Cuidado de La Salud en Huancavelica

(Due to time constraints, this entry has been typed in English.)

There are two hospitals in Huancavelica: El Hospital de MINSA and El Hospital de EsSalud. The main hospital that the PAMS volunteers worked at was El Hospital de MINSA. The word MINSA is short for "Ministerio de Salud". From my understanding, MINSA provides health services to the people in Huancavelica and other regions of Peru, provided they fill out the necessary paperwork and they have health insurance with either SIS or EsSalud. I will explain more about the healthcare system in Peru later in this post.

OUTSIDE OF THE HOSPITAL:

As you can see, the outside of the hospital consisted of tents for patient consultations on a number of departments, depending on the specialties of the HMM doctors/health professionals. The tents had nothing but a desk, a chair, and a small gurney for patient assessments and examinations. Unfortunately, the tents were also at the mercy of Huancavelica's climate; some days, the tents were extremely hot, other days there would be so much wind that the tents would start to topple over, and a few times there would even be rain. Still, I found the tents to be extremely effective for our workshops, and at nighttime there was even a light bulb attached at the top of each tent to supply light.

INSIDE OF THE HOSPITAL:

(This room could fit about 6 patients!)

Contrary to the tents outside, the inside of the hospital was consistently cold. And though the pictures may make the hospital appear larger in size, in reality it was quite small. Still, there were a number of departments and services available for patients as seen on this board:

I was amazed to see all the services that the hospital could provide, though the downfall is that many patients (waiting as early as 8am) had to stay in line for triage to have their vitals checked, papers filled, and be referred to another department in the hospital.

Here's a picture of all the patients waiting bright and early in line:

If you notice the sign on the first picture above, there is an acronym that says "SIS". SIS stands for Seguro Integral de Salud, and was a system established in 2002 to offer free healthcare to Peruvian citizens. Of course, even with the free healthcare services, residents still had to consider costs for traveling and medications. With these costs, not all patients could have access to healthcare.

On the other hand, EsSalud is another way that Peruvian citizens gain access to healthcare. EsSalud is short for El Seguro Social de Salud del Perú -- it acts as a social health insurance system that does require payment. There was a triage tent for EsSalud that stood in Hospital MINSA:

Patients who line up at this tent do have insurance for EsSalud, and thus access to other services. It's difficult to determine whether or not the services had higher quality or less of a wait time, but from several conversations and general understanding, the patients with EsSalud may have had equal or better quality of their services (compared to SIS), plus less paperwork to fill out. But, as you can imagine, only a few patients had EsSalud; the vast majority had SIS.

It was very interesting to see healthcare in action while in another country, especially one with such pressing issues in health. Of note, here are some interesting facts about rural poverty in Peru (thanks to T.C. for the facts!):

Rural Poverty in Peru: 

• Peru has one of the highest economic growth rates in the world, but 35% of people live below the poverty line.
• Poverty in Peru is deepest in remote rural areas
• Nearly 9/10 rural poor people are in the arid Andean highlands, where they produce basic food crops at a subsistence level.

—The 5 poorest states in Peru (in comparison to Lima’s 3%):

• Huancavelica (74%)
• Huánuco (61%)
• Cusco (49%)
• Cajamarca (50.8%)
• Apurimac (47%)

What does this have to do with health? Take those stats into consideration, and then consider the fact that, because a large portion of Huancavelica residents live in poverty or below the poverty line, many are uneducated and perhaps unaware of the preventable diseases and ailments they contract. In a nutshell, these diseases and conditions include:

• Parasites
• Rabies
• Food-borne and water-borne illnesses
• Sun burns and scars
• Childhood malnutrition
• Tuberculosis
• Vitamin and iron deficiency

So what are the health needs of the residents of Huancavelica?
Education, education, education.

The HMM student volunteers and I thus implemented several workshops at the hospitals and orphanage to educate the residents about the importance of hand washing, sanitation, sun burns, and fire safety. I'll be posting another blog about the workshops later on.

Overall, the solution for healthcare is difficult in a country with few resources and the majority of people in poverty or below the poverty line. Being at the different hospitals in Peru and seeing the healthcare system in action there was definitely a big surprise, too, just because it reminded me of the healthcare system in the USA: you may have to wait a long while before you get seen by any doctor, and when you do get seen, you may or may not get the treatment/medication you need, and there are certain hidden costs that aren't exactly presented to you until later on.

In other words, it's tough. There is no perfect healthcare system, but at least Peru is on its way to improving their healthcare, especially with the establishment of SIS.

More entries to come!

• Aldea Infantil "San Francisco de Asis"
• La Comida de Huancavelica
• Nuestros Talleres de Educación para La Salud