Tuesday, June 28, 2011

Reality Sets In

A woman, age 42, dying of Hepatitis. She is too weak to walk on her own and must be taken care of by her 13-year-old son, who dropped out of school. She has no husband, and no treatment or formal diagnoses to the illness that has plagued her for years. She is at a breaking point, not having eaten for a week.  She is so jaundiced because of her failing liver, so much so that her eyes and face are noticeably yellow. This is where we come in: five student nurses. Our job is simple: transfer her to the nearby hospice, so she can become rehydrated and comfortable. There is a simple request from her: that we all would pray with her before we left. We clasped hands and stood together on the dirt floor, in solidarity with her. She began to cry in the midst of her prayer, a common show of Peruvian emotion towards God. With her rosary around her neck, we slowly helped her into the truck and to the hospice.
The Hospice 
As we took her vitals, we quickly realize how dire her situation is. Not only does she have a deadly disease, but she also lacks the care she needs. Even if she had health insurance, she would be taken to a sub par hospital to receive a low amount of care. If she wanted the right drugs or treatment to curb the Hepatitis, she would need to travel to Lima or farther to get them. This is the reality of so many people here in Peru, where people simply die from preventable diseases. Here’s some food for thought: while 20% of the world’s population uses 80% of the world’s resources, the other 80% only uses 20% of the resources. This rings true in Peru not only with general poverty, but with health care as well.
We only hope that if she is to pass away in the next few weeks, that it is in peace at the beautiful hospice. The three hospice nurses and the Marquette team are working to give her hydration, comfort, and tranquility. Her name is Aurelia, and her 43rd birthday is on Thursday. We plan on bringing her flowers, because everyone deserves a celebration.

First Day

I was assigned to accompany Daisy, a staff nurse, on home visits today. Meg, another Marquette student, and I set off in vans on a bumpy ride to a pueblo, or small village. The desert air here is hot and dusty, and it doesn’t get much better when we leave the city and drive twenty minutes into the outskirts. The only road leading into this particular pueblo is a dirt one, and extremely rough. I learned from Daisy that normally, cars will not come here. If villagers need immediate medical care or general supplies for everyday life, they must walk 40 minutes to town. The nearest school is a half hour walk away, and small children make the trek daily.
To say that these people are poor is an understatement. The thatched roofs and dirt floors are common living conditions for most in the area. Having a concrete floor and a roof that lacks holes is a privilege. The first home we visited was just like this, and had an open fire in the back room to cook with. The smoke filled the living quarters (and our eyes) as we walked through the home to meet the owners. We were introduced to our first patients, a husband and wife with no children. The man, Jose, had arthritis so badly that his knees were swollen to the size of baseballs. Our job was to take vital signs on both of them and assist Jose with daily activities, such as cleaning and grooming. As Meg gave him a haircut, I washed his hands and feet and clipped his nails. Jose and his wife were so grateful for our actions, and their smiles expressed this perfectly.
Washing Jose's hands
Our next home visit was with a woman named Rufina, who had knee surgery and has trouble getting around her house. She was overjoyed with the fact we were washing the caked dirt off her feet and clipping her toenails. It is simple actions like this and people like Jose and Rufina that give heart to nursing. Building relationships with clients is a wonderful thing, and is one of many aspects of nursing that I fell in love with. Here in Piura, people are so happy, regardless of socioeconomic status. I am honored to be working with such amazing people, and I can’t help but think their happiness is rubbing off on me.
With Rufina in her home
Our plans for the rest of the day consist of visiting the Piura’s nursing home. We will probably be assisting them with stretching or any other activity that helps them to get moving. Some of the people can’t feed themselves, so we will be helping them with this as well. There’s so much more to come from a fantastic first day!

Monday, June 27, 2011


Today marks the first day of our community health clinical, although we are still touring the area and the sites that we will be working with. The parish we are staying at is the basis and background to all the work we are doing here in Piura. Sacramento Santisimo is a Catholic parish led by Father Joseph Uhem, who graduated from Notre Dame and has been building the programs here for 18 years. The focus in this parish is tending to acute needs in the community and serving the poor in the area. Their main program is called Family to Family, in which one can sponsor a Peruvian family in Piura for $25 per month. These families come from the surrounding villages, which contain houses made of dirt floors and bamboo walls. The houses have no electricity or running water, and many times, the main income into the household is nowhere near enough to sustain life.
For example, in 2010, Marquette University opted to sponsor a family here in Piura in response to the Community Health Nursing Program. This family contains a father, a mother, and their three small children. The father of our Marquette family is a mototaxi driver, a job commonly seen in these types of families. Although mototaxis are a common way of transportation in Peru and the jobs are available, our “father” does not make enough per day to maintain and support his family. Most of his income goes to the mototaxi company, not to him. The Family-to-Family program at Sacramento Santisimo has given this family and families that are similar food packages to help maintain everyday life.
Along with the food packages, the parish provides several programs for the families that tend to basic needs, such as healthcare. There is a clinic within the parish that is very often visited by the community.  The Marquette Nursing students will be working at this clinic many times during our visit here. Some of the other clinical sites we will be working with are the hospice, Vida Nueva: Drug Rehabilitation Center for Men, Vaso De Leche: Group for Women, and many more. I will work to expand on these sites as we visit them.
Marquette Nursing with the Gentlemen of Vida Nueva

As a group, we felt a calling to Vaso de Leche, the group for women.  They spend their time making breakfast for the children in the villages and spreading the knowledge they gain at the parish with their communities. We spent an hour with these women today, and we all felt that this was the aggregate we would want to concentrate on. I am scheduled to do my teaching project with this group of women, and I am ecstatic about it. During our time with them, the women expressed their excitement about us being there and us sharing our knowledge. They called us hermanas, or sisters, and we immediately felt at home.
With the Women of Vaso de Leche

As nursing students, we are always asked to teach in clinical. In fact, one of the main roles of the nurse is to teach, so the patients can advocate for themselves. Here in Vaso de Leche, we were fortunate enough to hear what our clients actually want to learn. I truly feel like we will make a difference with this group of women. We will help to make their group into something so substantial; something that the community can join and grow with.
I am teaching about the importance of nutrition and how food can affect health, such with blood pressure. I will complete this project two weeks from today and I am attempting to give it in Spanish to better relate to my audience. The women also requested information about first aid and infection control, and these topics will be taught by all of us as a group.
Tomorrow is the first day that we will venture out into the community to give care. We will go out from the parish in scrubs at 9 am to our clinical sites, mine being the nearby villages. I am to give home visits to the community tomorrow, and I am so excited to finally begin my role as a public health nurse here in Piura. 

Saturday, June 25, 2011

Introduction to Peruvian Health Care

      We arrived in Piura early this morning to a welcoming crowd from Sacramento Santisimo, the parish compound we are residing at. They were so happy to see the second group of Marquette students. As we drove through the bustling streets of Piura, I felt like I was headed home, especially after a long week of staying in a different bed every night. The hospitality of the staff at the church is fantastic, and we immediately felt comfortable within the compound walls.
            Right away, we were taken on a tour of the public hospital in Piura. The nurse showed us the surgical areas, where they mainly perform basic surgeries, such as laparoscopic ones. If one would need a major surgery, such as one for the heart, they would need to travel to Lima. In the hospital’s emergency room, there are many components that are similar to those in the United States. There are two observation areas, one room for pediatrics and one for adults. Next to these rooms are the triage area and the trauma room, which contains one bed. There was a large supply of medications in this room, all of them labeled in Spanish, which will certainly be a challenge later. In Peru, medications are not as modern as they are in the US. They are still kept in ampules here, which are glass containers that need to be shattered by hand. The drug would then need to be drawn up with a filter needle and then drawn up again with a regular syringe. In the US, there is more access to supplies, so this process has been shortened with most medications.
     In our time here, we will be working with the ER nurses, and the first group of MU student nurses have reported giving shots and placing IVs on their first day. There is complete independence of students here, especially the Peruvian student nurses. I look forward to this exposure in the coming weeks. We begin formal clinical days on Monday, and we are scheduled to visit Vida Nueva, the drug rehabilitation center for men.  For now, we are settling into our new home and beginning new friendships!

Thursday, June 23, 2011

Almost in Heaven

I battled with the right words to begin this blog post, but I realized that words cannot do justice to the experiences of the last 24 hours. I will do my best to explain the day’s activities, but I should let the readers know that my words can never correspond with the feelings or sights I experienced.
 The day began at 5 am with a walk through Aguas Calientes, a small mountain town just outside of Machu Picchu. The air was chilly as we boarded the bus that would take us into history. Being surrounded by the Andes is quite the thrill, especially because the cloudy mist covers the grassy, lush mountaintops. Standing at 5 foot 4, I’m used to feeling relatively small. However, in a place where the surrounding mountains stand at 12,000 ft on average, I felt like an ant staring up at the rest of the universe.
 As the bus tumbled over the gravelly, winding road, the Huayna Picchu Mountain was slowly uncovered, unveiling over 500 years of history. Sprawled out at the base of Machu Picchu and Huayna Picchu mountains is the great Inca civilization that was hidden from the Spaniards and the rest of society until 1911. Due to earthquakes, only 60% of the buildings in Machu Picchu are completely original, but the pure genius of the Incas shines through the architecture. The Incas had great respect for the Sun, and Machu Picchu’s layout is based on this culture. We were lucky enough to be there the day after the Winter Solstice, the biggest celebration in the Peruvian and Incan calendar.
On this day, the Sun shines at certain points within the Incan temples, and this reflects their worship and respect. For example, the Incan sundial still shows the exact geometry of the twelve-month calendar, corresponding flawlessly with the sun's rays. Also incredible, the stones within the Machu Picchu buildings are built in a trapezoid shape to enhance strength and durability. It amazed me that the Incas were able to build ramps to transport these 20-ton stones, let alone carve them into trapezoids. We spent the first hour of our tour gawking at the incredible sunrise over Machu Picchu and learning about this incredible civilization.
As a group, we decided to take on the task of climbing Machu Picchu Mountain. This is a relatively new hike for tourists; most opt to hike the Huayna Picchu Mountain. Knowing that it would be a 3-hour trek, we set off up the mountain. After a few minutes, I knew this would be a significant challenge.  At some points in the hike, I was literally climbing up the slate rocks and struggling to make it to the next flat platform, my heart pounding.  We hiked up 10,000 ft, and there wasn’t a single step that I didn’t think about stopping. By the time I stepped on the summit, I was overcome with a feeling of invincibility. If I could climb this mountain, I can make it through anything. The view was nothing less than worth it. I was left breathless, but not from fatigue. It was the beauty of silence and the freshest air filling my lungs that left me speechless and moved to tears. If I reached my hands up, my fingertips would have touched heaven. I truly believe that completing this adventure can change a person for the better, and I would recommend it to anyone of any age. Just bring sunblock. J
I am now currently in Lima awaiting the plane ride to Piura. We finally will begin our Community Health Clinical, and I am so excited. I am ready to fall in love with the people of Piura all over again, and this time, be able to give them basic health care and education. Stay tuned, this is still the beginning!

Monday, June 20, 2011


The first leg of our Peruvian adventure has begun! We arrived in Cusco early this morning and are currently in awe of this place. Culture is rich here, where women still dress in the traditional mountain garb. Babies are carried on the back, swaddled in wraps painted in the rich Peruvian pattern of colors. It feels like we have travelled back in time to ancient Incan custom. The streets are lined with hectic markets chock full of meats, fruits, and citizens working hard to make a living. For many of us, it is the first time travelling to a poverty stricken country, and it is quite the spectacle. However, the  poverty here is not what catches the eye. It is the unconditional kindness of the Peruvian people, and all five of us have experienced it already in one way or another. Peruvians are never afraid to pass along a smile to a stranger, which can raise the spirit of any weary traveler. They have even been patient with my broken Spanish, which is slowly, but surely getting better.
    My tripmates and I are sojourning in a local hostel, close to Cusco's Plaza De Armas. Tomorrow morning we will scale Machu Picchu, the great world wonder. I am hoping to see a llama tomorrow, and I will certainly post a picture if I should be so lucky! Stay tuned, the adventure has just begun!

Wednesday, June 15, 2011


In three days, five Marquette University Nursing students will begin a much-anticipated journey. We have known about our placement in this Community Health clinical in Piura, Peru since November, and now, it's finally real! Meg, Marianne, Rachael, Maria, and I (Chelsea) will be flying out of the US on Sunday morning to explore Cuzco and Machu Picchu before undertaking our month-long clinical. Here's a snapshot of our schedule:

June 19-20: Travel to Cuzco
June 20-23: Galavant around Machu Picchu
June 24: Fly to Piura 
July 24: Home

   I can't wait to share our adventures here! Our clinical is six days a week and includes working in the hospice, home visits to nearby villages, and work in the local emergency room. On top of all that wonderful nursing work, we all have put together individual teaching projects to present to the various population groups that we will be working with. But, there are more details to come relating to our clinical endeavors. 
   For now, I'm extremely enthralled with the fact that we will be acting as public health nurses in Piura. I travelled to Piura in 2007 with my high school, and upon leaving, I absolutely knew in my heart that I would be returning again. Fate led me to Marquette's College of Nursing and with a little luck, I was accepted into this program and will see Piura again, but this time, as a future nurse. I, along with my tripmates, are so excited to be serving this beautiful community. Stay tuned for more entries and pictures! 

Much Love,