Monday, February 12, 2007
Declare his Glory among the Nations (5)
As there is no real version of the National Health Service in Peru, patients can visit a vast array of clinics for medical attention, paying for each consultation and for every investigation. Examples for this include 35 nuevo soles (about £6) to see the doctor, then 10 nuevo soles (about £1.70) for every single blood test. My favourite part of the price list was in Obstetrics section - "Delivery - 1000 nuevo soles" (about £171), followed by "Delivery without pain - 1500 nuevo soles"!
Given the average monthly wage in Peru is 345 nuevo soles, equivalent to £59 a month or £708 annually, and the expense involved in visiting the doctor, even at the comparatively low prices of the clinic, many people visit their doctor only when things have got very serious. It also means that a lot of our normal health promotion strategies are abandoned - most people could never afford to buy the tablets to control their high blood pressure. Another difficulty here is that most of the older people are illiterate.
The doctors here also do operations. I assisted with one at 6am because it was the only time the anaesthetist could come to the clinic. The tiny operating theatre was baking, even at that time in the morning. Understanding the muffled orders of surgeons is difficult enough in English - never mind in Spanish!
With regard to the language, I had learnt to speak Spanish solely for this trip. I was staying with a Peruvian family and all my friends and colleagues were Peruvian, so I was constantly speaking in Spanish. It was all incredibly tiring combined with the unrelenting heat. Sometimes I would just retreat up to my room to read a book or letters to escape back into an English-speaking world just for a rest! It was lovely to get things to be translated too, even if I needed to correct some misconceptions. One of the letters included the phrase, "In the city of Wales, England!" I also had to try to explain that Scotland was a country in its own right and not just part of England or, worse, part of the United States!
Given the average monthly wage in Peru is 345 nuevo soles, equivalent to £59 a month or £708 annually, and the expense involved in visiting the doctor, even at the comparatively low prices of the clinic, many people visit their doctor only when things have got very serious. It also means that a lot of our normal health promotion strategies are abandoned - most people could never afford to buy the tablets to control their high blood pressure. Another difficulty here is that most of the older people are illiterate.
The doctors here also do operations. I assisted with one at 6am because it was the only time the anaesthetist could come to the clinic. The tiny operating theatre was baking, even at that time in the morning. Understanding the muffled orders of surgeons is difficult enough in English - never mind in Spanish!
With regard to the language, I had learnt to speak Spanish solely for this trip. I was staying with a Peruvian family and all my friends and colleagues were Peruvian, so I was constantly speaking in Spanish. It was all incredibly tiring combined with the unrelenting heat. Sometimes I would just retreat up to my room to read a book or letters to escape back into an English-speaking world just for a rest! It was lovely to get things to be translated too, even if I needed to correct some misconceptions. One of the letters included the phrase, "In the city of Wales, England!" I also had to try to explain that Scotland was a country in its own right and not just part of England or, worse, part of the United States!- The Ward and Accident and Emergency
- The Delivery Suite
- The Operating Theatre
- The staff at the clinic
2 Comments:
And for those who are used to US$, the exchange rate is about S/.3.50 (3.50 nuevo soles) to $1. Therefore, it would cost about $10 to see a doctor, and the average monthly wage is a little less than $100. Wow!
Keziah, I have been told that in many ways Peru is about 30 years behind the times. Did you find that was true medically? (With the instruments, medicines, etc. available to use)
Thanks for that, Ashley. I should have done that for you.
For my Australian friends, it would cost $14.15 to see the doctor and $606 to have a delivery without pain!
For the Canadians, it would cost $13 to see the doctor against an average monthly wage of $127.
It's difficult to comment on the medical care because I was somewhere so completely different. In the cities, I imagine that things are very up-to-date with a lot of influence from the United States.
Prescribing medicines was more limited due to availability and cost. Some of the time the casemix and treatment was the same as I would see here, but many of the tests and some of the treatments used were quite archiac.
For my own clinical knowledge, it was a great learning experience. You can't do the same tests as you would here, so you need to trust your clinical instincts and skills far more.
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