IMG 1134

 Edomia Poma Pallcarcajo works in the comedor in the communidad of El Jardines in San Juan De Miraflores to support her family, serving up nutritious, cheap government subsized meals to her neighbors. Since living in El Jardines, Edomia has worked to improve the life of her community through efforts like teaching a weekend class to local kids out of her house and helping her neighbors on home improvement projects. She was also MEDLIFE’s point of contact with the community for the recent stair project we completed there the week of December 18th. What makes Edomia and the community of Jardines even more remarkable is that they were able to organize to connect the community to the municipal water supply system and electric system, an effort which Edomia and her husband, who is general secretary of the group of communities city government, played a critical part in.

I spoke with Edomia to learn more about what her strategies and motivations are for the inspiring work she does.

* This interview has been paraphrased and translated from Spanish *

Tell me about some of the work you have done recently with MEDLIFE and within the community.

We have always wanted to have this project (the staircase) to live better, for ease of movement in our community. We have achieved this dream putting our strength, our part, of all our neighbors, men, women and children together. It is difficult, but nothing is impossible for us. Sometimes, the situation is not so easy in this place, in this part of Peru. We live on a little hill. With all of our strength we have brought water and plumbing to our community. I give this message to other communities who also organize and do their part: Not having money doesn’t mean that you cannot improve, that you cannot have. You need to have strength and make a decision. Go to your neighbors, be an example, speak with them, they too can learn to work together. Unity creates strength. Every step we take brings us closer to our goals.

I also want to say thank you to the young people who have visited us from abroad. They are our brothers, I welcome and thank them from my heart. For me, it is a joy to work together with them and my community, smile and walk down the staircase with ease.

What is are some obstacles you face when trying to get the community together to work together on a project?

In a community, not everyone is collaborative and wants to work together. They are not bad people. There is always someone who is discouraged, who has lost hope. But they are not a bad person. They have not been taught, they don’t have the experience, but they too can learn to think in a new way. Some people wait (to work on community projects) until they have a salary, or until they get a reward, but let me tell you the greatest reward you can receive is the happiness of your neighbors, and to see you impact of your work culminate in your community. One person alone cannot  make a big difference, but together as a community you can. Give your hand to your neighbour, never your back. You will see a changed family, a new family, and this will make you happy. 

IMG 1142MEDLIFE Projects Director Carlos Benavides Discusses a potential project with Edomia.

 Have you ever been discouraged?

When we were working on the water and plumbing project, some people thought that I was receiving a salary for this work, or that I was taking the money for the project and using it for myself. But that wasn’t true, I worked on the project because I wanted it for my community. I felt very sad when one of my neighbors accused my of taking money. I had a dream of a tree that was full of fruit. I was underneath it next to the woman who accused me and it told me, help her, lift her up, so I helped her and lifted her up so she could reach the fruit. What did this tree want to tell me? I meditated and thought about it and decided to take a box and write “help your fellow man” on it and “we want a better life, to have water and plumbing,” and I went to city down below to try and raise money with this woman. We talked with passerby and sang. People gave us change… After some time, she forgave me and supported me on projects.

What was Jardines like when you got here? How did you start working to help others in your community?

When I got here, this place was sand. We didn’t have water or electricity. Our houses were made of wood and plastic bags. I started by giving people advice… I saw their difficulties and gained their trust. I used to always keep medicine in my house, when there (her neighbors) kids were sick, they would knock on my door and ask for a pill. They confided in me.

Later, I would go help them fix their roof, their rooms to make it like a house and help them take out all of the rocks. I would teach them: you can make your house better. I would tell them, I will help you, show me your budget on paper and I will help you make a plan to save money for improvements. Maybe you don’t have money to remove your roof that has collapsed. What about if you take a day and I will come to your house and we can do it together… At first they looked at me “hey neighbor, what’s going on? Why are you helping me take all the rocks out of my house?” But I did it as if it were my own. I showed them and they followed my lead. There are a lot of houses on this little hill that have been improved. 

15722588 302901013439773 1162283020 nEdomia with her kids on a new MEDLIFE Staircase

 What was your motivation to do all of this? Have you always thought this way?

I am from the district of Andamarca, from the province of conception. I left when I was 11. I saw how much need there was there. Many of us had the desire to study, but the economy didn’t help us. I didn’t even have shoes for elementary school, nor a uniform, notebook, my parents couldn’t help me. I saw my families like this. I wanted to be a professional. I wasn’t able to have a professional career.

I left and went to work in a chicken restaurant helping the cook when I was 11, but always with sadness in my heart, always with the desire to go back and help. Maybe even just by giving someone shoes, a notebook, some fruit... A lot of time passed and I never went back, I was just a child, I didn’t know how to get back …

I met my husband at 15, at 18 we went to Lima together and got married. I lived in a rented apartment in Pueblo Libre, then I went to Comas and had my first kid. He is in university now. He is going to finish in one year. I am so happy for him.

Since we were living in a rented room, it was so expensive. We went to visit some family in Pamplona, and they told us “there is an invasion in the hills. There is land up there. You can go.” We went looking for a place to live. At first I couldn’t get used to it because of all the sand. I suffered a lot. But I thought about my family and how am I ever going to be able to help them if I live in a rented room? It is better to stay here. So I spoke with my husband and we stayed. I still wanted to go find my family in the provinces, but I saw that my neighbours here were also from humble places in the provinces like me, and I said, well, it is better that I stay. Because the people here also need my help.

 

December 22, 2016 8:29 am

Mapping Bathroom and Staircase Projects

Written by Jake Kincaid

MEDLIFE has completed over 207 projects in Peru and 74 in Ecuador. Many of these projects are either Stair Cases or Hygiene projects, both of which have been a core component of MEDLIFE’s work from the beginning.

The majority of these projects had GPS coordinates saved for them in an archive. We decided to map them to get a sense of the scope of MEDLIFE’s between 2004 and 2017. Included in the map are the locations of most of the staircases, bathrooms, and a few school projects. Keep in mind, around 100 projects are missing from this map because we don’t have the coordinates. Can you find the project from your Mobile Clinic? Look for the year and month of the clinic.

In the steep hillsides of Villa Maria de Triunfo and San Juan De Miraflores, a simple concrete staircase can change lives. Families living in the area have no access to running water and instead are forced to haul buckets back and forth to their houses from large plastic containers filled daily by passing trucks. This task is not only time consuming but incredibly dangerous as the damp winter climate transforms the roads and pathways into slippery, eroding descents.

Adults and children alike are slowed down by the downward climb on their way to school and work, and fall-related injuries are common and costly. By building stairs, MEDLIFE is able to make the cumbersome daily journey easier, safer, and faster. It also is an important step in securing land titles and access to the public water system.

In 2011, The World Health Organization (WHO) declared diarrhoeal diseases to be the second leading cause of death in low-income countries. The WHO and UNICEF estimate that functional, clean bathrooms can reduce cases of diarrhea by more than 33%; simply being able to wash your hands with soap can reduce cases of diarrhea by more than 40%. Yet, for approximately 2.5 billion people, or 35% of the world's population, there is no functioning bathroom at all. If rural areas do not have functioning facilities, they are slower to be expanded upon and improved.

For MEDLIFE Ecuador, bathroom construction projects are an integral part of the health care work that we do. Projects are typically focused on rural, majority indigenous communities on the outskirts of cities. These areas are geographically isolated from access to reliable potable water and improved sanitation.

On January 7th, the Miami University of Ohio MEDLIFE chapter will arrive in Moshi, Tanzania for a week of Mobile Clinics From an outside perspective, it is easy to focus on the work that will be done in Moshi as the start and end of this chapter’s work, yet when volunteers arrive in Tanzania, the efforts have already started back in the United States.

Miami University, like many MEDLIFE chapters, fundraises throughout the year. Elaine Sidler, Miami University of Ohio MEDLIFE President, says the greatest source of fundraising comes from their Color Run 5k, now in its second year. The event brought in over $4,000 to bring the combined fundraising from other events to $5000.

allisonThe Miami University of Ohio MEDLIFE Excutive board.

According to Sidler, the funds were split between MEDLIFE for projects and the Oxford Free Clinic, a clinic in Oxford, Ohio seeking to provide basic medical care to underserved citizens and ensure they have access to the medications prescribed for their treatment.

A unique approach the Miami chapter has taken in preparing for their trip to Tanzania is the Pads for a Purpose event. Past president of the chapter, Allison Kumnick, came up with the idea after a MEDLIFE trip to Tanzania after observing the lack of access to menstrual hygiene products to women and girls in the area.

Kumnick learned about handmade, reusable pads from students from the Kansas University MEDLIFE chapter who were bringing them over from the United States. The pads are made from cotton stuffing enclosed in a towelling fabric and fabric square. These are cut in the shape of the a pad and sewn together to create the pads.

Kumnick was able to get funds from the Miami University Women’s Center on campus for materials. After reserving a room, they were able to get over 100 women sewing pads.   

allisonAllison Kumnick (left) helped to organize the Pads for a Purpose event at Miami University to create reusable pads to women and girls in Tanzania.

“We reserved a room in our student center and girls from MEDLIFE, sororities, and other clubs came together to sew the pads,” Sidler said. “The atmosphere was amazing; everyone was sitting with friends and talking while they made them and we were playing an awesome “Girl Power” playlist from Spotify.”

In areas with a lack of access to menstrual hygiene products, reusable pads can greatly enhance women’s ability to work, go to school and quality of life. Talking about menstruation is taboo in much of the world, including the United States, but having secure access to the products necessary to deal with it is a step towards greater freedom of choice for women and girls.

Thank you to the Miami University of Ohio’s Chapters contribution to MEDLIFE as well as their support of local health initiatives. We wish them well on their way to Moshi, Tanzania.

         If one only visits Lima’s developed and wealthier districts like Miraflores, San Isidro, Surco, or San Borja, in can be hard to tell that Lima is a city located in the desert and one of the driest capital cities in the world. But if you the continue driving into what are known as “los conos” on the city’s periphery, to the north, east, and south, within a few blocks the view changes dramatically and the realities of the desert are revealed as dusty hills covered in shantytowns stretching as far as the eye can see. In many of the low-income communities that cover the hills known as "pueblos jovenes" or "asentamientos humanos," the resources, community organization and urban planning are not capable of turning the desert green. Far from it, many people don’t even have adequate access to drinkable water. Overcoming significant barriers to access water is one of the most pressing daily hardships faced by the residents of Lima’s perpetually dusty slums.

screen shot 2016 12 14 at 4 03San Isidro, Lima, Peru.

.screen shot 2016 12 14 at 3 59Pamplona Alta in Cono Sur, about 11 kilometers across the city from San Isidro.

      The city has about 91% water coverage and 90% sewage according to the World Bank. However, the reality is that half of the population receives unsafe water and the poorest communities in “los conos,” at least half a million people are dependent on private water vendors that sell the water at up to 12 times the price of a public utility (2).

       To make matters worse, the poorest residents live in communities at the top of the hills that often have no road access or even a staircase to make the climb easier. The water trucks only drive to where there is road access and make infrequent trips to many communities, so residents are forced to walk long distances to get to the water trucks, and then carry the water up to their homes. In Lima, the poor pay the most for water economically and with their time and labor.

        Most of the communities that are not connected to Lima’s public water utility, SEDAPAL, because they do not have the land title to the land they settled on and are thus not legally recognized by the government. This is compounded by a total lack of roads, or by roads that are mere loose dirt paths and not driveable by construction limiting access into the communities.  

        The government has put in place several programs to attempt to improve water access, the most prominent of which was called “Agua Para Todos,” launched in 2007.  Despite a huge investment of public funds, the results have failed to reach vast stretches of the conos. Edomia Poma Pallcarcajo, a community organizer in Los Jardines has worked for years to try and get the government to connect her community to the public water utility with little success.

img 1134Director of MEDPrograms Peru Carlos Benavides and Edomia Poma Pallcarcajo planning a future staircase project in Jardines.

        “We tried to wait for the government to bring us “agua para todos,” but the years passed, and now we are old. Jardines has been here for 24 years. I got here when I was 19, now I am 42.”

In 2015, Jardines asked SEDAPAL how they could access the benefits of the program.  They told the community that in five or ten years, they could get connected.

“Then, I will be in my fifties,” Edomia said. “ I don’t want to still be without water.”

        In 2011 Agua Para Todos was investigated by the Peruvian National Congress and found that the program, along with the public utility SEDAPAL had been badly mismanaged with a cost of around $1.5 billion USD was accused of fraud. Antonio Iorvis, who has written extensively on the commodification of water and in particular Lima’s water system, concluded that Agua Para Todos clearly shows that a large investment of public funds does not guarantee improve water services or water scarcity. (1)

In light the dismal state of the public water service, Edomia and the community of Jardines decided to take matters into their own hands and contracted a private company to build the infrastructure for them.  One year later, Jardines is ready to connect to SEDAPAL. They will have water pumped directly into their homes for half the monthly cost of buying water from water trucks. The downside is that this project cost each household 1500 soles (about $500), a very high price to pay for low-income residents in Lima.

Privatized Water

Internationally, water privatization has been advanced as a solution to government failures to provide water, as seen in Lima. Joanna Robinson sums up the logic in her book about water privatization:

   “Some argue that water privatization was promoted as a lucrative investment for the private sector and a way for governments to allocate resources more efficiently, more recently private sector water delivery has been endorsed and encouraged by the World Bank and other global financial institutions, as a way of correcting the failures of public water management, including increasing environmental conservation, reducing social and economic inequities—particularly in developing countries—and providing clean water to the billions of people who currently lack access worldwide. Since the 1980s, public water systems have been under attack by proponents of market-based models of governance, who argue that “governments are less productive, efficient, and effective than markets.”With the massive governance failure on the part of the public sector, including poor planning, crumbling infrastructure, and pollution and degradation of water systems, private sector involvement in water systems has been hailed as a means of correcting those failures and increasing equity in terms of access to and affordability of water services by poor and marginalized populations.” (2)

In 2000, more than 460 million people had their water supplied by transnational water firms and that number has only continued to grow (2). The results of this effort have been mixed internationally and sparked heated debate, with many critics arguing that privatization is another form of neo-colonialism, and proponents on the other side of the debate arguing that it serves to spread access and increase efficiency.

In Lima, news that the government was considering privatizing SEDAPAL caused large protests that blocked traffic on major roads.  Protesters cited fear of increased tariffs, high buy in costs like those in Jardines and the extremely poor and expensive service for those currently being serviced by private water truck companies as reasons why privatization should be opposed.

Although some communities like Jardines have been able to construct their own water infrastructure, many cannot afford this, and high cost and constant struggle to procure basic necessities like water is a constant burden that holds communities back from moving forward. MEDLIFE recognizes that one of the best ways to empower communities is to alleviate this burden, and so help communities improve water access in whatever way we can.

How MEDLIFE Works to Improve Water Access

If a community can get the government to pay to build them the infrastructure, this is the best solution, but fulfilling the requirements is costly and there is no funding from the government for these sorts of projects. Along with being useful to communities in their own right, many MEDLIFE development projects serve to complete the requirements for both water connection and land titles.

Communities need road access and a safe entrance and exit from communities. This can be very difficult, as these communities were built without any urban planning oversight, and thus are often built on land that would never be chosen by a developer. Retention walls must often first be constructed to stabilize the land for construction and to prevent rockslides. MEDLIFE staircases fulfill the requirement of a safe entrance and exit.  

MEDLIFE is in the process of building a road in one of the communities we have worked in the most, Union De Santa Fe. This road, combined with the many staircases and the retention wall MEDLIFE has built should qualify Union Santa Fe for connection to SEDAPAL.  However Union Santa Fe Community Organizer Casani, who is working with SEDAPAL to organize the connection says that even after a six year development process process of building the staircases and the roads with MEDLIFE to improve infrastructure and help Union Santa Fe meet SEDAPAL requirements, the process will take around three years.

        We know that the families of Union De Santa Fe and countless other communities could not wait that long when they are thirsty today. We built a water pylon like the one in Jardines that connects to the SEDAPAL system down the hill and brings water directly into residents homes in Union de Santa Fe and now they have affordable water in their homes.

 screen shot 2016 12 14 at 3 56A photo of Urucancha taken from above by a drone.

However, sometimes, it is not possible to construct a Pylon to connect to the public utility, as many communities are located far away from connection points to the SEDAPAL system on very poor sites for construction. Meeting requirements would be extremely expensive and time consuming in these places, and then it could take years for the government to get around to doing the project.

In Urucancha, for example, a community in the Southern Cone that is located on the top of the hill that separates La Molina, one of the wealthiest areas, from Pamplona Alta, one of the poorest, a pylon project was not feasible. Yet Urucancha was badly in need of better water access, the water trucks only drove that high on the hill about every two weeks and residents had no way to store enough water to last that long. Recently, the water trucks have decided that the amount of water Urucacha was purchasing wasn’t worth the long trip up the hill, so they didn’t come for 6 weeks, leaving the residents with no option but to make the 40 minute steep hike from the next nearest water stop carrying their water.

Lack of water is Urucancha’s main problem, but storing water in sanitary conditions for long periods was also an issue. The big open barrels of water that can be cheaply purchased by residents to store water often become unsanitary and contaminated with “green fungus,” as reported to us by many residents.

img 1225Urucancha Residents next to the new water tank.

In this case, MEDLIFE constructed a huge tank that could be filled by the water trucks and leave the community with enough water to last between visits.  The tanks are sealed, and thus will keep the water clean from contamination. The trucks will make the trip often enough to keep the tanks filled, because they are now selling in bulk, which also reduces cost. This project brings water to 150 families.

We knew we could reach more people, so we are currently constructing a larger and more ambitious water tank project that will be able to service several communities at once higher on hillsides in Laderas. We are building three water tanks that will be filled by water trucks and then funnel water directly to the homes of 220 families and around 1000 residents. This will be our largest water project yet, and we won’t stop here.

 IMG 1145Water tanks under construction in Laderas

Sources:

1:Barajas, Ismael Aguilar, JuÃŒˆrgen Mahlknecht, Jonathan Kaledin, Marianne KjelleÃŒn, and Abel MejiÃŒa. "5."Water and Cities in Latin America: Challenges for Sustainable Development. Abingdon, Oxon: Routledge, 2015. N. pag. Print. 

2: Robinson, Joanna L. "1." Contested Water: The Struggle against Water Privatization in the United States and Canada. Cambridge, MA: MIT, 2013. N. pag. Print.

 

 

December 12, 2016 8:53 am

UPR-RP Chapter on the rise

Written by Sam Roberson

14523248 1075804579202742 8844398243053405975 nOmar Rene Torres Ferrer es el presidente de la UPRRP MEDLIFE Capítulo. El capítulo ha visto crecimiento de 30 personas a más de 400 miembros.

Como empezaste a trabajar con MEDLIFE? y Porque elegiste MEDLIFE? 

Comencé como miembro de MEDLIFE en el 2013. Solía participar en algunas de las actividades de Servicio Comunitario, pero mi currículo académico no me dejaba mucho tiempo libre para esto. No fue hasta el año pasado, dialogando con la pasada Presidenta, que es una gran amiga, cuando decidí que debía trabajar a tiempo completo con MEDLIFE. MEDLIFE tiene una filosofía que aspiro poder llevar conmigo toda mi vida, pensé que la mejor manera de perpetuarla era impactando al capítulo de forma directa, fue por  eso que decidí trabajar como Presidente de MEDLIFE UPRRP.

Que nuevas estrategias has utilizado como presdiente de su capitulo para llevar apoyo y inspirar estudiantes a trabajar con MEDLIFE?

Creo que el “ejemplo” es la forma más rápida y efectiva de motivar e inspirar. Me gusta estar presente, me gusta participar de nuestras actividades, no tan solo organizarlas. Solamente estando allí puedo entender lo que sucede, lo que hacemos y a quiénes estamos ayudando. Yo me considero un miembro más, pero con más responsabilidades, creo que es la mejor forma de hacer que otro miembro se motive a trabajar con MEDLIFE.

En tu opinión, cual es el mejor éxito de su capitulo? 

Creo que el mejor éxito de nuestro capítulo es nuestra participación en las Clínicas Móviles. El pasado año contamos con la participación de más de 75 voluntarios entre las clínicas de invierno y verano. Para este año contamos con alrededor de 95 participantes solamente en las clínicas de invierno, por lo que esperamos que cada año este número siga creciendo.

Que hicieron para recolectar muchos fondos para Kirua?

Tuvimos varias actividades para recaudar fondos para Kirua. Sin embargo, la actividad en la que más dinero logramos recaudar fue en una llamada “Off with his hair”. Les cuento, yo tenía el cabello largo, así que la directiva y yo pensamos que sería una buena idea establecer una meta de donaciones y si alcanzábamos los $250.00 me cortaría el cabello, raparía la cabeza y lo donaría. Logramos recaudar $645.00, creo que todos querían que me lo cortara. Así que hoy ya no tengo el cabello largo, pero cuento con la satisfacción de haberle dado un giro tan extraordinario con algo tan cotidiano como dejarse crecer el cabello.

Tienes algunos consejos para otra capitulos?

Sí, les diría que nunca debemos rendirnos a lo que aspiramos. Y me refiero a nuestra magnitud como capítulos. A veces pensamos que porque somos unos pocos no podemos generar un   cambio significativo, pero impactar la vida de al menos una persona es suficiente. MEDLIFE UPRRP comenzó siendo un grupo de alrededor 30 personas y hoy somos un capítulo que cuenta con 472 miembros activos. Posiblemente los que estemos trabajando hoy no veamos los frutos de lo que hacemos, pero alguien tuvo que sembrar el árbol del que hoy comemos. ¡No se rindan!

14087256 10155137047859554 1914547911 o

Cual es su mejor recuerdo trabajando con MEDLIFE?

Tengo varios recuerdos. La actividad que más recuerdo es el primer MEDLIFE Spot que realizamos, en donde nos encargamos de adoptar un espacio, que hemos visitado mensualmente, para llevar comida a los más necesitado. Sin embargo, debo decir que lo más que llevaré conmigo será cada una de mis reuniones con la Directiva. Mi trabajo, sin el apoyo de un grupo de trabajo tan extraordinario como con el que cuenta nuestro capítulo, sería en vano. Cada discusión, cada actividad que organizamos, cada conversación, cada reunión y hasta nuestras salidas como Directiva las llevaré siempre. La Directiva de MEDLIFE se ha convertido en mi familia inmediata, con ellos no solo me llevo los mejores recuerdos trabajando con MEDLIFE, sino grandes amigos que sé serán para toda la vida.

Que planes tienes para el futuro de su capitulo?

Esperamos poder impactar a más personas. Queremos que Puerto Rico y el mundo se entere de la buena labor que realizamos, queremos regalarle esperanza a aquellos que ya no la tienen. Por eso seguiremos trabajando arduamente para poder recaudar más fondos, realizar más actividades de Servicio Comunitario y reclutaremos más voluntarios que nos ayuden a llevarle medicina, educación y desarrollo a familias de bajo ingreso en todas partes.

 This interview has been translated to English

How did you start to work with MEDLIFE? Why did you choose MEDLIFE?

I started as a member of MEDLIFE in 2013. I started by participating in some community service activities, but my academic curriculum didn’t leave me a lot of free time. It wasn’t until last year, talking with the last President, who is a very good friend, when I decided that I should work with MEDLIFE fulltime. MEDLIFE has a philosophy that I hope to follow my whole live, I thought the best way to follow it was to make direct impact on my chapter. Because of this, I decided to work as the president of MEDLIFE UPRRP.

What new strategies have you used as President of your Chapter to gather support and inspire students to work with MEDLIFE?

I believe leading by example is the fastest and most effective way to motivate and inspire. I like to be present, to participate in our activities, not just organize them. Just by being there, I am able to understand what happened, what we are doing and who we are helping. I consider myself just another member, just with more responsibilities. I believe this is the best way to work to motivate other members to work with MEDLIFE.

In your opinion, what is your chapter’s greatest achievement?

I think our greatest success is our participation in Mobile Clinics. Last year we had more than 75 volunteers in Summer and Winter Clinics. For this year we have around 95 clinics in Winter Clinics alone, and we are hopeful these numbers will keep growing each year.

14192060 1045659268883940 8307740133507700143 n

What did you do to raise for the Kirua project?

 

We had various activities to collect money for Kirua. Nevertheless, the activity that we made the most money with was called “Off with his hair.” Let me tell you, I had long hair, and the director and I thought it would be a good idea to establish a goal for donations, which we hit at $250,  and I cut my hair, shaved my head and I donated it. We collected $645, I guess everyone wanted me to cut it. Today, I don’t have long hair, but I feel satisfied to have made such a big change with something as everyday as letting hair grow.

Do you have any advice for other chapters?

I would say never quit working towards what we aspire to. We can have a big impact as chapters. Sometimes, we think that because there are only a few of us we cannot generate a significant change, but to impact the life of just one person is sufficient. MEDLIFE UPRRP started as a group of around 30 people, and today we are a chapter comprised of more than 472 active members. It’s Possible, some who worked then didn’t see the fruits of their labor, but somebody had the plant the tree. Never give up!

What is your favourite memory working with MEDLIFE?

I have a lot of memories. The activity that I remember most is the first MEDLIFE Spot that we did, where we choose a place to visit each month that we visited monthly to bring food to those who needed it most. Nevertheless, I should say that what most moved me personally were all of my meetings with the board of directors. My work, without the support of the extraordinary group of people that make up our chapter would be in vain. Each discussion, each activity we organize, each conversation, each meeting and outing together as a board of directors never fails to move me. The board of directors of MEDLIFE has become like a family to me, with them I do not only have the best memories working with MEDLIFE, but great life friends.

What plans do you have for the future of your chapter?

We hope to impact more people. We hope that Puerto Rico and the World will be affected by the good work we are doing, we want to give hope to those who have none. That is why we continue working hard to be able to raise more money for community service and to find more volunteers to help us bring medicine, education and development to low income families everywhere.

December 6, 2016 9:33 am

Intern Journal: Kristine Zimmerman

Written by Kristine Zimmerman

The most important questions we ask are the ones that don’t have easy answers. They are the questions that call into mind our thoughts, ideas, and behaviors. They are the questions that beg for action and for more than passive opinions. The world asks us how we value the importance of a life. Are we willing to hold hand of a man that needs assistance up the stairs and kiss the cheek of a woman in need of a proper home? Are we willing to show the world that there are things we can do to improve the lives of many by not focusing simply on our own?

          Through MEDLIFE I have been given the opportunity to hear the stories of many patients. While on a patient follow up visit with a MEDLIFE nurse, Beatriz, I met Dionicio. He had a neurological disorder that inhibited his speech and mobility. In addition, he also suffered from diabetes and hypertension, which caused him more pain and inconvenience. He was still dependent on his mother. We visited him that day to ensure his identification and insurance paperwork was in order for him to be able to see a physician.

It was quite difficult to get up Dionicio’s house from the road. Because there were no stairs or even steady footholds, I felt like I could have fallen multiple times with just a misplaced step. This presented a minor inconvenience for me, but for Dionicio, it was exponentially more difficult. Imagine living in pain from a treatable disease, unable to get the treatment you need from your local healthcare system. The unavoidable pain increases as you walk, sit, stand, lay down, and you feel restricted from leaving your own house, deterred by the thought of subjecting yourself to more discomfort.

As Beatriz talked with Dionicio and his mother about his current condition, I saw how he winced in pain with each movement of his feet. I listened to his voice break as he spoke of the pain that plagued him with simple movements. Then, while Beatriz shuffled through his patient records, Dionicio began to cry.

To share in that kind of vulnerability with a patient, to comfort them, and to offer help when it seems like they are facing the worst, this is what MEDLIFE aims to do. The MEDLIFE mission is about more than providing health care for people who have limited access to it. MEDLIFE asks the hard questions, gets to real answers that empower people to ignite sustainable change and improve the wellbeing of all who are deprived of it. Being a part of the MEDLIFE movement has challenged me to truly listen to the stories of those living in poverty, and if I can, ask myself what I can do to help. I have stopped thinking; “what is the minimum effort I need to invest to be able to sleep at night,” and instead stay up all night thinking about what more I can do.

Two years ago I came to Lima with MEDLIFE as a volunteer and I experienced what it was like to pour all of my mental, physical, and emotional effort into a movement focused so intently helping people. I saw the results of this effort and then pursued further involvement in the organization as a year-long intern. Already, I can see the positive effect this investment has had on my perspectives, thoughts, and actions. I only hope that I can help MEDLIFE continue to expand, keep asking myself those hard questions, and work for real solutions. 

Voluntourism and medical missions have been heavily criticized both in the media and the academic community, and for a good reason: they often ineffectively funnel valuable resources and time into a trip that ultimately serves the participants instead of the community they set out to help. Simply put, one cannot effectively solve the complex and immense problems in global public health in a country and culture they do not know in a few weeks time. Progress in global public health is made on the timescale of years, not days.

Maya Roberts of Yale University summarizes the problem well in her critique of medical missions and what she calls “Duffle Bag Medicine.”

“I spot a young man, at most 19, smoking a cigarette, and leaning against the makeshift frame that converts the backs of pickups into the primary form of public transportation here in Guatemala. He is not a licensed medical professional; he is an American on vacation and he is about to distribute medication to patients… He has confidently slung a stethoscope around his neck, proclaiming an ability to provide medical care, an assertion that is at best questionable. He is from a small US town; all he needs to do to be part of this transient medical team is to finance his flight to Guatemala. He freely donates his time and energy, but he delivers “care” without the appropriate training, without knowledge of the predominant language, and without any clear accountability… This young man and his group are genuinely proud that they spend their vacation here and are especially proud of their contribution.  I worry that this pride prevents them from acknowledging that their actions may actually be harmful and do not necessarily address the complex needs of this community. Their short-term work is not integrated into a local infrastructure. Health promoters—local men and women trained to recognize serious ailments and to treat minor ones—are not introduced to these groups. Public health and preventive measures are not part of the overarching goals for the transient clinics; this inhibits the project’s long-term potential and puts the community at risk of receiving inappropriate care.”

MEDLIFE has taken the medical mission voluntourism model and fixed it by addressing these important critiques. We have local staff permanently based where we work who keep checking in with patients and build long-term relationships with communities to make sure that the valuable contributions made by volunteers on their trips are properly directed and able to accumulate into a lasting and sustainable change.

26334169914 abd4db06b6 zA volunteer listens to a patients heart murmur under supervision from an Ecuadorian doctor on a Mobile Clinic.

          Sometimes, on a Mobile Clinic, you really can just give a quick treatment and create a profound impact on a patient’s life. When a kid comes in with a bacterial infection or a parasite, pulling some antibiotics out of a duffel bag makes a big difference. However, being able to help that small number of easy patients isn’t good enough when many people who come into our clinics face much more serious and chronic problems.

When someone comes in with serious complications caused by diabetes, malnutrition, high blood pressure, or a tumor, things are more complicated. Sometimes on clinic, we run out of diabetes or high blood pressure medication and our volunteers are initially dismayed. MEDLIFE founder Nick Ellis explains that, in the end, it matters very little if we hand out a month’s supply of a diabetes medication. The impact on their overall prognosis will be negligible and the odds that they get more of the medication if they weren’t already taking it are slim. What really matters is that we found this patient.

27703185930 39248f1b74 zA patient's tumor being examined at a house visit after the patient was found in a Mobile Clinic.

 MEDLIFE works with local health care professionals instead of trying to replace them. Our Mobile Clinics use local doctors, this allows us to provide culturally appropriate care and provides greater opportunities for cultural exchange and for our volunteers to learn about how healthcare is practiced in the developing world.

Our follow-up program utilizes the parts of the existing local healthcare infrastructure whenever possible, so we are working together with local care providers. For example, the Peruvian health care system pays for tuberculosis treatment. The problem is that patients are often unaware that this is available to them and do not know how to access it. This is compounded by the well-known problems with proper adherence to tuberculosis treatment; medication must be taken regularly on a tight schedule or patients risk developing drug resistant TB, which is harder to treat and must be treated with medication that causes more severe undesired side effects. When we encounter a TB patient on a mobile clinic, we have our nurses visit them in their home and walk them through accessing the free treatment option, and often accompany them to their appointments. They continue visiting the patients in their homes to make sure they are following proper protocol.

We build a lasting relationship with communities; bringing clinics back to the same communities year after year to continue to address the root causes and allow our impact on the community’s health to accumulate over time. MED Programs staff was initially concerned when they noticed that the number of women coming in for Pap smears had dropped dramatically in communities we had been visiting for years. However, after speaking with community members, they realized that this was actually an encouraging indicator that our educational approach was working; the women had simply started going in for yearly pap smears on their own after learning about the importance of the screening in our clinics.

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We give our volunteers an opportunity to be a part of our long-term bonds to communities and patients. Volunteers often go back and fundraise for projects and patients that they encountered on their mobile clinics. Sometimes, that chapter is able to be present for the inauguration of a project they fundraised for. When that is not possible, we update them with videos and photos showing them where their hard work went and explaining why we need to fundraise to do a specific project or patient.

Voluntourism is a massive industry worth an estimated $2 billion with 1.6 million volunteers annually and it continues to grow. It is not going away. Despite shortcomings in results, it provides life-changing educational experiences to young students every year, fostering cultural exchange, a sense of global community, and inspiring young students to continue working to solve the problems they are exposed to throughout their careers. MEDLIFE has taken the broken model and fixed it. MEDLIFE Mobile Clinics and our patient follow-up program use a unique approach that ensures that the good intentions and hard work of volunteers produce life changing and sustainable results in the communities we work in, results our volunteers can be proud of. 

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November 30, 2016 4:31 pm

Specialized Care

Written by Jake Kincaid

screen shot 2016 09 26 at 8 08Delia in her apron after one of her first days working at the sandwich cart.

When Delia Martin discovered that she needed surgery for her rare chronic disorder, Caroli Disease, her primary concern was not the physical pain and distress she would have to undergo- she didnt have the privilege of focusing on her personal suffering. She was worried about how she was going to feed her children while undergoing the lengthy recovery, during which she would not be able to hustle through the difficult commutes and long walks required to survive in Lima's informal economy, the primary source of income for those who live in the cities slums.

After meeting Delia in a Mobile Clinic, MEDLIFEâ's nurses visited her in her home and spent enough time with her to understand that her illness was not just a medical issue requiring a medical response. If we wanted to really help Delia, we needed to take things a step further and find a way to empower her to care for her family. After talking with her, we decided that in addition to paying for her surgery, we would give her a food-cart that she could make and sell sandwiches from. She could do it right in front of her house and while sitting down- so it would not interfere with her recovery, and she could continue with this work after she had recovered.

Delia's situation required a special response, and because of donations from our supporters, we had the ability to give it her. MEDLIFE brings this philosophy to all of our follow-up patients, and it is this approach that distinguishes us from a medical mission. We specialize our care and quickly adapt it to meet patients real needs, which we discover by building a personal relationship with them inside and outside of medical facilities over the course of years.

Delia is not the only one, in the MEDLIFE patient archives there are hundreds of stories like hers.

1MEDLIFE Nurse Carmen visiting Maura after an operation.

Maura Morales has been a MEDLIFE patient for almost two years. She was in a tragic accident while working as a moto-taxi driver that left her leg mangled, useless and in need of major reconstructive surgery. Maura's bad fortune continued when after finally getting the surgery using the public health system, Maura became the victim of malpractice and was left with an improperly reconstructed bone and an infection that threatened to take her entire leg.

When MEDLIFE met her, she was in need of another more expensive surgery and had no way to pay for it. She could hardly get to the base of the hill her house was built on to get to a paved road, there was no sidewalk or staircase and the steep dirt path was nearly unnavigable on crutches.

MEDLIFE began following her case closely, and our nurses got to know Maura very well, an inspiring woman with an unbreakable spirit who never stopped smiling and cracking jokes with them no matter how many steel rods were sticking out of her leg or how much pain it was causing her.

In addition to getting Maura on health insurance that would cover her surgeries and paying for what was not covered, MEDLIFE built a staircase in Maura's community. We went with her to every appointment, and even carried her down the staircase when she could no longer walk on crutches after her surgery. Then, we redesigned her bathroom, which was just a hole in the ground, to make it handicap accessible.

Maura is recovering and MEDLIFE nurses continue to visit her regularly.

IMG 7757John before he got his prosthesis.

John Caisaguano was 3 years old when a simple toddlers fall went horribly wrong and caused him to lose his eye. After 10 years and thousands of dollars, it still remained a gaping hole is his face that made him the subject of ridicule in school, caused chronic pain and was at risk for infection.

John needed a prosthetic eye.

Adequate prosthesis of any kind are hard to come by in the impoverished mountain communities of the Ecuadorian Andes. The barriers to access are significant for those families who attempt to seek healthcare up to modern standards in the cities. For subsistence farmers, long trips, expensive travel costs, long waits and a baffling bureaucracy all conspire to prevent even the most determined from getting the treatments they need. That is why ten years after the accident, John was still without a prosthetic eye.

In a matter of months MEDLIFE was able to get him in to see a specialist in Quito to get the proper prosthesis put in.

Untitled 3John with his new prosthesis.

MEDLIFE was referred to Janet by the family of an old MEDLIFE patient who we had helped get a heart surgery to correct a birth defect. The family was contacted by a man in a nearby village whose daughter, Janet, had the same problem, and our old patient's family put them in contact with us. MEDLIFE nurse Maria set out to go find the family. After hours of driving around remote indigenous villages looking for the family, who had no cell phone, she tracked the father down in a market selling produce. He brought us to his daughter who was helping her family work the fields. MEDLIFE was able to get Janet an appointment with specialists in Quito and she will be getting her surgery soon after preparatory procedures are completed.

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MEDLIFE began when Nick Ellis decided he was going to find a way to get Darwin a heart surgery, who was then a young boy with a similar condition living in the same region of Ecuador. Today MEDLIFE is still finding these types of patients. Janet's surgery will be the fifth heart surgery that MEDLIFE has done for children in the Ecuadorian Andes.

This holiday season, MEDLIFE is trying to raise the money that will allow us to keep specializing our care in 2017 for our patients who require a unique effort on our part to help them. MEDLIFE has been able to support many patients this year and we are eager to help many more this holiday season. All funds from our Holiday Campaign will go to specialized care for our patients.

A heart surgery for Janet, prosthetic eye for John and food cart for Dehlia are just a few of our patients cases supported by MEDLIFE's Project Fund. What separates MEDLIFE from other organizations is that 100% of all funds raised during this campaign will go straight to patients, assisting them with medical costs and continuing their healthcare in our sustainable follow-up program. We appreciate all of your support and hope you have a wonderful holiday season! Find out more here!
https://goo.gl/jTr6Nq

November 22, 2016 9:28 am

Intern Journal: Allie Krugman

Written by Allie Krugman

529 allieFor the fourth day in a row, I opened my graduate school application portal only to reread the question - What are your reasons for interest in public health? - and minimized my browser. Although I had chosen to apply for graduate programs in public health before arriving in Peru, I was still not entirely certain this area of study was for me.  For this, I am grateful to MEDLIFE: My experiences working with this organization thus far have reinforced the importance of the public health field and my desire to influence it.

“Falta uno!” (“One more left!”) Announced Beatriz, nearly as out of breath as I was. We had one last flight of stairs to climb until we reached the fourth floor of the Maria Auxiliadora Hospital in Villa Maria del Triunfo, a smaller district on the outskirts of Lima and the third-to-last stop on the city's green line metro.  We were scaling the hospital steps to check in with Maura, one of MEDLIFE's follow-up patients who was recovering from surgery after a mototaxi accident had mangled her right leg.

After some effort, Beatriz and I finally reached Maura's room, a small four-bed space of which she occupied one corner. We had bought her a large bottle of water to replace her empty one, which I placed on her bedside table.  As Beatriz began asking Maura how she was, I watched as light emanated from this woman. Maura inexplicably answered every follow-up question with a smile and a laugh, in spite of her bedridden condition. Beatriz and I joked along with her, as if we had come to visit an old friend. When the time came for Beatriz to take a photo of Maura to document the follow-up visit, she put an arm around me and pulled me in with her.

Beatriz explained to me that Peru's patients suffer from an overburdened, underfunded health care system, similarly to the situation we face in the United States.  A lack of physicians results in brief doctor's appointments and little explanation of a patient's diagnoses or treatment options.

Enter MEDLIFE's nurses: armed with a lot of knowledge and even more compassion, Beatriz, Carmen, Ruth, and Janet fill in the gaps left by the system, providing a vital service to disadvantaged patients. Maura had suffered more than most could ever imagine: following her tragic accident in 2011, she underwent a botched surgery, battled infection, and endured many years of painful recovery. She struggled to obtain insurance that would cover her multiple operations and maintain financial resources as a disabled, single mother unable to work. MEDLIFE was able to pay for the final operation she needed, relieving some of the burden that she faced. Our organization also built a staircase near her home in the rocky hills of Villa Maria to prevent further accidents while recovering. During our patient follow-up visit, I saw the world of difference that MEDLIFE and its nurses made; in spite of her suffering and the poor infrastructure in place to address it, Maura had a source of infallible support. The light within her had not dimmed - the nurses would never have allowed it.

In one of our staff trainings, MEDLIFE's founder Nick Ellis gave a word of advice to those interested in entering the field of public health following the internship: ‘when writing public health policy, write it with the poorest people in mind.' These are the stakeholders that will fall through the cracks; the people that will bear the worst of a faulty healthcare system and unsafe infrastructure. People like Maura, who brighten the day of all who have the chance to meet them, who deserve the utmost support while they wrestle with the multitude hardships associated with poverty. Maura deserves to live in a society in which not only health is prioritized, but access to healthcare as well. She deserves to have not only her physical health in mind, but her wellbeing, protected by healthcare workers such as Beatriz.  When I am hopefully writing and influencing healthcare policy one day, I will do so with Maura in mind.

 

November 15, 2016 2:54 pm

Intern Journal: Brittany Cook

Written by Brittany Cook

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The morning meeting came to an end when I learned about the four follow-up patients Beatriz was scheduled to see for the day. Beatriz is one of the four exceptional nurses that works for MEDLIFE in Lima and I was able to go with her to see how she completes the MEDLIFE mission in her daily work. We set out towards Maria Auxiliadora Hospital in San Juan de Miraflores to help the first patient during a doctor's appointment. As we walked through the metal entrance gate, an energetic young teen ran towards us and hugged Beatriz. It was Gaby (*name changed), a patient of another MEDLIFE nurse who had a dental abscess and an external fistula. Beatriz asked her how she was doing and, after a short chat, said goodbye to continue our journey to meet with our first patient of the day. 

We made our way through the long, white hallway, down the winding staircase, and back into the corner designated for surgical and specialty consultations. The waiting space was buzzing with activity. Every seat was filled and the walkways were like the streets of Lima during rush hour. We took two laps through the waiting area but we could not find the first patient. As if she read our minds, Gaby and her family popped up behind us and Beatriz solicited her help in finding our elusive patient. With only a description of the patient, Gaby returned within five minutes with a location! While she was away, her mother expressed concern to Beatriz that Gaby would not get a much needed consultation because she had misplaced her DNI (National Identity Document-similar to a social security card in the United States).

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After Beatriz had worked with the first patient to figure out the next step in her treatment, she set out to help Gaby. Gaby needs jaw surgery soon so it was imperative that she had a consultation within the week. Without the DNI, the hospital was unable to make the appointment for her but Beatriz found another way. She went to a doctor that she had previously worked with and asked if he had any availability. He had an opening for later that day but he first needed her patient history. Beatriz went to the registrar to obtain the history but she was unable to access it without Gaby's DNI. After zig zagging her way around the hospital and filling out various forms, Beatriz found a way to get Gaby a temporary hospital DNI that expired at the end of the day. She went back to the doctor who was then able to access Gaby's medical history and fill out the paperwork necessary to schedule the appointment, much to Gaby's mother's relief. Gaby had the consultation and is now scheduled for her operation next week!

As I watched this all unfold, I realized two things. First, our nurses are dedicated to their patients and the MEDLIFE mission:

Our mission is to help families achieve greater freedom from the constraints of poverty, empowering them to live healthier lives. Our patients did not choose to be poor, but they have chosen to strive toward a better life; MEDLIFE stands beside them in this pursuit.

Beatriz already had a full schedule for the day but when a patient of another nurse came to her for help, she made the time to get her what she needed. Beatriz stood beside Gaby (when she was not busy running around the hospital) to get her the appointment that would enable Gaby to lead a healthier life.

The second thing I realized is that the MEDLIFE mission would be incredibly difficult to fulfill without the knowledge the nurses bring to the team. The medical system in Peru is difficult to maneuver which is why so many people are wary of seeking medical attention. The nurses are talented at getting our patients government aided health insurance, helping them work within the system during the treatment, and keeping the process moving when roadblocks arise. Without the nurses' abilities to work within the system to keep everything moving smoothly, many patients would not be able to get the care that they need.

The best part is, the nurses are motivated to do this work due to their own dedication and joy. Many of the patients live far away from our office in San Borja but there is no distance Beatriz and the other nurses are not willing to cover to bring the patients the aid they need to live healthier lives. Every day I come to work, I am surrounded by an incredibly selfless and dedicated group of people from different places and backgrounds. We have Beatriz, our nurse from Lima; Renato who lived in Honduras most of his life and studies International Business while working in Administration; Sarah from Britain who studies foreign language and European studies and works in communications; and me and my 10 fellow Volunteer Affairs interns who hail from eight different states in America and have varying educational backgrounds. Seeing first-hand the lengths Beatriz was willing to go to in order to help a patient was a great reminder of how fortunate I am to be a part of the MEDLIFE team during my internship.

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