The Beginning of the Hilton Prize Coalition Fellows Program
The Hilton Prize Coalition is celebrating its 5th anniversary this year. To commemorate, some of the first individuals to receive funding for fellowship placements in 2015 will be featured on the blog. Meet Meher Raza in the post below who used her funding to go on a medical mission to Peru where she worked on global health issues at local clinics.
This past summer, after completing my first year of medical school, I decided to travel to Peru as part of a medical mission.
After doing some research on the Americas, Peru’s Pueblos Jovenes really stood out to me. They are settlements created by women to empower their children to get better jobs during the revolution. I decided to join an organization called MEDlife that helped provide medical, education, and development to these regions on the outskirts of Lima.
I arrived a day earlier than my group and explored MiraFlores and central Lima on my own. I later joined my MEDlife group at Pakura hostel.
The next day we woke up bright and early to drive an hour to the outskirts of Lima to learn about the neighborhood we would be working in: pueblos jovenes — young towns. We were in ConoSur, the southern part. During the revolution, people from different parts of Peru that did not receive attention from the government and did not have access to jobs came to Lima. However, the overpopulated city was unable to house more migrant workers. These people decided to settle in the pig farms on the outskirts of Lima. As we drove towards these towns the ambiance shifted; the buildings and parks turned to small stores and broken roads. The cars turned to mototaxis (tuk tuks) and combis (mini buses) and as we got closer to it, the coast was replaced by hills with small huts.
The first step out of our bus filled my nose with a warm moist sour smell, which I was informed was a combination of pig farm and human waste. We stopped by the police station – there were only 16 workers for the entire ConoSur: 600,000 people! This was in stark contrast to Miraflores, that had 3 men in blue police uniforms on every block. We secured our belongings and started walking up the hills. The steep terrain did not allow cars or regular buses to ascend, so the only mode of public transport available were the mototaxis, which are generally more expensive.
As we started walking up we passed by the commercial area and then came to discover clothing lines and barrels of water. These barrels were used to store water that the waterbuses provided every day. This water was 5 times as expensive as the water that would be supplied via pipes in other districts in miraflores. Due to the unfriendly terrain, regular water and sanitation was impossible. This meant that the poorest in Lima paid the most for water—contaminated water. The water barrels, previously used for toxic substances, contained remnants of the toxins within the plastic. This combined with the parasites growing in the stagnating water accounted for 80% of the gastro-intestinal complaints at the clinic.
As we advanced further, the paths became narrower and steeper, until finally, we had to walk to find stairs. Along the way, we passed many old women and children, since most adults were at work. We greeted each other and they welcomed us into their neighborhood. We saw dilapidated homes with nothing inside and huts that had satellite televisions and nice furniture. Ana, our group leader who was originally from ConoSur, explained that many of these people are comfortable here, they make their home and they start making homes for their children’s families at the same time. They have no intention to move out to more sustainable areas. I am still trying to understand that.
After the reality tour we returned home had our first evening schedule: a meeting, a 3-course Peruvian dinner prepared by our hostel staff, and an educational meeting about Peru. In the days following we would learn about the healthcare system, MEDlife’s work, and its impact and then engaged in a few debates.
The Clinic: The next day onward we began working at the clinic. Each day, we started early in the morning with packing, driving over, and set up of the clinic at new locations every day. One day it was at a daycare, once at a school and once it was just outside a few homes and some empty huts high enough to be accessible to the geriatric population who could not descend the hills. The healthcare professionals helping us were all Peruvian locals who were experts in the language, culture, and common problems.
Dental Station: My very first responsibility was as a dental assistant. This was the fastest paced station, with constant filling and extraction procedures. Each individual had 8-10 cavities! Some adults had had so many extractions that they barely had 6 teeth left! In the interest of time, we only completed one procedure on each individual and referred him or her to a local dental clinic.
Education Station: This station was the transition between the vitals station and seeing the physician—the waiting area. We used this opportunity to educate the patients on various health problems. I used this opportunity to complete my research survey and educate them on diet, exercise, and hygiene. I asked them questions about their access to healthcare, the main health concerns, how often they skipped their medications, their hygiene and nutrition. The highlight of this station was asking them how often they brushed their teeth. I got all sorts of replies from 3 times a day to 7 times a day! This combined with my experience at the dental station showed that they had no idea how often they had to brush their teeth.
Tooth-Brushing Station: This was the resolution. We taught young children how to brush their teeth properly and how often to brush their teeth in the presence of their parents. Then gave them their own toothbrushes.
Physician Station: A common complaint was a musculoskeletal complaint from falls 6-8 months ago. Given the rigorous terrain this was a common occurrence. However, they rarely got it checked out because that would mean skipping work and spending many hours at the only hospital just waiting to be seen.
Gynecologist Station: Gynecological exams were a huge taboo. Women would lie about pap smears to avoid getting any preventative care. Many were afraid their husband would find out and would disapprove. We had to consistently go out and talk to women about cervical and breast cancer, risk factors and the importance of preventative care to convince them to see the gynecologists!
Project Day:During this trip we spent one day on the “development” component of MEDlife. We completed a project where we painted a daycare center that the previous group had started to build. We finished it with painting and installing non-flushable toilets- an innovative solution to the lack of sanitation!
Inspiration: My most inspiring encounter was not on the clinic or project, it was on a day off when I was at the hostel during the day and struck up a conversation with the cleaning lady. She was curious about my plans and what we were doing as part of MEDLife. Since this was the same hostel used for all MEDlife groups she was well aware of the clinic and the projects. So during our conversation she suddenly turned to me with a sparkle in her eyes and great enthusiasm and she asked me, “you guys just finished the daycare in Via Maria right?” I replied a short yes allowing her to get to the root of her excitement. “I’m going to use that daycare for my kids! I live right there!” Given the history I shouldn’t have been surprised that some one from there worked right here in Lima but I was also excited to learn all about her life there and working here. So I continued asking her questions. She explained how she takes multiple public transportation platforms and travels for 2 hours each day to get here. Her climb each day is 15 minutes in the morning and at night. Morning is okay in the daylight hours but night is a little dangerous but it usually gets dark by the time she gets home because of the long commute. She explained how she needed the daycare, how cheap and expensive it was to live there (the irony) and how much she appreciated our work.
Despite my interaction with many people when I was in ConoSur when she said told me her story, the entire project just hit so much closer to home! And we continued chatting excitedly about the new daycare.
Final Thoughts: My trip to Lima was a profound experience. I am extremely grateful for the opportunity to help others whilst learning so much about Peruvian language, culture, and health issues. I have definitely changed my opinions on some global health issues as a result of the trip and I hope to return and continue doing this kind of work in Peru and elsewhere around the world.