A Weekend in Huaraz, Peru, day 2

Read the post about day 1 in Huaraz first!

Shawna rapelling down a waterfall in Huaraz

Our second day in Huaraz was mostly free for tourism. It started off as a promising day, with a bright blue sky and a great temperature. Six of us contracted with a tourist company to do 'canyoning', which I took to be repelling down cliffs. Much to my surprise, it was actually repelling down waterfalls! (They did say to bring an extra pair of clothes, as we 'may get a little wet'- we were actually all completely soaked by the end!). We descended one waterfall, and then made a descent just beside the second part of the same waterfall. It began to rain just after we finished the first descent, and since we were all getting cold at that point, we wanted to avoid more icy mountain water! It was fun though, with some definite adrenal moments, and the area was beautiful.

Emily and Steve pose with alpacas in downtown Huaraz

That afternoon we went to the home of our medical student friend, Jose, to have dinner with his parents, the anthropologist and award-winning author (his father writes in Quechua, the native Peruvian language). We had a lot of stimulating conversation with Jose's family, about literature, medicinal plants, and a pre-Incan culture called Chavin, which has ruins nearby which they say are 2nd only to Machu Picchu. Sadly, we didn't have the time to visit the ruins, but we saw many pictures which looked amazing. The Chavin temple which is nearby has many intricately carved statues with snakes, jaguars and their diety which combines features of the two. The temple is 5 stories tall, and natural tunnels funnel light down onto the main carving of the god, which is in the depths of the temple.


That night we travelled back to Trujillo on the sleeper bus, and arrived back home in time to have breakfast and go right back to the hospital!

A Weekend in Huaraz, Peru, Day 1

This last weekend FIMRC organized an optional trip to the city of Huaraz, so that we could learn about traditional Peruvian medicine. We all decided to go, and were glad we did because it was an amazing experience. Huaraz is a smaller city than Trujillo, about 8 hours away and located in the Andes mountains. It's situated in a valley between two distinct mountain ranges, one snow covered and the other not.

Rural village in Huaraz where we saw traditional medicine.

On Friday night we took a sleeper bus from Trujilllo to Huaraz. These double decker VIP buses are a common sight in Peru, and are incredible. The have reclining seats, food and drinks are served, and there are movies (that may be less incredible, as the movies often play when you want to sleep). We 'slept' on the bus overnight and arrived in Huaraz in time for breakfast. We were met there by a Peruvian medical student, Jose, whose parents live in Huaraz and who had arranged our educational experience. Jose's mother is an anthropologist and his father is an author. His mother joined us and we took a rented minivan far into the valley, and then up a mountain. Our destination was a small village at the top of a mountain- it was a fairly remote Peruvian village, off the beaten path. The landscape was amazing- it was a scenic village of mud brick houses, flowers, birds and great mountain vistas.

Jose's mother talks to a local woman about medicinal plants.

We were introduced to the local healer, who explained Peruvian medical plants to us, and who was going to show us two traditional Peruvian medical ceremonies. The first was healing by Cuy (Guinea Pig), which involves rubbing the patients entire body with a live guinea pig, then killing the animal and disecting it. Any health problems found in the disected guinea pig are thought to reflect those of the patient (ie, if the guinea pig is pregnant, so is the patient- so they always use gender specific animals). The second process is healing by flowers, which is both diagnostic and curative. They take a large number of flowers, which are bought especially for the purpose, heat them up in a clay pot, and then rub the patients body in them. The pattern in which the flowers fall is also important, and the patient can't wash the flowers from their body for at least a day. The ritual also involves throwing the flowers at full force against the patient, much to our surprise. Emily volunteered for the guinea pig diagnosis and Steve underwent the flower healing- it was a fairly surprising experience for all involved, but very authentic and we are told still an important part of P eruvian culture. Many people, they say, will undergo one of these two processes before they will go to a hospital.

Undergoing the guinea pig healing ceremony.

After visiting the local healer, we continued through the valley to visit the ruins of a city which had been covered by an earthquake 30 years ago. The area was built like a memorial, with giant flower and rose gardens and monuments to the dead. It was eerie, but a beautiful place. It rained on us there, but we were interested enough to walk around and see most of the area.

Next, we went to a small mountain town with a nice central plaza and an ice cream shop. We watched them make the ice cream (more like gelatto), and then bought cones for 30 cents each. A few of us then walked over to a coffee shop. It was a really nice way to spend the day.

The Peruvian Hospital Experience

A significant amount of our time in Peru has been spent in the Belen Hospital of Trujillo. A typical day in Peru has us shadowing Peruvian physicians in either pediatrics, surgery, internal medicine, or OB/GYN. We arrive at 8am and leave the hospital usually just before 12:30. So far, we've been doing two days in each service, and in groups of two students with a FIMRC staff member or Peruvian medical student to help translate.

So far we've done 7 days in the hospital, and everyone has had at least one day in each service. From my own experience, surgery and OB/GYN have been the most interesting- a sample of what I saw in each: in GYN I had a Peruvian physician who was interested in teaching and took the time to explain important information about each patient. We saw many women with pre-eclampsia, and many who had had C-sections due to high blood pressure, although the doctor said they probably were not really in pre-eclampsia at all. We saw a number of premature rupture of membranes also. In OB, I saw two natural births. An episiotomy was performed on one mother because it was her first child- it seems to be standard practice to do an episiotomy for a first time natural birth.

In surgery, I saw two C-sections, which seemed to me to be done quickly and professionally. Although I haven't seen much surgery in the US, I imagine it would be hard to tell the difference between a Peruvian and American surgeon unless you know where to look- for example, to save money on buying booties for the OR, most doctors have plastic bags wrapped around their shoes; they use every last bit of their sutures; and one doctor told me he doesn't change his gloves as often as he would like to in order to save money. The doctor told me that 50% of all births in Peru are by C-section, and the national health insurance covers the cost.

I also saw a prostetectomy, and the doctor invited us to get as close as possible to see the surgery. They made an abdominal incision and when it was time to remove the prostate, the physician had his entire hand up to his wrist inside the abdomen, he would occasionally pull out chunks of prostate. The blind feeling for the prostate was fairly surprising, but the surgery was very professional and quickly done.

Pediatrics and Internal Medicine were interesting at times- both services had patients with interesting diseases that you don't see often in the US, such as congenital CMV infection, Stevens-Johnson skin rash, spider bites with necrosis, and lots of cancer. However, these services are busy, and the floors are loud. Although I can have a conversation in Spanish on most topics without too much of a problem, I was completely lost in IM and Peds because of the background noise, the fast cadence of speech, and the fact that the doctors were often speaking to a group and not directly to me. Those services were not as educational as the surgical ones, where you get more personal attention from the physicians and there is less distraction from noise and bustle of the hospital.

Overall the hospital experience has been educational- we've seen how things are done differently, and in many cases, how similar medicine is - in Peru. The Peruvian medical students have been great about volunteering their free time to come and shadow with us, to make sure that the Peruvian medical staff knows who we are and to help translate and to keep us company.