Published: May 31st 2010May 31st 2010
(Excuse my Spanish, I know it is bad)
The medical centre was actually in Chupaca, not Huancayo as we originally thought. It was a 30 minute ride in a combi-bus, which we caught just outside where we lived.
The bus ride was often cramped, with many people piling on, like it was some sort of clown car. It would take a set route, but would stop anywhere, and a person would hang out the open door yelling at people as they passed, to try and beckon them over to the bus, as if they could break some sort of Guinness world record for getting the most people on. For our particular bus, the person would hang out the door and yell “Chupaca, Chupaca, Chupaaaaaaca” as if the third time was the most important and needed to be emphasised.
The medical centre itself is like a tiny hospital, with about 8 inpatient beds, 6 cots for infants, and provides services for general medicine, obstetrics, emergency, dental, pharmacy, blood collection & analysis, and Xray. Except imagine all these things as if it was 30 years, or more, ago. Like that cop procedural show where he wakes up in the 70s,
except this is a medical drama.
In the lab, there are no machines to do any of the blood counts. It’s all done by the techs and their microscopes. Haemoglobin is approximated by hand using the heamatocrit. Radiology hangs out the films in the courtyard to dry in the morning sun before they can be reported on. I’ve only seen one computer (that works) in the whole place, and it’s in an office that I’ve never seen anyone in.
In obstetrics they use a Pinnard’s stethoscope to measure fetal heart rate, which I remember seeing in a video they showed us in a lecture once, and everyone laughed because it appeared to be such an antiquated tool, and looked awkward and inaccurate. Of course in Australia we use Dopplers and CTGs to monitor fetal heart rate. But here I was, in Chupaca, using one, bent over a pregnant Peruvian woman’s belly trying to count out the fetal heart rate over a minute. The obstetrician had handed me the Pinnard’s and said, “Escucharlo. Tuk tuk tuk tuk tuk.”
They even use it during labour. I witnessed a harrowing ordeal in the Sala de los partos when a woman
was giving birth, and had managed to push the head out after an episiotomy, and as the doctor tried to deliver the shoulders he realised they were stuck, shoulder dystocia. I was merely observing but I was extremely anxious, and I could feel the tension in the room. The mother was fatigued and mumbling, “No tengo fuerza. Ayudame” over and over again. Everybody rushed about the room. One nurse seemed to be in charge of monitoring the baby with the Pinnard’s - it surely would’ve been very difficult to hear the baby’s heart amongst all the commotion. Everybody else was yelling “Puja! Puja! Puja mamacita, puja!”
Without going into it too much, mum and baby were okay in the end, but I will never forget that scene.
However, everyday was not like this. Other days at the clinic have been fun. There are some interesting cases to see. Miscommunication and trouble translating always seems to go awry amongst the four of us. Today, they ran a drill in co-ordination with a local school to practise earthquake protocols. It was interesting to see how efficient they were. And the kids were fine actors!
There are more photos below