Peru Project Introduction
Peru is a South American country well known to many Americans as a popular tourist destination. While medical care and resources are readily available in Lima, the capital, much of the country is still suffering from sub-standard care. Our involvement in Peru is an attempt to extend much needed pathology and laboratory services in the underserved areas far removed from Lima. Our initial contact is in the town of Pucallpa.
Pucallpa is the second largest town in the Amazon basin in Peru. The town’s population is 200,000 but the medical facilities here serve a population of 600,000 in the region. The Ucayali district is one of the poorest in the country. By United Nations standards, over 75% of the population live below the poverty level with 30% in extreme poverty. Being far removed from Lima and lacking any economically viable resources, the funding for healthcare in this region is of low priority in the eyes of the central government. There are two government hospitals in the area. Until recently, all biopsies are sent to Lima for processing and the typical turnaround time is more than one month.
Dr. Arturo Rafael Heredia recently finished his pathology training in Lima and accepted a post at Hospital Amazonico de Yarinacocha in August 2005. His ambition is to establish a histology laboratory in his hospital and bring surgical pathology services on site. If this service is properly utilized, he should be processing 5,000 specimens each year. The hospital’s budget is stretched and could not provide Dr. Rafael with all the needed equipment for a histology laboratory.
Over the past two year, Dr. Rafael has been gradually building up his practice and currently processes about 200 cases per month. The cassettes are manually processed in an incubator in the clinical laboratory, the specimens embedded in paraffin that is heated over an alcohol lamp and sections are cut in a recently acquired microtome. The quality of the sections is variable because the processing is not well controlled. Nevertheless, this demonstrates the determination and innovation of Dr. Rafael. We have sent a donated microscope and an embedding center to Dr. Rafael but have run into much red tape and costly duty at the Peruvian Customs. If we can improve the channel of shipment, we would like to provide him with a simple rotary tissue processor.
The Los Angeles Society of Pathologists (LASOP) Foundation recently selected Dr. Rafael as the recipient of its educational scholarship grant. The plan is to have Dr. Rafael spend a six-month sabbatical at USC-LA County Medical center from July to December, 2008. He plans to use this opportunity to improve his diagnostic skills in gynecologic and gastrointestinal pathology.
While Dr. Rafael is spending his sabbatical in Los Angeles, Pathologists Overseas plan to send volunteer pathologists to Pucallpa to cover his practice and insure uninterrupted patient services.
