Thank you for your interest in Stony Brook’s medical mission to the Sacred Valley  region in Peru. (download pdf)

This is a project that is constantly evolving, improving, and also struggling as we face challenges in helping improve the lives of people who live in medically underserved areas in the Sacred Valley and the Andes Mountain.

The project was started by Case Western Reserve University Medical School and the Cleveland Clinic in Ohio. Stony Brook Medical School in New York then became involved with the project and this will be their fourth year participating medical mission and the second year providing cataract surgery to the severely visually impaired. The project focuses on the hopes to collaborate with healthcare professionals in Peru to improve the lives of people living in the town of Lamay and the surrounding mountain villages. Furthermore, through screening patients for advanced cataracts and providing cataract surgery free of charge, the project continues to build and advance towards sustainable care.

Since its inception, this project has been made possible by hours of work and dedication by students, physicians, families and friends who have found a common goal of reaching out to those in need and also learning from them the challenges and the joy of providing care to a medically underserved populations.

We are truly grateful and humbled by the kindness and warmth we have received from the Peruvian communities both in Peru and in the U.S., and the friendships we have formed over the years.

Our hope is that you can bring your unique talents, skills, and passion to making this project even more fruitful and that you will gain invaluable experience through this effort.

Dates of the next trip:
July 1-12,  2013 / Deadline for participation decision February 25, 2013

Affiliated  NGOs: Peruvian Hearts, Peruvian Medical Society
Student contact 

Trip advisors: Debra Messina MD, John Shanley MD,  Natalie DiGioia MD Travis Kumph, Michael Cipoletti

 

A Promise To Peru

 

About the Project

What do we do?
A Promise to Peru has established an annual mission to the Sacred Valley of Peru and Cusco in an effort to provide the people in this area with health care and address public health issues. The mission takes place for two weeks in July with the dedication and efforts of volunteer physicians, nurse practitioners, nurses, allied health professionals from the tri state area and medical students from Stony Brook University School of Medicine. It is a student-­‐initiated project and we receive our funds primarily through the fundraising events we host. Each year, over 1000 patients are provided with basic medical care and education.

Since this past summer, an exciting addition has been made to the basic medical mission. Under the leadership and guidance of Dr. Debra Messina, we have incorporated a one-­‐week cataract surgery mission to the trip. Patients from all over the region come to the clinic to be examined and evaluated for cataract surgery. Those that are eligible are sent to the operation room set up by the surgical team, after which they are provided with directions for proper care and requested to return for a follow-­‐up visit the following week. At the end of cataract surgery mission last year, we over 400 patients and performed close to 40 cataract surgeries.

Where are we  going?
You will be covering a large area of villages and towns in Sacred Valley Region – located in the Andes Mountain range.  The nearest major city is Cusco, which is about 1 – 1 ½ hours away by car.  It is close to where Machu Picchu, the beautiful Incan ruins and one of the Seven Wonders of the World is located. The image below is of the town of Urubamba, the Sacred Valley village that the trip is based out of whc.unesco.org

Peru

1. We provide medical care to patients in a number of settings.

- Puesto de Salud in Lamay
- The most equipped clinic, located in the town of Lamay
- Staffed by 1 Peruvian physician, a resident, a midwife, and a pediatric nurse all year round.

2. Mountain Villages
-These are remote areas, 1-­‐2 hours away from the town of Lamay, where there are usually no physicians. We bring back packs of medications and medical supplies, and see over 100 patients from infants to elderly adults.

3   Arco Iris Clinic
-Due to the generous donation of Helena Van Engelen, the founder of Fundacion Niños Del Arco Iris, the cataract surgery mission is held at this central location to allow patients from neighboring villages and towns to see an ophthalmologist, receive a diagnosis as well as the necessary treatment.

4.  Regional Hospital of Cusco
-Hospital visit provide the opportunity to gain insight into how medicine is practiced in such a facility in a third world country.

 

When would I be there?

The next trip will take place on July 1, 2013 – July 12, 2013.

This year, you can participate for 1-­‐ 2 weeks. We encourage students to stay for the complete duration of the trip in order to receive a complete, fulfilling experience.

Attendings and residents, we recognize that your time is limited, anywhere from one to two weeks of your time would be helpful.

Edwin Gonzales, our main contact person in Peru and a great philanthropic community leader, has expressed his wish that we would provide more continuity of care.  We hope you will join us continuing to keep on this project by helping organize and expand the future trips.

 

Who  is  running   the  project?
The project is run by medical students from Stony Brook Medical School with the help of many physicians, nurses, and other support staff form the tri state area. We receive our funding primarily through A Promise to Peru’s multiple fundraising efforts and the generosity of local businesses. These funds are used primarily for purchasing medications and supplies for the medical mission as well as the cataract surgery mission, which are then transported directly by the participants of the mission to Peru. Friends New England, a Boston-­‐based non-­‐profit is also supporting the project providing services regarding travel logistics, community development, project sustainability, and institutional collaboration (www.friendsne.org).

 

Why  Peru?
Peru is a beautiful country with rich cultures and warm-­‐hearted people, and we have been fortunate to work with wonderful community leaders throughout the project.  We chose the location because one of the medical students who started the project got in touch with a Colorado-­‐based, family run NGO called Peruvian Hearts (www.peruvianhearts.org). Peruvian Hearts offers support for orphanages and schools, providing nutritional and educational support to people in the Sacred Valley region.  They expressed the need for healthcare for the medically

underserved, and so a project was initiated to work with them. Peruvian Hearts has introduced us to the mayor of Lamay, and community leaders in the area, such as Edwin Gonzales, who is our main contact person in Peru, owner of the hotel where we stay at, and also a generous philanthropist.  We have also received great help from Dr. Victor Rozas from the Peruvian American Medical Society in getting approval from the Medical Board in Peru to practice medicine in Peru. Helena Van Engelen and her team at Fundacion Niños Del Arco Iris have been instrumental in the cataract surgery mission. Her foundation provides education, medical care and daily meals to many uncared children in the Sacred Valley.

 

Patient Care

What   kind of  patient  population do we  serve?
The majority of patients who come to us are farmers with limited access to medical care.  We see a lot of chronic diseases, such as musculoskeletal pain, as well as malnutrition, gastrointestinal complaints, skin problems (warts, scabies), and vision problems.  Upper respiratory infections are also common during the season (winter in the Southern hemisphere). Unfortunately, we also face many psychosocial issues, such as depression, alcoholism and domestic violence. We manage these issues in collaboration with the local health care workers, who understand the local culture and can provide long-­‐term follow up. We also rely on local doctors and nurses for acutely ill patients who require hospitalization.

A Promise To Peru

What  languages   do  patients   speak?
Most patients in the clinics in the town speak Spanish, but when we go to a mountain village, most people speak a local language called Quechua. We get help from the health care workers in Lamay to help translate between Quechua and Spanish.  But if you know someone who speaks Quechua, please try to recruit them. Spanish fluency is very welcomed as well.

 

What  medical  resources are available?

We work in a very resource limited setting. For the most part, all we have is what we bring with us in our own suitcases.

The diagnostic tools you have for the most part are what are in your white coat pocket – stethoscopes, ophthalmoscopes, otoscopes, and good history and physical exam skills. We will try to bring blood pressure cuffs, thermometers, glucometers, and a portable scale with us.

Labs: There is a small lab at the central clinic in Lamay, but the cost of running the lab comes from the local clinic’s budget, and they discourage us to use it unless it is absolutely necessary. They can do CBC, BMP, some STD screens, and urinalysis. We try to bring urinalysis strips and pregnancy tests ourselves.

Imaging: We don’t have access to imaging facilities. We are trying to get donations of an ultrasound or to buy a cheap one – if you have suggestion of where we might find one, let us know.   We don’t have EKGs or IV equipment with us either.

What  do  we do if  the  patients   are  really  sick?
Depending on the site we are at, we are about 1 -­‐3 hours from the major hospitals. If patient needs urgent medical attention, such as surgery, IV rehydration, etc, then we would work with the local physicians to get them to the nearest hospital.

What   if  I get  sick?
 The diseases you are most likely to get are common colds and some traveler’s diarrhea.  Also, since we are in a high altitude, there may be a need to take acetazolamide (diamox) for the first few days. Please make sure you have international health insurance coverage and evacuation insurance. Visit http://www.medexassist.com for more information on international health insurance.

Be sure to tell the student coordinators your emergency contact information. Please receive all the travel vaccines, such as Hepatitis A, Hepatitis B, diphtheria/tetanus/pertussis, Yellow Fever and typhoid. Please discuss the details of the vaccination schedule with your local travel clinic. People usually don’t need malaria prophylaxis unless you plan on going to the jungles before or after your time in Lamay.

What would my role be in patient care?
This is flexible, depending on who else is there (or isn’t there) when you go, which communities we go to, and what the staffing needs are. We’d like everyone to use all your talents and make the patient care as efficient, safe, and comprehensive as possible.  To give you some idea, these are some examples of tasks you would do:

Pre-­‐clinicalmedstudents(1-­‐2nd  years): See patients Mon – Fri, help with vitals, intake, taking history and performing physical exam with either senior med student or a physician. Help with other areas such as the glasses clinic or the pharmacy. Present cases and help of an attending or a senior medical student

Seniormedicalstudents: They are precepted by a physician. They will supervise junior medical students. Organize case presentations and evening didactics.

Physicianadvisors: See patients in various settings, precept students in clinic, help coordinate didactics in the evenings, provide verbal/written feedback to students.

Nurses: Help with triage of patients, develop patient education material and programs, and help with patient record keeping.

Eyespecialists: Help with collecting and neutralizing donated glasses, perform limited eye exams (direct ophthalmoscopes), obtain donations of antibiotic eye drops and artificial tears, buy eye medications, provide training to students to perform a basic refraction and dispense distance and reading glasses, as well as non prescription sunglasses. Those  interested  in  participating  in the  cataract surgery  mission,  please  contact  Dr.  Debra  Messina  at  the  email provided  on   page  2.   

Studentcoordinators: Be a liaison between the Peruvian healthcare workers and the group. Coordinate travel details, transportation, and didactics in the evenings. Be involved in decision making on which communities to go when and assigning roles for the participants.

Non-­‐medicalsupportstaff: Assist with translating, record keeping, educational material, pharmacy, eyeglasses clinic, taking the vital signs, coordinating patient registration, providing basic arts and crafts to the children.

Please ask specific questions with regards to what your level of training and experiences are, and we can answer case by case what you can do.

 

A Promise To Peru

 

 

Eligibility and Costs

Who  is this project open  to?
The trip is open to all students, healthcare professionals and their families. We can use a wide variety of skills – please fill out an application if you are a student or a resident.  This can be downloaded from www.apromisetoperu.com. If you are an attending physician or other healthcare provider interested in going on the trip please contact one of the 4 coordinators listed on page 2 and ask questions if you’re not sure.  We take others through a case-­‐by-­‐case basis. Chances are, if you are truly passionate about contributing to the project, and can meet all the deadlines in making the decision to go, we can probably accommodate you one way or the other. Family members are welcome and they can provide assistance during the course of the day at the clinic.  We feel that the environment of the mission may not suitable for children under the age of 14.

Examples of people who we are recruiting include but are not limited to:

- Adult primary care and subspecialty physicians
- Pediatricians, Family Physicians
- Women’s health specialists (OB/GYN physicians, midwives)
- Eye specialists (optometrists, ophthalmologists, certified ophthalmic technicians)
- Physical therapists
- Psychiatrists, psychologist, those experienced with domestic violence issues
-  Pharmacists
-  Medical students
- Nurse practitioners / RNs, nursing students
- Spanish translators (English-­‐Spanish, Quechua translators)
- Support staff (families and other helpers without medical training background, such as translators, spouses, etc)
- Art teachers

What   are  the  requirements  for going  this  year?
- Attend as many scheduled meetings as possible

-  Join at least one of the committees / projects in preparation for the trip.
- Work on improving Spanish skills as much as you can
- Be nice to the coordinators and submit documents / deposits / travel itineraries on time… please!
- Act responsibly and professionally throughout the preparation, time in Peru, and afterwards   

Do   I  need   to  be  fluent in  Spanish?
The patients speak Spanish or a local language called Quechua. Although you do not have to be fluent, all students are required to have basic Spanish skills. There is no Spanish language requirement for physicians and other healthcare professionals. However, we strongly encourage you to study as much Spanish as you can prior to the trip to be able to provide the best care to patients.

How  much  would  it cost?
Donations for the project are suggested, but you are only responsible for the cost of your travel. The estimated cost of the trip for one week is $1,500, however this can vary if you decide to share a room with others. The prices are based on the presumption that the airfare is purchased in early spring. If you wait to book your flight in April, the cost may be as high as $1,400 for the airfare alone.

Airfare: $1,000 roundtrip from U.S – Lima $200 round trip airfare between Lima – Cusco

Accommodation $25-­‐60 / night if you pay ½ of the hotel cost as deposit by April 1st

Food: ~$20/day (breakfast, lunch, dinner)

 

What  criteria are used for  the  application process?

The application is a way for us to find out who is truly committed to going on the trip, and what your interests in the project are. Also this allows us to focus our recruitment process to ensure that each week will be staffed by adequate number of physicians per students.

We will try our best to accommodate anyone who is truly committed to going, and is willing to help coordinate the projects. Because we need to process the legal documents, we will not be accepting late applications.

Some things that will be taken into consideration are:
-  Balance of physician to student ratio per week
-  Clinical Expertise
-  Spanish Skills
-  Commitment and involvement in the planning of the projects
-  Attendance to the meetings, at least once a month.
-  For med students: balance of pre-­‐clinical (1-­‐2nd  years) and clinical students (3-­‐5th  years), willingness to serve as a leader for the subsequent years, length of stay in Peru (Preference generally given to those who can stay for the whole duration of the trip, for continuity of the experience)   

How  many people can go on  the  trip?

The hotel can host up to 40 people if every room was completely occupied. For the 2013 trip, we will be accepting approximately 10 medical students. Ideally, we would like as many physicians to participate as possible, whose families are warmly welcomed to accompany us and participate in all aspects of the clinic.

Getting Involved

How  can   I get mor  information?
Come to our meetings!

How do  I  apply  to  go  on   the  next  trip?
Medical students and residents will be notified on the status of your application by mid-­‐December 2012.  The decision will be made based on your clinical experience, Spanish speaking abilities, in addition to your prior involvement in the planning of the project. Attendings and other health professionals are welcome to join at any time. In interest of planning, organizing, and working out the logistics, an early commitment would allow the trip to run smoothly and efficiently.

How can I make a donation for th  project?
Please contact the student leaders at for details on donations. This trip relies heavily on the commitment of those involved and the donations from those supporting their efforts. Therefore, please support our mission and help us collect funds for this great cause.

Travel Logistics

How  should  we  purchase   our   flights?
Please plan on traveling on the Saturday before the week of your participation starts.  We will send you the itinerary of the flight the group is taking, and you will be responsible for booking and purchasing those tickets. Please make every effort to travel with the rest of the group on these flights.

Where  will we  stay?
You will be staying in town of Urubamba, about 20 minutes away from Lamay, in a beautiful hotel called La Quinta Eco Hotel. There will be wireless internet access in the common lounge. Based on the weeks you choose, reservations will be made for you from Sunday night of the week your participation starts to Saturday morning of your final week. Several room options are available according to your preference and budget. laquintaecohotel.com

Participants of the cataract surgery mission will also have the option to stay at the facility built by Helena Van Engelen. lascasitasdelarcoiris.com

Planning Committees

All student participants will be required to join the planning committees. These committees may change depending upon the number of participants for the coming year.  Tentative committees are as follows:

Student  Roles
- Fundraiser Planning
- Physician Recruitment
- Glasses and Eye Care Project

Public Health Projects:
- Clean water Project
- Parasitic desease prevention
- Physical therapy for back pain

Patient education sessions:
- Back exercises
- Patient education sessions
- Dental care
- Women’s health
- General hygiene
- Pediatrics Project
- Record keeping/Patient data coordination
- Medication coordination
- Collecting medical equipment and supplies

Coordinators
- Clinic coordination and student education during the rotation
- Hotel coordination
- Packing supplies
-  Travel coordination
- Website management

Health  Professional   Organizers  (non-­students)
- Nursing Coordinator, Midwife, PT/OT
- Family Medicine Residency Coordinator
- Medical Supervisors

Preparation  classes
- Spanish classes and cultural sensitivity
- Patient interview simulation sessions

A Promise To Peru

A Promise To Peru

 

A Promise To Peru