Our Experience in Palpa, Peru
A group of doctors and medical staff from Allure travel to bring life-saving care to the needy
by Dr. Charles Mok
As many of you have been following on the Allure Medical social media pages, a group of us recently returned from a mission trip in rural Peru, South America.
We met up with doctors, anesthetists, and helpers from Michigan (plus two doctors who were from Iowa), and headed to Lima Peru, the fifth largest city in the Americas with about 10,000,000 residents. Lima is a modern city, and about 1 of 3 residents of Peru live in Lima. The other 2/3 live in smaller towns, or in rural areas.
We landed on a Saturday night, and Sunday morning we hopped on a bus, a newer coach, with about 30 suitcases of medical supplies and gear with 17 people and headed to a smaller town called Ica. In Ica, we met Alfredo and Maritizia, locals from Palpa, a much smaller town in southern Peru. Alfredo spoke English and became our interpreter.
They helped us load our 30 large suitcases onto the roofs of two vans, we piled in and drove to Palpa.
After about 14 hours of buses and vans, we arrived in Palpa Sunday night and were put up in a nice local hotel. My room had a private bathroom and running water, a feature not enjoyed by many of the residents in that region.
That night, we set up at the local hospital, unloaded our gear, and went out for dinner. We had the opportunity to meet our new friends who were from the United States and went on the mission with us, as well as our Peruvian hosts.
The next morning, we walked to the hospital. We brought as many supplies as we could carry on as luggage with American Airlines.
We were not sure what supplies and equipment the hospital would have. Before we started to evaluate the patients, our team set up two operating rooms with three operating tables.
One OR (Operating Room) was a good size, like a large bedroom, so we put two operating tables in it. There was another room used for minor procedures and delivering babies, so we set this room up as a third operating room.
The electricity was 220v, so we had brought electrical converters allowing our sensitive equipment to function. Not many of the plug outlets worked, but we had splitters and extension cords so we could make due.
Peru is South of the equator, and there is winter, but they are also very close to the equator. This means it gets quite warm, and the sun can be intense. So we taped the windows off with black garbage bags to keep the ORs from getting hot. When we arrived, it was already stifling in the OR’s, and it got muggier as we started working.
Dr. Carl Pesta and Dr. Preveen Prassad have both been on missions, including Palpa, in the past. They were pretty comfortable with what we would need, and how the days could go. What we had not prepared for was the enormous number of patients who wanted surgery!
Our hosts made it clear to us that we weren’t expected to do all the surgeries, and had a list of the conditions that needed help. So we devised a system to allow us to use the skills we have learned at Allure to manage a large number of patients in a timely and efficient manner.
On Monday we chose to do major cases that would take longer and require some follow-up care, but not the patients who may be a little older, sicker or more complicated. We chose to wait until Tuesday to do their cases so we could have flow and efficiency worked out before tackling these more significant and risky cases.
On Monday we did mostly gall bladder removal and hernia repairs in people younger than 60 years old with no major medical conditions.
On Monday, we assigned duties to each member of the team. We had a list of patients and set up areas for pre-op (get the IV, go over medical history with our only interpreter, review any tests and medical conditions, talk to the family, and mark and prepare the patient for surgery).
We had help from the residents in the area as well. We had three surgery residents work with us from time to time; they wanted to learn from American surgeons, as well as the local surgeon, who wanted to help out and have experience on some surgeries he hadn’t done before. A doctor from the nearest major city, Dr. Jonathan Fong helped as well. He was very experienced and advanced, and helped out a tremendous amount.
Monday night, we celebrated with some of the local townspeople.
Exhausted, we went to bed early. We tasted the local food (mostly fried food, corn or potato was the staple). Chicken is typical, and guinea pig is a delicacy they had served to us (yes, it tastes like chicken, so I had the chicken).
Tuesday, we were back at it. Today, we had more challenging cases, with patients who were a little sicker, a little older, and their surgeries a bit more complicated. But by this time, we were a well-oiled machine. On Monday, we learned not to waste time, how to make due with the little equipment, lighting, water, and supplies that we had, and we were able to plan to have enough supplies to do every case that we could perform.
In spite of Tuesday’s more difficult cases, we moved very efficiently and were keeping ahead of schedule. We began to believe that we could do every surgery that was needed. In fact, because we were ahead of schedule, we worked with the local helpers to add more people on sooner, so we could stay ahead in case any delay or obstacle got in the way.
Wednesday we had some minor cases. Younger people with gall bladders, minor hernias, and some children with various tumors. Wednesday was a catch-up day. We were able to manage any issues that came up with the prior surgeries, and take care of the rest of the patients.
Thursday we finished up some minor cases. Another gall bladder, some tumor removals, and then we started packing. We left many of the supplies we brought with the local hospital but had to bring back our instruments and tools for missions in the future. Most of our the team left the personal clothes they brought with them for local residents to keep.
Since we had traveled so far, we had planned a group trip for relaxation while in Peru, and I will talk about that in another blog.
This trip was one of the most profound experiences of my life, and it was for our team members as well. I am not writing this to brag about our sacrifice of time, resources, and energy. This article is to let you have an idea of what it was like to have this experience. Most of us had never been on a mission trip before, and I assure you, probably for all of us, it won’t be our last. It was a very impactful experience.
At the end of the week, we were tired and dirty but overjoyed because we performed over 50 surgeries to those who really needed it.