Chile & Peru

Impressions of Chile and Peru

Michelle Emerson - medical student from Sydney Medical School, undertook an Elective with ISSIE in 2012–13

Over the summer I had the fantastic opportunity to travel to South America, particularly Chile and Peru, to experience their culture, language, and health care system. I spent three weeks working through the ISSIE with local clinics in Valparaiso, Chile and one week working in Ollantaytambo, Peru.

In Valparaiso the clinics I visited were primary care facilities, similar to general practices in Australia, but with a multidisciplinary approach, thus they also had nurses, midwives, nutritionists, physiotherapists, psychologists and dentists. The health care system is structured very differently to Australia, in that each geographical area is designated a certain health team (containing a certain number of doctors, nurses, etc.), and people from that area may only visit their allocated health care team. I visited two different clinics, Padre Damian de Molokai and Jean y Marie Thierry, which had different locations in and thus different clientele from Valparaiso. In these clinics I had the opportunity to sit in with doctors (general practitioners and paediatricians), nurses, midwives (who take on a much larger role in Chile), and other members of the clinics health care team. It was an extremely interesting experience to compare the structure of the health care system to Australia, and to see that much of the burden of disease is very similar to Australia.

In Ollantaytambo (near Cusco) I spent time at the local medical clinic, which was a catchment clinic for many mountain communities of Quechua people (the native population to the area). The clinic was severely understaffed with only one doctor present on any day and a constantly full waiting room. I had the chance to sit in with the consultations with the doctor, and also with the nurses performing growth checks and providing food, as malnutrition is a big problem in children. It was saddening to see the lack of resources and man power with a very large need for more services. It was also interesting to see the extremely different presentations patients came with compared to Australia, a lot more communicable diseases and preventable diseases.

Overall I had such an amazing and enlightening experience and would recommend this program to anybody who wants to gain an overall understanding of primary health care in Chile and Peru. However, I would stress that speaking at least some Spanish is highly necessary. On a side note, I would not recommend this to anybody who wanted a large hands-on component to their elective/ILA. This program is almost entirely observational but very educational.

Lastly, I have no photos to show you because my camera (among other belongings) was stolen in Peru – so be careful, especially on overnight buses!