This trip will be a continuity of our partnership with Health Bridges International to create a project to demonstrate the community-based Family Medicine residency training model to share ideas and promising practices that are evidence based and rigorously administered. There is an opportunity to use collaboration to be a multi-national training program and a model for training family physicians around the country of Perú. Health Bridges International (HBI) works to build bridges of collaboration within extremely impoverished and marginalized communities. They are dedicated to sustainability and the development of projects that realize long-term change. To this end, HBI connects resources to needs through innovative programs, leveraged with integrated technology solutions and projects that build local- level change agents. The work of HBI is grounded in the Four Pillars of Bridge Building: Training, Consulting, Connecting and Serving (HBI, State of the Organization, 2019).
The community of Alto Cayma is located in Arequipa, Peru. By working with the continuity clinic there, the people in the immediate area would benefit from evidenced-based consistent primary care. Currently there are only about a dozen Family Medicine Residency training slots in the entire country of Peru. Our hope is that over time, through collaboration with Family Medicine residency training programs in Peru, there will be a greater downstream impact in improving the delivery of primary care in other communities throughout the country.
Health Bridges International (HBI) are already in the initial stages of developing a graduate medical education program at an outpatient, community-based clinic in the area of Alto Cayma, just outside of Arequipa, Peru. Health Bridges International has a 20+ year partnership with the Catholic Priest (Father Alex Busuttil) who runs the clinic. For a number of years, they’ve provided CME, conferences, and technical support to the clinic. However, recently they’ve come to a clear conclusion that a more concerted effort toward the formalization of a Family Medicine training program will have greater long-term impact and sustainability. With the establishment of a residency training program this clinic will impact not only the local community but also future residents and their patients all over Peru.
While in Arequipa, I provided medical care of many forms. I spent most of my time working in a low-cost clinic, providing healthcare to people that can not afford to be seen in private hospitals. Although they have access to public hospitals, this system often has excessive wait times and provides only basic services. As such, I was able to help fill in the gap with many patients and provide same-day general medicine visits and performed many joint injections for arthritis. The community I served had many people who have worked essentially every day of their life, often doing hard physical labor in fields scattered throughout the city, and have significant joint damage as a result. Word quickly spread that we were helping with joint pain and many patients came to see us in clinic. However, perhaps my favorite part of my trip was going out into the community to visit people in their homes. The promotoras who work with the clinic are members of the community who are able to facilitate communication between the clinic and patients who have difficulty leaving their homes. These patients were passing through significant trials but were continuously generous, kind, funny, and joyful.
