Dental Project Peru Trip 2

01-04 July 2004

Thursday 01 July 2004

5.30am and we are getting ready to set off on Dental Project Peru’s second trip.  There are four of us on the team.  Jill Patterson and Alan Haddock are a couple who have come over from England for a bit of adventure and dentistry!  I have known Jill for almost 10 years and it was with Jill that I first came to Peru in 2001.  She is about to return to university to study Medicine in order to do Maxillofacial surgery – good luck Jill!  Alan is a surgeon who has been working in hospital for about 10 years.  Lots of experience with pulling teeth!!  Our assistant on this trip is a friend of mine – Carlos.  He is a second year dental student studying here in Cusco.

The destination for this trip is an area North of the Sacred Valley.  We will visit 4 communities in 4 days.  I have organised this trip with the help of Padre Ricardo in Calca.  He runs an orphanage there and is very involved with local communities.  He has offered us the use of his truck – but we have to get there first!  Clark will not be coming on this trip but he has managed to find us a vehicle to get us to the orphanage.  It is a 1955 Chevrolet truck – red!  It is a beauty.  The bed on this truck is the biggest I have seen, we will have no problem fitting all the equipment in!  But the adventures start at 5.30am when “Big Red” will not start….

We all help out with the pushing to try to get her going.  It takes over an hour and many extra hands to finally hear her splutter to life.  But then we are off!  The drive to the orphanage in the Sacred Valley is usually less than an hour, but “Big Red” takes her time.  When we finally arrive, the Padre thinks we are crazy to have travelled in this truck but cannot hold back his laughter – we must have looked quite strange.

We say goodbye to Clark and the four of us plus driver and helper cram into the next truck.  The drive is beautiful!  We climb and climb, curving and twisting our way skyward.  The highest pass is at 4800m and there are a couple of pale faces at this point!  We arrive in Amparaes, our first town of work, mid morning.  We head straight to the orphanage/childrens home where we set up surgery in an outdoor courtyard before taking our first patients.  There are over 30 children in this home and we see them all.  They are from different backgrounds, but unfortunately, most of them have a sad story of how they come to live here.

I was pleased that we had the opportunity to save some of the teeth of these children, but unfortunately, most teeth were too badly decayed to restore.  The children were a pleasure to treat and kept a vigilant watch over each other being treated throughout the day.

After being given a nice lunch of hot soup and rice which was much needed after the cold and rain that had been present throughout the morning, we continued treated patients until about 5pm.  Then it was time to get packed up and set off to Lares – a 3 hour drive. 

We were very fortunate to have an excellent driver because the drive to Lares proved quite treacherous.  The rain turned to snow and with it came a thick fog.  We could barely see the front of the truck!  The road was thin and winding and a lot of caution had to be taken to get to Lares in one piece!  We were exhausted when we arrived but our poor driver then had to return to Calca – another 3 hour drive!  He rested for a while but then insisted he must leave.  We were met by Lorenzo, an Italian volunteer I had met and co-ordinated this trip with previously.  He had prepared some excellent Italian pasta for us which we ate appreciatively before heading to the hostel in the rain to finally sleep – it had been a long day!

Friday 02 July 2004

The plan for today was to get up and drive the hour or so to the community of Cachin.  It had rained all night and continued into the day.  So we piled into yet another truck (borrowed from the Health Post) and headed off through the mud.  The drive was beautiful and the mist and rain only added to the majesty of the setting.  But, again, there were a few moments of bated breath and gasps as we slipped around on those very thin roads.

When we arrived at the Health Post in Cachin, there was already a small group of people waiting for us.  They were all dressed in tradition clothes and brightly coloured ponchos – a magnificent welcome.  The men helped us unload and set up our surgery.  Then it was straight to work.  We had two chairs working – I did most of the fillings while Jill and Alan worked together on the extraction patients.  Lorenzo helped with sterilising instruments while Carlos was in charge of “crowd control” outside. 

It continued to rain throughout the day.  Patients arrived, soaking wet, who had walked many hours to get to us at the Health Post.  The need for care was obviously very high.  There was one lady who had a lot of decay in her upper central incisors.  It was very rewarding to be able to fill these teeth, thus saving them and her smile.  And she certainly did smile when she saw the final result!

Jill and Alan had quite a good system working together.  Jill’s Spanish was good enough to be able to communicate with the patients in order to diagnose them and then Alan would get in there and quickly get the work done.  Then Jill would take her turn in the doing the treatment.

Carlos was great with the patients.  He was very efficient with taking their details and ensuring everyone was seen.  He even screened the patients to see if they needed restorative work or extractions.

We spent the night in Cachin in an adobe shelter.  Our friend there told us ghost stories as the shelter was built on a graveyard.  We all went to bed a little nervous but were sent off to sleep by the rhythm of the persistent rain outside.

Saturday 03 July 2004

We woke to – surprise surprise – more rain!  We left Cachin in the morning to drive to the community of Choquecancha.  This was planned as our 3^rd destination.  The road does not arrive at the village but stops about 1 mile from the village where a stream/small river crosses.  After about an hours drive we arrived at the “stream”.  With all the rain, this had turned into a raging torrent.  We had planned to unload the truck here, cross the water and walk to the village.  I got out and went to the water edge.  I had to decide whether we were going to cross or not.  There was a very high volume of fast moving water and it was cutting away at the unstable banks of mud and sand.  Every few seconds there were chunks of the bank breaking off and being washed downstream.  There was not a safe way to cross, even with only the most basic of equipment.  I spent a lot of time deciding and after talking it over with the rest of the team, we decided that it was too dangerous to cross.  And if the rain continued, it could be that we could not get back across at the end of the day.  So very disappointedly, we had to turn back (which in itself was a very tricky manoeuvre on this thin mud road). 

We returned to Lares where we set up surgery in the Health Post.  We radioed the Health Post in Choquecancha to tell them that we were unable to get to them.  They were very disappointed as there were a lot of patients waiting for treatment – but they understood.  We told them that we would now be in Lares for 2 days and if any patients could get to us we would treat them there.

The next thing was to get the word out to the people of Lares and nearby communities that we were there treating for an extra day.  And they came in throngs!  There is an orphanage/childrens home in Lares and so all the children came from there which kept us very busy.

As the rain continued, we were told that it was snowing heavily on the passes and the roads were impassable.  There was over a metre of snow on the 4,800m pass!  That night while we ate dinner, word came that a combi bus with 12 passengers had gotten stuck on the pass and could not be retrieved.  They were likely to spend the night there.  But a group of men from the valley were trying to get to them.  We were supposed to leave the following day – but this looked unlikely.

Sunday 04 July 2004

The plan had been to work this final day in Lares and leave about 6pm back to Cusco.  We woke to the sound of silence – no rain!!  This looked promising.  Word came over breakfast that the direct road to the valley was impassable and would remain that way for days.  But there was a chance that the other road, (which would be about 6 hours to the valley and then another hour to Cusco) might be passable if it did not snow any more.  We were all hoping for this as it was quite urgent we return to Cusco – Carlos had an exam the next day, Lorenzo had a bus to catch to Bolivia that night before his Visa expired and Jill, Alan and I had flights to Lima the next day!

We continued treating patients all morning in Lares.  Our truck was to be sent from the valley to collect us and take us back to Cusco.  But there was no sign of it and we could not speak to anyone by radio.  So there was nothing to do but carry on working.  This was a great day, however, because this was when Carlos extracted his first tooth!  I had been looking throughout the trip for a straight forward tooth that Carlos could extract.  The opportunity came with a female patient with a relatively mobile lower left first molar.  After loosening it slightly, I gave the forceps to Carlos and coached him through the procedure.  He did excellently and was very pleased when it finally popped out – well done!

At 2pm news came that a mini bus had arrived in town.  It had gotten over the pass and reported that the road was still covered in snow and quite dangerous – but passable!  We were very excited but felt stranded as our truck had not been sent to collect us.  We spoke to some people in town and the mini bus driver eventually agreed to take us back over the pass.  We had to leave immediately.  We treated the last patient and then quickly packed up the equipment.  We were heading out of town by about 3.30pm.

From Lares, we began to climb and the snow soon appeared.  It was beautiful!  We could see our road curving up the mountain in front of us and could see only whiteness surrounding it.  We had about 2 or 3 hours before it got dark and we all wanted to get over the pass before then.  But it was slow going as we crunched through the snow.  Our driver was excellent.  As the light faded we got close to the pass.  Here there was about half a metre of snow on the road but we stuck to the tracks that had already been made, and edged our way up the mountain.  Eventually we were there – and over and heading down the other side.  Sighs of relief all round.  But this next hour was the scariest as we worked our way through the snow – but downhill!  It was very dark and freezing when we came upon a broken down bus on the road in front of us.  As we slowed to pass it, all the passengers charged our bus.  They all wanted us to take them down to the valley.  But there was no way we could take them all.  So shouting and arguing broke out.  We had room for only 2 people in the bus.  But people pleaded to ride on the roof.  So we let them.  But after about 30mins I asked the driver to stop so that we could squeeze these people from the roof inside the bus as they were surely going to freeze on the roof.  So the remainder of our journey was “cosy and cramped”.

Many hours after we had set off from Lares, we arrived back in Cusco.  We raced to the bus station where Lorenzo only just caught his bus to Bolivia.  We were back safe and sound and exhausted.

The whole trip had been one adventure after another.  But what a great experience.  We treated over 300 patients, relieved a huge amount of pain and managed to save a considerable amount of teeth.  This trip reminded me how the extreme geography of Peru, if mixed with difficult weather conditions can make life, well, challenging!