Podcast N° 9 - Text Version
Hi, I’m Jorge Suarez, a General Practice Physician from Lima, Peru.
Welcome to MediPodcast: Medicine in cyberspace
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So on this episode, the first one in English I will talk about what you need to know if you are coming to Peru, my home country. It will be mainly focused on visitors who are doctors, nurses , medical students and volunteers.
First of all you have to know that a vaccination certificate is not required to enter the country. However, official policy of Peruvian health authorities requires all travelers entering into the Amazon to carry proof of Yellow Fever vaccination even if an outbreak has not been reported . Recommended immunizations you should consider for travel to the Andes and Amazon are typhoid, polio , tetanus/diphtheria and Hepatitis A. Falciparum malaria exists in all areas below 5000 feet and in the areas of Jaen, Lambayeque, Loreto, Piura, San Martín, Tumbes and Ucayali. Dengue fever outbreaks are common in the Amazon Basin. All health centres, which are controlled by the Ministry of Health, will provide free information and medication to anyone entering a high risk area.
In the Peruvian jungle, at least in the city you won’t deal with cougars, anacondas or cocodriles. There are insects everywhere but they’re not usually dangerous.
Most jungle people in small towns (and in the city too) don’t have good sanitation habits, that’s why they get so many infectious diseases and parasites. Drink only bottled water. Pasteurised milk is widely available. Avoid dairy products that are likely to have been made from unboiled milk. Avoid street food vendors and the cheaper restaurants. Only eat well-cooked meat and fish, preferably served hot. Pork, salad and mayonnaise may carry increased risk. Vegetables should be cooked and fruit peeled. Always check the expiry date of processed food. If you have some care washing your hands, food, always trying to be clean you will have no problem. Of course sometimes it can be a goal very difficult to achieve. Just imagine being touched by not so clean hands of funny, loveable, tender local kids.
If you are going to collaborate in some clinic days it is good to know what diseases you will probably see. Most patients, specially children, will have a worm infestation. For that Albendazole or Mebendazole can be used. These patients could also have anemia.
Some patients will consult because they have arthritis usually severe due to lack of treatment. Other patients will complaint about skin lesions of different kind, they are very common in the jungle because of humidity and sun rays.
A very spread belief among local people is that vitamins can do miracles for health, so they always ask for them. Remember that previous medication against worms is always needed before taking vitamins.
In the highlands besides diseases mentioned before you will see people with respiratory complaints because of the cold climate, that could also be a problem for you and of course you can get “soroche” as it is known the high altitud sickness.
In the coast if you go to any poor place around the city you will have to deal with the effects of dust and sand in people’s health such as respiratory diseases , skin lesions and parasites.
In the jungle, in the highlands or in the coast you can taste a lot of delicious meals, don’t go home without enjoying them. Maybe you will fear having to eat a guinea pig, but don’t worry, if you don’t, nobody will get angry with you. You have to realized that many centuries ago there were no cows, goats or sheep here in Peru. Llamas and guinea pigs were the only protein source , that’s why we don’t see them as pets.
And if you are worried about travelers’ diarrhea kep on mind that Peruvian food can be too spicy or heavy for what you are accustomed to. You can get sick but it usually lasts for only one day or two.
If you want to do a research or know more about infectious diseases and parasites here in Peru you can check the Gorgas Course’s website. Targeted to physicians, nursing professionals, physician assistants, and public health professionals.. Clinical exposure is not merely observational. Intensive interactive clinical teaching by one of the listed course clinical faculty is done in small groups. Each participant will attend at least one clinic in each of the tropical subspecialties listed, and highly illustrative patients will be arranged for those days. Clinics and rounds in Cuzco and in Iquitos will feature pre-arranged highly illustrative cases. Unlike in many other on-site tropical training settings, the patients seen by Gorgas physicians have full access to advanced diagnostic microbiology, immunology pathology and radiology so that diagnoses are in most cases confirmed and not merely presumptive.
Visiting the Johns Hopkins magazine online we can know about a group of American physicians, residents, and nurses who made its way across the dusty courtyard of a temporary clinic set up on the edge of town in Chulucanas. The team came to this northwest corner of Peru to spend two weeks tending to sick children, many of whom have never seen a doctor before because of their parent’s poverty.
Reading the whole article one can find some misconceptions and misunderstandings mainly because an Spanish word can have its equivalent in English but the meaning is usually different specially for rural people . That’s why it’s not enough for American doctors and volunteers to work along with local translators but with the local doctors. One fact the American group realized was that they have treat the disease but not the cause. It’s better when the traveling clinic doesn’t stand alone but it is part of a group of tasks to be done: helping with children’s education, water systems, promoting better ways to raise the animals or cultivate the fields as it is already being done in other Peruvian places like Caxamarca, Moyobamba, Iquitos.
One last thing to say, which is better ? To see for example three hundred people and give them medicines or see just one hundred people, hear their problems and teach them how to prevent diseases and stay healthy, of course spending more time in each person. The final answer is yours.
Well, I have to apologize for my bad English, don’t worry, you can find this podcast’s text version at www.drsuarez.net/Podcasting/
I hope this podcast was useful for you. Thanks for hearing MediPodcast . Good bye.
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