The last time I was in Peru, I was lucky enough to meet some friends of my father who have dedicated their lives to doing public health work here in Peru. Dr. Jesus Toledo and his wife, Maria Elena Toledo, a nurse, have spent much of their spare time supporting different health projects around Peru. They put me in touch with the folks in Julcan and were instrumental in getting funding for it to be able to expand as a network and to build their labor room.
They have also showed me different projects that they are supporting in Lima. On a Saturday morning Maria Elena (or Mamalena, as most people here call her) took me to one of the barrios in San Juan de Lurigancho - Casuarinas de Martires. San Juan de Lurigancho is the biggest district in Lima and although it has areas of much economic activity, it is also home to pueblos jovenes and much urban poverty.
We first stopped by the health post and got a quick tour of the tiny establishment, which is significantly less well equipped than either health center I worked with in the provinces. We then went up to the top of the community – where they are now just installing water systems and I gave a talk on hypertension followed by taking everyone’s BP. It was a group of about 20 young women and children. They listened attentively and had good questions for me after the talk. What came across during those talks was that these women seemed very similar to the patients I see in Chicago. Young, many children, poor, worried about how to feed their kids, send them school, how to make ends meet. And these worries spill into true physical symptoms.
Something that stood out to me that day was a young boy who came up to me and told me that his brother had TBC (Tuberculosis). He said he was on treatment, but he asked me worriedly if his brother could get better or if he would die? I’m not sure why this question rattled me for a second, especially after the other things I’ve seen and heard here. I said that yes, if he took all his treatment he could get better and with that the boy smiled and ran off, and returned to give me a big hug when I left.
TB is a big problem in Peru and multi-drug resistant TB an even bigger problem, particularly in the pueblos jovens/slums of Peru’s big cities (Tracy Kidders Mountain Beyond Mountains has a good section on this problem). TB is the 4th leading cause of death in Lima and about 3% of new TB cases are multi-drug resistant. Anyway, these experiences make me think that there is plenty of work to still be done in the city and it’s what we do in the states, provide care to the urban poor, we could do a lot for these communities too….All in all a good day.
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