#1 rule when you travel to latin america - don't lose your iPhone!!! I was a little bit tired after a few long days at the hospital figuring out how everything works and I think I left it on a locker in the changing room or it fell somewhere on the Metropolitano....I got back to the hospedaje and NO PHONE! Booo :(
I raced back to the hospital and I couldnt' find it, nobody saw anything but it's also somewhat of a high use area....no way I was going to locate anything on the Metropolitano. So I just took it as a lesson re-learned. Keep track of all your valuables at all times when travelling in foreign countries. Life without my iPhone for the first 24 - 48 hours was ROUGH but now it's not so bad, I'm adjusting. I can't wait to get back to the states and replace it, given that Japan has recovered enough that the iPhone has not faded into extinction.
PPH = Peruvian Public Hospitals. My research involves another definition of PPH but I think talking about Peruvian Public Hospitals is important. There is universal health coverage in Peru as well as a fair amount of private hospitals, however, most of the population is of low socioeconomic means and rely on the public hospitals for the majority of their healthcare needs. I think the best image would be to think of the VA system back in the U.S. and imagine if Yale, for example, as a private institution helped to run and staff the VA Hospital but the VA was responsible for providing healthcare for everyone in Southern CT and not just veterans. That brings up images of understaffed departments, over worked personnel and older equipment - small snippet of insight of what it's like. However, you also have motivated individuals that do the best they can day-in and day-out. In a one-room labor floor with 5 beds and a delivery room with two beds they attend to almost 5,000 births annually. One fetal heart monitor for all 5 beds and one doppler. They have an "intern pump" on their IVs - which is to say a thumb, a timer and counting the number of drops per minute - to regulate their infusions. Tocometers are replaced by human touch - feeling a mother's uterus as it contracts and gauging the contractions on a semi-standardized scale while recording the duration. Lots of one on one time with the mothers, lots of leopold maneuvers, lots of going back to the basics. The delivery rooms are fairly modern and their techniques and procedures are not too far from the states. It's been an interesting week so far figuring out how their systems work. I'll have more to add on a later about the medical training system - their interns and Residency selection process are a different from the U.S. but otherwise they're pretty close and the structure is very familiar when working in the hospital.
One of the highlights of the week was attending a speaker panel on the employment of IUDs in the postpartum period sponsored by USAID. A Dr. from Paraguay presented a study he did at the national hospital on the insertion of IUDs in the postpartum period and the current placement rates, complications, training, etc.... then a series of selected speakers commented on the presentation and the presenters as well as the panelists took questions from the audience. among the panelists were a past president of the Peruvian Society of Obstetrics and Gynecology, the Peruvian Minister of Health for Reproduction and Sexual Health, and the president of the Peruvian College of Obstetrics. Great questions, awesome presentation and what a great idea!!! Peru tried a smiliar initiative similar to the study in Paraguay back in the early 90's based on the experience of some success in Mexico. It eventually went away but now it's coming back. Especially, with the issues of family planning, continuity of pre-natal care and lack primary care access the Copper IUD is a great solution. I think one of the most interesting points was the fact that a lot of the time it's the providers not feeling comfortalbe with the IUD as an option that limits it's use - it's a lot easier to prescribe a pill and a shot every 3 months than to take the time to counsel and maintain the proficiency on properly inserting an IUD. I thought this would be a great option for many of the uninsured and immigrant populations in the U.S. that don't have continuity of care. Another interesting project to follow-up on in the future.
Sorry, no pictures on this blog!!! No iPhone :( However, I'm working on getting an inexpensive camera so I can keep sharing the Peru that I am experiencing.
This weekend - Islas Ballestas & General Elections!!! Whoop!
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