What a great day! The day started as an uncertainty and quickly became a real meaningful experience for every member of the team.
After loading the bus in Miraflores (a toney neighborhood in Lima close to the coast and well known for the “gringo” amenities) we started the 2-plus hour drive to the community of Valle Sagrado in Carabayllo (and area that one of my close colleagues once described as “the end of the earth”).
Ironically, the community of Valle Sagrado is named after one of Peru’s most sacred and revered areas – the ancient and historic valley of ruins near Cusco. Once you get past the nomenclature reference – there is very little in common between the Sacred Valley of the Urubamba region (see: http://www.cusco-peru.org/cusco-surroundings-cusco-sacred-valley.shtml) and the Sacred Valley of Carabayllo.
Our “clinic” for the day was the home of Sra. Torribiya – a woman who has been a defacto community leader for the people living in extreme poverty of this region. Torribiya’s spirit and commitment to organizing a better “tomorrow” for her neighbors are inspiring. She never fails to greet our teams with a huge smile and a lovely sign (see photo).
After loading the bus in Miraflores (a toney neighborhood in Lima close to the coast and well known for the “gringo” amenities) we started the 2-plus hour drive to the community of Valle Sagrado in Carabayllo (and area that one of my close colleagues once described as “the end of the earth”).
Ironically, the community of Valle Sagrado is named after one of Peru’s most sacred and revered areas – the ancient and historic valley of ruins near Cusco. Once you get past the nomenclature reference – there is very little in common between the Sacred Valley of the Urubamba region (see: http://www.cusco-peru.org/cusco-surroundings-cusco-sacred-valley.shtml) and the Sacred Valley of Carabayllo.
Our “clinic” for the day was the home of Sra. Torribiya – a woman who has been a defacto community leader for the people living in extreme poverty of this region. Torribiya’s spirit and commitment to organizing a better “tomorrow” for her neighbors are inspiring. She never fails to greet our teams with a huge smile and a lovely sign (see photo).
After a quick, and very purposeful, set-up – we started to serve a sea of patients. The line seemed to grow and grow and grow. By the end of the first hour of clinic it was apparent that we would not be able to attend to the masses of patients awaiting our clinic providers. As such, we triaged the line and took a firm interest in providing the most comprehensive care possible to the patients we were able to serve.
As our goal behind this clinic was to evaluate the needs of the people in Valle Sagrado regarding their access and utilization to healthcare services – we were very focused on ensuring that our Peruvian nurse Raquel had an adequate environment to ask the detailed questions in our assessment survey. This “adequate environment” did not last long – as the droves of patients waiting to be seen pressed into the small clinic space.
Not one to be deterred, Raquel pressed forward and managed to complete almost 20 surveys (little did we know that each survey would take so much time to complete). However, by the time Raquel completed the last question on the second survey we all knew how important this information would be to the development of a comprehensive care plan for the community.
I write this BlogSpot update from the comfort of my first class bus seat as we embark on a 15-hour drive back to Arequipa. As such, I have not had a great deal of time to systematically review the data we gained in the survey – but, a cursory review has my jaw dropping. Many of the respondents described incomes at less than 300 soles (approximately $100) per month; and this is for a family of 5. Additional data revealed the depth of poverty enveloping the community: of the 20 respondents not a single family has access to indoor plumbing or water, many of families described 6 or 7 day work weeks with 12-hour days for little more than 15 Soles ($5 USD), most of the families surveyed said that they knew “where” to get medical and dental care – but could not afford the cost of transport and prescription medications. The most revealing data we retrieved pointed to a barrier that few studies have discussed – the opportunity cost of receiving care.
Raquel told me on our drive back from the clinic site to our hotel that she was very surprised at the number of people who were enrolled in the government’s SIS program (analogous to a Medicaid program for the lowest socioeconomic strata) who were unable to utilize the program due to the “cost” of missing work to attend a day long waiting game to try and get an appointment. She told me that person after person described the extreme hardship of not being able to utilize the services of the SIS program – because of the “costs” (time off work, transportation, etc.) of accessing care. By the end of our clinic day I felt that I had gained a sufficient enough understanding of the needs of the people of Valle Sagrado to help shape a proposal for expanded care delivery to one of our in-country partners.
You can only look into the eyes of child who is suffering from extreme poverty with significant empathy and deliberate intention. The pain and loneliness their eyes express speaks volumes to their needs. The goal of HBI is to help develop a collaborative response to the extreme poverty of Carabayllo and to begin to build the bridges that will allow all of the children of Valle Sagrado the opportunities of education, healthcare, and the unlimited hopes of tomorrow.
Stay tuned to this BlogSpot for more info regarding our collaborative work in the Sacred Valley of Carabayllo.
As our goal behind this clinic was to evaluate the needs of the people in Valle Sagrado regarding their access and utilization to healthcare services – we were very focused on ensuring that our Peruvian nurse Raquel had an adequate environment to ask the detailed questions in our assessment survey. This “adequate environment” did not last long – as the droves of patients waiting to be seen pressed into the small clinic space.
Not one to be deterred, Raquel pressed forward and managed to complete almost 20 surveys (little did we know that each survey would take so much time to complete). However, by the time Raquel completed the last question on the second survey we all knew how important this information would be to the development of a comprehensive care plan for the community.
I write this BlogSpot update from the comfort of my first class bus seat as we embark on a 15-hour drive back to Arequipa. As such, I have not had a great deal of time to systematically review the data we gained in the survey – but, a cursory review has my jaw dropping. Many of the respondents described incomes at less than 300 soles (approximately $100) per month; and this is for a family of 5. Additional data revealed the depth of poverty enveloping the community: of the 20 respondents not a single family has access to indoor plumbing or water, many of families described 6 or 7 day work weeks with 12-hour days for little more than 15 Soles ($5 USD), most of the families surveyed said that they knew “where” to get medical and dental care – but could not afford the cost of transport and prescription medications. The most revealing data we retrieved pointed to a barrier that few studies have discussed – the opportunity cost of receiving care.
Raquel told me on our drive back from the clinic site to our hotel that she was very surprised at the number of people who were enrolled in the government’s SIS program (analogous to a Medicaid program for the lowest socioeconomic strata) who were unable to utilize the program due to the “cost” of missing work to attend a day long waiting game to try and get an appointment. She told me that person after person described the extreme hardship of not being able to utilize the services of the SIS program – because of the “costs” (time off work, transportation, etc.) of accessing care. By the end of our clinic day I felt that I had gained a sufficient enough understanding of the needs of the people of Valle Sagrado to help shape a proposal for expanded care delivery to one of our in-country partners.
You can only look into the eyes of child who is suffering from extreme poverty with significant empathy and deliberate intention. The pain and loneliness their eyes express speaks volumes to their needs. The goal of HBI is to help develop a collaborative response to the extreme poverty of Carabayllo and to begin to build the bridges that will allow all of the children of Valle Sagrado the opportunities of education, healthcare, and the unlimited hopes of tomorrow.
Stay tuned to this BlogSpot for more info regarding our collaborative work in the Sacred Valley of Carabayllo.
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