Blood donor poster (my blood for my country, donate blood, donate life) Notice that the words at the top says one donation saves three lives...
Adult general medical ward
Pediatric ICU
Aldo under sign for pediatric emergency room
Rolling cotton balls
Where to start! Yesterday was amazing. I spent the day with Heather’s friend, Rebeca, who is a doctor here in Peru. As best as I can understand, the process for becoming a doctor here is similar to the process at home. Rebeca attended medical school immediately after high school. Her program was seven years long. Unlike America, she did not have general studies, but instead focused only on medicine. All graduates are required by the government to serve for a year in a government clinic of hospital. This year may or may not be a paid service. There is a lottery to pick who of the 800 students will get one of the 400 paid situations. The 400 who do not get a paid position must do their service at their own expense. Rebeca was not lucky enough to have one of the paid positions. She served in a hospital for police for her required year. She seemed understandably frustrated that the paid positions are chosen only by lottery with no attention given to merit.
After school and the year of service, she is qualified to be a general physician (GP). A GP receives an average pay of 1500 soles (or $500 American) per month. To work in a hospital, a GP must take an exam and be placed in a residency program for two years. After this time, the GP becomes a specialist and may work in a hospital. Rebeca is studying for her exam and hopes to become an internist. The average pay for a specialist is 3000 soles ($1000 American) per month. The other difference between a GP and a specialist is that a GP usually works 10 hours per day for 5-6 days a week. A specialist only works 4-6 hours a day for 3-4 days per week.
The hospital we visited is akin to University of Colorado Health Sciences Center (UCHSC). The hospital consists of 10 pavilions or wards. The wards are separated by sex and medical vs. surgical. There is a small pediatric pavilion, a maternity pavilion, as well as an oncology pavilion. The hospital is a government hospital, but is not a charity hospital. The patients must have insurance, the Peruvian equivalent of Medicaid/ Medicare, or be able to pay for services rendered. The hospital campus is large with many buildings. Each ward is housed in a separate structure. Additionally, there is a medical school for the training of doctors, nurses and other medical professionals. Rebeca said that the hospital we visited is the largest and most respected in all of Peru.
The pediatric emergency room is just that, a room. Ok, technically two rooms, one for registration, triage and recitation and another for nursing procedures. The main room (for nursing procedures) had 6 beds. The nurse I spoke with was lovely and very accommodating. She was pleased to show me their crash cart with all of its contents. It would be easier to check than ours at Children’s since there were only about half as many supplies. It is set up like ours, with meds in the top drawer, respiratory supplies in the second, and various other supplies and kits in the third (and last). They see about 40 cases a day with only 2 nurses.
Some of the things that struck me were the assistive personnel making cotton balls from large sheets of cotton batting, and on another ward, they were making packets of gauze pads beginning with a large sheet of gauze which had to be cut into strips and folded, then about 10 pads were placed in brown paper which was folded into a packet and taped shut. This was in the surgical ward, and I presume (hope?) that the next step involved sterilization. Another interesting thing was the pediatric ICU which had about four beds and two nurses, but I did not notice any “fancy” machines, including IV pumps. The doctor who showed us around was named Aldo. He is a friend of Rebeca. All in all, it was a very interesting experience and I am glad to have had the opportunity.
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