Update from David – Instituto Nacional de Salud del Nino – 7 Aug 2013

Day 3 – 7 AUG 2013

Pediatrics hospital – Instituto Nacional de Salud del Nino

I was very excited about our hospital tour today. As you may or may not know, pediatrics is one of my top considerations for specialization at this point. The Navy has a very good peds program, and with 12 nieces and nephews I have grown to love interacting with the wee ones! Unfortunately we were informed immediately that our tours would be cut short today due to protests and strikes. They were to occur in the hospital within two hours of our visit, and it was preferred that we weren’t around for them. Just to be safe. . . That being said, we set off on our tour immediately visiting various floors within the pediatric hospital. Our first stop was the neurosurgery floor. The head doctor of each section gave us a tour, presenting each case to us. We were also given the opportunity to interact with and speak with the kids (those who weren’t too shy to say anything at least). The majority of cases on this floor included hydrocephaly, meningomyelocele, or brain tumors. One of the children had a facial palsy affecting the nerves for her muscles of expression. When she smiled only half of her mouth showed it, but she didn’t seem to be too bothered by it, showing off her adorable smile for Anthony many times. Another patient had a spinal injury that left her paralyzed and on a trach. Sadly, we learned her parents had brought her to the hospital and left her there. We soon became aware that this happens all too often in Peru. I remember this being the case in India as well. Many times families and/or single parents have trouble earning enough to feed themselves, let alone children. Then when a child becomes sick or disabled the burden of care becomes too much for them and they become abandoned. I am in no way justifying this, but it seems to be the mechanism for how this occurs: a truly sad and unfortunate scenario.


Our next stop was to the orthopedic floor where the majority of the pathology was broken bones. We saw numerous femur fractures, which will amaze me to this day. It is the biggest and strongest bone in the human body, yet we saw compound, full thickness breaks of the shaft itself. Some were the result of accidents, others from kids being kids playing in the yard. We also saw a girl with a shattered pelvis, which she suffered after a wall fell on her. Many of these injuries seem to correlate with the relatively unsafe conditions which many Peruvians live in. The majority of buildings we see do not look at all structurally sound or clean. Each child here had numerous x-rays documenting the course of his/her injury or disease. It seemed a bit overkill, but it may be one of the few diagnostic and imaging studies they have, so they make use of it. One interesting case was a child who had a portion of his femur shaft missing. It never developed. The doctors placed screws and rods in the leg, twisting the knobs on the device each day to stretch the leg to try to match it with the growth of the normal one. Each day it was turned roughly 1mm. We assumed that one day the gap in the bone will be filled.


After our walk through orthopedics we were taken to the burn ward. Though I’m sure difficult to see, I was especially interested in this visit and the standards of care the doctors used here. After waiting a few minutes in the hall more sad news was shared with us. A young boy had been brought in by his father with a number of severe burns covering a large area of his body. Shortly after he was admitted the father left, not to be seen again. The doctor was busy working with their version of child services, and no one else was available to give us a tour. Another sad case of the unfortunate fate of impoverished individuals.


During our tour we began to hear the constant beat of drums and some chanting outside the windows in the center courtyard of the compound. I made it over to get a look at the scene and snap a picture, but it appeared as if the rally had already moved on by the time I got there.


It was very interesting to see this children’s hospital and to try and compare it to similar hospitals back home. As was the case in our first tour, the sanitary conditions were questionable, but it seems like they were doing what they could with what they had. The children all seemed so joyous and carefree despite their afflictions. Many of them smiled and waved to us, and bantered with our poor Spanish. Many of them were also busy doing school work with lessons in mathematics and grammar.


Categories: Updates from Peru

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