An Assistance in Peru

(16.05.2011)

When your plane is landing you are a bit frigthenend, this mental reflex, is you think about states of the third world: dirt, terrorism, corruption, contaminated food. Then the ride to the city, past neon signs, dark corners and not finished buildings: half USA, half bomb attack. We get to know Melva Delgado who lives in Monterrico. Melva will become our Peruvian mother, considerately and friendly like the rest of the family. Their house is open for us, they show us the city and introduce us to the culture of this beautiful land.
Somehow the first day of work in the Hospital del Nino begins. The entrance hall reminds you of a station: children, parents, doctors, everything is confusing. For a short time we are about to turn around and run away. Doctor Ramirez who leads the intensive care welcomes us in his bureau. He guides us to the ward for burned children. There we spend the first three weeks of our work, accompany the ward round and help at surgeries. We are allowed to intubate, to arrange for instruments and to bandage the freshly operated.
In Germany burned patients are isolated under rigorous hygienic conditions, here up to ten children lie in one room without any air condition, without soap, without towels, A few of them are insured, most of the time the doctors collect money to buy medicine. Blades for pneumatic knives to transplant skin are used up to fifty times. In Germany these are only used once. Material is valuable.
We are integrated, whether physiotherapist or chief physician, everyone takes some time to answer our questions and are interested on a personal level. After two weeks we change to the acute day ward. There everything is about diagnostic findings, you get a good overview about children diseases which are also frequently in industrial nations, enlarged here by the wider range of infections. Here you should know ho to speak Spanish to communicate with the children, their parents and the doctors.
Whenever we want to we are allowed to visit other wards, the cardiac surgery or the abdominal surgery, the ward for infections and the genetic consultation-hour. The second part of our work as an extern brings us to Iquitas, a city with 400.000 inhabitants at the Amazon, right in the jungle, no road leads there. In the state hospital Reginal all established wards can be found, even a neurosurgery. The hospital lacks a lot of equipment. They do not have a machine for computer tomography, electrolyts cannot be analysed, the labatory has got three microscopes, they do not have any bedclothes.
We start to work in the consultation for dermatology. Dr.Colan is our excellent and patient teacher. In an short period of time we have the possibility to see a lot of typical tropical diseases, among them leishmoniasis, leprosy, mycosis, aids and snake bites as well as the known spectrum of pemphigus to psoriasis up to ichtyosis. Most of the patients cannot afford to pay their treatment, therefore they wait as long as they can. When they come their disease patterns are already far progressed. That is tragical, especially if they have badly infections and ill-natured tumours. We see phases which are only known out of teaching books in industrial nations.
In the afternoons we help in the acute day ward or in other wards. You learn every kind of infection techniques and you are allowed to sew, to lie a catheter and to take a blood sample. The wards are looked after by medical students in their last training year, everyone is interested and cooperative, they inform us over interesting cases and take time for explanations. If you grow into the team, you are allowed to take patients in and bring them to the right doctor.
We have been in Peru for four months, we have travelled there, into the mountains, into the desert, to the coast and into the rainforest. The Peruvians are proud of their country, they are right. Poverty is not a characteristic of Peru. It characterises a great part of the world. Who works in the health care knows this. It is a frightening experience, but it helps to see things from a new point of view. Peru is rich in tenseness, in wonderful people and in experiences which cannot be made in our normal surroundings.

Maja Korsch, Jens Petersen