Community Health in Peru: The Home Stretch

No class, book, or professor in Nursing School could have prepared us for this week. Day after day, we faced new challenges with people whose hardships are bigger than ours will ever be. In the nursing home, we spent our last day with the women giving hand massages and teaching chair exercises. This place was always a challenge, because there is one nun and her assistant to look after about fifteen patients. Sadly, the people who inhabit this wing are women with extreme cases of dementia. Many of them sit in chairs for hours, a blank stare occupying their faces. It was certainly humbling to be feed them, give them a massage, or simply be present with them.

After the nursing home, we came to our last time with our women’s group, Vaso De Leche. Over the past three weeks, we have been working on our aggregate assessment presentation, to be done for them this week. Our presentation focuses on three nursing diagnoses that fit in with what the women can do to fully reach their potential. They already do so much, mentoring for their communities and feeding the village children breakfast on a regular basis. In these women, we saw strong, confident people with a loud message. However, their voices are unfortunately muffled by a society that condemns women to the home, left without the opportunity to grow. Many of them had their education cut short by fathers who believe that women have no place in the professional world. But, this group goes against the grain.

  They are a voice for education, mentorship, confidence, and teamwork. We diagnosed them with stress, readiness to learn, and a lack of structure within their programs. In the weeks that we have been here, we have given them our knowledge. But no measure of education can be equivalent to what these women have taught us in return. Their perseverance and grace in their daily struggles has given us inspiration to become stronger women; advocates for our peers and our community. We have been so inspired by their inquiry and curiosity, and we only hope that our suggestions and outreach will be taken to heart, from women to women. As relieving as it is to have this presentation and the twenty two-page paper done, we are anxious to see if Vaso De Leche will expand and grow like we hoped it would. Only time will tell.

Finally, it was time today to say goodbye to the hospice. We spent the most time here, bonding with people whose strength has no measure. We worked with Hermelinda, the woman whose leg is consumed by a deadly cancer. She persevered through every painstaking dressing change, even helping us on occasion. Unfortunately, her time here is limited, as doctors have given her a prognosis of four months. Given that she is uneducated, sick, and a woman, no one, including the nurses at the hospice, have told her about her cancer. Due to cultural humility, we have shut our mouths at this Peruvian show of silence, simply hoping that it will change in the future and that she will stay strong through her time left.

A few times on this trip, certain things about Piura have rocked me to the core. None of them were like today. This morning, we lost a patient in the hospice. David, who suffered from complications from prostate cancer and pneumonia, passed away during the night shift. Over the past two weeks, we noticed physiological signs of impending death, such as fluid overload in his hands and feet. But none of us expected to walk into his room during our time here, only to see a white sheet over his body. David was the hospice’s first patient, coming in three years ago, fully able to walk and talk. The hospice nurses, Daisy and Coco, watched him deteriorate to the point of feeding tubes and a complete loss of speech. Today, these nurses graciously dealt with his death, saying that he was a father to them and a dear friend to the other patients. Here in Peru, people do not hire morticians or funeral homes to deal with the body. It is the family, and if present, nurses. So, accompanied by David’s son and the hospice nurses, we changed him into clean clothes and helped lift him into his casket. With Luis, another patient, we watched the car containing David drive away. Luis nodded toward the car, one last goodbye to his friend.

After a few moments, Coco brought us back into the moment. She said, “We are so sad to see him go. But here, there are other patients who need our help, and we will go into their rooms with a smile. Our day starts now.” Her words could not be more true, since we still were scheduled to tend to Oswaldo’s bed sores. Oswaldo is always difficult, because his wounds are deep and his mood is usually depressed. Today was the same, but when we finished, Oswaldo smiled. Somehow, through the daily dressing changes and paraplegia, he still manages to smile. I will always remember that smile as one of the most beautiful things I have ever seen.

Our upcoming final week here will consist of bittersweet goodbyes and work with a group of surgeons. We are to help with intakes in the villages for hernia surgeries, some of us also assisting a pediatric dentist with translating. We are sad to end regular clinical, but also excited about the change of pace. One week left of Marquette Nurses in Piura, and we are hoping to go out with a bang.