MEDLIFE

Water access is an issue that communities around Lima continue to face. Development in the slums of Lima happens backwards, in that people move in and then utilities like electricity and water are installed, often times taking years to get a steady access.

The best option in Lima for water is connecting to SEDPAL, the city’s water system, however, many of the communities MEDLIFE works with lack the property rights and thus the legal designation as communities and are not eligible for water from SEDPAL. Communities without access to the city water supply, rely on water tank trucks to visit and deliver water.

Without a steady supply, those living on the outskirts of Lima use tanks and barrels to store their water. Sometimes, the containers were used in the past to store non-potable water or chemicals. These containers also run the risk of contamination from bacteria as they are often not adequately sealed and reused without cleaning.

Tanks being used to store water in Ladera de Nueva Esperanza. The center tank was used to ship food additives originally.

People will buy water directly from the truck and fill in water tanks to use throughout the days between visits. Fabiolo Rosales, a resident of Nadine, lives at the top of hill of her community at the base of a wall built to keep settlements from spreading onto private property. When looking over the wall, she sees the wealthier districts of Lima with access to the city water supply and the occasional swimming pool dotting the cityscape.

“We buy our water for 25 soles and we pay much more than people living on the other side,” Rosales said.

Rosales experience is not uncommon. Buying water from the trucks can cost up to 12 times as much as public water utilities. Along with the money, there is the time spent waiting for a water truck to come and the labor of carrying the water back home. The poor truly pay the most for water.

Private water truck navigate the dirt streets of the hills to sell water to resisdents with no acess to public water.

The problem Laderas de Nuevas Esperanza faces is the road that leads to the community, is narrow and dangerous for the large water trucks to drive up, so often they do not. MEDLIFE worked to build a water reservoir for the community to safely store larger quantities of water between the infrequent visits of water trucks. Residents worry though, that during wet winter season, the truck will not be able to make it up the road.

The water reservoir in Laderas de Nueva Esperanza was completed in January 2017.

“The water truck doesn’t come here often. Sometimes we need to wait for two days starting at 5 am, all day long, waiting for the water truck to come,” Maria Salas, a resident and community leader in Laderas de Nuevas Esperanza said.

The next step in Laderas de Nuevas Esperanza is building a road. MEDLIFE aims to bring more stability in access to water in Laderas de Nuevas Esperanza. With a water reservoir more water can be stored safely and for longer periods of time. A road would bring more frequent trips from water trucks as well as greater access to the community for other services.

Last week was the start of MEDLIFE's spring clinic season with 41 volunteers from Queen's and Laurentian Universities of Ontario, Canada. Over the course of 4 days of clinics, the volunteers were able to serve 368 patients around Lima. 

Volunteers visited 4 different communities around Lima.

All 368 patients were able to consult with a doctor. In total, 172 of the patients were children.

290 of the patients recieved medicine after meeting with a doctor.

Gynecologists were able to preform 52 pap smears to screen for cervical cancer.

Dentists and volunteers were able to serve 113 patients throughout the week.

Volunteers worked with children while parents visited the clinic. They taught handwashing and toothbrushing techniques and handed out 253 toothbrushes.

We thank all volunteers who came out to Lima for a week of learning and serving!

When running mobile clinics, MEDLIFE aims to provide people from low income communities with primary health care. Cost is a problem in access to health care, but just as important an issue is actually getting into the hospital.

It’s estimated there is 1 doctor for every 20,000 people living on the outskirts of Lima. The time that patients spend with a doctor is a rare moment to talk with a health professional. To give the best possible care to patients MEDLIFE uses doctors and dentists from Lima to staff mobile clinics.

Analida Palacios works as a physician at Clinica Oncologia y Radioterapia, located in the San Borja district of Lima. Her usual place of work is located in a wealthier district of Lima, where patients can afford to be treated in a private clinic and forgo the long waits for service.

Analida in the San Juan de Miraflores district of Lima.

She first heard of MEDLIFE through a co-worker who was working with the group. After hearing about the concept of the mobile clinics, she decided to join herself to provide basic healthcare and consultation to the people in low income areas of Lima.

“We bring medicine, we bring prevention with pap smears and breast exams,” Palacios said. “I think the population will be more prepared.”

Just sitting down and being able to talk to a doctor can be an invaluable experience for those who have little to no access to healthcare. It is not uncommon for doctors working clinics to meet with patients with health problems ranging from diabetes and breast cancer that have gone untreated for years.

Although, Palacios is not following up with the patient's herself, she is the first contact they have with MEDLIFE and sometimes, any health care at all. In the private clinic where she works across the city, Palacios is able to use ultrasounds and labtests to diagnose and treat patients.  As MEDLIFE is travelling to different communities it is up to the doctors working the clinic to determine if a patient needs further attention, through conversations and basic health checkups.

“You can do the basic stuff, but you can also speak with the patient and the family,” Palacios said.

When travelling to communities, Analida Palacios determines which patients need to go on to seek additional care from hospitals or clinics with MEDLIFE's assistance.

Palacios says she looks for signs that would point to a diagnosis while taking in what the patients tell her about their symptoms and lifestyle. If a patient needs further attention, they are admitted to the follow-up program, where a nurse working full time with MEDLIFE will accompany them to hospital and clinic visits to get the care they need.

“If we don’t come here with this type of medicine, nobody will,” Palacios said.

In the weeks following MEDLIFE’s mobile clinics, nurses are busy traveling door to door to patients homes to follow up with those who need further care after the clinics. This is the second step. After the medical clinic has come to the patients, the nurses will come to patient's home to talk more about treatments.

In the community of San Martin, Carmen, a MEDLIFE nurse, talks to an woman in her sixties through the door of her bodega. She had visited a mobile clinic in her neighborhood and this is her first meeting with a nurse to choose to become part of MEDLIFE’s patient follow-up program. Carmen explains her symptoms could be indicative of breast cancer and she should have a mammogram.

“What do I have to do?”, the woman responds.

It’s a valid question. MEDLIFE aims to break down the barriers to healthcare, the most obvious being the monetary, but long waits, transportation and  A trip to a clinic or hospital can mean a day away from the responsibilities at home or work, a steep cost to those living in poverty.

Carmen tells her a MEDLIFE nurse would accompany her to visits and assist with paperwork. She decides to join the follow up program to get a mammogram.

Those living in the outskirts of Lima can have a long journey without paved roads into the city for an appointment.  

For Luis Oyolo, a trip to the hospital is a family affair. Luis must use a wheelchair due to a fracture in his vertebrae. He typically has at least two family members accompanying him to visits, for loading in and out of taxis and navigating the curbs and bumps of Lima.

Many taxis will choose to not transport Luis due to the burden of loading and unloading the wheelchair. MEDLIFE is able to cover most of the cost of the taxi, but the cost of time used by Luis and family members spending most of their day in a waiting room is still there.

Luis waits anxiously with his father and brother for a consultation in the National Institute of Rehabilitation in the south of Lima. This is the only hospital with a rehabilitation program close to where Luis and his family live. The waiting area is full of patients, young and old, waiting for an appointment as well, most accompanied by family. When Luis is called in, they spring at their chance to talk to a doctor.

“I was first hospitalized in a hospital very close to my home, but unfortunately not all hospitals are the same,” Luis said. “I was in a hospital for 20-30 days, where the doctors did not come, they did not see me, they did not take care of me.”

Finding a hospital with the right care and ease of access for a patient is crucial for a long term solution. Although it is Luis says this hospital is still close to his home, making a physical rehabilitation program one step easier. Throughout his rehabilitation, a MEDLIFE nurse will work with Luis, helping to sort out the various papers and forms.

MEDLIFE can cover almost the entire cost hospital visits and operations, although even with funding, the daunting task of navigating the Peruvian healthcare system can keep those who need care out of hospitals and clinics. One of the most valuable services MEDLIFE nurses give to patients acting as a guide to the healthcare system and accompanying them to check ups and procedures.

Money is not the only barrier to healthcare. To fully address the problem of healthcare access in a sustainable way, local and personal difficulties must also be taken into account.