Arequipa, Peru: Clinical and Cultural Immersion
Report #2
March 13, 2009
Starting Tuesday we were divided into groups and we began our work in the community. Twenty-one of us were divided into four groups and were assigned to either home visits, school health, nutrition services, or the clinic. The home visit group walked throughout the community and interacted with people of the community. We were invited into homes where we initiated our assessment, a “first-hand look at lifestyle”. Through our conversations with families, we felt humbled by how little they had, yet how happy they were with their lives.
The time spent at the primary school was a great experience in school health. As in the United States, without the school, many children would be left at home while their parents were at work. In Arequipa, as in the States, the school provides a positive environment and reduces the likelihood that the “kids will get into trouble.” Our assessment revealed there have been incidences in the past where children drank kerosene or experienced electrocution from the “rigged electrical lines”. The school not only provides an education, but a safe haven for the children while the parents work.
While assigned to nutrition services, we assisted with the preparation of food for those in the community who cannot afford it. Each day meals are prepared for 650 families throughout the community. We also assisted with the delivery to families who qualified for nutritional support. Being involved in the preparation and delivery of the meals allowed us the opportunity to assess the diet from both a nutritional and a cultural perspective. Additionally, while delivering the meals, we were introduced to other members of the community which enhanced our assessment of life in the community.
In the clinic, there were four different areas that we observed to begin to compare and contrast medical, nursing, and health care practices/protocols. The professional providers worked with limited medical equipment or technology when compared to the technology and equipment used in local clinics in the United States. However, services were provided to the clients appropriate for the clinic setting.
On Wednesday and Thursday this week (March 9-13), we conducted research in the community to determine the lifestyle and common health practices in Alto Cayma. We set up multiple interview stations throughout the community to collect data from the people. Fortunately, Father Alex has worked with the people for more than a decade and has impacted significantly their lives; therefore, he was able to recruit a large sample for the interviews. Based on a preliminary analysis of the data collected from 212 participants, most people in the community are without running water or indoor toilets. There is typically one water source for several square blocks. Most of the people take care of their physiologic and personal needs in the home, as did earlier settlers of America and the rural poor in less developed sectors of the counties. Work and resources are very scarce and life is harsh. However, the people seem to be very happy and contented with their living conditions. One thing of note is the high level of generosity among the people of the community. Everyone seems to have the community’s goals in mind rather than an individual/self-oriented focus. The healthcare practices of the people are different from the majority in the US. Many families in Alto Cayma have never visited the doctor or dentist. Those who have sought healthcare visit established practitioners rarely. These behaviors can be attributed to cultural practices and the lack of money and other resources. For example, one family reported that they did not see the doctor because they preferred to use folk medicine and/or local cultural protocols, e.g., “bathe with pee and herbs” to treat illness. While some expressed similar cultural beliefs, the majority reported the lack of money as the primary reason for not seeking medical care.
Today, Friday March 13th, we had the opportunity to participate with the Christian Foundation for Children and Aging (CFCA). We assisted with the registration of families who were to receive nutritional supplements/food packs prepared by the local mission. We also assembled packs of school supplies for families who could not afford to purchase them. This was important because the supplies will give many children in the community the opportunity to more fully engage in formal education. In Peru as in America education is power and a building block to improve the community.
In conclusion, this has been an exciting, informative, and challenging week in Alto Cayma, Arequipa, Peru. We are learning to view the world from the lens of others. Our goal is to learn, provide service, and become more sensitive to the cultural norms that are the foundation for behaviors and practices in global health.
Ryan Bowers
Adam Sturkey
Brian Sisk
First Semester Senior Nursing Students
