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Peru: Giving and Getting Back Even More

The route from the village of Larapa to the Peruvian capital of Lima is torturous: six hours on horseback along steep mountain trails and twenty hours more by bus over roads paved with rocks, with timbers and often with nothing at all.  But for Luis Mamani, this difficult journey is also a journey of hope. Each mile brings him closer to a team of American neurosurgeons and the advanced spinal surgery that will save his life.

Through Eagle Condor Humanitarian, a nonprofit charitable organization providing medical outreach programs to people of lesser developed areas, Dallas Neurosurgical and Spine’s Dr. Michael Desaloms and Dr. Jeremy Denning have volunteered a week of their time to treat patients in need from the most remote and impoverished corners of Peru. They and four other American surgeons have arrived at the Lima airport with what seems like tons of donated equipment and supplies and carrying what is most certainly the only hope their patients have of receiving the advanced surgeries they need.

“Hospital care in Lima is actually quite good,” says Dr. Desaloms, “but many people can’t get to it.”  And as might be expected, it’s not just distance and geography that has put proper treatment out of reach. “Here in the U.S, a vial of surgical bond is $40, which in the scheme of things is pretty inexpensive,“ Dr. Desaloms says. “In Lima, that’s about what a hospital worker makes in a week.” Outside the major cities where 70% live under the poverty line, meeting the cost of even basic surgery is almost impossible. “The stuff that we do – spinal surgeries – without Eagle Condor, they would never get that operation.”

Over the course of the week the six American surgeons screened dozens of patients for spinal conditions. In all, 12 surgeries were performed. “We did two very unusual, very complicated spinal surgeries. Both were intradural spinal cord tumors that had eroded part of the spinal column. This called for a very intricate procedure where we had to remove the tumors and then fuse the spinal column back together with screws and rods.”

And what is it like performing complex spinal surgeries in Peru?  “Dr. Victor Torres, our host, has dedicated his life to helping the underprivileged,” Dr. Desaloms answers, “and he’s a very resourceful guy.  We were based in one of the city’s oldest public hospitals, which was fine for most things, but we weren’t happy with the O.R. for spinal work.  Next thing you know, Dr. Torres has made arrangements with a private hospital called Maison de Sante. It was just what we needed.”

With support staff drawn from the Lima medical community – including “two outstanding anesthesiologists” – Dr. Desaloms and Denning spent eight hours in surgery with the 35-year-old Luis Mamani, successfully removing an aggressive tumor that in mere months had made it impossible for him to walk and was now threatening his life. Their second patient was a young woman whose severe back pain was revealed to be caused by a massive tumor on her spine. After 10 hours of surgery, Desaloms and Denning are confident she’ll recover to lead a full and normal life.

“The patients are just awesome. They’re very friendly, very gracious – and tough as nails,” says Dr. Denning. 

Not that there weren’t a few situations requiring quick, sometimes unorthodox, solutions. In one case, getting a proper biopsy meant hailing a cab and sending the patient‘s family through rush-hour traffic with a tissue sample in a Styrofoam cooler so that the head of pathology at another hospital could analyze it. Dr. Desaloms even snapped a photo of the tissue on his iPhone and sent it to a pathologist in Dallas for a second opinion.

Down to the last of their plasma supply and fearful they would have to call a premature halt to one woman’s operation, the surgical team was surprised by the appearance of a new unit of blood – a gift of the Eagle-Condor doctors who emptied their pockets to cover the cost. In fact, there were any number of occasions when Drs. Desaloms and Denning and their team went out to buy everything from sutures to medications when donated supplies ran short.  “We take a lot of things for granted here in the U.S.”

While the benefits to his Peruvian patients are obvious, Dr. Desaloms makes it clear that his Eagle-Condor experience could teach the American medical community a thing or two. “In Peru the patient’s families are much more involved in the care of the patient. Part of it is out of necessity, of course – smaller staffs mean families assist in everything from feeding patients their meals to dispensing medication. But even beyond the necessity, Peruvian families take a much more active role in the patient’s recovery. You can see the difference it makes. And that’s something we should very much take to heart here in the U.S.”

Less than six months after their week in Lima, Dr. Desaloms is already making plans to return again next fall for a week or possibly even longer. “Without a doubt, this has been the most rewarding experience of my medical career,”  he says. When asked if there’s anything he’ll do differently next time around, he smiles. “Definitely,” he says. “This time we’re going to take a lot more stuff with us.”

 

To read Dr. Desaloms' blog on the DNS 2010 Mission Trip to Peru, click here.

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