with latent TB do not have any symptoms. The United Nations public health agency estimated in its 2013 report that about a third of all active TB cases are unreported worldwide.
Antibiotic resistant TB, on the other hand is on the rise globally and has been called a public health crisis by the world health organization. Patients with drug resistant TB must take multiple drugs daily for as long as two years. Making this happen is extremely expensive and difficult.
One of the only ways to stop the spread of antibiotic resistant TB is to ensure patients follow it in the first place, and don’t create new strains of resistant TB. To do that sometimes you have to go out and see them in person.
The boy and his mom promised to go and get a test. Janet says she will stay in touch. Hopefully he will actually go this time. I have a feeling this time around his mom will make sure of it.
When we met the students and teachers from the Galte, Yagachi school in Riobamba, Ecuador, their classrooms were deteriorating. Thanks to successful fundraising campaigns led by MEDLIFE at Wayne State University, MEDLIFE-Ohio State Chapter and MEDLIFE at UGA, we worked with parents, teachers and community leaders to build new classrooms for the school. The new classrooms will provide a safe and comfortable learning environment to ensure that the kids at the Galte Yagachi school receive an education with dignity! Watch the video here.
Director of MED programs Carlos Benavides stood on a steep dirt path in Paraiso, a community where MEDLIFE has never done a project before. It was daytime and the deplorable living conditions in the pueblos jovenes were in full view.
When MEDLIFE enters a new community, it is often necessary to start from scratch. Sometimes people have never heard of the organization. MEDLIFE may not have any contacts with the leaders of the community, if there are any. So how does MEDLIFE get to the point where a specific problem is identified, and we have engaged with the community enough to organize a community meeting?
Often, engaging the community starts in the simplest way possible: visiting the community, approaching people in the street, knocking on doors, explaining to them what MEDLIFE is, and listening to their needs.
Carlos was in Paraiso on one of those preliminary visits. He was scouting out the dirt path for the construction of a small stair-case. It will benefit many families, but MEDLIFE is making it primarily for a specific patient, known as Pompinchu, a famous comic with osteoporosis and a broken leg. He can only walk with a walker, and MEDLIFE is trying to make the walk up the hill to his home safe for him and his neighbors.
No one said hello on the walk up to Pompinchu’s house, it was up to Carlos to take the first step and engage the community. “Do you know what MEDLIFE is?,” Carlos asked over and over. The response was always no. He would stop them, explain what MEDLIFE is and why MEDLIFE wants to build a staircase in the community. Then he gave them his card, asked them to spread the word about the project and help organize a community meeting. Hopefully they would actually call.
Next, he went to speak with the people who would be directly impacted by the project.
Pompinchu’s house is in the middle of a row of shacks mostly constructed out of wood and corrugated iron siding on a steep hill; I wonder how they don’t slide off.
Carlos knocks on a neighbors door. A middle-aged man answers, and Carlos asks him what he thinks of the staircase project. Would it benefit him too? Is there a real need for it?
The neighbor replies that the need for a staircase is great when it rains a lot. “When the land is wet, it is like soap,” he said. “It is always a problem for my family too. There have been enough accidents here.” MEDLIFE will have to get rid of some of the plants in the path that he has planted. He doesn’t care, but it is important to bring up these sorts of things with community members who will be directly affected by a project.
Carlos asks him to talk with other people in the community to help organize a meeting to discuss the project. He agrees and takes the card.
The row of shacks that the staircase will lead to sits beneath a concrete two-story home that towers above the shacks surrounding it like a bizarre monument, a constant reminder that another life is possible here. The shacks would shock most people who have never visited a slum while the two-story home would not look out of place in a lower middle class neighborhood in the US.
Carlos pauses, looks up at the large home and begins to talk about why it is so important to help a community to self-organize. It was as if he was trying to answer the obvious question that enters ones mind when wealth and poverty are so sharply contrasted: why aren’t people helping one another more within the community? It is clearly possible for people to work together to make life better for the community and for every living in it- but it hasn’t happened.
“The problem is self-organization, communication; [getting people] to come together and work hard is quite difficult,” Carlos said as he glanced back up to the concrete house above the row of makeshift shacks.
“For example you see that two-story house- there are the socioeconomics of life. He stayed here and progressed here. People don’t organize themselves well so we need to help them, motivate them, and say to them that it’s oneself who changes their own life. We make staircases, plant plants, paint them, make handrails, everything, everything we do, it is just in five days and here it is –a great staircase.”
All it takes is five days of people working together to make a long-term impact on the quality of life of the community. While MEDLIFE pays for building materials, designs projects, and brings volunteers to help with some construction, it is ultimately the community that actually builds most of the staircase.
Before we leave Carlos tells Pompinchu’s neighbor again to please call and tells him that “we can build it if there is not a problem mobilizing the community.”
Later that day he headed to another community, 15-A1. MEDLIFE has already built a staircase and held clinics here. Here the community is engaged and organized. They already helped MEDLIFE build a staircase. Now, MEDLIFE is working on building a water pylon, so that the community can have access to cheaper water, and so they don’t have to carry water bucket by bucket up the steep hillside to their homes.
The difference between 15-A1 and is immediately apparent. Everywhere we go people stop Carlos to thank him for the staircase, discuss working on the water project, or to just say hello. The people in 15-A1 already know about the development projects happening in their town; Carlos doesn’t have to tell them about the water pylon. Many of them tell Carlos that he can count on them to be there to help construction.
A pregnant woman holding a crying baby stops Carlos to tell us how hard it is for women with small children to carry the buckets of water up the hill, how she doesn’t want her children to have to drink water full of dead flies and fungus.
This community is engaged and rallying around the project, and things are happening. A community meeting is being organized by several contacts who came to meet us and discuss the project.
But it takes time to get to this point. It starts small. It starts with getting a few people in a community like Paraiso to spread the word and work with MEDLIFE to make a project happen.
At the bottom of the hill Carlos hails a moto-taxi, he knows the driver. He mentions how difficult it is living without any light in the community he lives in that is visible through the moto-taxi window on the adjacent hillside. “This town needs lights, this town needs water, it is different everywhere,” Carlos said.
Carlos tells him he will talk to some people; maybe MEDLIFE can do a project to put lighting in his town.