One Week in Ollanta – A Visitor’s Perspective (cont’d.)

Continued from “One Week in Ollanta – A Visitor’s Perspective

5/21 Ollanta à Pisac

We take off on a shopping excursion for the majority of the day. The market was a gigantic maze of scarves, ponchos, chess sets, yarn, hats, blankets, jewelry – you name it, we could buy it (and some of us did!).  The trip out was again picturesque, but much greener (mucho verde?) – a different side of Peru. We stopped on our way to try some chicha, a traditional fermented maize drink with some alcohol and many “vitamins”. Funny, Anthony Bourdain has been here (note to self, find the episode on YouTube). The original chicha is bitter, sour like vinegar. The chicha with fruit with very tasty, and many of us purchase a glass. Another item off the bucket list: try the chicha!

Two types of chicha

Once back in Ollanta, we have our second Spanish class. Our Spanish is better by the end of the day but I am still nervous for tomorrow’s clinic. We don’t know any medical Spanish, so how are we going to do this? The majority of the lesson was again grammar, but at the end Jamie and I were able to have our professoras go through the entire human body with us. It was hysterical – pointing to different bones, body parts and drawing different body systems on the board to get to the appropriate name. Ok, we’re feeling better about tomorrow; but what is it going to bring?

5/22 Clinic day Ollanta #1

The Coordinator of Chaos at her best – setting up the clinic and organizing the system takes so much. Flexibility is essential and we fixed the minor glitches early on. All in all – 90 patients today. Most of my day was in triage, which I was very comfortable with. I’m not an NP – so this was my spot. The afternoon was a little trickier, and I began to see patients with a consulting NP (thank goodness for Natalie!).  We took the “easier” patients, with a translator. However, one case sticks out. I was called over to see this gentleman with a wound, a specialty of mine. Upon beginning to take the dressing down, I knew that this was going to be a). big and b). possibly infected (with any assortment of organisms, big and small – use your imagination, or not). How am I going to treat this? What supplies do I have?  We took his dressing down, which revealed the largest venous stasis ulcer I have every seen. Thank goodness Coordinator of Chaos had a donation of silver sulfadiazene. The wound is not infected, but could be easily. Where’s the plastic surgery consult? Where’s the vascular surgeon? Oh, that’s me today! Dress the wound; the patient needs to come back tomorrow. I know I can’t heal this, but I can make it better today.

Women waiting for triage

5/23 Clinic day Ollanta #2

Assume the positions! The line is not as long, and we’ve got a good system going. Also, enter new student volunteers. Jenn brought one into triage and we talked him through blood pressures, taking heights and weights, and other basics. I’m hoping to see some of my patients from yesterday; they are supposed to return. The morning goes very smoothly. The afternoon runs as smoothly as the morning – here comes “the wound patient” for a return visit! Remove, wash, dry. Translate: more pain? Less pain? How does it feel? Better than before? He allows me to take pictures – a). to keep track of treatment (can we heal this?) and b). for educational purposes.  We give him one tube of silver sulfadiazine (100 soles in la botica) and dressing instructions. Our Peruvian nurse will do a home visit in one week. Enough dressing supplies between now and then. This will not heal the wound. This is not sustainable past my time here, but this will prevent an infection for at least one week. I know I can’t fix his problem in this short time, but he tells us he appreciates the care he has been given and we made a difference. That, above all else, is the reason we’re here.

The Coordinator of Chaos with two patients

5/24 Ollanta à Socma Mobile clinic.  

We won’t see as many people today, we may do some more “touristy” activities (hiking), but we are still trying to help.  Logistics are different but we have our Coordinator of Chaos to keep it running smoothly.

5/25 Ollanta à Machu Picchu

5/26 Ollanta and FESTIVAL!

5/27 Ollanta à Cusco à Lima. Lima overnight. Will need to decompress.

5/28 Lima à JFK (0100). A long trip. Plenty of time to reflect.

I don’t think that we’ll return home the same. Some of us have never traveled internationally for medical missions; some of us are well traveled. One thing I know is true for all – we will NEVER forget this experience and we WILL provide better care at home for it. Our purpose was to provide care to an underserved population to help improve their lives; in all actuality, we are also changed.

Written by Visiting Assistant Professor Tara Sacco, MS, RN, CCRN from St. John Fisher College in Rochester, New York

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