August 5, 2011 3:32 pm

Dealing with Tropical Disease in Panama

Written by Lisa Berdie

During the MEDLIFE Mobile Clinic in Panama this summer, student volunteers were shocked by the large number of patients who came in with ulcers on their skin. The doctor who worked with us on the clinic explained that these were symptoms of Leishmaniasis -- a disease which is rampant in the jungle and mountainous areas of Panama.

Leishmaniasis is transmitted through the phlebotomine sandfly, which thrives in the intertropical regions of the world and threatens the 350 million people living in these areas. There are an estimated 12 million current cases of leishmaniasis worldwide, with another 1.5 to 2 million people infected annually. Around 88,000 people die each year from the disease.

20-1There are three different types of leishmaniasis -- cutaneous, mucocutaneous, and visceral -- which each cause different symptoms. Cutaneous leishmaniasis is the most common and least dangerous form of the disease. Generally, several weeks after the initial bite by the sandfly the patient develops lesions on the skin. Though not generally painful, the lesions -- which look like ulcers -- can occur all over the body and can cause up to 200 sores at a given time. Though the lesions can heal on their own, they cause scarring, which can leave people disfigured and stigmatized.

Patients with mucocutaneous leishmaniasis develop lesions similar to those with cutaneous leishmaniasis, but the lesions occur in the mucous membranes rather than on the skin of the patient. These lesions generally occur between 1-3 months after the initial infection; however, there have been cases where it has been decades after the initial bite that the patient shows symptoms.

Check out our photo update from this week's mobile clinic in Lima, Peru! We're half way through the week, and looking forward to seeing more patients in different communities tomorrow and Friday:

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July 27, 2011 11:49 pm

Parent Education in Peru

Written by Oana Butnareanu

18-1On a cold and misty Thursday afternoon, after an exhausting day of stair-building during our engineering brigade, I headed down the muddy slopes of Pamplona Alta alongside a few other MEDLIFE staff members towards a surprisingly clean green building, just a few minutes from our work site. 

This was one of the nearly half-dozen Wawa Wasi centers in Pamplona Alta – low cost daycare programs where children under four years of age from low-income families can spend the day while their mothers are studying or working outside the home. Wawa wasi is a Quechua phrase meaning "home for infants." The program was founded in 1993 as a collaborative effort between the Peruvian government and UNICEF to alleviate the dire needs of the increasing number of families living in poverty. For a nominal cost, children are provided with two full meals a day and are instructed in a number of subjects such as basic hygiene and early education.

18-2We were visiting this particular Wawa Wasi in the community of Mirador Dos to give a presentation to local mothers on basic hygiene and prevention of parasites. Stomach and intestinal parasites are rampant in Pamplona Alta due to exposure to contaminated water, food, and even the dirt in which children frequently play. Although we had expected to have somewhat of a larger audience, we were pleased with the ten or so parents who turned up. I began by asking the mothers how many of their kids had ever had diarrhea (although children worldwide frequently get diarrhea, it is a common cause of death in developing countries). Seeing an overwhelming number of hands go up, I clarified some of the common causes of diarrhea in developing countries, such as ingesting contaminated food and water. We then covered several essential points concerning hygiene, such as hand-washing and how to prevent transmission of contagious diseases.

July 22, 2011 3:04 pm

What Is a ‘Healthcare Desert'?

Written by Lindsay Bigda

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This week, the Save the Children Federation (SCF) – an international organization that enforces children's rights in developing countries – released a report on so-called ‘healthcare deserts.' The term is akin to others used in the development world to describe areas devoid of resources (e.g ‘food desert'); SCF defines a ‘healthcare desert' as an area where a child “has not received any of the six routine immunizations, including diphtheria, whooping cough and tetanus, or received medical treatment or advice for diarrhea.”  

According to the report, at least 40 million children live in such healthcare deserts, lacking access to health care workers and medications for easily preventable (but often fatal) diseases such as diarrhea, pneumonia and malaria. SCF's study focused on 25 countries throughout Asia and Africa, naming India as the country with the most children in need. Yet, curiously, India's economy has grown in recent years. What's more, the child mortality rate has decreased globally. We look, on paper, like we are generally on target to meet the Millennium Development Goal of reducing -- by two thirds -- the under-five mortality rate.

Cervical cancer is the most frequent cancer contracted by women in Peru. It is the number two cancer killer of women in Ecuador; in the USA, it doesn't even crack the top 10. Women in Peru and Ecuador are 3-4 times more likely to be diagnosed with cervical cancer than women in the USA. The likelihood of mortality exacerbates the problem: the mortality rate for women in Ecuador and Peru is 5 times higher than for women in the USA.

The statistics explain enough: cervical cancer is a big problem in Peru and Ecuador. What is MEDLIFE doing to stem this epidemic?

Offering free pap smear exams
. The Pap smear is a screening test that detects warning signs of cervical cancer and pre-cancerous changes in the cervix. It is used extensively worldwide, and is generally recommended that women ages 18 and up receive an annual test. MEDLIFE hires a gynecologist or nurse-obstetrician to conduct pap smears during our Mobile Clinics. The exam is performed on site in a private gynecology tent, and the samples are analyzed at a local laboratory the following week. Individual results are then delivered to our patients by MEDLIFE patient follow-up coordinators.

Reaching women in need
. Hiring a gynecologist is easy -- getting local women to show up and take the test is the real challenge! There are many financial, educational, and cultural obstacles which prevent or discourage women in Ecuador and Peru from receiving regular Pap smear exams. MEDLIFE removes many of these barriers by physically bringing the Mobile Clinic directly into communities and need, and be offering the exam free of charge. On all Mobile Clinics, MEDLIFE conducts an educational program aimed at explaining the how the exam is conducted and enlightening women as to its importance. In the past two years, MEDLIFE has provided Pap smear exams to approximately 2000 women in Peru and Ecuador.

This summer MEDLIFE conducted it's third-ever Mobile Clinic in Panama. It was the first time that the Mobile Clinic had visited the rural interior of the country, and also the first time that we had completed a community development project there. MEDLIFE's two summer interns in Panama, Lisa Berdie and Miriam Marshall, assumed a great deal of responsibility in coordinating the logistics of the Mobile Clinic and development project. They share the details of the project below:

13-1Two weeks ago, 32 student volunteers, accompanied by local medical professionals, conducted a MEDLIFE Mobile Clinic in Penonomé, Panama. It was a great way to start developing meaningful relationships in a new part of the country as we extended our services to four different communities. The first three days of the Clinic were held in the same location and people walked for up to three hours to come see our doctors. It was truly amazing to witness the lifestyle of people who live in such a remote place!

The opportunity to work alongside community members on the development project was one of the most rewarding parts of the experience. We worked together to construct a bathroom next to a building that functions as a central meeting place for organizations in the community. Primarily, a group called the Madres Maestras (Mother Teachers) meets in this building. The group has day care centers throughout Panama and is especially active in the province of Coclé (where the Mobile Clinic took place). The organization provides support for families and believes that early education is essential in childhood development; the Madres encourage every parent to be a teacher for their child.

July 14, 2011 10:27 am

Meet the Interns: Meredith

Written by Tommy Flint

Meredith McKay is MEDLIFE's Media Intern in Ecuador. She has spent nearly 6 weeks in Riobamba so far and has a lot of great material from two Mobile Clinics. Currently, Meredith is in Lima, Peru, capturing footage from our stair construction project for a MEDLIFE Engineering Brigade video. Find out more about Meredith's work in her interview:

12-1Where are you from?

I grew up in the suburbs of Atlanta and now attend the University of Georgia in Athens, GA. I study International Affairs and Mass Media Arts with a focus in filmmaking.

How did you hear about MEDLIFE?

A couple of me good friends started the UGA MEDLIFE Chapter this past year. After hearing about the amazing time that UGA students had on their first Mobile Clinic in Lima, Peru, I knew I had to get involved somehow. The Media Internship has provided me with an invaluable experience to work with MEDLIFE and appreciate Latin culture.

What's your focus this summer?

In the media field, I'm primarily focused on filmmaking. We're creating new promotional videos to show how awesome the Mobile Clinics are, as well as videos on the other aspects of MEDLIFE's operation that many students are unaware of, such as patient follow-up care. I'm particularly excited about a nutrition education video that JP, Rachel, and I are working on -- it will teach better dietary and nutritional practices to the families of Cebadas, Ecuador, where malnutrition is rampant.

What's the biggest difference between Athens, Georgia and Riobamba, Ecuador?

The biggest difference between the two cities is definitely the food! In Riobamba you can get fresh fruit juices and ceviche, but I still miss barbecue and cobbler!

Thanks, Meredith! We're looking forward to seeing the Engineering Brigades and Mobile Clinics videos soon!

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The interns get their hands dirty!

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Cassidy, a visiting student from Iowa State, receives a construction lesson from a community member.

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The community leader levels the stairs.


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The MEDLIFE team works together to pour cement.

July 11, 2011 10:01 am

Addressing Malnutrition in Rural Ecuador

Written by JP Gorham

Our summer interns in Ecuador have been working to reduce malnutrition in Andean communities. JP Gorham, Dartmouth '11, can fill you in on what they've accomplished so far:

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After returning from my first MEDLIFE Mobile Clinic in Cebadas, Ecuador three years ago, I was restless. MEDLIFE's commitment to sustainable health had inspired me, but I couldn't help but think that we could be doing more. I wanted to help the communities on the ground, but as a student, what could I do?

Before our internship in Riobamba began, Rachel and I spent time researching the problem of malnutrition in Ecuador. We found that in spite of a huge monetary commitment, the government's preventative approach to eradicating child malnutrition had largely failed to improve the situation. In a 2004 survey, 23% of Ecuadorian children under the age of 5 are chronically malnourished. This number jumps to 40% in the Andean region, where we're living this summer. We wanted to help in the Ecuadorian governments efforts to bring those numbers down.

 

July 7, 2011 4:24 pm

Meet the Interns: Oana

Written by Tommy Flint

Oana Butnareanu is serving as a MEDLIFE summer intern in Lima, Peru. How did she end up in Latin America?  She puts it in her own words:

9-1Where are you from?

I was born in Romania and I grew up in Hollywood, California, but I'm totally Latin American at heart.  I just wrapped up my junior year at Stanford, where I am double majoring in Biology and Iberian and Latin American Cultures.


Why did you decide to be a MEDLIFE intern?

I love Spanish, people, medicine and adventure! I have always wanted to work with underprivileged communities in Latin America, especially in a medical setting, and this seemed like the perfect place to start.

What was your first impression of Lima?

I dubbed Lima “the city of contrasts.” It's absolutely astonishing that places of extreme poverty like Pamplona Alta and areas of relative wealth (by Peruvian standards) like Miraflores and Jockey Plaza can exist within a few kilometers of one another. The people are also pretty amazing; they're some of the most warm and welcoming inpiduals I have ever met!

What do you look forward to most this summer?

Peruvian telenovelas (soap operas)! Also trying the amazing local cuisine and hanging out with all the Peruvian staff here in the office – they're awesome!

Oana's fluency in Spanish has come in handy so far – she has served as the group's translator on a number of occasions. We look forward to having Oana assist with a number of educational initiatives MEDLIFE is launching this summer. Check back here to see the results of her work!

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