Sowmya Satagopan

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4/20/17

Honors Service Learning

The service learning project that I am going to talk about is a mobile clinic in

Peru. For spring break this year, I went on a Mobile Clinic medical trip that was

sponsored by a chapter called Medlife. So, for a week I volunteered in Peru with other

fellow interested students and helped out people that needed it the most. At first, I just

registered for the trip because I thought it would be a good opportunity to volunteer and

get educated on medicine in other countries. From the first day onwards, I realized that

this trip was not just about getting educated about medicine, but also about the culture

and the society of the Peruvian people as well. I was able to socialize with the Peruvian

people therefore I was able to learn not only about their culture but about their traditions

and their values.. Since I got to interact with the people at the clinics I believe that I

looked in a different way to the them then if I were to interact with patients in the States.

I realized that they evaluated me based on the fact that I was from the United States a

country where medical care was abundant and readily accessible for people. This class

ties in with my service because I got exposed to the Peruvian peoples values and

beliefs about medicine and how it differs from that of the United States.

March 13, Monday

On the first day of the trip, we got exposed to the culture and got to learn more

about the way people live in Cusco, Peru and how they go about in their daily life. First,

we toured the actual town and saw that each town or city was designed the same way.

Every town in Cusco had a main plaza, a church, stores lined along the plaza and a

small clinic. It is very community-like and it reminded me of the suburbs because it is

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arranged in the same way. The Church was the main form of religious place and in Peru

they have holy places called Hucas which was usually a sacred mountain place where

on top of the mountain they had a place of worship. Each town also had a market where

the people sold their goods that they usually made at home and that was their main

form of income. Their value system was shown through the way they conducted

business; the people selling products usually bargain down to the needs of the buyer

just to sell a specific product. They believe that if they price an item higher a tourist will

most likely buy the item because they are not from that country therefore they can easily

be tricked. I thought this was very cleaver because they make more money off of

tourists yet they still appreciate them appreciating their culture and traditions. In Cuzco,

the closer you are to the bottom of the mountain the better off you were financially.

However, the farther you go up the mountains, the more spread out the villages are and

the more financially unstable the people were. After we saw the city, we went up to the

village and toured a medical clinic that was near the village. The clinic was very small

and held only a few people at a time. They first had to get registered and then inside

there was only one room that the doctor was in so each patient had to wait a long time

to get treated. At the clinics near the village, the doctors only triage patients, and then

give them a prescription to go to the hospital in the city which was down the mountain.

However, it is a whole day trip that the villagers have to take and it costs them one days

worth of work to make that trip back and forth. This shows the extent of healthcare that

the villagers had and how deprived they were of medical treatment and equipment. I

knew before going to Cuzco that people had limited access to healthcare and that they

struggle to get treatment, however I did not realize how hard it was until I saw it with my
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own eyes. The conditions that they were living in were so dire; their houses were made

of wood, and cement, they had no electricity or running water. They lived in poor

conditions to the say the least with not even the basic necessities, however they were

so grateful for what they had. When we interacted with them in the clinic they were so

genuine and were curious to know why we were there. It was eye-opening to get

exposed to the people, the city and their way of life because it made me appreciate my

life more. It was nice to connect with the Peruvian people before I started working in the

clinic because I feel like now I am more aware of their lifestyle and the connection only

made it easier to treat them.

March 14, Tuesday

It was my first clinic day. After we woke up, and ate breakfast we got on a bus

and rode up the mountain to our specific clinic which was one and a half hour long. We

arrived at a place inside a dirt road where there was a huge playground and a school

building, and farther down there were houses that were clumped together. We got off

the bus, and our coordinator told us that we were going to set up our stations in each

classroom of the school and around the playground. There were six stations; Dentistry,

Toothbrush, OBYGN, Triage, Doctor, Pharmacy and Education. The coordinators

already sorted each volunteer into a group for the week, so for the first day I was

assigned to Dentistry and Tooth brushing. For my morning shift which was at Dentistry, I

got to hold instruments and see what the dentist did with each patient. Our station was

set up in a classroom to the side and all our instruments were placed on a table and we

tried to be as clean and sterile as possible. The patient would sit on the chair, I held the
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flashlight and then we looked inside of the patients mouth to see what problems they

had. Then the Dentist would diagnose him in Spanish and translate it to us after. I got

to see the inside of each patients mouth and see what he was exactly talking about.

After each patient left, I had to sanitize all the instruments, put them in a wash bath, and

then restock them on his tray. Our first patient was a small child who had pain on the

right side of his mouth. After we saw his mouth the Dentist was showing his multiple

cavities and he filled it in for the child. The next patient we had was an old woman who

said that her teeth were aching, the dentist probed her teeth and we saw a bunch of

stones falling off. He explained to us that after a cavity or infection goes unnoticed it

forms stones in the mouth and gets stuck in between the teeth and gums. Since the

people living in villages far from medical care, their teeth are in worst condition and their

stones are harder to take out. I noticed a lot of similarities between each patient and

saw that most of them either needed a filing or needed their stones to be picked out.

That was interesting to see that everyone had the same problem and it was all due to

the fact that they didnt have better access to the Dentist and did not realize the

importance of cleaning their teeth or getting it checked out by the Dentist. I worked at

this station until lunch time and then after that I went to the Tooth brushing station. In

this station, I got to teach little children how to brush their teeth and I put fluoride on

them. First, we had to register all the children and we made them pick a toothbrush of

their choice. After that we had little pamphlets of instructions in Spanish since the

children did not understand English that well. So, after they picked out their toothbrush I

took them and read out the instructions and did hand motions on how to brush your

teeth. There were buckets on the ground so that they could spit and rinse their mouth.
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Once they finished brushing, they rinsed and then I put fluoride on their teeth. Most of

the children were cooperative and had fun with brushing, some were scared and

nervous to put the brush in their mouth but after they saw their friends doing it they were

more inclined to do it as well. I was at their teeth. It was not that shocking to see that

they did not know how to brush their teeth because many underdeveloped countries do

not have access to brushes, and toothpaste. They also are not educated about dental

hygiene and how it affects their body. I was glad that I could teach the children and I

hoped that they would remember to brush everyday and stay healthy. It was very

different to see how the villagers raised their children and how it differed from the way

we raise our children. In Cuzco, the children are free to roam around without their

parents and the are allowed to come to the clinics without their parents being there

which I thought was very different. In the United States, it is usually expected of the

parents to take their children to the doctor until the age of 18. The way that the Peruvian

people raise their children is more individualistically and let them learn on their own; I

believe this is partly due to their work schedule, the men are usually working in the

farms and the women also help in the farm, and take care of the home. Overall, today

was an educational day for me because I got to see patients with similar diagnosis on

their teeth and got to educate children. One of the hardest things that I realized right

away was communication. Most of the villagers spoke Spanish or Quchia which was a

language that was spoken by the villagers that lived there. I did not know how to speak

either, I knew basic Spanish but it was not enough to explain medical terms. Language

as we talked about in class is the one common thing between a culture, it allows people

to communicate and unites them because they can understand each others past,
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present and future. However, tourists or people like me that volunteer at clinics, have a

hard time communicating because it is hard to communicate in a language that neither

party understands. However, even though it was hard to talk through language, I was

able to talk by moving hands and using hand gestures. When I talked to the children I

used motions on my teeth to explain how to brush and that was helpful. So even though

language is a barrier I had to overcome it or else I would not be able to work. I am glad

that the first day of clinic went this way because it was a nice ease into the rest of the

week and it taught me that I can only learn by actively speaking and observing.

March 15, Wednesday

Second day of clinic, waking up was so rough. Every morning we had to meet

our coordinator in the hotel lobby by 6:40, and we had to have breakfast before we got

on to the bus. So, I woke up around 6:15ish, I ate breakfast and then got on the bus.

Todays bus ride was long, because we went to this village that was much farther out.

Once we got there, there was one big warehouse facing a bunch of mountains and

farther out near the mountains there was a huddle of huts. We were setting up our clinic

inside the warehouse. All the stations except OBYGN and tooth brushing was inside the

warehouse, OBYGN was inside a different room that was closed and tooth brushing

was outside set up in a tent. For today, I was assigned to Pharmacy and Education for

today. In Pharmacy, the pharmacist told us to stock up all the medicine that was in this

big box on two tables, then afterward she listed every single medicine and told us what

it was used for. Most of the medicine was simple antibiotics but there was also pain

medication for infections, pain and other normal over the counter medications.
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Pharmacy was the last station that the patients stopped at so we had to wait a while for

each patient. After the doctor gave them the prescription, one person would mark down

how much medication was given and the other person would count the tablets and put it

in a bag. I noticed that many people had the same prescription because they had all the

same symptoms that needed to be treated. It is obvious that pharmacy is important

because medication is what makes people feel better. However, I wondered what

happened once they ran out of the tablets; because the clinics only stop at each village

once a month but most of the patients prescription was for a week or so. I realized that

for these people it did not actually matter that they got their prescription late, but it was

the fact that people came to help them and were able to provide them with medication.

This showed the beliefs that they held; they knew that medicine would help them get

better but they were more grateful for the people that came to help them more so then

the treatment that they received. After pharmacy in the morning, I got switched to the

education table which was where we educated the patients on the different diseases

that are common. We had pamphlets for blood pressure, diabetes, STD/STIs, and heart

diseases. The patients waited at our table after they got triaged. We looked at their

symptoms and would give them the according pamphlet that corresponded with their

symptoms. We went over the pamphlet with them, where we told them the treatments

and what to do to prevent that particular disease. When we explained the pamphlet to

them we asked them questions such as how do they prevent diseases and how they

prevent themselves from getting sick. Most of the villagers actually believed that

vaccines prevent disease and that they believe that HIV/AIDS can be prevented if they

used the proper protection. I was shocked that they knew a lot of this information
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because in underdeveloped countries people usually are not that educated and do not

believe that medicine will actually them. For example, I know in India some of my

relatives think that going to the doctor is a sign of weakness and that doctors just take

money and do not properly treat them. So, it was a change to see that at least some

underdeveloped countries are knowledgeable and believe in the health care system. I

think most of it is due to the fact that people have clinics in these villages and volunteers

like myself explain to them about different diseases and how to prevent them. Once we

finished explaining to them we would stamp their papers and then send them to the

doctor. This was more of table event so we just waited for the patients to come to us,

however this was one of the most important stations because it is imperative to educate

the people in these villages. I believe that treating patients and giving them medication

is important but giving them the knowledge of how to treat these symptoms is more

important because it will stay with them. The villagers also know what is going on in

their body and they will realize that it is fixable. However, I realized that even if they

have the knowledge of what is going on in their body their access to healthcare is very

limited, and most of them cannot afford the care given by the healthcare system in Peru.

Therefore, unless their symptoms worsen usually villagers do not go to the hospital

which to them makes sense because they do not want to make the trip from the village

to the city since it costs a lot of money. Their access to healthcare is what limits them

and makes them vulnerable to getting diseases. This is why I believe that the clinics that

Medlife hosts are helpful because the villagers are able to receive treatment and

medication at no cost. This day of clinic was very impactful because it raises awareness
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and giving them the necessary precautions and medication is necessary for the

villagers.

March 16, Thursday

Today was my last day of clinic, it was so weird to see time flying by so fast. I felt

like I learned too much in such a short time. We got on the bus, and went to another

village, this one was also mostly set up outside with tents while only OBYGN got the

private room. The village was a little bit farther out from the school so we had to go to let

them know that we were here to give medical care. After we recruited people, a few

villagers came with their children and we started to treat patients. My first station today

was Triage, we were the second station that people came to so we got take their blood

pressure, talked about their symptoms, took their vitals and then send them off to their

appropriate station or doctor. My job at Triage was to take blood pressure which was

fun. I got to gain clinical experience and see the differences that people had in their

blood pressures. When I took blood pressure I had to tell them to take off their sweaters

and push sleeves up, but since I could not speak Quicha I would do like common

gestures such as pulling my sleeve up and telling them that I was taking blood pressure

by pointing to the machine. Most of the symbols I used were common to all cultures and

I was so thankful that they were able to at least understand me through symbols and

realized what I was trying to communicate to them. Most of the villagers I saw had

normal blood pressure, but some of them were really low and or really high and that I

thought could be due to the fact that they live higher in altitude so their heart takes more

force to pump than for people that live in normal altitude. After a few patients I switched
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to taking vitals so I took everyones weight and wrote that down on their chart. It was a

lot of interacting with patients which I enjoyed a lot because I finally was able to pick up

some Spanish and was somewhat able to communicate through talking or making

symbols with them. Therefore, for me it was an educational experience because I got to

use my language skills and some basic medical skills as well. After lunch, we got to

switch stations and the next station I went to was Doctor, basically here I shadowed the

doctor and observed how she interacted with the patients, and diagnosed them. The

first patient we got was an old woman who had back pain and leg pain, she said that it

was common for many villagers to have such pains; so she just prescribed pain

medication for her. Most of the patients we saw had the same symptoms and I realized

that since they were all farmers they all did the same manual work therefore their bodies

had the same pains. Another patient we saw was an old man who our doctor thought

drank liquor before coming to get treated, he was slurring his words but he said that he

had back pain and trouble breathing. She listened to his heart and gave me the

stethoscope to listen as well; when I listened I could hear cracking and deep thumping

which I noticed was not the way normal heart beating sounds like. The doctor said that

the sound I heard was the lungs which were filled up with fluid which was due to him

smoking and she said that was probably the reason that he was not able to breath

properly. After she prescribed him with some medication and told him to quit his

smoking and drinking habits to start to feel better. One of the most interesting patients

that I saw was a little child who had rashes on his back. The doctor looked at him and

within like a few minutes she was able to diagnose the child with having a bacterial

infection. I was very surprised because the doctor was able to diagnose the patient just
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by seeing their symptoms and listening to their heart beats. Without taking any x-rays,

or MRIs the doctor on the spot was able to diagnose the patients which I thought was

very inspiring because doctors in the States would not have been able to do give a

proper diagnosis with as much as detail as the doctors in Peru without the necessary

tests and labs. Even though the villagers in Cuzco did not have access to taking these

medical exams the doctors were used to treating patients without these examinations

that they had everything stored in their brain and that is when I realized the difference

between doctors in the States and the doctors that worked there. I realized that doctors

in Peru were actually more interactive with their patients and probably retained more

information about their patients and knew the patterns of symptoms in these villages

than doctor in the States ever would. After we diagnosed the patient, we gave them the

necessary medication and I was able to recognize the different medications because I

worked at pharmacy the day before. Most of the patients got the same medications and

it was impressing to see that I actually retained some information from the day before.

Overall, it was an educational end to my clinic day because I gained a lot of insight and

a new perspective to medicine. I was very motivated, and one day I wish I could also

come to underdeveloped countries and treat patients because that is when I will

actually know if I became a good doctor or not because it is so encouraging to see

doctors be able to diagnose with the bare essentials and I hope to one day do that too.

Even though we have the necessary equipment in the United States, the doctors

seemed closer to their patients culturally when they were able to treat them with just the

basic necessities. It was very compelling to see that it only takes knowledge to help
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someone, you do not need expensive machines or other people to treat one patient, all

you need is everything that you studied and the education that you got.

March 17, Friday

Project day evoked curiosity and some fear because I did not know what to

expect. I heard from different people that it was a lot of fun, but then others said it was a

lot of work and that we had to work with the villagers. I was excited to do something

different and I hoped that the experience will be just as rewarding as the clinical days

were. When I got to the project site, it was like any other village with a big area in the

middle with houses all around and mountains surrounding it. The project coordinator

split us into groups and took us to the different houses that the villagers needed help on.

My group went to the first house on the road; the house was two floors, where the

bottom had the kitchen and little shelves to store food and the upstairs was a small

bedroom for the family. The whole place was gated and the bathroom was outside a

little bit farther away from the house. It was very dirty outside and everything was

covered in dust or trash. To get to the upstairs room which was the room that we were

working on we had to climb on top of a wooden staircase that was very squeaky and

hard to climb on. Once we got up there the ceiling was very low so we had to watch our

head when we went inside the room, and the room itself was very small. It was divided

into two parts one part was just dusty and there was a bunch of cut wood lying around,

the second part was filled with corn and other stuff that the family had stored. We had to

make a shelf, and clean the room for the family. The man of the family helped us with

cutting wood and we helped him put the shelf up. The first part was a lot of manual work
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so we divided our time doing it, each person sawed the wood until we got tired and then

we each took turns doing that. After we sawed the wood he measured the shelf and

made sure that each one was the same size so that it was easier to nail it together. The

nailing of the self took a long time as well because we had a hard time having the nail

go in straight. So, again we took turns with the hammer and after what I felt was a long

time we built the shelf for him. After that we were told to clean the floors because they

were dust filled, so we thought we would be done early because we wanted to go help

the other groups. However, the cleaning of the room took almost an hour because the

more we swiped the more dust that came from the floor. We again took turns sweeping

and taking the paint plasters of the ground, there was so much dust everywhere and I

wondered how did this much dust even collect in such a small place. After we cleaned

and put the dust in a trash bag we set up his bedroom for him. We put up a cot, folded

his clothes and put it on the shelf we build and afterward we hung up pictures that he

had and made the room look like a bedroom. It was very rewarding to see the before

and after because I got to see my hard work right away and that it felt like I actually

gave back to the community and did something was tangible for the village. After we

finished this house, we just helped other people and then went to the large area and

played with the village children. Since, today was our last day of the clinic trip all the

groups came to this village and we had a final celebration where the village thanked us

and gave us food. I was so grateful to them for having me help them because I gained

invaluable experiences and got inspired more than I could count throughout the whole

trip. It was so eye-opening to see how people survived with the bare essentials but still

managed to be happy and live peacefully. Overall, it was a trip that I thought I gained
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the most out of and I am so glad that I put in the work and dedication because I

ultimately believe that I got out what I put in.

This whole trip in general made me realize that importance of health care and

how people take it for granted in the United States. I think by the end of the trip I learned

to look at Peru in a sociological way, I was able to critically think about the Peruvian

people and got to understand their belief system. The way that the people view

healthcare, business and life in general is different in that they have different priorities

and they accommodate based on their living situation. The people in Peru see

themselves in a sociological perspective because they can see the truth of their lifestyle

and they use that to see the constraints as well as the opportunities that are offered to

them such as the mobile medical clinic that I was able to volunteer at. Through this I

could see that the power in this country was held by the people that lived mainly in the

city and not to those people that lived up in the mountains because they were not that

active in the community. I was able to learn how to thing critically from these people by

observing them and seeing how they take things in their life very light and how they

choose to live those conditions which I thought was dire but to them it was their choice

to live in their native country. The experiences that I was able to acquire from the trip

made me realize that the villages that we did not visit were at a disadvantage because

they did not receive the same free healthcare that was being offered to other villages

that were in the same state as them. However, the service site does not have access to

all the villages because some of them are too far up to go to, and some do not have

electricity so we would not be able to give them proper treatments. By incorporating the

things that we learned in class with the things that I learned from Peru I was able to see
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and assess the situation that the Peruvian people were in, especially the people that

lived up top on the villages and their inaccessibility to health care was a constraint that

was put on their health. If I thought about it sociologically their health diminishes only

because they do not have access to the clinics but for people that live in the city who

have access to healthcare, have better health. There were many things that I wondered

while I was at the clinics, like what did they think of us? I knew that they were thankful to

receive healthcare and treatments but what did they actually think we were doing this

for? Did they realize what our organization was and did that each person was there for

their own different reason? I chose this trip because I thought that it would help me gain

experience in a different environment something that I have not yet experienced. I have

volunteered and shadowed doctors around Detroit and I got to see the disparities that

people faced here. I thought by going on this trip I would be able to learn something and

get something out of it, but I know some people went for a resume-filler, others went just

because they wanted something to do over break. I also wondered what they thought

about the way we put importance to healthcare? What did they think about the medicine

that we gave them and did they actually understand what was going on in their bodies?

I hope the villagers got as much out of it as I did because this experience was

invaluable and I was able to change my way of thinking about medicine and third world

countries. To end with, I am glad that I chose this service trip to go on because I did not

realize how much about their culture I would learn. I was able to not only help out at a

mobile clinic and give to people that did not have access but I was also able to gain an

enriching experience about their society and that helped me understand their way of

thinking and how they view basic healthcare.