Five Days Inside A Compassion Bubble
Ever since I returned from a trip to Peru in early February of this year (2015), I’ve been telling people that it changed my life. “What do you mean? How? Why?” they’d ask. And I’d have an incredibly difficult time explaining and answering those questions. In fact for the first couple of weeks after I got back, I couldn’t even talk about the experience without dissolving into tears. I was in Peru for ten days, and for five of those days, I was with a medical team from Oregon, including my father, that travels there every year to treat indigenous children at a tiny clinic deep in the Andes.
I’m a lifelong reporter, so I took with me all of my usual audio and camera equipment in anticipation of bringing back a story. And that was the promise I made when I was granted access to join the team. But it’s taken ten months to get it done… to get it out of my system. I’ve struggled with why that is. Sure, I’ve been busy — who hasn’t. But in talking recently with a friend who volunteered at this same clinic, I realized he was uniquely qualified to understand the real reason: “You’re worried you won’t do it justice.”
Every once in a while, as a journalist, a story like this will come along and literally change your life, and what you want to do with it. For me, this is that story. I hope I’ve done it justice.
If you’re fortunate enough to travel to Peru’s Machu Picchu, you’ll probably ride a bus from Cusco to Ollantaytambo to catch the PERURAIL train, or to start your walk on the Inca Trail. Along the way, while you blink, you’ll pass the town of Coya, population 3,700. It lies amid a vast oasis of green corn fields and red quinoa plants on the banks of the Urubamba River.
Coya is one of the smallest towns in the Valle Sagrado de los Incas (Sacred Valley of the Incas), high in the Peruvian Andes at nearly 10,000 feet.
In late 2014, Peru’s Institute of Economy and Enterprise Development declared that the country could gain first world designation by 2027 with the right economic reforms (and 6% annual growth). Its capital city, Lima, bustles with all the activity, good or otherwise, of any world metropolis.
But the vast majority of Peru is still “developing” — the preferred designation for what used to be called “third world.” Coya is an embodiment of the halting pace of progress. You can get a Coca-Cola and Pringles at the corner bodega, and you might even get weak wifi, but you can’t flush paper down the toilet.
And at the local medical clinic, surgical feats that the Western world would consider difficult-though-routine medicine are, instead, the stuff of science-fiction.
In February of 2015, I accompanied a team of doctors and nurses from Salem, Oregon, including my father, on a medical mission to Coya. My dad had been going on these missions for years, and the team allowed me to join up in my capacity as a journalist.
They touched down on a Sunday morning in Cusco, the nearest major city, rode an hour in a cramped van, checked in to the one small hotel in Coya, and headed straight to the clinic after more than 24 hours of travel.
Clinica Kausay Wasi provides heavily discounted and often free health and dental care to about 200,000 indigent, and mostly indigenous, patients in the Sacred Valley and beyond each year. It was founded in 2005 by Guido and Sandy Del Prado. Guido is a retired U.S. Foreign Service Officer, a former Peace Corps Director, and a force of nature. He was raised in the Sacred Valley before attending school in the U.S.. Sandy is American, and a former Peace Corps volunteer who then spent 25 years as a Health Project Officer with USAID.
“ This clinic was created with one thing in mind,” Guido told me, “that the [indigenous] Indian population has not received: number one, good healthcare, and number two, the Quechua-speaking people do not have the respect of the professionals in the [Peruvian] health service. A Quechua-speaking person is treated like a second-class citizen. In our clinic we treat all people with dignity and efficiency.”
Quechua is the indigenous language of much of South America, and was the native language of the Incas. But it is rapidly falling out of favor with each succeeding generation, and is listed the Unesco “Atlas of the World’s Languages in Danger.”
The clinic brings in a different medical specialty each month. In January of 2015, volunteer optometrists from the U.S. fitted around 900 children and adults with glasses in less than two weeks.
Then in February, the orthopedics team, led by Dr. David Shaw, arrived to lines around the block of patients hoping for procedures to correct serious bone deformities. People from all over the Sacred Valley hear about these medical missions through local radio and printed flyers, and they travel long distances to get to Kausay Wasi, sometimes for days on foot from their communities high in the Andes.
The clinic itself is smaller than an average Walgreen’s, with two operating rooms, two recovery rooms, an X-ray lab, limited farmacia and several exam rooms.
It’s a striking reminder that 21st century medical care does not exist in most places on the planet, including here. The operating word for the visiting doctors and nurses is improvisation.
The clinic is funded almost entirely by donations. $200 American dollars buys medical care for a family for an entire year (scroll down that page for the adopt-a-familia program). Patients are asked to contribute what they can to their treatments and operations, even if it’s five or ten Peruvian soles (US$1.50–$3). But if they cannot afford even that, they are not turned away.
Guido tried to work with private hospitals in Peru to bring medical care to the indigenous population before establishing the clinic, but those facilities ultimately balked at “having poor people there,” he said. And so in a country where the medical system is severely stratified by income level, Clinica Kausay Wasi provides what its patients would otherwise simply go without.
On these medical missions, the orthopedic team from Oregon only sees young patients — children. With limited time and resources, this gets help to those who will live with the results the longest. And the first order of business is to triage as many children as possible from the large crowd lined up outside the building and in the waiting room.
Triaging dozens of patients in a single day in Coya is a far cry from how it goes back home in the states. Doctors have only minutes to evaluate what’s wrong, order xrays, and decide the best course of treatment. They also must weigh various risks against one another. One young patient came in who needed a surgical procedure that the doctors could certainly do, but he was a hemophiliac, and they couldn’t risk blood loss without having a separate blood supply available.
But at its root, medicine is medicine, no matter what the facility or circumstance. Doctors diagnose. Parents worry. Children try to understand what’s happening, and grab onto your soul along the way.
During triage on that first day, the nurses and anesthetists unpacked what amounted to 1,100 pounds of medical equipment — two 50-pound bags brought from Oregon by each team member, full of everything from masks and gowns to scalpels, rods, surgical saws and hammers, all packed with military precision.
All of the materials and devices are donated, as are the skills and time of everyone on the team.
Dr. David Shaw has conducted these missions to South America — both Ecuador and Peru — for years, under the auspices of Capitol City Medical Teams. Before the trip, he made it clear that this shouldn’t be a story about American doctors going to save poor kids. “It’s not about us,” he said.” Okay, I replied, let’s see what I find.
What I found was American doctors saving poor kids from physical disabilities that made what was already an extremely hard life, even more difficult. The lack of standard pre-natal and maternity care means that maladies like cerebral palsy are far more common than they are in developed countries, and problems are not caught and treated early.
Many of the children who came to the clinic were unable to walk correctly, or at all, because of severe bone deformities that all three orthopedic surgeons on the team said were unlike anything they see back home. And in Coya, the doctors don’t have anywhere near the tools of modern medicine that they’d have in a U.S. facility. It means the team is practicing medicine that is almost old-fashioned in its approach.
“These are big-time cases,” Dr. Shaw told me. “Even if we had the equipment they would be complicated. Here, we have to go by feel, our knowledge of anatomy and experience. So it can be done but it makes it so much more complicated.”
In the case above, Dr. Shaw said he debated whether to do anything at all. “When I got the x-ray I almost fell over because I had not seen anything like this. She has such narrow bones and we don’t have the type of hardware that is needed. And a lot of people would say oh there’s no reason to do anything, she’s a fine, happy little girl, reasonably functional [even without surgical intervention]. But the other side of it is she was not able to walk because the lower legs were so deformed her toes were pointing straight down because of the deformity. So the purpose of that first surgery was to straighten out the legs enough so that the heel will come down, at least the foot will be flat on the floor.”
One of the other complex malformations the team saw this year was an 11-year-old girl with club feet. Both of them. Angled at 90 degrees sideways from her legs.
This patient could walk, but not like the rest of the kids, and with significant difficulty. And finding shoes? Good luck.
But she managed, like all children learn to do. Life is already hard when you live in an area so remote that there are no modern conveniences, like plumbing and electricity. Club feet are just another … not even an obstacle to overcome. They’re just a fact. So the possibility of turning those feet so they faced forward was something she could barely comprehend.
On day two, patients and their families were again queued up outside the clinic. Some of them had, at that point, waited 24 hours or more in Coya in the hopes of seeing one of the doctors, who had already triaged some three dozen children on day 1. But what struck me more than anything that morning, was the patience of those who were waiting. There were no complaints. No anger at any delays. Just a palpable sense of gratitude that there still might be hope for help. Parents were clearly worried for their kids, but the patience with the highly organized chaos surrounding them was astounding. The nurses from Oregon confirmed this was not what they experience in waiting rooms back home.
In addition to the five doctors in Coya — three orthopedic surgeons and two anesthesiologists — seven other team members, most of them nurses, led a system of pre- and after-care that was nothing short of miraculous, given the facilities and time constraints. Surgical schedules posted… equipment sterilized… patients and families kept informed of what was happening when. And through all of it, every team member kept saying how deeply meaningful the experience was for them, not just for those in their care.
This was the 20th mission for nurse Lettie Turner, who spent most of her career caring for adult patients. “ When I was asked to come on the very first trip, I was a little hesitant of recovering babies and young children,” she said, “but I thought ok I can go on one trip. And it is pretty addicting to come back here. To be one person on a great team to help 30–40–50 kids, and also give some education to parents who maybe didn’t know some things they could be doing around the house to help these kids, positioning [their bodies] and stuff like that.”
I mentioned earlier that the operating word (so to speak) for everyone on the team, and indeed for all clinic staff including Guido and Sandy, is improvisation. Those improvisational skills were tested on the second day when road work led to water being shut off throughout town, including at the clinic. You cannot conduct surgeries without water, especially hot water. Guido — who I also noted earlier is a force of nature — got to work twisting whatever arms he could in local government and beyond, and the team had to start using water from a small cistern on top of the building. That water was then boiled on a stove and placed in thermoses for use in the operating rooms.
Guido said those kinds of struggles are just part of daily life at the clinic. “It’s a challenge,” he told me, “It’s a challenge with the communications system, it’s a challenge with the electrical system, it’s a challenge with the local authorities, we are a subject of a lot of inspection and we have to be more catholic than the Pope. But those are the hazards of underdevelopment. And by the way, underdevelopment has very little to do with politics, and it has very little to do with economics. Underdevelopment is a state of mind. You get out of it by educating people.”
Improv also defines the prosthetics that are used to assist patients in walking. They’re made in a one-room facility on the other side of the city square… with hand tools and whatever they can find to construct a leg or other appendage.
Once the surgeries started on day 2, long days bled in to evenings. O.R.s were cleaned and sterilized between procedures, patients were prepped and then monitored post-op. And for the remaining days at the clinic, the only goal was to make these kids’ lives better — less painful, and at least a little bit more normal. The tears flowed with the pain of surgery, but the smiles were bigger and far more plentiful.
When you’re exposed to that much time — even just five days — in what I now call a compassion bubble, it’s hard not to become emotionally connected to what you see and experience. There is a reason they call it the Sacred Valley. I cried every day after getting back to the hotel, and I wasn’t sure why at the time. But now I know it’s because we spend so much of our day being bombarded by bad news, allowing ourselves to be consumed by hashtag-first-world-problems, and giving far more consideration to the ridiculous rather than the sublime, that when you’re suddenly immersed in the polar opposite of all that, it’s disquieting.
I realize it’s cliché to go to a developing nation and spend time with people who live in abject poverty and come away wondering what, exactly, you’re doing with your life. It’s the stuff of books and movies-of-the-week and platitudes.
It’s also what happens when you find yourself in a place where so much joy and beauty and gratitude exists… where it shouldn’t. Not by our standards. Not by any standards, really.
There is, of course, a danger in talking about observing happiness among people who have nothing — and some of the children didn’t even have underwear — because no one would ever argue that these families wouldn’t benefit from an improved standard of living. But I was moved — deeply moved — by what I saw and experienced, by the children who laughed in the face of great adversity, by what the medical teams from both Oregon and from the clinic accomplished, and by the fact that there was nothing but consummate compassion happening at every turn, and in every moment of each day.
When I embarked on this story, I figured it would be about my dad. A journalist goes along on a journey and sees for the first time what her father has made his calling for literally as far back as her memory goes. And yes, I did love watching Dad perform surgery, and I love that these missions are a part of his life.
But the experience went so far beyond that. It changed me. It changed what I want to do with my own life. I still can’t fully explain it, and I certainly don’t know whether I’ve done it justice here.
But as a direct result of my time in Peru, in two days, I am leaving this country on a one-way ticket and moving abroad to find and tell more stories like this one. Stories of people who are doing good in the world, and shining light into what often seem like very dark times.
Stories of life inside a compassion bubble.
Because whether it’s in a tiny village in Peru’s Sacred Valley, or somewhere deep in the recesses of Southeast Asia, or wherever the stories might take me… who doesn’t want to spend more time in one of those?
To adopt a familia and provide a year’s worth of healthcare for them at Clinica Kausay Wasi, contribute here: http://ccmedicalteams.org/how_you_can_help.php
