The purpose of this mission is to provide medical and dental care to communities located high up in the remote mountainous areas of Peru. As an OB/GYN, I will provide gynecologic care and education to the women in three communities as part of a Mountain Medics Int. medical and dental mission. Current gynecologic needs include infection treatment and prevention, contraception, menstruation problems, pelvic prolapse management, and gynecologic cancer screening. Education will focus on infection and pregnancy prevention.
The population I will be serving are impoverished indigenous peoples of remote Peru that lack access to basic healthcare. The 3 communities that I will be working in have no access to regular healthcare. I chose Mountain Medics Int. and this mission because they have a proven model of healthcare delivery to remote Peru. I am a Spanish speaker and am the grandson of migrant workers. I feel strongly about honoring my heritage by bringing healthcare to under-served Spanish speaking peoples.
My objective is to contribute to the overall mission of delivering needed healthcare to under-served people in remote areas of Peru. As an OB/GYN, my goal is to meet the two identified greatest needs, being, treating and educating about gynecologic infection, and contraception. These remote areas currently have no access to gyn cancer screening. I will be assessing the need for and feasibility of implementing a gyn cancer screening component for future medical missions. Finally, I intend to use the opportunity to explore medical mission work, with the intent of volunteering on a regular basis.
Mountain Medics International (MMI) is a US-based, volunteer-staffed, nonprofit organization aiming to improve the health and quality of life of developing mountain communities around the world. MMI teams volunteer healthcare providers with local providers who know most about the region and culture, to provide free clinics to the most remote communities with little to no access to healthcare. In October, I was one of 17 volunteers who participated in MMI’s medical mission to the Santa Teresa Cuencas region of Peru.
Our team of volunteers consisted of internists, pediatricians, family physicians, OB/GYNs, family nurse practitioners, physician assistants, a dentist, several non-medical volunteers, and an OB/GYN from Peru. For some of the clinics, we were joined by nurses from the Peruvian Health Ministry. Many of our patients only spoke their native indigenous language of Quechua, requiring us to have Quechuan translators, and Spanish translators for non-Spanish speaking providers.
The villages we visited were within a 1-2 hour drive from where we stayed in Santa Teresa, along dirt roads high on the mountains. We traveled daily by van and truck with our medical supplies and equipment to a new village for each clinic. At each new village, we set up an ambulatory clinic in schools and community buildings. On one of the days, we worked in a modest medical clinic consisting of a 5-room cement block structure, with shutters (no screens) for windows, one toilet (no seat) and no hot water. Our gyn exam table was a folding spring bed with welded on stirrups. Little did we know, that was the best it was going to get. All of the buildings had electricity, but, not all of them had water or toilet facilities. Not typically used to provide medical and dental care, we had to do a bit of cleaning and be very creative with the available rooms and furniture. In one of the buildings we found a tarantula.
The services we provided included triage, general adult medicine, pediatrics, gynecology, dental care (including extractions), dental education, and immunizations. For women’s health we took a thorough history and performed gyn screening exams. Our pelvic exams included Pap smears done using the older alcohol fixative method and a magnified exam with acetic acid for dysplasia. When we identified moderate, or, greater dysplasia, we treated with cryotherapy per WHO protocol. To asses risk for cervical cancer in these remote areas, a US hospital donated collection supplies and pathology examinations of cervico-vaginal specimens for high-risk HPV. A couple, likely benign, pelvic masses were found with recommendation for higher order evaluation. In one young woman who was postpartum day #3 from her delivery by cesarean section, we diagnosed endometritis and mild pneumonia. We were concerned about progression to sepsis, so, we placed her on oral antibiotics and arranged for the six-hour ride by private vehicle to a hospital in Cusco. Thankfully, we found little life-threatening pathology. Universally, people were eager to have their heath assessed and seemed to get a lot of reassurance from their evaluations. I lost count of how many times I heard “por favor regrese”, “please come back.”
The Mountain Medics International Medics mission was my first medical mission experience. I found the experience very rewarding, both, personally and professionally. The people we served were warm, friendly, and grateful. The administrative duties and documentation related to the patient encounters was minimal, allowing all of our time to be used for patient care. The areas we served were in remote mountainous areas that rarely, if ever, get medical care. Given the huge unmet need for medical and dental services, I left Peru with the feeling that our work was but a small drop into a very large bucket. Then, I remembered some of the people we met and cared for, and thought, it surely mattered to them.
I want to thank the Dox Foundation for a grant to help cover air travel expenses, helping make this medical mission possible.
