Wednesday, June 2, 2010

PINCC finally up and running in Peru

After some frustrating false starts on Monday and Tuesday in Lima, our team finally began its work seeing patients and training local medical personnel early Wednesday at the outlying Medisol clinic run by a Peruvian non-governmental organization called Pathfinders.  This is the group PINCC coordinated with to come to Lima in the first place.

Monday, we met with the head of the highly sophisticated and huge maternity and perinatal hospital, but ran into some surprises when we went to set up at the gynecology clinic, where specialists were already seeing their own patients, most of whom were not candidates for PINCC's visualization exams.  Most of the women were seeing their gynecologists for all kinds of reasons, and, in spite of arrangements having been made at the administrative level, we were clearly not expected.

Even without patients, though, our OB/GYN resident Dr. Emily Corrigan and our trip medical director and OB/GYN Dr. Melissa Miskell trained 6 senior gynecologists on the LEEP machine until it blew a fuse.

Then on Tuesday, we had another day that went somewhat awry because we had a few patients who wanted to be seen but no medical staff to train.  Nevertheless, the hospital administration took most of our group on a tour of the hospital while your correspondent went on a breakneck- paced search on foot for new fuses for the LEEP.  That search, led by a local doctor, was successful.

After the tour, we cleared out early, and that departure sparked an urgent meeting with hospital brass to make sure they understood PINCC's operating practice and how it can fit in with the hospital's setup. They had apparently not understood the difficulties we had encountered the day before and on Tuesday morning.

Wednesday and Thursday, as a result, have been designated as training days for midwives at the outlying clinic, and we'll be back at the hospital for another try on our last day here, Friday.

The stark contrast between two weeks ago in San Salvador versus Lima this week illustrates how things evolve with PINCC's model.

In San Salvador, it was PINCC's ninth trip, and the Health Ministry has become not only a huge supporter but a major partner as well.  (Please see my earlier blog posting.)

There, senior people from the government literally help us run the clinical operations, providing nurses and doctor for training, exams and treatment -- which results in hundreds of women being served and dozens of lives being saved.

Here, in Peru, PINCC -- while invited to come -- is an unknown quantity, and an adjustment period is needed as both sides learn each other's systems and look for ways to work together successfully.

In spite of the situation at the hospital, the team of volunteers had no problem shifting gears and setting off in all directions to explore, shop, eat Peruvian food, shop, sightsee, shop again, and even catch up on sleep.

The politics were left to be resolved by Melissa (who has now been on three continents for PINCC) and trip administrator Carol Cruickshank, whose local cultural understanding and eternal optimism and endless patience combine to move things forward.  (Carol has lived in both Peru and Nicaragua.)

-- Larry Shushan

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