Lessons from Pampas Grande, Again

Blogging now from La Paz airport (13,000 ft above sea level), where--like Pampas Grande-- we're once again having to work a little harder for our oxygen. We're waiting here for another 4 hours or so, when our plane will embark on a 9 hour flight to DC.

This year's quest to Pampas Grande and back was another empowering, insightful, uncomfortable, frustrating, sometimes disturbing, wonderful experience for me. This trip marks my third visit to Pampas Grande, and for the above-mentioned reasons, it has been the most fulfilling yet.

I know I'm sounding counter-intuitive here. Uncomfortable? Frustrating? Disturbing? Immediately, It doesn't make sense that these feelings can untimely culminate in fulfillment and accomplishment. That's the funny thing about Pampas Grande-- each time I go, I learn a new public health (and life) lesson that I never saw coming.

My time in Pampas Grande was uncomfortable because I had to adjust nearly every nuance of my voluntary and involuntary behavior. Seriously, you name it-- speaking, eating, sleeping, getting from place-to-place, being on time, showering, and especially breathing--it's all done differently than back at home. It seems simple, but it genuinely takes up so much energy.

My time in Pampas was frustrating because I couldn't communicate as proficiently as I would have liked. Although I can hold a simple conversation in Spanish, there is definitely room for improvement with my language skills. Still, language isn't the only barrier here; there's a cultural one, too. If you can take a moment to picture a modernly-dressed, blonde-headed, Spanglish-speaking girl in an isolated, rural, Andean community in Peru (where many people have never traveled outside their district) you can see where I'm going with this. Plus, with no cell phone reception and RGHA team members constantly working at different places in the community (school, library, clinic), it was extremely difficult to communicate with one another. Maybe next year we should figure out a smoke-signal system or something. Someone proposed guinea pig couriers. Just a thought.

My time in Pampas Grande was disturbing because I saw serious health outcomes that are completely preventable. For instance, a two-year-old boy came into the clinic with six teeth rotten below the gum. The dentists extracted each of them over the course of two days. The damage was so bad that the dentists predicted that his developing adult teeth were already harmed. I wish I could say this is uncommon, but the dentists most frequently performed cavity fillings and extractions, from people aged 2 to 90 years old. Seeing the two year-old with a mouth-full of dead teeth just irked my core because it didn't have to happen. We know easy, relatively inexpensive behaviors that can prevent this. So why is dental health so poor in Pampas Grande?

For me, each element of my discomfort, frustration, and disturbance yielded an over-arching reaction: Do I understand how people live here, and how can I work to help people here lead healthier lives? To get to this point, I've had to experience a small slice of the lifestyle in Pampas (I say "small slice" because our living quarters are quite comfortable and clean and we get to eat three square, delicious meals a day). I've had to work alongside the communication challenges that often hinder health intervention programs from working. And finally, I've had to see with my own eyes the preventable health disparities. With this experience, I am more equipped to analyze what I can do to help the people in Pampas Grande achieve better health and wellness.

I believe that our group is on the right track with making better possible in Pampas Grande. We saw more patients in clinic (in Pampas and nearby Shancac) than ever before. We have implemented long-term, evidence-based health prevention efforts for skin damage and joint pain. We interact with the community through projects, meals, art, and festivities in order to build trust and cooperation. We are collecting survey data in order to form hypotheses about future health interventions. And finally, we are preparing for a longer-term visit to the community.

Personally, I know that what I have learned on this trip is an invaluable tool that I will use in all of my endeavors in public health. I don't have the answers yet, but this summer, I hope to put this tool to good use for Pampas Grande as I take the position of the first employee of the Richmond Global Health Alliance.

Salud para todos.

Blair Armistead, B.S.
Candidate, Master of Public Health
Virginia Commonwealth University
RGHA Intern, Summer 2012

P.S. - Pictures to come, I promise.