I Cannot Complain about our Healthcare System

Today was quite a day. I don't even know where to begin, my head is still spinning. So this morning we met at Mark & Lori Berry's house (my team leader and his wife). So they recently moved into the house that they are renting. The owner of the house has been making some changes and fixing things, well actually has hired different groups of people to work.

We were meeting to have an orientation for myself and Kiera, who is interning here for a few months. It was only a few minutes into the meeting when we heard a huge “thud” and then some moans. We ran outside to find one of the workers had fallen off the roof at the doorway, and already had quite a bit of blood covering his face. He had a deep laceration above his left eye and an obvious break of his left arm above the wrist. We jumped right in and started applying pressure to the eye wound, and ice, elevation, and a makeshift splint. I wasn’t really sure at first how we were going to transport him to a hospital, not really knowing how that works here. With the head wound from his hard hit, it was unsafe to use a taxi to transport him. We were able to call an ambulance, which the firefighters respond to. (Which is fortunate—many places in Peru do not have an emergency system like this, in fact many of the shantytowns outside of Lima do not either). The firefighters came, placed a neck brace on him, placed him on a backboard, and soon they were off. Mark and one of the coworkers of the guy who fell went along with them in the ambulance. The pastors wife of the Santa Anita and Huaycan Churches, Reyna, and I went in a taxi a little bit later.

In that time period during their departure and ours, the police arrived for questioning. Once they found out that this man who fell did not have insurance (which is quite common here because often insurance is hard to come by, or the system is just as corrupt that it doesn’t really reduce costs.) He wanted to place the blame on Lori, after seeing that there were North Americans living there. Reyna kept trying to explain to the policeman that they weren’t responsible; they didn’t hire the guy, that the responsibility was on the owner of the house. He still kept trying to get Lori’s passport number for the records, and Reyna kept explaining that her info was not needed. Then the gardener jumps in as well and said that she was not responsible at all. We were told that he was probably trying to place the fine on her anyways because she was North American. He finally drove off very angry. Unfortunately here when many people see a white face all they see next is $$$$$.

So Reyna and I went on to the public hospital that they took him to. [Approx. 11:30] A series of unbelievable things will now follow about the health system in Peru:

In order for a patient to be seen those with the patient need to pay for an admittance fee. So you have to walk to a different area of the hospital to get that. When that is covered, the person will be seen, but only to determine what medicines or supplies are needed. Then those need to be bought. There is a pharmacy in the hospital, yet in another area, but if they don’t have everything, we have to go out of the hospital grounds to one of the pharmacies across the street to purchase the rest, and if that continues, we keep looking in all the pharmacies in that area until we have all that we need. (Meanwhile the patient is still on a gurney waiting to have help---in our case, broken arm and bleeding head). This hospital is also a teaching hospital (which that alone makes me cringe! These students are learning how to treat patients, but how to treat them horribly!) But there were several students who were eager to sew him up, so that was the only thing really that happened fast in comparison with the rest of the day. So that all was taken care of. We are still waiting for more to happen. Pretty much, if you want your patient to be seen or attended to, you have to keep asking people to check on things, you have to stay on top of them. (This was Reyna’s role, which she did amazingly well! I was always kicked out, they kept saying only family---I don’t know why they thought I wasn’t!! :] )

So then Reyna keeps asking for attention, getting different answers from different people, “Oh, we’re waiting for the doctor to come from surgery,” etc, and being brushed off. Finally after maybe another hour, someone comes to look at the guy, sees that he doesn’t have another set of paperwork, and asks us to get his triage paperwork. (This being the first time we’ve heard of this, and of course going to another place to have paperwork, fortunately a bit closer.) The triage paperwork isn’t like triage for us; it was just his information, being name, birthday, age, parent’s names, and what he was in for. This happened maybe at 2:00. So we should by now have all the paperwork, although it has been a maze to get it all. X-rays have been ordered, as well as an echogram to check for internal bleeding. Fortunately the x-rays can be taken in the ER. Unfortunately, when he was taken for his echogram, the workers in that department were on strike, a strike that only started a few hours before. Not even the nurses were informed of this, however they were commenting on how often this happens. Finally a radiologist came to our aid, and took the test for our patient.

He was taken back to the ER, to sit and wait for a doctor that still had not come to look at his arm (this arm, which was still laying to his side, not elevated, iced, or splinted.) They kicked me out about as soon as I would go back, and me being a nurse didn’t help, who knows, maybe intimidated? I mentioned to Mark, that if we were still getting the run around and they weren’t going to be doing anything to this guys arm, then it at least had to be elevated, as it was now around 5:45. When he went back to say something to someone about it, he and the coworker were kicked out again. Mark asked me if I could go back and say something to someone, once I found Reyna. Maybe it was good timing, but when I did find her, she was talking to the “traumatologist” who told us that she was going to set his arm in a few minutes (probably the first true statement we got the whole day from the staff there).

The doctor went looking for assistants. Reyna mentioned that maybe I could help her. Granted, I didn’t really know what she was going to have her help do, but then my mind remembered the situation earlier with the police, and that if anything went wrong with setting his arm or casting his arm, would they pin it on the north American girl who was assisting? The doctor pulled in 2 assistants: a nursing student, and a woman custodian, who left her garbage can and broom next to the door before she entered in. What was the doc going to have her do? Maybe I should have gone in anyways! So his arm was placed and he got his cast on. It was now maybe 7:00. (He had arrived there between 11-11:30) So then we get him out of that room after he received his cast (who is now pushing his gurney? We are, in order to keep on top of things getting done for him). We waited outside in the ER hall for his next X-ray to see if it was set well. Now adjacent our guy in the gurney was someone dead wrapped up in a blanket on top of a gurney. We took him into the radiology room, where there was no radiation protection. The radiologist wore nothing, nor placed anything on the patient to protect him, and there were 2 doors leading into this room, with only one that was closed. We waited for the results from the doctor. His arm was set fine, but she wanted him to stay overnight for observation for the head wound.

So if a patient comes to a hospital emergency room, someone needs to be there staying on top of everything. This person runs around in a labyrinth of places to go to have all of the right paperwork, all the medicines, etc. What happens if there is no one to help them? If a patient is admitted, the family is responsible to bring food to the patient. If there is no family, friends, or no one knows the person has been admitted, do they go hungry?

Rafael, this man who was injured is a father of a 1 year old little girl named Gianella, his wife is 18 years old, and they live up high on a hill in a shanty area, where they do not have electricity nor running water. He couldn’t find work, and needed to provide for his family, the coworker asked him to help him this week, and the day of his fall was his first time working there. He has no insurance, nor probably the opportunity to get it. What happens now? He can’t work. There are no sick days for the unemployed. There are no food stamps.

Does it make you think? It makes me think!!! This is real. This is what happens everyday. If only I could somehow add the smells, the blood, the screams, or the cries that I heard in the hospital into this blog. It is here, a simple bus ride from my home, and I could take other rides to other hospitals here and see the same. My gut still turns from observing so much there at the hospital. Not just the frustrating system, or lack of system. The lack of hope. The many running out crying. Why?

A hospital operated like a mechanic’s shop: paperwork, and techincal skills. It is real people who enter, but are treated without dignity. It sure isn’t health care.

Our team wants to do what we can for this man and his family. They are not believers. We’ll see what God has in store, and how we can serve in this situation. The truth is that there may not be hope in that hospital. But at least 4 people walked in there yesterday with the only Hope that the world has.