Quisuar Health Post Report – August 2017

Leeds University medical students Ella and Laura spent August at the LED health post in Quisuar, high in the Cordillera Blanca of Peru. Here’s what Laura has to say about the experience….

Quisuar Health Post

Our adventure starting by driving through the Llanganuco pass and trekking for two days to arrive in Quisuar. This was to be our base for the next few weeks. We were centred at the health post which has now been running for twelve years. The aim of the project is to provide healthcare and education to a less privileged and remote village in the Andes. In the mornings we ran the clinic seeing villagers with common problems, for example, worms, gastritis and back pain. In the afternoons we would teach English to the children.

Leeds medics, Ella and Laura, with the children, on their last day of English lessons in Quisuar

Ella and I, with the children, on their last day of English lessons in Quisuar

Skills and Attributes developed

There is no doubt that my confidence as a clinician has improved throughout this experience. Our previous exposure to patients in England has often been just observing and it is usually hard to get the opportunity to utilize what we have learnt. I was surprised at how much knowledge we had gained throughout medical school and how we were able to adapt these to the environment. One of the biggest daily challenges was communication. I had tried to learn Spanish before and during my trip. The problem however was that many of the villagers could not speak Spanish, but Quechua. As we learnt this is an impossible language to pick up in a few weeks. The consultations where therefore a lot less straight forward than we had witnessed in England. It was an invaluable experience, as we had to think outside the box in terms of communication. For example, many of the villagers could not read, so when testing eyes we had to point at pictures and things in the room instead.

Once the diagnosis had been figured out, then it was on to treatments. In England often patients leave with multiple medications, however, these were not available and this is not sustainable. Therefore, we had to think of ways to help which did not involve medication. For example, physiotherapy movements for pain and massaging using hot water and oils. It was often down to our judgement and an educated guess.

This experience has also broadened my cultural understanding. Peruvians are very superstitious and believe highly in non-medical treatments for diseases. They explained how they had cured asthma by placing the skin of a particular animal on their skin. It often effected compliance with the advice and medication we had provided, which with potentially life-threatening illnesses like asthma, can be very dangerous.

Benefitting the Wider Community

The project impacted the local community by increasing their understanding of certain illnesses and the importance of hygiene. We worked alongside a Peruvian Nurse Tula. We taught her how to conduct a Muscoskeletal examination of different joints and a thorough examination of the heart and lungs. We also taught her about different illness, for example the different types of diabetes and how you diagnose it. These are skills she can continue once we have left.

Ella and I (Laura) with our guide (Juan) and the nurse (Tula)

Ella and I with our guide (Juan) and the nurse (Tula), at the Quisuar Health Post

In conclusion, I loved my time in Quisuar, being fully immersed in Peruvian culture, without Wi-Fi and bucket washing for a few weeks. It was an experience I would love to relieve, I would recommend it to anybody that asks and hopefully one day I will return.

Laura Chapman

Interested in volunteering with us in Peru or Nepal? Use the Contact LED form on www.lighteducationdevelopment.org or message us on facebook.com/LEDCharity to find out about opportunities in 2018.

Summer 2016 in Quisuar

This summer, Leeds University medical student Ross Gillespie spent 4 weeks as a volunteer at the LED health post in Quisuar. Here’s what he has to say about the experience….

I have recently returned from Quisuar having spent 4 weeks in the LED health post, located in the captivating mountain range of the Cordillera Blanca. I’m Ross, a Medical Student of Leeds University, UK, and I’d like to share a short account of my experience over the summer.

My journey began in Lima, a vibrant and busy city with some real gems to offer. An 8 hour bus journey lead me to Huaraz where I met Val, Juan (translator and entertainer), the crew, and four trekking Americans, Janet, Meara, Tara and Nalini. After some acclimatisation walks and some generous meals in the local hotspots of Huaraz we stocked up on medications and food, prepped our kit and headed into the heights of the Cordillera Blanca.

As with previous visitors a private coach journey winding through various towns and villages and over the Llanganuco Pass would lead us to Chingil. Here we would spend the night, before the 4 hour trek over a 4450m pass to the health post in Quisuar. The surreal beauty of the surrounding landscape seen throughout this journey was truly unique and a clear sky allowed us to appreciate the peaks, which appeared from all points of the compass.

Arriving at the village of Quisuar we were greeted by the locals with a traditional welcome party of singing, dancing and general frolicking before arriving to our goal destination of the health post. Here we met Tula, the nurse and I settled in for my 4 week stay.

As mentioned in other reports, the location of the health post is quite unique with incredible views surrounding it. The health post is basic but is well stocked with basic medications and equipment, somewhat loosely comparable to a GP surgery. This allows for a generous consulting room and a private examination room (which doubles up as the bedroom) in which to practise, as well as a small waiting room and decent kitchen.

The first week was especially busy in terms of patients, but we quickly established a system that seemed to work. With Tula translating to Castellano (I must admit, life was made much simpler by being able to speak Spanish, although not essential), a comprehensive history was easy enough to obtain and follow with examination and an appropriate management plan.

Conditions we encountered were mostly chronic back pain, gastritis, infections (of varying types) and the usual signs of ageing (poor vision, aches and pains, loss of strength). The village would most certainly benefit from some dental care and education seems to be the key step missing to further develop the health of the region.

We spent two days in the secondary school teaching about nutrition, mental health and general health. We were keen to address sexual health, a topic which is too frequently ignored or avoided in this region given the reserved nature of its people, however it is essential that any proceeding visitors do their utmost to educate the teenagers about this. Persistence is key, and has been successful in the past with vast reductions in teenage pregnancy rates.

I spent most afternoons teaching the local children English, with ages ranging from 6-16. This was very rewarding and its nice to see kids who remember how to play, using their imagination, and not have their eyes fixed on a screen at all times! We also brought school resources and skipping ropes etc to share with the children and schools.

Juan would cook breakfast, lunch and dinner and free time during the week was spent updating computer records (kids height/weight, consultation records, inventory), training Tula and doing home visits. Weekends were spent trekking and visiting nearby towns and villages. Juan and I trekked to Pombabamba (about 12-14 hours the long way around) and spent a weekend their, restocking and buying gifts for the children. We also visited the two lakes and attempted fishing (NB: spinners or ‘mariposas’ are useless, you need to sink a worm to have any chance), and spent a day at the big Sunday football tournament in Pochgoj.

The political stance of the village is not easy to gauge, but with an elected president representing the people, there is normally someone who knows what is going on. With big companies trying to exploit resources by giving false promises and strange new laws on employment of teachers, it is quite unclear as to the political direction of the village. The most important thing is that the health post continues to have its positive impact on the community, and with consistent support from the majority of the local village, and in fact surrounding villagers, this should not be challenged any time soon.

Tula is great with patients and is keen to learn to further her ability to help others. She is trusted and respected by the patients, and is a key asset to the health post. Juan, who plays a multi-faceted role of translator, guide, cook, entertainer and friend is an easy going Peruvian, and with an innate ability to read people, he knows just how to keep spirits high!

Returning home, we took the lazy option of a coach to Pombabamba and a bus back to Huaraz (about 14 hours of travelling door to door). Back in Huaraz I spent a week in the local public hospital in general surgery/A&E, which was eye opening to say the least. Here the interns taught me and treated me as one of their own, generously inviting me to meals and nights out. They exemplified the welcoming and humble nature of the Peruvian people.

Overall I had an amazing experience, and one that I will surely never forget. I would like to thank Val, Juan, Tula and the Crew (Melki, Antonia, Freddie, Augustin (Cuchin)) for their help throughout my stay. I am also most grateful to the people of Peru who made the experience so rich and memorable.

Ross Gillespie

Interested in volunteering with us in Peru or Nepal? Use the Contact LED form on the website (www.lighteducationdevelopment.org), or message us on facebook.com/LEDCharity, to find out about opportunities in 2017.

For photos, look at our LED at work – Peru 2016 album on Facebook. 

Peru Update: 2015 Report

September saw the LED Trustees autumn meeting, and Val provided her report on this year’s activities in the Cordillera Blanca:

In 2015, LED provided:

  • 200 homes with solar lights in the villages of Ingenio, Pisco, Pampiti in the NE Blanca. We last visited / distributed solar lights in Ingenio 10 years ago (a couple of the lights were still going strong!).  We concentrated on providing lights to older people and women with children.
  • school supplies for Ingenio, Quishuar, Jancapampa – books, pens, dictionaries, laminated posters, sports kit (including footballs, hula hoops and 60 football strips); enough to last for the year.
  • 3 new greenhouses and a compost bin, courtesy of Anthony and Sheila’s hard work, all producing fresh veg for the schools and some of the elderly and women in Quishuar.
  • a technical plan, drawn up by Anthony, to use in obtaining approval for the two new classrooms built last year in Carhuacacha.
  • water pipeline and supply repairs in Quishuar.
  • staffing and supplies at the Health Post in Quishuar:
    • Retired GP Sarah Watson (together with Anthony Watson and Sheila Larking) spent 3 weeks volunteering her skills and expertise, as did Leeds medics Paul, Alex, Josh and Hugo, for 5 weeks. Picking up on work done by Dr Anne Ince and Leeds medics Jessica, Emma & Ellen in 2014, our medical volunteers ran daily clinics in the health post and made lots of house visits to remote homes where people too old or ill to travel to the health post. Sarah did a height/weight check on all the children of Quishuar to check growth and nutrition.
    • Since April, funded by LED and Paul de Shazo, we’ve employed a Peruvian  nurse at the health post. A trained nurse, Tula speaks both Quechua and Spanish, and carries out consultations at the health post year round. She undertook further training with Sarah and the Leeds medics during their time in Quishuar.
  • sexual health classes for both adults and secondary school kids; English classes for primary and secondary kids.

A few Thank Yous

We couldn’t have achieved all this year’s solar light distribution without the generosity of Mia, Brian, Donna and Jim from Canada, who donated and helped to distribute 60 solar lights to remote homes in the Cordillera Blanca of Peru.

Sarah and Paul, Alex, Josh and Hugo also provided very generous donations of medical equipment and medicines. This really helped our budget as the overall cost of medicines for the year to date has been c. $7000.

Paul de Shazo’s continued support enables us to run and staff the Health Post year round.

Thank you to Sarah, Anthony and Sheila, Paul, Alex, Josh and Hugo, for all they did in the Cordillera Blanca during their time there. If you’ve not already seen their reports, you can read them here:

There are loads of photos on our Facebook page, but here are some highlights:

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Looking ahead

Our plans for next year? More of the same!

If you are interested in volunteering – in any capacity – please do get in touch.

Peru Update: Our Medical Elective in Peru

Leeds Uni Medics Alex, Josh, Hugo and Paul have sent us this report on their time in Quishuar this summer

Our group, four medical students from the University of Leeds, visited Quishuar health post for our medical elective (a period of training where students are encouraged to work abroad). This lasted 5 weeks in July and August of 2015.

Before our arrival in Quishuar we had flown into Lima and spent 10 days visiting tourist attractions in the South of the country (because it isn’t a trip to Peru without a shameless ‘selfie’ overlooking Machu Picchu) before we returned to Lima then took the bus to Huaraz. We were met in the Cafe Andino (‘gringo’ hangout and purveyor of extremely large breakfasts) by Val and Paul, and after a quick catch up we began preparing for our stay in the health post. Over the next 2 days we acclimatised to the altitude in Huaraz whilst buying food for 5 weeks, spending 3 hours navigating multiple Peruvian pharmacies to re-stock the health post and assembling the kit required to make our way there.

Leeds Medics 2015 - Quishuar welcomeAfter a public bus ride to Yungay, riding on a truck into the Cordillera Blancas, staying overnight in Chingil and then a 4 hour walk over the pass, we finally reached Quishuar and were greeted by a procession of women in traditional dress dancing who guided us to the Health Post. This was followed by music from a drum, violin and harp, further dancing (which we joined with more enthusiasm than skill) and lunch to celebrate our arrival, followed by a brief set of speeches. All in all this was a lovely welcome to Quishuar and also a dive into the deep end of culture in the Cordillera Blancas.

Leeds Medics 2015 - Quishuar Health PostOver the course of the 5 weeks we spent in Quishuar, we operated with two of us working with Tula (the nurse who works at the post) to run the clinic each day 9am – 5pm with the other two conducting home visits, doing odd jobs, and during the school holidays teaching the local children. The healthcare was very different to the UK, largely due to the difference in types of condition but also the health knowledge of the local population as well as the difference in available resources. However once we got in the swing, by familiarising ourselves with the stock of the health post and brushing up on our (non-existent for some of the group) Spanish we began to feel much more like GPs back at home.

The local population are subsistence farmers, and as a result of this the most common illnesses are back pain (from heavy lifting), worm infections (from poor hygiene), gastritis (from the worms, alcohol and poor diet) and sexually transmitted diseases (from poor sexual education). The vast majority of patients presented with at least one of these, as each patient tended to come with multiple problems since the culture is that of accessing healthcare only when absolutely necessary.

Leeds Medics 2015 - Quishuar patient

One case that particularly struck me was that of Maria, an older woman with rheumatoid arthritis. Maria had suffered with her condition for many years, largely losing the function of her hands and making it difficult at age 80 to continue to work on the farm! We saw her every week at her house, high up on the side of the valley overlooking the village, where we would check on her health and provide medication to aid the pain and inflammation for the next week. We could see she clearly valued this input, however small it was, and it was so nice to see the huge impact such a small intervention can have on an individual level. However this was also memorable because this level of progression could have been slowed dramatically by using medications which are commonly available in the UK, but completely out of reach for someone like Maria in Quishuar.

Leeds Medics 2015 - Quishuar kidsIn our free time, as well as enjoying the fantastic scenery, we spent our mornings teaching/entertaining primary school children by teaching basic English, hand hygiene, and more than a little football. In the afternoons the decidedly more shy secondary school children were also subjected to English lessons, as well as health education including sexual health and basic first aid. Later reports confirm that all the children in the village can now say “Hi, I am Carolina, I am 8 years old and that is red” but are unlikely to understand your response.

Looking back, the health post is one thing that really makes Quishuar stand out from the surrounding villages. As well as the benefits of accessible healthcare which is utilised by people from many of those villages, it provides a meeting place and a centre of the village, being virtually the only place with street lighting. LED also provide a great deal in terms of support for local schools, and by providing solar lights they have given the village virtually all its supply of light after 6pm every day.

We had a really interesting experience in Quishuar, tough at times, moving at others but overall we are delighted to have contributed to LED’s cause of holistic improvement of the lives of those living in Quishuar. We return to the UK better medics and certainly grateful for the NHS and all it provides us.

Until next time!

Alex, Josh, Hugo and Paul