Team Peru 2008 - Wrap-up

The 2008 Team Peru campaign has come to an end. The team has gone their separate directions – some for exotic excursion trips to Machu Pichu or the mighty Amazon jungle, and some on their way back to their U.K and North American homes. Everyone, regardless of their destinations, has left this experience profoundly impacted by our work.

Our last week of the outreach campaign was in the southern Peruvian city of Arequipa; and had our team working on a variety of projects. Some of our team in the Alto Cayma communities helped with a construction project on a one room home for a single mother and her special needs children. The intrepid laborers helped with mixing concrete, carrying wheelbarrow loads of sand, and hosting piles of bricks. The project enabled a family to have running water, an operational commode and a separate space for hygienic food preparation in their modest home. It was a very fulfilling project that had our team’s members working side by side with our Peruvian partners; and learning first hand about the struggles of desperate poverty.

Our team of three Portland, Oregon based electricians helped to complete the re-wire of the Policlinico Maria Madres de Dios with a new electric infrastructure and new voltage converters. The group, working in collaboration with a Peruvian electrician, added a separate line of 120-volt electricity to run the multitude of donated medical equipment in the clinic. For years, the clinic has had to run their important diagnostic equipment through a converter. The project undertaken by our team allowed for a more seamless use of equipment and a safe guard to prevent overloading valuable equipment.

In yet another community based project, a team of tireless volunteers from our campaign helped to re-paint the exterior of the Mission of Alto Cayma’s child care center and micro-economic center. Scraping layers of old paint and sanding the rough edges on the buildings lava rock walls – kept the work team busy for a number of hours. The camaraderie and commitment to finishing the project – kept the team committed to the long hours for the entire week. Alas, there remains more than enough painting to keep future teams busy for weeks to come.

In the clinic - our team of five North American nurses held a one-day series of workshops for their Peruvian colleagues. The workshops, designed to create professional exchange and open dialogue around clinical care challenges, were a big hit by everyone attending. Subjects ranged from best practice guidelines for diabetes and hypertension, to massage therapy and community nursing. The real beauty of this collegial exchange was the trans-cultural interactions that occurred. Nurses from North and South American had the opportunity to discuss the unique triumphs and challenges of practicing nursing in two very different environments.

Our team dentist was busy. In one clinic outreach to a community school – Dr. Tom Palandech examined over 100 children in a little over 5 hours. He helped to provide follow-up care for the patients screened in the school at the Policlinico and worked side-by-side with his Peruvian colleagues. Dr. Palandech, a career-long Public Health dentist, was well prepared for the differences in practice style that he encountered in Peru (as he has participated in a previous Team Peru outreach and spent his entire career in community dentistry with the U.S. Government’s Indian Health Services) and enjoyed the opportunity to learn, serve and grow. By the end of the trip – Dr. Tom was a committed member of the HBI Team.

Finally, HBI will be starting a community based survey project in the communities of Alto Cayma. Thanks in great part to a team of U.S. and Peruvian medical students (a team of five medical students from all around the U.S. have been placed in Peru through the HBI Health Professions Student Placement Program for the summer moths of 2008) – the survey will look to gain a broad epidemiological profile of the people of Alto Cayma. Our team will administer a multi-faceted survey that hopes to further define access and utilization to medical and dental care – as well as basic information about the barriers to accessing care and simple economic measures. The survey is set to start on Monday, 30 June and will continue through the month of September. More details about this important research project will appear on the HBI Website and through our BlogSpot.

During our last day of the outreach campaign our team met with Father Alex to “wrap-up” our experiences and our projects. During this meeting, Father Alex reinforced the importance of viewing our time in Peru as a great opportunity to learn about service – and not a “mad dashed race” to complete a number of projects or to see hundreds of patients. He told our team that the greatest gift we bring to the communities were we work is ourselves. He spoke of the genuine “connections” that are created when we "serve another person without expectation."

As we ended our final team meeting – the group felt a collective sense of accomplishment from our two-week outreach efforts; not for the projects we completed or the patients we served, but simply for the tremendous lessons we learned.

No campaign is complete without a farewell dinner party. Our party was a gastronomic explosion of Peruvian delights. With over 80 dishes represented on the evening tables – the toughest decision team participants had to make was not “what to eat,” but “when to stop eating.” Never a group to leave a table full of food – the team packed up the left over food and shared the delicacies with family and friends.

So ends another Team Peru Medical, Dental and Social Outreach. We want to extend a very big "Thank You" to everyone who participated in, contributed to, and supported the 2008 Team Peru Outreach Campaign. Your support means so much to us!

Please stay tuned to our website for more information about the on-going work of Health Bridges International and the 2009 Team Peru Health Care Outreach Campaign.

Mountain Outreach - Building Bridges

Wednesday was a fantastic day that had the outreach team working in the high Andes. We conducted clinic at over 14,000 feet above sea level in a mining camp. Our team of healthcare providers were able to serve in a number of different ways – from the direct delivery of medical care (mostly upper respiratory tract infections) to dental care (extractions and screening examinations) to health education and physical therapy instruction. In a little over 6 hours our team attended to almost 150 patients. Our campaign is conducted in collaboration with our long term in-country partner agency – The Mission of Alto Cayma.

For over 12 years the Mission of Saint Paul has been delivering integrated care to the underserved communities of Alto Cayma. The mission has a “brick and mortar” clinic that delivers healthcare services to over 22,000 patients each year and provides over 600 meals each day to the most marginalized of the community. Current programs are facilitated out of Parish owned amenities and are under the direction and fiduciary auspices of the Parish Council.

Working in a team based approach – the mission utilizes the “triage” services of a social worker to identify and enroll persons into a social advocacy program. The mission has developed comprehensive vocational training programs and child advocacy projects that help to link underserved families with educational, social and economic resources. The Mission provides outreach to isolated mountain communities two days per month and helps to ensure adequate access to medical and dental care through the main clinic. Our remote clinic was an extension of the on-going longitudinal healthcare provided by the Mission; and is designed to continually connect marginalized populations to services.

One bi struggle the Mission is currently facing is the advancing cost of food. As the cost of basic food stuffs and general healthcare services have far outpaced the wages available to the people of Alto Cayma employed in the informal sector – the need for more expanded advocacy services is ever apparent. Many of the families living in Alto Cayma fall into the lowest socioeconomic strata as determined by the Government of Peru – and do not posses the economic leverage to purchase even the simplest staples of food and housing/shelter.

Our collaborative plans call for the expansion of the nutrition and feeding program and an expansion of the integrated healthcare delivery model that will provide greater access to general healthcare services to a broader geographic area. You can support to this expanded capacity project by donating to Health Bridges International.

Once again – thank you for your continued interest in the work of HBI and our “bridge building” efforts.

Sometimes it feels like you are sticking a finger in the dike

Today was another day of outreach into a community school. We were a scaled down team of providers that worked out of the Maria Madre Clinic in Alto Cayma. In just over 5 hours were attended over 140 children – many suffering from malnutrition, advanced peri-oral disease and respiratory tract infections.

The amazing part of working in Alto Cayma is the opportunity for longitudinal care. As our clinic outreach efforts are merely extensions of the on-going work that Father Alex’s clinic provides in the community – our efforts are closely tied to a bigger mission which is to change the plight of poverty in this vast peri-urban settlement.

The number of children seen in the outreach with significant malnourishment was astounding. It seemed like ever other child was classified as falling below the 5th percentile for weight, height and age matched indicators. Our response to this issue is to develop a program that sends a social worker into the homes of the highest need families and works to identify resources for social and economic advocacy. We have “flagged” all of the patient’s charts and plan to conduct home visits and re-check the children’s height, weight and hemoglobin status in the next 3-months.

Long term visions include the expansion of a nutrition/feeding program and the development of a mobile health care clinic to serve the school and surrounding area with twice monthly health screening and wellness clinics. We are also evaluating the development of a “school based health clinic” model that will send nurses from the clinic into the schools surrounding the parish every week for triage services and to continually track high risk children and their families; our ultimate goal is to create a “safety net” mechanism to catch children most vulnerable to homelessness or the myriad of preventable pediatric maladies.

Wednesday has our team in the mountains working in an isolated mining community at almost 15,000 feet above sea-level. Our goal is to bring medical and dental care to an impoverished area and to support the on-going efforts of the Parish of Father Alex. Stay tuned to our BlogSpot for more updates.

HBI Team Peru - Week 1

Our first week of clinic has been a smashing success. In just over 4 and ½ days of clinic our team of Peruvian and American healthcare providers were able to provide medical, dental, psychological evaluation and focused counseling and health education services to just over 840 patients. Our fantastic team of dedicated providers made this week of clinic one of our most successful outreach events yet!

Our project was conducted in the communities of Mala, Chincha, Pucusana and Asia (communities strongly impacted by the massive earthquake of August of 2007 – see: http://hbint.blogspot.com/2007/08/internatioanl-aid-for-peru-help-is-on.html). This last week was our 11th outreach campaign into these communities and was conducted in collaboration with our long term partner Union Biblica del Peru and is a part of our bigger schools based outreach program.

The Health Bridges International Schools Advocacy for the Vulnerable and Endangered Children (SAVE) program is a comprehensive approach to addressing poverty and childhood endangerment. The foundational element of the SAVE outreach program is volunteer mission teams – staffed by Peruvian and U.S. physicians, dentists, nurses, psychologists and dedicated helpers. Working in close partnership with Union Biblica – HBI is attempting to create a programmatic response that will make a meaningful impact in the lives of homeless and abandon youth. The programmatic goal of the SAVE outreach project is to create a “response” that will work to prevent familial breakdown before young children become abandoned to the streets.

The schools based outreach program is designed toward reaching into the poorest communities – areas where families are at greatest risk of breaking down. The SAVE program focuses on geographic areas in the country of Peru where economic depravity and social violence fracture family stability; areas where the children that live on the streets of Lima are coming from. This week found us working in such schools; institutions with very little resources and few of the standard academic opportunities found in the U.S.

The mission of the SAVE program is to identify youth who are at greatest risk for homelessness – and connect these children to outreach workers. The outreach/social workers then build trust and relationship with the family unit to provide a broad range of services that are designed at keeping the family from fracturing. As is the case in most developing nations, the community schools of rural and impoverished areas are often the strongest element of the social network. Partnering with teachers and community leaders enables the SAVE program to build a “safety net” in communities that are extremely vulnerable to economic and political ebbs and flows.

In essence, the SAVE program is designed at offering an “up stream” approach to a social problem that is firmly entrenched in economic disparity. Research studies have now connected the degree of social capital in a community (as defined by the collective efficacy or the belief a community has in its own abilities to create and structure change) to health outcomes, economic prosperity and crime figure adjustments. What this means for the SAVE outreach program is that by creating an even stronger community foundation in the schools - homelessness can be prevented in vulnerable youth populations.

This last week had our teams working in some of the poorest schools in Peru. Through compassion and true commitment to providing the highest quality healthcare services possibly – our team was able to reach out and hopefully change the lives of desperately impoverished children.

As the bulk of our school based program is designed around identifying children who are at greatest risk of homelessness and abandonment to the streets – our greatest assets are the community workers from Union Biblica who spend so much of their time working in the schools where we provide clinics. Union Biblica helps with case management of identified high risk children and family level interventions. The social workers from Union Biblica have great relationships with the teachers, staff and children of the schools where we work. The Union Biblica social workers were available all week to consult with a physician or provider about a potential “Vulnerable Youth” – and help to connect the youth with resources. The Union Biblica schools workers then help with follow-up and even conduct home visits when needed.

In a home visit scenario, the Union Biblica social worker develops a more global understanding of the family’s needs and the stressors that are underlying family unity and cohesion. The social worker works very closely with the child’s school and assigned teacher to create a comprehensive care plan to prevent further vulnerability with in the child’s development. Throughout of week of clinics we were very fortunate to have Alan Chang as our Union Biblica Schools Outreach Worker. Alan’s dedication to serving the underserved and commitment to helping vulnerable children was a real motivation for all of our team members.

This next week has our team working in the southern Peruvian city of Arequipa with another long term HBI partner and long term program collaborator - the Mission of Alto Cayma. Stay tuned to our BlogSpot for updates and on-going news of HBI’s Team Peru 2008 Campaign. Thank you for your support!

Is it really any better?

Peru: 90 percent of Peruvians feel country's growth has not helped them

For almost 15 years HBI has worked and traveled to Peru. Our organization has spent an enormous amount of time in a variety of economic sectors - from the very wealthy of Miraflores and San Isidro - to the desperately impoverished of the high Sierras. One thing that has been painfully obvious over the last couple of years is the growing divide between the wealthy of Lima and Arequipa and the increasing levels of poverty amongst the people of rural communities.

As this divide grows greater and greater it will be ever more important that organizations work to create programs and projects that help to bridge this tremendous division. More and more emphasis must be placed on creating effective and sustainable models of infrastructure and professional development for Peruvians to assist the marginalized segments of their population.

Pasted below is a news article that appeared on the daily website "Living in Peru" (see: http://www.livinginperu.com/). The information outlined in this brief articles confirms the long held assumptions of many social scientists and social justice activists - the economies of Latin America (and more specifically Peru) are growing like "gang busters", but the impact of this massive economic revolution is not penetrating down to the people who need it the most.

Author: Israel J. Ruiz - "Ninety percent of Peruvians feel the country's economic growth over the past several years has affected them very little or none at all, revealed a national poll carried out by CPI polling firm.

• According to the survey, 71.9 percent of the people polled throughout the Andean country affirmed that Peru's growing economy had "not benefited Peruvians at all", while 19.3 percent of those polled stated it had benefited them "little".

• Polls showed that more people outside of Lima (78.6%) felt they had not been affected positively by the country's growing economy.

• 68.6 percent of residents surveyed in Lima assured they had not benefited from the country's improved economy.

• On the other hand, there were more people in Lima (23.6%) than in provinces (13.6%) that said their livelihoods were "a little better".

• CPI's survey revealed that only 3.5 percent of the people living in Peru that were surveyed said the country's growth had had a positive effect on their lives.

The study also showed that the main problems Alan Garcia's administration had not solved were poverty, low wages and unemployment. It was reported that more people living outside of Lima made these complaints. 1,443 people were polled in 24 of Peru's regions."