Peru

Last week, in an update called “Friends Helping Friends” in San Clemente/Pisco Peru,” Steve Henrichson, RMF Director, Peru, touched on an aspect of community that is at the core of Real Medicine–the idea that community is created by working together, friends helping friends. Celebrating recent collaborations benefiting the Policlínico Peruano Americano, his article gives thanks to the partners who sustain us now while providing some perspective as to how far we have come since those first days in Peru back in 2007.

When Steve Henrichson first landed in Pisco with Rene Castillo, he had a long list of needs and a shorter list of names. Even so, thanks to his efforts in gathering support for the cause, in three short years his growing team has mobilized one of our most comprehensive health programs in the world.

Peru in 2007 to now: Meeting Initial Concerns

Looking back at the early days to what we have now, the transformation is simply inspiring and a true testament to how Real Medicine starts with basic care and grows from there, adding additional programs based on financial ability and community need. In one post titled “Peru–1st week in Peru,” Steve voices the thoughtful concerns of someone at the beginning of a great and daunting journey:

I was a bit anxious before leaving for Peru because I didn’t really know what to encounter.  We had a plan but there are several things that need to fall into place.  I had several questions floating in my head before the trip.  How safe will it be?  How responsive will people be to our efforts?  What obstacles will we be dealing with?  All are valid concerns, but after one short week, things are already beginning to ¨fall into place¨  and my confidence has been reassured.

Later, in this same entry, Steve sets the scene of life is beginning to emerge from the rubble, where thousands of people sell goods in the streets while living in tents; where hospitals that have survived are overwhelmed and working out of temporary shelters, without needed medications and equipment. He describes maternity wards treating patients without the guidance of ultrasound and where once successful doctors are out of work at a time when all skilled hands are in need.

It is in these early entries Steve almost forms a check list, a road map of the clinics growth. Since that day, many of the issues facing health care workers have changed with the work of RMF and our supporting partners: the temporary tent wards have been exchanged for a stable, permanent health care center, we have a maternity ward equip with an ultrasound machine, and we have hired once unemployed staff who have now become like family to the 70 patients who visit the clinic a day.

Peru today: Moving Beyond Expectation

What is perhaps more incredible though is that, in the small span of time from the clinics opening, these initial needs have not only been met but well surpassed. For example, not only do we have an ultrasound machine but, due to our affordable costs, we have become a referral site for it’s use, with other doctors sending mothers who might not otherwise be able to afford the test. More so, not only have we hired local staff but Dr. David, an our of work doctor introduced in the first accounts as a hopeful partner, has since not only joined the team but has become our head doctor, the bed rock of our health operations.

“When we hired Dr. David he didn’t have a job and was living in a tent city with his wife, who was pregnant at the time,” says Steve in a recent interview, “he delivered his first child himself in their small backpacking tent–that was all he and his wife had.” Since joining our team at the clinic, Dr. David has been able to save up and buy himself a house in a pretty nice part of town. He has had a few more children since he has started working at the clinic too. “It is really nice to be able to see his family grow and to be able to support his family,” says Steve, “we provided work, he worked hard, and life went from there.”

2010, Broader Awareness and Global Connection

Since 2007 the clinic has become not only a source of stability and growth for the community, but now, in 2010 we are beginning to see both patients and staff become empowered enough to look beyond themselves to help still larger communities.

One nurse, Leila A.C. Gutiérrez Luna, who has been working at the clinic since its opening is now is also using the stability of the clinic as a platform for something bigger. Feeling that it is safe to dream big she has proposed a plan to begin fighting child malnutrition in the surrounding community and has taken it upon herself to draw up the plans. Her willingness to aim for higher goals for the clinic is proof that consistent support has allowed her to dream bigger than she might have before.

“We try to share the clinic with the community as much as possible in the sense that we want the people to be proud of the clinic that they have in their community,” says Steve, “we want them to be able to take ownership and responsibility, to make it their own.”

Beyond even this larger focus, the stability created through continual donations has even allowed people in the community the security to look outside themselves on a global scale. When Haiti struck the clinic staff took the initiative to hold a fundraiser to benefit the victims of the earthquake, charging entrance fees that raised $300 US dollars. “After suffering through an 8.0 earthquake in 2007, the people from Pisco are all too familiar with the horror and despair that comes in the wake of such a disaster,” says Steve of that event, “They didn’t hesitate when an opportunity arose to open their wallets to help the Haitians.” Stable enough in their own place, the community around the clinic was willing to give what little they have in the hope that others might be able to receive the same care that they have seen since the quake.

“Ultimately, the clinic has provided constancy to the community,” says Steve, “And that can do a lot to give people hope for the future. When they see that we are still here, years later, they begin to feel like they have somewhere to start from–and from there anything is possible.”

Read more about RMF Peru

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.

The Big Bounce

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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