Another day, I went to visit a couple of the villages to see the work of Buena Comida, the Good Food programme, where they are teaching school children how to grow vegetables to encourage better nutrition. The main diet consists of rice, potatoes and yuca, a starchy root vegatable, with the occasional beans, chicken or cuy - guinea pig! It is surprisingly tasty, if a little hard to get all the meat off their wee bones!

The Clínica San Lucas at that time employed two doctors (a gynaecologist and a physician specialising in general (internal) medicine), two nurses, one pharmacist and two laboratory technicians. The work of the clinic is rather like that of a General Practitioner here. There is not such thing as a prescription though. You can just wander into your local corner shop and pick any of the vast array of medicines you would like!

Another main work is the annual week of free surgery for patients, mainly children, with cleft lip and palate, involving maxillofacial surgeons from Lima and the United States, psychologists, and speech and language therapists. The rest of the year is spent identifying these children and visiting them in their homes, which could be five hours walk from the nearest road.

I went with the co-ordinator of this programme to visit some of these children and to offer some basic medical help to the villages. These children are often ostracised by their school friends and family (especially by their fathers who see it as a slight on their masculinity to have a 'deformed' child). Some of the older ones no longer go to school because their teachers have sent them home, saying they can't speak properly, no one can understand them, and they are too difficult to teach.

All the families I met were living in incredible poverty - I can really see how much I take for granted. They had no running water, no electricity, no toilets, no beds, with the nearest medical help several hours walk away. There was no doctor free to go and visit these children so I was sent to do the medical part of the job! It was scary having to make diagnoses on the spot, having not graduated and not havcing the usual equipment and investigations of medicine back home. Everyone (including me!) had parasites, so I just went ahead and treated them, but I diagnosed many an ear infection on the basis of pulling the kid's ear and asking if it hurt!

1. Children tending their school garden, learning how to grow vegetables
2. Guinea pigs on the kitchen floor, all ready for the next meal!
3. Keziah with a baby with cleft and palate. He was six months old but couldn't suckle properly and only weighed 6 pounds
4. Visiting the villages to see children with cleft lip and palate
5. Look at the drainage system for the village - there is no running water or sanitation there