No hay agua.
I saw the sign on the window of a house early Saturday morning on home visits- it reads in English “There is no water.” Sunday morning as we walked to Mass we noticed masses of people lined on the street corners with large plastic containers. Sister Margaret Mary remarked “is there a tupperware sale going on that I didn’t know about?” The reality was that there was no tupperware sale, but that our neighboring district, La Libertad, no longer had access to running water. They would go without water for a total of 5 days as the main line that provides water to the district and surrounding areas had ruptured. As I walked, I watched the large mass of people wait in hopes that a truck would soon arrive with water to fill their buckets so that they could go on with their daily lives. I watched them waiting in line, thinking about how lucky I am to be blessed with access to running water, something that so many people around the globe unfortunately do not have access to.
No matter where I travel, people are always waiting in line- waiting for water, for food, and at the clinic to receive medical care. I stand in awe at the lengths these people will go to receive the basic necessities that I take for granted back home. They wait, and they wait, and they stand in line and wait a little bit more.
The Maternidad itself is expanding and construction is now taking place to build a new two-story clinic. I emphasize the two stories because everyone in the Maternidad is obsessed with telling me how it will not only be brand new, but will have two whole floors. This renovation has caused the location of the posta to shift to a multipurpose classroom at the back of the clinic. Had I not been to the Maternidad before I would have assumed that the clinic would have always been housed in the classroom. Temporary partitions have been put up which house five consultation rooms. The waiting area is filled to the brim with patients both young and old, and the line to get into the posta extends along the sidewalk each morning. A small covering has been placed over the sidewalk waiting area to shield patients from the sun as they wait to see the doctors. The construction has not stopped the clinic from providing for their patients. Today alone a little under 1,100 patients were seen in the Materidad. The nurses trekked out on 215 home visits during the month of July seeing roughly about 8 patients a day.
I have been spending the majority of my time going on home visits. Everyone in the clinic, myself included, are amazed at how well my Spanish skills have improved even without speaking the language since I last left Chimbote. I am now able to hold conversations with staff and patients alike without hesitation, and am able to understand almost all of the conversations the nurses and doctors have with their patients (I now only wish that I was not leaving the country in 8 days). I entitled this post “In between the lines” not only because of the number of masses of people lined in the streets or in the posta this week, but because of my new appreciation for the work of the Maternidad and the patients that they serve through my understanding of their language.
Sunday morning in during Mass I noticed a woman sitting in a wheelchair at the entrance to the Church. I later recognized her to be a patient of the Maternidad that I worked with almost on a daily basis last year. Señora G has diabetes. Poor management of her condition combined with sparse medical care had led her to develop ulcers on her right foot. Each day she would travel to the Maternidad so that we might clean her wounds and change her dressings. I would always venture into the room with her to assist with the cleanings as I was not only intrigued by the magnitude of the wound, but also her incredible tolerance to pain. I had hoped that the daily care would have helped to lessen the severity of the wound, but as I looked at her in the chair, I had learned that in the past year she had to undergo an amputation of the limb. The moment she saw me, her face lit up. We spoke for several minutes talking about my studies, my return for “such a short period of time”, her family, but also how she had been improving since her amputation. I was joined by two new visitors to Peru, the grand niece and nephew of Sister Margaret Mary. I explained how I knew Señora, and also shared details of her condition. They were astonished at the fact that she would loose a foot because of her diabetes, they questioned why she was not on insulin and why she (and her doctors) weren’t able to control her condition. Welcome to third world medicine, I remarked.
Returning for a second time has allowed me to view things in a different light. The shock that I first experienced, much like that of my two American counterparts, has faded as I have come to understand this way of life which vastly contrasts the life I know back home. In my last post, I talked about the man with the paralysis of his legs and how he had not seen a doctor solely because he could not afford to do so. I stayed up late the night we visited him searching the web for possible diagnoses for his condition (my guess was muscular dystrophy, but it didn’t explain the problems with his hands). The next morning I watched as Señor D was wheeled into the clinic by his older brother. They had managed to come up with enough funds to get transportation to the clinic and we would provide a consultation with a doctor and physical therapist for no cost. Turns out that he does have muscular dystrophy and that his hands were clenched together from almost 10 years of trying to walk with crutches. His care is now under our therapy unit as they work to loosen the stiffness in his hands and work with him to strengthen his leg muscles.We were able to visit his house again to meet his sister who is also suffering from a form of muscular dystrophy. Her condition is much more severe, but she will be receiving care from the Maternidad’s therapy unit to strengthen her muscles as well. It’s stories like theirs that make the trek into the barrios each day worth it. The thing I like most about this work is that it couples both medicine and empathy so beautifully. The home visits allow us to sit with the patients, to hear their stories, and then work with them to provide the necessary course of treatment. The problem, however, lies in the unequal distribution of the health care and also the cost associated with receiving treatment which leave those like Señor D, his sister, and Señora G to receive treatment right on the cusp of it being too late.
The past week has afforded me so much time to think, to read between the lines and come to understand so much about the Peruvian way of life, the field of medicine and how it all intertwines with my call to serve. This post has been my hardest to write as I struggle with finding the words to convey what I have seen and what has lied both in my mind and in my heart over the past week. Amid the heart break and the questioning I have found solace and inspiration. I so very much look forward to all that the next few days have in store and forever will consider myself blessed to have been welcomed into the hearts and homes of the people of Chimbote.
With love from Peru,