Articles by Steve Henrichon

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It is important for me to give credit where credit is do.  Even though this blog is seen through my eyes and it relates to my experience, it is important to note that this project would not be possible without Rene’s involvement.  For starters, he is fluent in Spanish and he was able to lead all of the meetings and all interactions.  That is just the tip of the iceberg, however.  Rene understands the Latin culture very well.  He commands the respect of everyone he meets whether that be doctors, lawyers, construction workers, priests, etc.  He reads into situations that I could never understand.  It would not be uncommon for Rene to bring over a 12-pack of beer for the construction workers and then actually pick up a shovel and give them a hand.  When I first told Martina about how I wanted Rene to join me in Peru, I described him as a modern-day Che Guevara…not in the crazy communist sense, but in his level of awareness, passion, and ability to follow his heart.  I am lucky, as are the people of Peru, that Rene took on this project and made it his own.  We make a great team!!

One week after our inauguration, Rene and I left for five days.  We thought it best to leave the clinic in Guillermo’s hands so he can begin making his own decisions.  It is our goal for us to be involved in the clinic as little as possible so the clinic can be as self sufficient as possible.  Anyways, we took a 12 hour bus ride to Arequipa.  Arequipa is the gateway to Colca Canyon which is the deepest canyon in the world.  After trekking, camping, mountain biking, and rafting in the canyon, we made our way back to Pisco.  Since we took the overnight bus, we arrived back at the clinic at 6:30 am.  Even 1 ½ hours before the clinic opens, there was already about thirty people waiting in line.  I couldn’t believe it.  We walked past the crowd and a child runs ups a hugs me and everyone laughs.

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In the first couple weeks, we have been seeing between 35 and 60 patients per day.  The majority of the people arrive in the morning.  Even the people who arrive at the clinic just before we open may still find themselves at the back of the line where it may take hours for them to be seen.  Everyone is patient however.  We play educational movies in the waiting room and we provide crayons and coloring paper for the children to help keep them entertained.

We have had to tweak the process a little bit which was to be expected.  To help handle the patient load, we brought on a second nurse, named Richard.  Keeping track of 60 people all trying to be seen can be a very daunting task for one nurse alone.

I believe that the people of San Clemente are proud of their clinic. It is a beautiful clinic…clean…safe…and I believe people find it a very comfortable place to go and receive their health care.

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The inauguration was on December 10th.  The work crew finished just in time and we had a crowd of people working into the night on December 9th to make sure all of the preparations were set.  We even hired an artist to paint the Real Medicine Foundation logo above the front door.  We invited many notable people from San Clemente and the event was also attended by many of the residents as well.  Both Rosy’s mother and Fio’s mother helped by preparing a few hundred hors douvres.  We had a plethora of candy to pass out to the children.  Maria’s grandmother has a bodega (wine vineyard) in Ica and she provided several bottles of sweet Peruvian wine.

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Rene and I acted as the MCs for the ceremony and we spoke in the central area downstairs with the morning sunlight filtering in.  Pocho blessed the clinic.  David, Guillermo, Martina, and Vanessa Vertiz from MSD all had a chance to speak.  I read off an impressively long list of people whom we needed to thank…anyone who helped out along the way.  It took me a long time to get through this list.  It just goes to show that certainly could not have done this alone and we wanted to reinforce that this is everyone’s clinic.

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Every building needs a “Padrino” or “Godfather” and we asked the mayor of San Clemente if he would do us the honor of serving as the godfather for the clinic.  This is an honor and he graciously accepted.  Martina served as the “Padrina” or godmother.  It is a Peru tradition to have a bottle of champagne hanging down from the doorway.  Martina and the Mayor each took hold of the hammer and together they smashed open the bottle of champagne to the applause of the many onlookers.  The last step involved everyone (about 100 people) each receiving a small cup of wine so we could cheers to the good health of the clinic.  We have done it.  Our clinic was open and people were excited.  It really was a joyous event.

Vanessa Vertiz from MSD had arranged for a popular news group from Lima to come down to cover the event.  We had eaten dinner with the team the night before at Miramar to get to know them a little better.  Fanny was excited because she recognized the interviewer from a very popular morning show.  The team filmed the inauguration and then they interviewed me, Martina, and Rene.  I hope my Spanish was good enough to make it through the editing room.  The story was to be aired all throughout Peru.  Even Jorge from Miramar was mentioning how he was seeing commercials on the major channels advertising the story of the Policlinico Peruano Americano.  We are famous!!

After the inauguration, we had a bit of an open house.  The doctors began to see patients who had lined up.  We gave tours to several interested people and we worked for 3 or 4 hours.  In the afternoon, we took the entire clinical team out to a celebratory lunch at a nice seafood restaurant in Pisco.

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Father’s Week-end video download Transporter 3 That next day, we took Martina on a tour of San Clemente and Pisco.  Fiorella let us use her car and Rene drove.  Taking a tour through San Clemente is a big eye opener for anyone.  The town is very impoverished.  The majority of the residents live in shacks erected with this special type of siding called caña (sugar cane).  Many of them don’t have water as the town is growing much faster than the infrastructure.  We drove throughout the dusty streets and we stopped at the different Olla Comunes (Communal Kitchens) to spread the word about the inauguration.  This ended up being quite an experience.  Everyone recognized me and Martina…and I mean everyone.  Apparently a lot more people watch the local talk show than I had expected.  We were a big hit.  At one of the Olla Comunes, there was a crowd of about 30 or 40 people.  I talked to them about the clinic and extended an invitation to the inauguration.  One of the girl’s requested a kiss and I gave her a peck on the cheek.  The entire group erupted in cheers!  I then went down the line a kissed all of the eager blushing ladies.  I apparently had a bit of a fan club in San Clemente.  I could get used to this.

We started on our way again.  People would see us drive by and immediately recognize us and wave or the kids would chase the car.  We passed one small olla comun and we noticed a young boy with his right eye completely clouded over.  We stopped and Martina and I went to speak to the boy’s mother so she could take him to the clinic.  Upon further inspection, the eye was not clouded over.  It was a beautiful shade of blue.  His mother had the same sky blue eye which was a stark contrast to her other dark brown eye.  I have never seen anyone with two completely different eye colors like a Siberian husky.  The little boy, who couldn’t have been more than three, was just as interested in me as I was with him.  He let me take a series of photos of him and his beautiful eyes.

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Martina graced us with her presence on the Friday before the inauguration.  Guillermo and I made the 4 hour bus ride up to Lima to receive Martina at the airport.  This trip to Lima helped me realize just how far I have come with my Spanish in just a couple months.  Guillermo and I conversed in Spanish the entire bus ride and then I took the opportunity to share a little of American culture by treating him to dinner at Tony Roma’s World Famous Ribs in Miraflores.  That evening, we also had a meeting with Jerry Galea and Jesse Clark with the UCLA Department of Infectious Diseases about a potential HIV program out of the clinic.  Jerry is actually making the trip down to San Clemente for our inauguration on Monday.

Martina was due to get in at 12midnight but here plane was delayed and she didn’t arrive until 3:30 or 4am.  It was a long night but, nonetheless we were up at 7am for a full day of meetings.  We first met with Helga from PAMS.  Helga is a specialist with the Peruvian customs and she has been working with Direct Relief International regarding medical shipments into the country.  She agreed to help facilitate a shipment from DRI for us as well.  Next we met with Vanessa Vertiz and Oscar Espinoza from MSD and updated them to our progress in San Clemente.  Vanessa will also be traveling south for our inauguration.  Lastly, we visited the 600-bed childrens hospital.  The Director, Adrian Ramirez, is actually married to a German wife and he loved speaking german with Martina.  He gave a personalized tour of the hospital and Martina talked him into coming down for the clinic’s inauguration.  I am amazed that these people are taking time out of their very busy schedules to be part of our special day.  The magnitude of the clinic is represented by people like Jerry, Vanessa, Dr Ramirez, and an entire news team making it a priority to come down to San Clemente for the inauguration.

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When we arrived in Pisco that night, we went straight to the television channel in San Clemente in hopes of getting some airtime to advertise the inauguration.  Nacho (the talk show host) was there but they we airing a previously recorded program and they instead had the studio filled with children who were preparing for tomorrow’s holiday by making signs and crafts.  Nacho decided to put us on the air anyways, so they fired up the camcorder and interrupted the program in session.  Martina, Rene, and Guillermo spoke first.  Martina introduced herself and spoke about Real Medicine.  Rene and Guillermo spoke about the clinic and mentioned the inauguration.  Then…I sat down.  I knew what was to come.  In Spanish…”Steve, have you tried any new foods since the last time you have spoken to us?”  hahahah!!!  They love speaking to me about foods so I humored them by recounting a list of foods that I new would get some chuckles…including Cau Cau which is made from cow intestines.  I then invited the entire town of San Clemente to the inauguration on Monday.  I was very tired at this point in the day and I don’t believe my Spanish made a whole lot of sense but hopefully they got the gist.

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Ever since the school campaign, we have discussed installing a school nurse at the school who would report to Guillermo.  The school has 3600 children.  They deserve to have a nurse.  In addition to filling a significant void at the school, we are reaching out to the families through their children.  It increases our clinic’s exposure.  If little Jose is ill and he needs further treatment than what the nurse is able to provide, then she refers him to the clinic.

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Last Exit buy It was Wednesday.  The Director of the school love the idea and he asked when the nurse will be starting.  Guillermo said “The nurse will start on Monday.”  Hmmmm…okay…that gives us a couple days to advertise the position, conduct a series of interviews, make a decision, purchase equipment for the nurse to use, and create and overall gameplan.  I like the way you work Guillermo!  Make yourself accountable and then do what you need to do to live up to your word…that’s the Real Medicine way.

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After interviewing a handful of nurses, Guillermo decided to hire Glenda.  To follow the philosophies of the clinic, Guillermo made it very apparent that the responsibilities of the job included prevention and education.  On the first day, Glenda, Guillermo, and I went around to several classrooms to introduce ourselves.  When we would work in, I would say “Buenos Dias Ninos!!!”  and all of the students would yell in unison “BUENOS DIAS!”  I couldn’t get enough of that.  By the second day, Glenda already had a plan to lead a series of workshops for the children on “washing your hands!”  I accompanied her on a few of the workshops for the 1st and 2nd graders.  She talked about why it is important to wash your hands and when you should wash your hands.  “Necesitan lavar las manitos!!”  We had a demonstration and then the children could come up and wash their own hands.  It was really cute.  Other workshops in the future may include “eating healthy” or “sexual education” for the older students.

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We also set Glenda up with an infirmary.  Students come in with belly aches but she also has her hands full with simple injuries from the playground.  These kids play really rough and they always seem to be throwing each other on the concrete.  One youngster came in with his head split open and she had to clean the wound and close it up.

Since we now moving into a large house, we could take the next step of expanding our services by traveling to Lima for another very lonnnnng day of purchasing medical equipment.  Guillermo and David refined a list of equipment we needed before the trip.  David stayed behind and worked at the clinic while Rene, Guillermo, and I traveled to Lima.  We had a two-page list of equipment we intended to purchase.  We gave copies of the list to several equipment vendors which line the streets on Emancipation Avenue.  This enabled us to compare quotes of individual items so we could make sure we were getting the best deals.  We bought exam tables, pediatric tables, gynecological exam table, surgery utensils, resuscitators, air splints, pinchers, pantascopes, stethoscopes, negatoscope, materials for casts…it was an extensive list.  We carried as much of with us on the bus and we shipped the rest.

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In addition to the medical equipment purchase, we expanded our medicine formulary.  We now have over 100 different medicines to offer to our patients.  Good thing we have a dedicated room for the pharmacy in the new clinic.  The room will be filled with racks which rise to the ceiling and those racks will be filled with medicine.

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We have officially found the permanent site for our clinic.  The search is over!  We decided to leave our first choice (the commercial lot) behind as the owner was very hesitant to show the property to us.  He was not cooperative in the least.  It was never meant to be.  Conversely, Carlos, the owner of the green house, was extremely cooperative and eager to work out a deal with us.  I don’t know where we were led astray to consider the “commercial lot” as our first choice but we quickly realized that this “green house” was by far the best option we could possibly have dreamed of.

American Pie 2 full movie Scooby Doo Meets Batman dvdrip The house is perfect and it will make a great clinic.  A lot of its appeal has to do with Carlos’ enthusiasm for converting the house into a clinic.  He offered to paint the house inside and out.  He offered to leave behind any furniture which we could use.  This included a stove (for laboratory), refrigerator (for vaccines), bookshelves, desks, beds, a television, DVD player, couches, chairs, and dining table.  He offered to install sinks in two of the bedrooms so they could be used for exam rooms.  He offered to construct an entire addition to the house based on our design to be completed by February.  The addition is to have two exam rooms (equipped with water), a garage for the ambulance, and an open air waiting room covered by an awning.  All this is to be done at no additional charge!!  We negotiated to $400/mo.  This is a huge amount of money in San Clemente but a very reasonable rate for what we are getting.  The next day, the crew of painters were already painting and the construction workers were already beginning on the addition.  Absolutely amazing.

The house is two stories.  It is made from modern materials and it is earthquake safe.  There are a lot of big windows surrounding the house and the upstairs rooms each have balconies.  The inside of the house is actually open-air.  The kitchen (future site of laboratory) is open air and when you walk up the stairs and along the hallway, you are half outside.  It is a very cool style.  Because of the design, the central part of the house is flooded with natural light.  It has three clean modern bathrooms with showers.  It is equipped with Satellite (paid through 2008), phone, and DSL.  On the roof lives the sweetest Brazilian Mastiff who wouldn’t hurt a fly unless that fly is actually burglar trying to break into the house in the middle of the night.

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The house is conveniently situated on the Pan-americana highway so it is very easily accessible by those who are sick…but not too easily accessible where a plethora of curious passer-bys could just stop in to receive free treatment.  This will help keep the crowds manageable.  If someone is sick, they will come to the clinic.  If not, they probably wont go out of their way.

Everything is coming together.  Pending any setbacks in painting, we are scheduled to have an inauguration on December 10th.  All we need to do in the next week is make a trip to Lima to buy $4000 of more equipment, double the amount of medicines in our medicine formulary, advertise the inauguration on television, extend personalized invitations to some 20 important individuals, create flyer invitations to distribute to the entire town of San Clemente, move the temporary clinic over to the new site, arrange for 500 pieces of hors deurves to be prepared between three cooks, arrange for several bottles of wine to be supplied, create an order of events and speakers, somehow find the national hymnal, create a name for the clinic…hmmmmm…now that I think of it, preparing for the inauguration is a ton of friggin work.  I best get started.

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We arrived at the clinic in the morning and Rosy was not herself.  She seemed very distant and she was fairly unresponsive.  I come to find out that she was mugged on her way to work.  She takes the bus from Ica but she was running a little late.  At the bus stop in San Clemente, she got off the bus and got into a mototaxi.  Mototaxis are little scooters that can cart one or two people around town.  They are very cheap and efficient.  They are personal so when you get into the mototaxi, it does not stop to pick other people up.  Well, Rosy’s mototaxi did stop to pick someone else up.  The driver picked up his friend who surprised Rosy when he opened the door and squeezed into the back with her.  He then pulled out a knife and took about 120 Sol in cash (equiv of $40) and her cell phone.  It was just payday so Rosy had a bit of money in her purse.  She was not physically harmed but the experience was certainly quite traumatizing for her.  After Rosy explained the story to us, I immediately pulled out a wad of cash and repaid her 120 Sol plus an additional 80 sol for a new cell phone.  Covering her material loss was the least we could do.  We still had a more serious problem on our hands however, because Rosy was still pretty shaken up.

To lighten the mood, we devised a signal, a simple flick of the nose, that Rosy would do if she sees the perpetrator again.  That would alert me and Rene and then the mugger would get the Gringo-beat-down of his life.  That made her smile.  San Clemente is not the safest place so we openly discussed precautions that both Maria and Rosy could take to prevent similar situations in the future.  This includes traveling together and never getting in a taxi or mototaxi alone.  Here’s the icing on the cake…Maria says “Can you believe that this happened on Biologists’ Day?”  Rosy is a biologist and this is her special day.  I thought that was funny so I instantly started making jokes about Biologists’ Day only to realize that the day is actually taken fairly serious.  Happy Biologists Day!  That sounds a bit odd…doesn’t it?  In Peru, they have a day for most professionals…Biologists’ Day, Nurses’ Day, Firemen’s Day, Doctors’ Day, Taxi Drivers’ Day…and these are legitimate holidays reserved for the professional.  We ended up taking Rosy and Maria out to dinner to celebrate Biologists’ Day in style.  When it was all said and done, it seems as though Rosy ended up having a fun day despite the morning events.  Mission accomplished.

Happy Headhunters’ Day, Steve!!  I like the sound of that.  If anyone wants to send me presents for Headhunters’ day, I am instituting the new holiday for January 20.

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Our clinical Director has arrived!  Dr. Guillermo relocated to the area from a small mountain town between Cusco and Ayacucho.  Right from the start, it was apparent that Guillermo is a doer.  I mention that we need to get something done and he picks up his cell phone and takes care it right then and there.  We will be transitioning over many of our responsibilities over to Guillermo and start to step back.  Guillermo will also be practicing clinically so that will relieve some of the pressure to see as many people as possible without getting to spend enough time with each patient.

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