A crazy and exciting past few days: hospital rounds, anatomy lab, fluoride treatments, and lots and lots of kids to play with!

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Wow! The last few days have been crazy and so much fun! When I left off I was about to attend an anatomy lab at the public university here in Huancayo. Each of us split up to join a group of medical students. Currently they are studying the muscles, arteries and veins and nerves of the face, eye and neck. My group spent time teaching me each nerve, muscle, artery and vein in these areas in Spanish and then quizzed me. I am not sure when the last time was that my brain worked so hard. It was an amazing experience. I was surprised by how clean the lab smelled. It may have something to do with the open windows at the top of the walls in the anatomy lab. Everything here is open air: the hospitals, homes, universities and schools. On Wednesday morning we returned to the hospital and I rounded in Internal Medicine. This is the area where all of the cases that are not surgery, OB/GYN, or pediatrics are admitted. I saw cases of cirrhosis of the liver, alcohol withdrawal, pneumonia, and a possible case of either Addison's disease or lung cancer that has metastasized to the kidney. After rounds we traveled to Conches Chicas, a smaller village outside of Huancayo to give fluoride treatments to the children at the the school there as well as a skit about dental care. The majority of the children were missing several teeth due to decay. Many had very visible cavities and in some cases just the remaining outer circle of a tooth with a completely decayed middle. Although there is free dental care provided by dental students here many people either live too far away or do not care or understand the importance of dental care. The children were very welcoming and grateful for us to be there and more than willing to participate in the fluoride treatment. Although they did not have the best teeth they had some of the most beautiful smiles I have ever been privileged to see. After the treatment we went to the first, second third and fourth grade classes to do a quiz on dental care and also to hand out toothbrushes. In each class the children gave us beautiful and intricately carved gourds that they had made. They are called Mates made from several different types of gourds. It is the village craft and each of the students learns how to make them at an early age. they are beautiful with detailed carvings that are then colored by blowing the smoke of a smoking piece of wood on the gourd in certain ways. Each different technique produces a different color. In the afternoon we went to Rosario which is an orphanage in Huancayo, to teach English. This orphanage is set up in a different way with six to eight children living in one smaller home with a Tia, which is like a house mom. There are eight houses total in the orphanage. It give the children a little bit more of a home feeling. They were wonderful children. My group worked with six boys between the ages of 7 and 13. they were very excited to have s there and enthusiastic about learning English. That night we had Peruvian Chinese food which is nothing like American Chinese food, but still very good.
On Thursday I rounded in both surgery and pediatrics. The pediatrics unit is overwhelmed right now with cases or children with diarrhea and vomiting. The doctor thinks there may be a virus going around. Thursday also marked the announcement of the first case of swine flu in Peru which was in Huancayo. People in Peru are very concerned about swine flu because they really do not have the ability or resources to deal with it well. After rounds I sat in on several consultations with the Rhumatologist. He is very kind and more than willing to explain each case to us. He has us sit in and watch his examinations and if he finds something interesting will have us feel it for warmth or nodules or excess fluid. Yesterday an older man came in with gout. We were able to view the uric acid crystals under the microscope. We also went to a consultation in internal medicine to view the x-ray of the patient with either or Addison's or lung cancer. The x-ray is unclear in diagnosing the patient and a biopsy has not been taken due to lack of the tools to take the biopsy. This is the stuff that really shows the difference between an American hospital, a Peruvian hospital that serves patients with insurance, and a Peruvian hospital that serves patients with out insurance. There is one oncologist at Carrion which is the hospital that serves patients without insurance. He is there for consultation but if a patient needs chemotherapy or any surgery besides intestinal surgery or a c-section.
In the afternoon we went to Es Salude which is the insurance hospital in Huancayo. It is cleaner, more open, and has a lot more space for patients than Carrion. Inpatient rooms house only two people not all of the patients in the unit, and there are volunteers all over the place ready to serve you. We spent time coloring, dancing, and playing with all of the the patients in the psychiatric ward. They were wonderful talented people. They all seem to be able to draw very well, dance well and they all sing. It was a fun visit. We will be going back to there every Thursday afternoon.
this morning we were at the hospital again and I was in internal medicine for rounds. Only one new case of a man with diabetes. After rounds we went to a classroom and learned how to take vital signs and what each of them meant. Alex, one of the fellows in the program from USC, leaves today for Cuzco and Machu Pichu. Tomorrow we will be going to Es Salude to spread the word and hand out fliers about a blood drive. Many people in Peru are afraid to donate blood due to myths about having a limited supply of blood during your life or that it will be very painful and so there is an extreme shortage of blood for the hospitals to use. Tomorrow night we will go to a music festival here. On Sunday we are driving to Huaytapallana to hike. It is snowy mountain at 15,000 ft above sea level (3,000 ft higher than Huancayo). We will be taking a five hour hike up the mountain. I am very excited to see the wonderful views this trip will provide me. Don't worry I will take lots of pictures!!
Everything is going well!! I am truly loving my experience here in Huancayo and learning so much along the way. The food is good and the scenery is great. I miss you all lots.
Caitlin

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