Updates from Peru

Two new updates from Peru: Times are changing in Peru, and nowhere is this more evident than in how the political system is handling many of the formidable challenges facing the country. Two brief wire service articles that first appeared on the website “Living in Peru” (see: http://www.livinginperu.com/) provide a very fitting example of such challenges and the governments responses.

Congress approves new divorce bill in Peru

(LIP-ir) -- In a plenary session of congress Thursday afternoon, congress approved a bill that is to make it easier for Peruvians to get a divorce.

With a 61 - 8 votes, a bill that will allow couples in Peru to get divorced at municipalities and notaries across the country was passed.

The project was presented in 2006 by Congresswoman Rosario Sasieta, who claimed the divorce process in the country was an extremely heavy and unnecessary burden on Peru's judicial system, stating that the whole system was put into action to handle one divorce.

She also explained that Peruvians had to pay a great deal of money for a divorce and that the process was too long.

With the recently approved bill, citizens that mutually agree to end their marriage will be able to do so through municipalities and notaries.

It was reported that this would only apply to couples that had already established the custody of their children and the distribution of property and possessions.

Many Peruvians applauded the effort and stated it would solve many couples' problems.

On the other hand, Monsignor Luis Bambarén affirmed that this was not a good decision and would only lead to more divorces and "quick fixes". He stated that more attention should be given to strengthening families.

There are currently 3.6 million divorce cases pending in Peru's court system.

Doctors end 21-day strike in Peru

(LIP-ir) -- Several hours after a 5-hour meeting with authorities from Peru's Ministry of Health, the Peruvian Doctors Association announced Tuesday afternoon that it was going to end its strike.

At a union branch in Lince, Dr. Julio Vargas, president of the Peruvian Doctors Association, accompanied by Health Minister, Dr. Hernan Garrido Lecca, announced that the union had agreed to end the strike, which began on January 8 with 13,000 doctors.

Peru's Ministry of Health held a meeting with representatives from the Peruvian Doctors Association from 8:30 a.m. Tuesday until approximately 2 p.m. After the meeting, Vargas stated he would take the Health Ministry's proposals to union leaders and decide if the strike would continue.

He added that the Doctors Association was always willing to negotiate with the Health Ministry to come to an understanding, stating that despite the strike, patients had been cared for.

Vargas pointed out that patients had not been transferred to other hospitals as a sign of good faith. Doctors had threatened to begin releasing patients if demands were not met. The government assured doctors that if these measures were taken they would be prosecuted.

According to Vargas, the union was requesting that health service in Peru be improved so patients in the country could be better assisted.

Requests also included a higher budget to establish an adequate system and work with human resources departments, which were unmotivated because of low salaries.

Vargas explained that there were 7,000 medical centers that did not have the necessary funds or equipment to provide a quality service to patients.

Building Bridges

(PICTURE: The Alto Cayma Medical Clinic, Arequipa, Peru, SA)
I am on my way to Arequipa to help with the organization of a historic event for both HBI and the Alto Cayma Medical Clinic. The purpose of this trip is to help organize and structure the "First Annual Alto Cayma Medical Conference and Training Symposium."

Father Alex and the Policlinico Maria Madre de la Misiones (the Alto Cayma Clinic) recently received two separate shipments of supplies from the United States. These supplies, medical equipment and durable goods, are a great compliment to the current infrastructure of the clinic. Some of the new equipment - two diagnostic ultrasound machines, a flexible sigmoidoscopy and endocosopy unit, and a 12-lead EKG unit – is above and beyond the current skills of the clinic staff.

HBI will help the Policlinico Maria Madre de la Misiones to organize and implement a small health care training conference for the providers working in the clinic. The training, facilitated through volunteer medical professionals from the United States who have expertise in the subject matter they will be presenting, will be a two-day intensive experience with both didactic and hands-on training. A select group of providers have been identified and have indicated their interest and availability in participating in the conference.

Equally important to the Policlinico Maria Madre de la Misiones is the identification and recruitment of Peruvian medical specialists to volunteer in the clinic. More and more patients are being seen in the clinic that requires specialty consultations and examinations. In order to more efficiently deliver specialty care – the clinic needs to attract a pool of volunteers that can donate their time weekly or monthly to provide specialty consultations. Essentially the clinic would create a mechanism for bringing more comprehensive care directly to the patients rather than referring them for care – which requires organizing child care, time away from work, transportation and assorted other expenses (both tangible and intangible). The conference will invite select specialists from the Arequipa area to participate in the trainings – as a mechanism for recruiting their involvement in the clinics operations.

This conference is an important "next step" in the development of HBI, as the conference helps to facilitate sustainable improvements in people’s health through increasing in-country public health clinic’s training and services. It creates a sustainable services - a major mission and focus of all HBI programs and projects. Most of all HBI is dedicated to supporting and mentoring the next generation of “change agents” in communities and countries of need. This conference allows HBI to unite in-country providers with North American volunteers to create collegial exchanges and opportunities for mentoring.

Please stay tuned to this Blog site for updates on the conference and ways that you can help to support the work of Health Bridges International as we work to build sustainable "bridges" for change around the world.

Thank you for all your support - Wayne Centrone, HBI Board President

Physicians Strike in Peru

13,000 Doctors Begin Strike in Peru

(LIP-ir) -- Julio Vargas, the president of the Peruvian Doctors Association, announced Monday that doctors would begin a strike on Tuesday January 8. As promised, over 13,000 doctors in the Andean country began a strike on Tuesday morning. According to Vargas, the union is requesting that health service in Peru be improved so patients in the country can be better assisted. Requests also include a higher budget to establish an adequate system and work with human resources departments, which are unmotivated because of low salaries.

Vargas explained that there were 7,000 medical centers that did not have the necessary funds or equipment to provide a quality service to patients."We are not even asking for a higher pay, but for bonuses that we are legally entitled to. Bonuses that would in some way ease the depressing economical situation doctors are living," affirmed Vargas. Peru's new Health Minister, Hernán Garrido Lecca labeled the strike "unfair" and demanded that the union end the strike so that negotiations could proceed. The Health Minister visited several of Lima's hospitals early this morning and stated that doctors were working as usual.

Emergency rooms, intensive care units and other such services will continue to operate, said César Palomino, the general secretary for the Peruvian Doctors Association.

An update from Peru

Peru's Government Begins Program to Keep Children from Begging on Streets

(LIP-ir) -- The Ministry of Women & Social Development (MIMDES) will carry out the first “raid” of parents who rent or use their children by dressing them in rags and have them beg in the streets, announced Minister Susana Pinilla.Although she did not mention where these raids would take place exactly, Pinilla explained that a ministerial group was evaluating the punishment bad parents would receive for these acts against children's rights."Any person that uses a child for these activities will receive a serious punishment, this is to avoid the use of children for begging on the streets in different ways, for example, begging on a corner, selling on the streets or used as ‘mules’", she stated.

She said the Ministry of Women would not allow children to work because this was a commitment made in the Free Trade Agreement between Peru and the United States.“We are firm on this subject, it is better that Peru's society understands the consequences of their actions, because we will use all the law's power to avoid this situation”, she stressed.On previous occasions, this initiative was named “Campaign against begging”, in which Peru's National Police along with the Public Ministry and the Ministry of Women took in abandoned street kids and placed them in the care of the National Institute of Family Welfare.

News source: ANDINA

HBI Team to Ancash - Update

(Photo: Our clinic in Kusi)

(Photo: Our great team . . . well, not everyone)

(Photo: The beautiful Union Biblica del Peru Kusi Camp in Ancash, Peru

This past week was truly a life enhancing experience. For almost 10 years I have dreamed of putting together a healthcare outreach program in Peru that was lead by Peruvian doctors and facilitated in an extremely underserved area. This past week allowed that dream to become a reality. In just under 5 days of clinic – our team of healthcare providers served almost 1,200 patients!

What made this project so unique and important was the use of Peruvian physician, dentist, psychologist and nursing staff. Peruvians caring for Peruvians has been the goal of HBI since we started working in medical outreach campaigns over 8 years ago.

In our first 4 days of clinic we operated out of a small camp run by Union Biblica del Peru in the northern district of Ancash (see: http://www.perutravels.net/peru-travel-guide/ancash-huaraz.htm). The camp, named Kusi after the local Quechuan (see: http://en.wikipedia.org/wiki/Quechuan_languages) word for “happy,” was the perfect environment for our team to immerse themselves in the service of giving. We stayed in the dormitory houses of the camp and ate our meals with the abandon street boys from the orphanage. Each day we learned about one another, we learned about giving selflessly and we learned about working as a team. By the end of our week stay – we were a finely honed “machine;” completely dedicated to making a difference in the lives of the patients we cared for in the clinics.

A very important aspect of the clinics was the simple fact that the Peruvian care providers were extraordinarily knowledgeable about the needs of the people, the prevalence of local diseases and the access (or lack there of) to on-going care and resources. They were the true “bridge” to ensure that the people we served in our clinics gained referrals and information about ways to get their basic healthcare needs met long after our team left. The Peruvian care team was also very supportive in teaching and training our three North American providers in how to best care for Peruvian people. The team truly came together under one very important mission – serving one another and being present to the needs of those all around us.

Our last day of clinic took place in the community of Valle Sagrado in the sprawling peri-urban slum of Carabayllo (in Northern Lima; see: http://es.wikipedia.org/wiki/Distrito_de_Carabayllo). For over 4 years HBI has worked in the community of Valle Sagrado – bringing various services and medical/dental campaigns. From our first interaction with the community, our goal has been the development of sustainable programs and projects. In the spring of 2007, the community organizing committee of Valle Sagrado requested that HBI helped with three “simple things” – procurement of warm weather clothing for the children of the community, assistance in the development and staffing of a community kitchen (comedor), and the on-going delivery of medical, social and dental services through outreach campaigns.

In June of 2007, HBI delivered warm weather clothing for all of the children of Valle Sagrado (see our posting - http://hbint.blogspot.com/2007/08/carabayllo-project.html). HBI has been working with the community organizing committee of Valle Sagrado to plan and structure the development of a sustainable community kitchen. Once again during this campaign we were able to continue to facilitate our long standing promise to deliver health and medical care services. In just over 5 hours of clinic our team provided care to an astonishing 197 patients – 157 medical and psychology visits and 40 dental visits. In addition, we were able to meet with the community leaders to discuss ways to build a more sustainable infrastructure for care delivery.

Some of the ideas that were discussed in our meeting include: the development of a small healthcare post in conjunction with the Ministry of Health (with nursing staff and health promotion through locally trained health promoters), the formation of a “Health Promoter” (see: http://community.gorge.net/ncs/background/promoters.htm) training program for the area, the development of a community center and community engagement program (a comprehensive social outreach project that would include vocational training, health and hygiene education, life skills classes, and legal aid), and the construction of a water filtration/purification plant for the area.

As you can see – a great deal of ideas have come from our one week healthcare campaign. It will now be important for HBI to take these ideas and strategize toward the development of sustainable programs and projects to meet the needs of the communities we support and collaborate with. Please stay tuned to this Blog site and our webpage (http://www.hbint.org/) for on-going updates and specific ways that you can get involved in supporting the work of Health Bridges International and our in-country partners.

Thank you for your support of the work of HBI - My best, Wayne Centrone

Journey to Ancash

What started as a dream has come fully to fruition. It has been a great goal of HBI to develop projects and programs that are lead by and staffed with in-country professionals and partners. Our November outreach to the District of Ancash in Peru is just that – a Peruvian medical and dental campaign staffed with almost exclusively Peruvian providers.

The primary mission of this campaign is to support the on-going work of Union Biblica in their projects with homeless and abandon children. We will be operating out of a facility they have constructed in the hamlet community of Caraz. Our focus will be the demonstration of a clinic outreach model. The hope is that Union Biblica can secure funding from a mining consortium to develop a permanent medical center at their Kusi camp. Our role will be the demonstration of a fully effective medical and dental clinic model – so that Union Biblica can request funds. We are merely acting as a facilitator for a much bigger project that will be driven by a Peruvian non-governmental organization.

Over the next week of clinic, we expect to see some 1,000 patients - providing a broad range of medical, dental and social services. Our team is made up of 6 physicians, 4 dentists, 3 nurses, 2 pre-medical students, 1 dental student, a social worker and a law student (what an eclectic group). We hope to help to connect patients to longitudinal care in the Ancash area by working with the Ministry of Health and EsSauld (the Peruvian social security bureau). Our hope is that we can help to create a permanent “safety net” clinic for the community of Kusi and the people of Ancash. Our goal is the development of sustainable partnerships that create lasting change for underserved communities.

Please stay tuned to this Blog site for updates on our campaign and ways that you can get invovled in Health Bridges International outreach programs and projects. Thank you for your on-going support!

Colombia - An Awakening

September 22, 2007

Dear family, friends and supporters of HBI,

I just ended a whirlwind trip to Colombia – specifically my trip was to the Caribbean city of Barranquilla (for more information about this fascinating “hidden gem” of a city, please see: http://en.wikipedia.org/wiki/Barranquilla); and, I must admit – I am a bit disappointed.

Let me explain - Colombia is an absolutely fascinating country. There is so much prosperity and strategic economic development – it seems like it should be a model for socioeconomic development for Latin America. Colombian’s have a thriving middle class and a very rich history of intellectual, artistic and cultural pursuits. At this point you are probably bracing yourself for the “but” part of my statement – well . . . please don’t get me wrong, I really enjoy visiting Colombia. In fact, I count Bogotá as one of my absolute favorite cities in the whole world. I love the Colombian people – they are sophisticated, urbane and very generous.

My issue is not with any one person or group of people, or any country for that matter – it is with the societal structures that allow abject poverty and disenfranchisement to continue in our modern age. You see, my disappointment is rooted in the number of people that I witnessed living on the “fringes” of the Barranquilla “society.” My issue is with the number of homeless people I encountered, I witnessed in my brief stay in this tropical paradise.

I had a couple of hours before my flight back to the States to walk around Barranquilla – and what I saw caused me great distress. Let me state from the very start, Colombia is a safe country for international travelers. I feel very secure exploring the streets and cafes of most cities I have visited in Colombia; and it is never a good idea to walk around a “foreign” city by yourself. With that said, I like to walk around the cities I visit. I feel it gives me a great chance to jump into the cultural equivalent of the “deep end of the pool.” I think of these walkabouts as an anthropological experiment. I can see how life really unfolds for the people making their “lives” amidst the chaos.

Barranquilla is a port city of over 2 million people (in the entire metropolitan area). There is a thriving industrial base and a few well respected universities. Barranquilla can also lay claim to the music mastery that is the global pop phenomenon Shakira (see: http://www.shakira.com/)– yes, she hails from this Caribbean paradise. I was staying at a cultural landmark – the Hotel Prado (see: http://www.cotelco.org/hotelprado/), in the downtown section of the city. During the first ten minutes of my cab ride into the city from the airport, I was amazed at the number of people living on the streets. This “amazement” was later brought to a real angst when I ventured out on my walk.

My walk consisted of a leisurely (make that a sweaty) stroll lasting about 2 hours – through "good" and "not-so-good" sections of the city. Yet, wherever I went I witnessed people living on the streets. People lying on the sidewalks, people curled up in card board boxes, people standing with blank stares. People living on the margins of this society. People living amongst the mass of humanity, but invisible to the eyes of so many passersby.

As many of you know, I am very much attuned to the plight of homelessness and disenfranchised people. I have spent my entire professional career working with homeless young adults. Perhaps this is why I saw so many marginalized peoples? Perhaps the Caribbean climate of Barranquilla makes it “easier” to live outside? I am not above a biased thought or two, but this homeless “epidemic” seemed a bit above the average for what I have witnessed in other Latin American cities.

Now, as I write this journal entry from the seat of the plane that is carrying me back to Portland, I wonder what messages I can take back from my experiences. I wonder what steps HBI can take, can implement, to help build bridges for some of the most marginalized citizens of Barranquilla and other developing country cities. I know that my first response (emotion driven response) is to want to “jump in” and develop a homeless drop-in center, perhaps even partner with the Colombian government to develop a street outreach program that works to bring people from the streets to a center where they can receive social service advocacy. I don’t know that this is the best way to approach homelessness in Colombia. It may be more profound to invest in the development of a systematic model to delve into the numerous factors that lead to marginalization. A program that is sustainable, culturally appropriate and based on the needs, desires and wishes of the people who are most impacted by the program – the homeless.

What we are trying to do at Health Bridges International is bring creativity, pragmatism and collaboration to everything we are involved with. Our next steps in Colombia may be as simple as researching the current state of outreach and assistance to the homeless in Barranquilla and working to support these efforts. Whatever we do, it will be driven by our deep respect for God’s plan and the belief that partnerships are the basis for sustainability.

I am profoundly impacted by my experiences in Colombia – and I know that we at HBI will be lead to use that impact to bring hope to “invisible” members of our society.

Thank you for reading about the work of HBI; and thank you for your continued support.

Blessings,

Wayne Centrone
HBI Board President