Thick fog hovers below. The grandiosity of the hills sends shivers down my spine. Looking into the distance sends me into a whirlwind of emotion, the view is simultaneously the most beautiful and horrific thing I had ever seen. I find myself squinting, desperately trying to find the endpoint of the shantytowns that run up and down the hills before me.
I’ve been in Lima, interning for MEDLIFE, for almost two months now. The shantytowns never seem to end, the number of patients pouring into the mobile clinics accumulates, and the white-board for follow-up care patients fills itself everyday. The task begins to seem intimidatingly big and impossible to complete. Despite these discouraging initial thoughts, working with MEDLIFE has altered my perspective in the best way. The small steps we take as volunteers, interns, leaders and health care professionals changes lives in big ways and remarkable progress has been made. Writing about my experiences over the last few weeks seems near impossible! It feels tremendously difficult to begin to find words that match the emotion I feel and to eloquently explain how life altering medical, educational and developmental projects can be, and have been, in the lives of our patients. It is one thing to hear of poverty, and another to hear people’s stories while sitting in their living rooms.
Living in Lima has taught me to never expect things to be on time. My housemates and I all know better than to assume we will be leaving for a patient follow-up visit with one of our field nurses at the scheduled time. One must factor in at least twenty to thirty minutes later than said departure. This easy going and laid-back culture I find myself in is, once you get used to it, a very pleasant change. Having said this, the opportunity to go on these patient visit, has taught me that they are well worth the wait. They all begin similarly: a bus ride. Or make that multiple bus rides, “moto taxi” trips and train journeys. Upon arrival to a very impactful visit I went on, our field nurse Janet, like countless other times, pulls a patient’s chart out from her MEDLIFE draw string bag and takes us up and down the hills, through unpaved roads and unmarked homes. How Janet finds the address we’re looking for, perplexes me still. I make it a point to stop and breathe. I find myself having to do this multiple times a day.
After a few knocks at the patient’s door with no answer, Janet moves into phase two: “seÃ±ora!” she screams. “SeÃ±oraaaaaaaa!” Audible footsteps appear and a shabby door on loose hinges swings open. We are invited in by an elderly woman who, I learn soon after, was diagnosed with diabetes at one of our previous mobile clinics. Some of our initial concerns are raised very soon into the visit. Her home’s infrastructure is shaky and the dirt ground is exposed. The makeshift walls let in beams of light. They create a display of rays that pierce through the dark, damp room in hundreds of directions. These issues only add to our patients existing health concerns. Another big concern is her diet. As we converse, she begins to tell us what she eats on a daily basis. Having a grandmother at home who has been diabetic for years, I know that our patients’ list is worrisome. Her diet consists mostly of carb filled and starchy foods. These products are usually cheapest and most filling, something desirable in a context of poverty.
Janet decides that it would be a good time to take our patient’s blood sugar level. The first test shows a blood sugar level of 320 mg/dL. A normal sugar level for someone with diabetes should be anywhere between 100 mg/dL to 140 mg/dL depending on food intake. This initial test seems very high, so Janet does another reading about ten minutes later: 435 mg/dL. Tension rises in the room and I am told that our patient is at very high risk of experiencing serious and irreversible damage to her body. High levels of glucose act as a poison, damaging the body’s pancreas, kidneys, heart, arteries and nerves. Through the quick-paced Spanish, I decipher that, if her glucose level is not lowered, we will have to go to the hospital immediately. We wait three more minutes and test again. This time, the machine reads a glucose level of 512 mg/dL. Before anyone can say anything else, we are gathering our patients’ belongings and bringing her to the nearest hospital. Access is limited; we must get a taxi, as ambulances are expensive and unreliable. There are six of us including our patient, without any time to waste, we cram ourselvesin and head towards the closest building with insulin. The most disappointing and eye opening experience of that day was once we arrived at the hospital, we were told by two hopeless looking patients, that the emergency room was closed. This seemed absurd to me, how can an emergency room be closed? We speak to a doctor and he delivers us the worst news thus far; they don’t have insulin.
This story represents an example of lack of access. This is an arbitrary concept that includes poverty, injustice and deficiency. It was an overwhelmingly sad way of, for me, actually understanding what lack of access meant. It meant that our patient was not able to control her diabetes due to lack of access to a healthy diet, healthy living space, and tools to regulate her disease. It meant that our patient couldn’t always get to a hospital, and when she did it meant that there was a lack of resources such as medications and staff. By some twisted way of faith, MEDLIFE was present that day, and was able to help that patient. She eventually got brought to a much larger, and further away, institute that did have access to insulin, and is doing well today.
Being able to put my experiences of this internship in order in my head has been most challenging. Being able to a part of an organization that sustainably changes lives has been incredible. Being able to live in a city in South America has been exciting. Being able to share this experience with other interns and volunteers has been life changing. I leave this internship with an exhilarating motivation to take on whatever life has in store for me and to boldly plunge into helping end global social injustices.