More Peru Update- Clapham

Day 10: 1/20/14

Last Thursday morning, we did a dental outreach at two local public elementary schools (primarias as called in Peru). We were led by three advanced dental students. Dental students here are charged with operating a dental program for 10-12,000 kids in Huancayo. The schools were pretty nice and the classrooms seemed very happy places, reminding me a lot of happy elementary schools in the US, with educational posters and motivational phrases posted all over. The kids were what you'd expect, super happy to have visitors and eager to have the attention of an adult putting fluoride in their mouth and cleaning their teeth. I felt like I was having déjàvu of being in a classroom in the States, but with just enough of a distinct Peruvian flavor (and a lot more dental cavities) that you knew this wasn't the case. Some interesting moments to give you an idea: I observed two boys playing "Papel, piedra, tijeras", the exact Spanish version of "paper, rocks, scissors." Later, we passed by a class of maybe 40 little boys having their gym class in the courtyard outside, all perfectly in a line to do stretches or exercises while over the loud speaker Whitney Houston's "I will always love you" blasted full volume over the courtyard. Also for a little while a particularly ambitious little girl was trying to be my assistant by prying open her classmates' mouths so I could better access their back teeth. Unfortunately I had to relieve her of her self-assigned post because she was hurting her classmates as well as blocking my view of their teeth! The vast majority of the kids were so loving and even the shy ones enjoyed the attention. I more than once observed that after I showed a kid's rotten or dead tooth to one of the dental students, later that same child would become the center of positive attention from classmates as kids gathered around him/her to see what exactly warranted the gringo calling over another adult to discuss.  It was a SUPER busy morning but I'm pretty sure we all loved it and all wore smiles for those three hours.  It was so fun to explain to the kids in Spanish that they had to wait three minutes before they could spit out the fluoride and 30 minutes before they could eat or drink and that they couldn't have milk or cheese or yogurt the rest of the day to preserve the effect of the fluoride, and then to observe their faces and realize how seriously they took these instructions.  During an opening presentation to us MSU students, the lead dental student told us that 95% of kids in their program have cavities... And after having my hands in about 20 of their mouths, I'd say I'm a believer in that statistic. I'm happy that Peru on the system level has taken dental work to the classroom, and Although I have no idea obviously if this is possible, I hope this program continues to grow as it was obvious to me in three hours this is a great need here. 

Then today in the morning, I went with Laurie to Carrion hospital, the general public hospital that I went to a few times last week. Again I was impressed by just the crush of people in the hallway, waiting to visit a patient they knew or be seen by a doctor or technical person or wait in line to receive their prescriptions or talk to someone about their bill. I got to choose what service we would round with today so I chose general medicine! Similarly to how I described my experience above, it was like going to a general medical floor in the States...but with a Peruvian twist. Unfortunately, this time the twist wasn't funny. There was an elderly patient with a history of heart failure admitted for aspiration pneumonia. There was a young man admitted for a small bowel obstruction and possible perforation....but the tragic twists were these acute admissions were secondary to decreased level of consciousness from neurocysticercosis and intestinal tuberculosis, respectively. I had the opportunity to view the radiographic images of these patients as well as of another patient with miliary tuberculosis. And also discuss the cases with a Peruvian attending, residents, and a student. And perhaps by being a little obnoxiously persistent with asking questions and my willingness to be laughed at for my terrible pronunciation I was able to learn more of the language of anatomy, physical exam, and medicine in Spanish. 

We are all so grateful to LMU, MSU, and FIMRC for these amazing opportunities. 

P.s. This weekend I tried grilled octopus (pulpo a la Parilla), more beef heart (anticuchos), and a ceviche with raw salmon and tuna and yams! All were tasty enough to try again.

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