Articles by Steve Henrichon

The Policlínico Peruano Americano
March 7, 2009
By Steve Henrichon

The pace is picking up at the Policl One Way buy

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nico Peruano Americano in San Clemente, Pisco, Peru. We have had to make several midstream adjustments to expand our service line and make our services accessible to as many Písquenos as possible. Here is our most recent update:

Patient Flow: We are now seeing 90+ patients per day on average.  We have extended the hours and the doctors have really been taken strides to make most efficient use of their time to handle so many patients.  Morale amongst the team is high and everyone is excited about the clinic’s success and new equipment to help improve delivery of care.

Equipment:

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We have received and installed all of the equipment from the Direct Relief International equipment grant. Shopgirl on dvd With this money, we have been able to purchase an ultrasound machine, hospitalization bed, suction unit, pulse oximeter, oxygen tanks, medicine cabinets, autoclave, etc. To help protect these investments, we have also increased security measures

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at the clinic by closing up open spaces, reinforcing outside doors and windows, and reinforcing inside doors/windows to the office in which the ultrasound unit is kept.

For more photos of the equipment purchase and security upgrade, click here.

Consultation Fee: On March 1^st, we instituted a symbolic 1 Peru Nuevos Soles (PEN) fee per consultation as an experiment.  Our goal is to find a way to keep our clinic operations sustainable, to create a partnership in health with the patients at our clinic and allow them to take co-responsibility for their health and wellbeing, and ultimately make them self-sufficient and independent of our support. At 90 patients per day, this money will also – to a small degree – help subsidize the increased medicine costs.  In certain cases where the patients are in desperate financial need, the consultation fee will of course be waived.  We do not anticipate that this fee will prevent anyone who needs treatment from actually receiving it, although it may prevent people from abusing the “free” nature of the clinic.

Ultrasound Fee: We are planning to charge S/15 for each ultrasound procedure.  We are receiving referrals from the other clinics and the hospital in Pisco.  This fee will also go towards subsidizing ultrasound services for those patients who cannot afford such a fee.

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Campaigns: We continue to perform campaigns.  Most recently, we participated in a campaign (with other health providers) aimed at increasing health education and prevention in the community.

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For photos of campaigns and clinic activity, click here.

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We originally decided on “Clinica de las Americas.” We dropped that name less than one day later when Rosy heard an advertisement on the radio for another “Clinica de las Americas” in Pisco. What are the chances?

We settled on POLICLINICO PERUANO AMERICANO. We threw the “Americano” in there to appeal to those who may be prefer to visit an American sponsored facility for their care, which seems to be most people. The term Policlinico is actually the most descriptive name for our clinic. We are not considered a “clinica.” Peruvians consider a Clinica to be small hospital complete with several specialties. A policlinico is a small medical center which has a few services, usually referring to the inclusion of a laboratory which we will have in a couple months. In the states, any health center smaller than a hospital, we refer to as a “clinic.” Everything is a clinic. In Peru, there are several specific terms for the different structures…Hospital > Clinica > Policlinico > Centro Medico > Posta.

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We were really hoping that the Dominican Sisters would want to partner with us.  We thought they would do an outstanding job managing our project once we return to the US.  Nina Zully was the sister that was lobbying on our behalf but we had to rely on her to present our case to her superiors.  She took a trip to Cusco to meet with her superiors and we waited patiently for her return.  When she did return, she did not have good news.  They ultimately decided that they did not want to attach their name directly to the project because they feared they would not be able to dedicate the amount of time and resources to really do an effective job.  We tried to assure them that the clinic would run itself.  Ultimately if they are not eager to take responsibility then we would be shooting ourselves in the foot by convincing them otherwise.

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So…he we are.  We have a functioning clinic.  We have a clinic staff.  We are scouring the area for the right building to move into.  Yet we still do not have a partner organization to take responsibility for the project.  We werent about to settle either.  We have no intentions of leaving the clinic with an organization that we dont trust 100% to effectively represent our best interests.  We will not leave the clinic with an organization that does not share the same vision, ideals and values, and work ethic.

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As it turned out, the answer was staring us in the face.  Lets start our own Peruvian NGO which is composed by our friends who want to take ownership of the project…friends we know and trust to represent our best interests…friends who already have an invested interest in the project…friends who have been with us since day one.  I am talking about Doctor David.  The Good Doctor has already taken ownership of this project.  It is reasonable to assume that he will one day leave the clinic to pursue other endeavors.  When that time comes, he will still be associated with the clinic as a member of the Board of Directors and he will continue to oversee the direction of the clinic even if he is not physically there.  We presented our idea to David and he was very receptive and excited.  So we put the plan into effect.  The NGO would consist of David, Guillermo, Luis (David’s brother who is a lawyer), and Edgar (An orthodontist; David’s best friend).  This is a very strategic union of professionals in the community.  Luis is a lawyer and he has experience setting up NGOs.  He handled the majority of the paperwork and provided us direction on the proper steps to take.  We also presented the idea to Guillermo who was also very receptive.  Guillermo will actually serve as the President of the NGO as he is the clinical director.  He is responsible for preparing the monthly and quarterly reports in the first place so it is only natural that he will serve as the president.

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Well, one less thing to worry about.  We have our partner organization!!  We just had to step back and think of an out-of-the-box solution.  In hindsight, I am somewhat thankful that things didnt work out with the Dominican Sisters.  We are now in a much better position moving forward.  We suggested some names for the NGO but Guillermo and David settled on “Real Medicine Peru” and I couldnt be happier

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Spring time is approaching in Peru. The patient stream remains steady at about 30 patients per day and in the month of August we were able to enlist 242 new patients from the community. Females patient still outnumber the males, 2 to 1. In the local school of 3600 children which we sponsor, Nurse Maria Elisa was visited by 442 children. Maria Elisa also conducted many health workshops for the students and their parents.

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To read more on Policlínico Peruano Americano, please visit the RMF website.

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When Worlds Collide move The Gathering Storm video I have posted 200 pictures of my experience in Peru on the web.  If you are interested, check out:

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One of the inevitable truths that I have learned through this whole experience is that it usually takes a horrible disaster before changes are made.  In this case, many parts of Pisco were in much need of help even before the earthquake.  Yet it took a deadly earthquake to attract the attention of people and organizations looking to help out.  Now, schools and health centers are being built…health programs are initiated and the people are being cared for.  Many aspects of their social system are being improved better than they ever were even before the earthquake.  They would not have received this attraction from the international community if it weren’t for the disaster.

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Puccini for Beginners release Its hard to sell a project without the shock factor.  You need the graphic pictures and stories in order to inspire people to act.  There are hundreds of thousands of places throughout the world that could use help but they slip under the radar of the international community.  Im afraid they may never see help unless they suffer a disaster of their own.  Its an unfortunate truth that I don’t think there is much we can do about it…but I still wanted to note it anyways.

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:  One day I was working in my room/office and I heard there were some American doctors downstairs eating lunch.  I went downstairs and introduced myself to this huge group of Americans who I soon learned were not doctors.  Instead they are missionaries from some radical sect of Christianity.  I explained to them about the clinic and they were really interested.  I chatted with the missionaries for about 30 minutes and then I said my goodbyes and excused myself.  One of the missionaries got in my face and challenged me. “Have you accepted Jesus Christ into your life as your lord and savior?”  Crap.  Are you serious?  We were doing so well and you had to open your mouth and blow it.  I tried to deflate the situation by suggesting that that was a pretty bold question to be asking someone after just having met them.  The interrogation about my faith continued and I was having trouble with my exit strategy.  Soooo I just sat there like a dumbass with an unconvincing smile on my face while this dude explains to me why it is foolish for anyone to believe in evolution.  He was standing about 2 inches from me and his passion from this one-way conversation was borderline psychotic.  The rest of the table just looked at us but I could tell they were a little embarrassed by their brother’s direct manner.  I finally cut him off in mid-preach and slapped him on the back and walked away.  I have to admit, I was a little creeped out.  I don’t really agree with missionaries spreading the word of God in 3rd world countries in general but I am still respectful to most.  Every now and again, I meet a missionary who I just want to lock in a small cell and throw away the key.

Sara Helen:

“You have to visit the tomb of Sara Helen?”
“That doesn’t sound like a very Peruvian name…who the hell is Sara Helen?”
“She is a witch who was burned at the stake in England.  They didn’t want her remains in England and they eventually ended up in Pisco.  She is now buried here.  I pray to her…as do most other people in Pisco.  We pray to her about our troubles and she is responsible for most of the evil doing in Pisco.”

I did go visit Sara Helen’s tomb and it was covered in flowers.  People were there praying to her.  Witchcraft is still fairly common in the area, many people see witch doctors, many people pray to Sara Helen.  I also heard that her ghost comes out at night and meanders through town.

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Spanish: My Spanish was quite basic upon arrival in Peru.  I certainly couldn’t carry on a conversation.  Over the past 10 weeks, I have amassed enough words in my vocabulary to have an effective conversation for hours.  This is when my Spanish is improving by leaps and bounds because I have a solid foundation of the language.  But, just when I was getting quite comfortable, I boarded a plane and flew home.

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No Entiendo!! Monster-in-Law divx We bought a ton of medical equipment in Lima that we had to transport on the bus back to Pisco with us.  I purchased three tickets for the 8:46p bus for me, Rene, and Guillermo…but when the bus showed up, the bottom luggage compartments filled up before we could put our equipment in.  So we waited for the 9:02p bus.  Rene and Guillermo were in charge of seeing that the equipment gets on the bus…and I was in charge of saving our seats (seats #1, 2, and 3).  I knew I was going to run into problems since our bus technically left and other people would have seats 1-3 on the new bus.  Eventually some people got on and they tried to kick me out.  I showed them my ticket and they quickly told me that my bus has already left.  I just looked at them blankly and held my ground.  They started yelling at me.  Some guy in the back of the bus said “El Gringo no entiende!!”  The gringo doesn’t understand!  Ha!!  I just played stupid and they thought I truly didn’t understand.  It was my finest performance.  Finally Rene and Guillermo got on and took there seats which I had still managed to save for them.  They got into a yelling match with the rightful owners of the seats but we held our ground.  The bus officials even tried to kick us out but we didn’t leave.  Eventually everyone gave up and found other seats at the back of the bus.  As the gingo, I can get away with a lot.

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Competition from Soap Operas? In Peru, the majority of the people arrive at the clinic very early in the morning.  The clinic is very busy from 8a-12n.  Very few people trickle in after 12.  I have my theories.  Keep in mind that 75% of the patients are women/mothers.  A)  Women need to get back home to prepare lunch and dinner for their families.  B)  Women do not want to miss their latin soap operas called “novelas” in the afternoon.  I am dead serious.  We are competing with friggin soap operas.  C)  They are just used to coming in the morning…always have…always will.  It doesn’t make a ton of sense to me because if they come in the morning, they will probably have to wait for a couple hours to be seen.  If they come after 12n, they can most likely walk in and be seen within 20-30 minutes.  Oh well.

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My apologies. The last time I wrote in the blog was on November 9^th. At that time, we were just about to open our temporary clinic at of the catholic parish hall. I had written my blog from my beach side hostel. It is now January 9^th…two months later. A lot has happened. I know quite a few people have been following the blog and checking it on a regular basis. If that is the case, you have probably been disappointed when the blog stopped on November 9^th right in the thick of things.

You see, processing my experience and explicating myself through my blog consumes quite a bit of mental energy.

When we opened the clinic on that Monday, November 12^th, I said goodbye to any amount of free time I did have. Every waking second, was dedicated to the operation of the clinic and my blog inevitably got pushed by the wayside. There were things I had to get done in Peru…while I was physically in Peru…and unfortunately my blog could wait until a later date…like 2 months later on January 9^th.

Now the trick is to relive my experiences from November 9^th even though soooo much has happened. Jumping ahead a bit, I am now in Los Angeles. I Tried release

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I left Peru on Dec 22 and flew to New Hampshire to spend the holidays with my family.

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We are currently operating the clinic in a permanent capacity out of one of the most beautiful houses in San Clemente. We are now seeing between 35-55 patients per day between two doctors. We have been filmed by a major Peruvian News crew and the story had been televised nationally. The clinic has been, and will continue to be, a huge success. My experience in Per uhas been the best experience of my life.