Written by John W Wang, M.D.
Peru and its Challenges

I came to Peru for the second time with a team of 16 (students, professors and other volunteers), from the University of Massachusetts, Lowell, primarily to spearhead a medical initiative in Ancash Province, some 300 miles north of Lima.

Up to 2 years ago, Peru was just a country in South America in my conscious thought. I knew nothing more about it, save for the fact that llamas flourished there.

If Lima is a bustling city with 10 million inhabitants, many with cell phones, riding in cars, taxis and buses, enjoying the amenities of a modern city, these villagers in Ancash subsist on 2 soles per day, mainly on agricultural products eked out off the rough and unforgiving terrain.

These people have no running water, no electricity, no heat, and no indoor bathrooms or lavatories. They live in abject squalor and poverty, among mounds of refuse, sewage and animal dung. Their children are stunted, anemic and are malnourished, despite food aid and humanitarian efforts from the World Bank, UNICEF, WHO, many NGOs (non-governmental organizations), and religious organizations. They sleep huddled in adobe huts with just one room, with a smoky indoor wood fire to try to warm themselves. (This winter, because of an unusually cold snap, schools are starting later in an attempt to protect young children from exposure to the cold).

The medical clinics are largely bare structures with little medical equipment, staffed by nurses and health technicians. Doctors do visit but a few times each year, and then only for a few hours.
None of the clinics I visited had any microscopes or any facility for making any examination of blood, sputum or stools. The nurses see their patients, listen to their complaints, do a cursory examination, and prescribe medications, based on their best judgment.

Many of the children go on to die, and indeed, according to statistics, a good percentage of all deaths in Peru are of children under the age of 10 years. During my last trip to Ancash Province, a mother tearfully recounted having 6 children, 3 of whom are dead, and the other 3 struggling with illnesses that no one seems to be able to diagnose or cure.

In my report to the professor, I suggested that among the many priorities, one of the most urgent, and perhaps the most effective, is to make accurate diagnoses so that effective treatment can be instituted. Millions of dollars have been spent on food and medicines for these people, but the means to make accurate diagnoses are still sadly lacking.

Microscopes are indispensable. Without them, we have no eyes to see small microorganisms and parasites.

It is easy to see that worm infestation is a big problem among the people, certainly among the children. Worm infestations are not just a nuisance, they weaken the natural resistance to disease. It is easier for children to succumb to pneumonia, tuberculosis, malaria, leishmaniasis, Bartenellosis, stahphylococcus, streptococcus and salmonella and a whole host of other infections that healthy people can resist.

And so children and older people die, like so many trees falling in the jungle, unheard, and unseen.

An effort has been made to collect microscopes from many sources in the United States to give to the Peruvian people. A pilot project is being launched in Ancash Province. (Ancash Province is one of the poorest regions in all of Peru). This project is slated to run over 3 years, and success will be measured in terms of improving mortality statistics, of infant mortality rates, neonatal mortality rates, weight records and scholastic achievement in school among primary and grade school children.

Positive response from senior officials

In my initial visits with senior officials in the Ministerio de Salud, the US Embassy and the US Peace Corps in Lima, I have been greatly encouraged by the overwhelmingly positive response to this initiative. People at the grassroots level are also excited when they think of the possibilities, and are eager to participate in any way they can. I have had occasion to speak at the Rotary Club International in Lima recently, and the response there was electric. Good people everywhere are rallying to the challenge.

Can we deliver?

Many people have come and gone. Good intentions are not good enough. There has to be sustained effort. Days of blood, sweat and tears await us. We need to earn the trust of the people. We must be willing to live among the people, not just for a mere few weeks, but for months, and years. We must build a team of likeminded people, willing to serve without tangible personal reward. We must expect to take casualties, even deaths, among team members. If the Peruvian people see that our interest and our commitment is more than skin deep, they will rally to us and join us in this difficult struggle.

Many people have invested heavily in this project. Each of the microscopes we have collected costs around $1000.00 US (3150 new soles), and we have 44 of them, to date. We hope to collect more, so that every clinic and every high school has at least one. People have donated funds sacrificially, and we have to be accountable. They expect and deserve to see results. The microscopes have to be used with care, and we need to see that they are not damaged, stolen or destroyed. Health personnel have to be carefully trained to make full use of these diagnostic tools.