July 22, 2011 3:04 pm

What Is a ‘Healthcare Desert'?

Written by Lindsay Bigda


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!


The interns get their hands dirty!


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


The community leader levels the stairs.


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:


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!

Whenever a MEDLIFE Mobile Clinic encounters a patient with a medical problem we can't immediately address at the Clinic, we record their contact information so that our local staff can get in touch the following week. From there, MEDLIFE will do whatever it takes to help the patient receive adequate medical treatment. We have no restrictions on the types of follow-up work we engage in, meaning that we are able to assist individuals and families with any and all medical problems they face.

Our team of interns in Lima recently had the opportunity to visit one of our follow-up patients to talk about her experiences since we first encountered her on a Mobile Clinic. Here's her story, as written by summer intern Minnie Dasgupta:

8-1Meet Elka – a 23 year old woman living in a small green house in the rocky hills of Pamplona Alta, miles outside of Lima's metropolitan center. She shares her two-room home with her grandmother, grandfather, mother, and two young children. As is often the case in communities such as Pamplona Alta, Elka's family has not received a great deal of support from the father of her children.

For three long years after the birth of her first child, she ignored a number of vaginal symptoms and convinced herself that nothing was wrong. But when she heard about the chance to receive a free Pap smear, she took action and visited a MEDLIFE Mobile Clinic in September 2010. (though the local Ministry of Health medical posts also provide a limited number of Pap smears, Elka did not have the government-sponsored insurance plan at this time).

MEDLIFE has been working in Pamplona Alta since March 2010.  The majority of Mobile Clinics and MEDLIFE Fund projects in Peru serve the communities of Pamplona Alta.  Zenobia Gonsalves, our media intern in Lima, captured the shots below.
Located in the hills surrounding Lima, Pamplona Alta is a shantytown or Pueblo Joven characterized by conditions of extreme poverty and a lack of infrastructural development.  Now housing more than 20,000 residents, it was first populated in the 1990's when massive numbers of Peruvians immigrated to Lima from the rural countryside -- either displaced by the Shining Path terrorism that marked this decade, or looking for better opportunity in Peru's capital city.
Dirt paths crisscross the valley walls, reaching the families who reside at the top -- a long climb from the main avenue below.  Can you spot the 3 MEDLIFE staircases?
Prior to this flood of immigration, Pamplona Alta was occupied by other residents -- pigs.  Pig farming remains to be one of the primary industries of the region.  Currently the small ranches, or chancherias, occupy the most expensive real estate on the valley floor, while the human population resides higher on the valley walls, with entire communities resting on steep, rocky slopes.  Typically owned by Peruvians living outside of Pamplona Alta, the chancherias contribute both an unpleasant odor and large amounts of waste to the valley.  Above, a pig rests in his shelter.
The pig pens of the chancherias mix with the housing for local families.
Though they may more closely resemble tool sheds than houses, entire families (and in some houses, multiple families) reside in these small shacks.  As evidence above, most houses rest on makeshift walls of loose rock -- or worse, discarded car tires.  The potential earthquake damage instills great fear among residents, and as such the Peruvian government is attempting to add retention walls to Pamplona Alta's steepest slopes.
Water and sewage lines haven't yet reached the vast majority of the valley's communities.  Water trucks, run by private companies, deliver water on a daily basis.  This system is marked both by its high expense (water costs 10 times as much as it does in areas where lines exist), and the possibility of contamination, both from the trucks themselves and the dirty containers in which it is stored.  Families who don't live by the roads accessed by the water trucks must haul water to their home, bucket by bucket.
The lack of sewage lines means that residents use outhouses -- holes in the ground that sometimes are left unsealed.  The seepage of this sewage into the ground leads to high rates of parasitic infections, particularly among children who often spend their free time playing in the dirt.
A rooster surveys the valley floor.  Many families raise hens to supplement their diet, or sell at market.
The community of Minas 2000 received MEDLIFE's first-ever stair project.  Why? When six months pregnant, the woman residing on the green house on the left fell on the rocky slope outside of her home, prompting an extremely premature birth.  MEDLIFE has sought proper treatment for the child, who is now a healthy 2 year old, but wanted to do more to prevent future accidents.  The first project was greeted by strong enthusiasm by Minas 2000 and neighboring communities, and MEDLIFE hasn't stopped building stairs since!
A recently completed staircase sports a MEDVIDA logo.
A private (though free to attend) high school sits in stark contrast to the painted houses below it.  The school was built and is partly run by a Catholic aid organization, but currently half of the classrooms remain empty because the government is unable to supply a full teaching staff.
A government-sponsored nursery adds color to the hillside.
The valley floor of Pamplona Altra stretches towards the more developed center of Lima.  Government services and infrastructural projects such as paved roads, retention walls, water and sewage lines, and electrical grids are slowly creeping into the valley.  Hopefully, the families of Pamplona Alta will soon be receiving the services and structural development that their neighboring city-dwellers enjoy.
All photos Zenobia Gonsalves.  Text by Tommy Flint.

MEDLIFE has been working in Pamplona Alta since March 2010.  The majority of Mobile Clinics and MEDLIFE Fund projects in Peru serve the communities of Pamplona Alta.  Zenobia Gonsalves, our media intern in Lima, captured the shots below.


Located in the hills surrounding Lima, Pamplona Alta is a shantytown, or pueblo joven, characterized by conditions of extreme poverty and a lack of infrastructural development.  Now housing more than 20,000 residents, it was first populated in the 1990's when massive numbers of Peruvians immigrated to Lima from the rural countryside -- either displaced by the Shining Path terrorism that marked this decade, or looking for better opportunity in Peru's capital city.


Dirt paths crisscross the valley walls, reaching the families who reside at the top -- a long climb from the main avenue below.  Can you spot the three MEDLIFE staircases?



Meeting with community members of Buena Vista to coordinate an upcoming community development project, of course! Here's why:

5-1Running a successful MEDLIFE Mobile Clinic takes more work than just showing up to a community with a bus full of doctors, medicine, and excited student volunteers -- you have to make sure that the locals know you're coming! Just ask Carlos Benavides, MEDLIFE's Director of MEDLIFE Fund projects in Peru, and our all-around community contact for projects and Clinics in Lima.

Embracing MEDLIFE's mantra of "Listening to the Poor", Carlos seeks to involve local families and individuals in every community development projects MEDLIFE engages in (Carlos dedication to our communities and patients is legendary -- he has been known to stay in Pamplona until 1am speaking with community leaders, only to show up at 6am to a local hospital the following day to accompany a patient through a medical exam).

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