An Emergency in Huaripampa

The first day Marisol thought it would be good to one of the further sites in their network. Huaripampa is about an hour car ride outside of Huaraz. The road is not paved, but compared to Julcan it seemed like a breeze and the views during the drive are great. We arrived at the health center at about 2pm and the nurse and a technician were the only one there. She sat down to talk with us about her experiences and shortly into the conversation we were interrupted by the tecnica who said an emergency had arrived. There was no doctor there so she asked if I’d come see the patient. They pulled an unconscious lady out of a taxi and brought her into the topico. She did not look good. She had a grayish hue to her. I checked for a pulse and felt nothing, listened for a heartbeat and nothing. I calmly told the nurse that I there was no pulse and she quickly got an ambu bag and we started CPR (the whole time I was thinking, well this sucks). We gave her some epinephrine and kept going at our CPR, but it didn’t work. It’s not clear what she died from maybe a heart attack, stroke, but who knows. The family said she had heart problems but there was nothing in the chart. She was only 56, but looked about 70…not an easy life. Once the family was settled we went back to our meeting and the nurse told me all about her experiences in Huaripampa.

Being by herself was not unusual. The doctor works 6 hours and that’s it. After that he’s gone and who knows what he does b/c the town is really small and not a whole lot to do. She says if there is an emergency he will usually come if he’s around, but sometimes he’s just not there. So, it can be pretty scary for her. But her main goal in an emergency is to stabilize patients and get them to Caraz and they have an ambulance so they can get transport their patients. Ambulance really just means big van with a bed, there’s no oxygen or anything really helpful. Anyway, like most places in Peru her biggest issues are human resources and money. The budget is incredibly small. The money that they get from the government from seeing patients with the SIS health plan has to go towards maintenance, community work, and buying medicines. There is really no money left over to expand or improve things. The main illnesses they deal with are respiratory and diarrheal. There is no lab or ultrasound. Their staff consists of two nurses, two midwives, a couple tecnicos, and a doctor. The midwives also cover other health posts that are even further away. The nurse has been at this health center for 3 years and really wants to improve things, but just doesn’t have the means.