Katherine Racicot '06
Class of 1966 Dickey Intern

ProWorld Service Corps Website: http://www.proworldsc.org

 

            In the fall of 2004, I worked for the NGO ProWorld Service Corps in Urubamba, Peru, as a Dickey Center Intern.  ProWorld Service Corps is an NGO begun in 1998 that has branches in Peru, Belize, and Mexico.  Interns work for a minimum of 4 weeks, but can continue for as long as they want.  All internships begin on the first Thursday of the month. In Peru, interns work during the morning and early afternoon, take two hours worth of intensive one-on-one Spanish classes per day, and have the weekends free for travel with ProPeru or independently.  All interns live with home stay families.  While in Peru, I worked on two projects, which are discussed below. This is a very flexible internship that can fit most students' interests.  I worked as a health volunteer, but other volunteers taught English, aided in small business development, or worked at a battered women's center.  ProPeru is very willing to work with students that want to begin new projects.  Staff members maintain close contact with the volunteers throughout the internship, making sure that each volunteer has found a balance between structure and independence that works for them. 

            I cannot say enough good things about this internship.  I highly recommend it and would love to talk to students who are thinking about trying it.  Go to Peru!  Go even if you don't speak a word of Spanish! I had the best 8 weeks of my life there!

My two projects:

Es Salud Hospital, Urubamba, Peru
Internship Dates:  10/6/04-11/29/04

Timeline:

I watched consultorias every Tuesday and Wednesday morning from 8 am to 1 pm.  Some Mondays and Thursdays I watched consultorias in the afternoon after returning from the stove project. I also worked in Es Salud’s medicinal plant garden. Some nights I was able to work in the emergency room with Dr. Miguel Aragon.

Summary of Project:

At Es Salud, I had the opportunity to work alongside the doctors. Every morning I would watch consultorias. Often, the doctors would let me be the one to talk to the patient and ask them why they were coming to the hospital and what their symptoms were.  Each patient had a medical chart/folder with a record of all their hospital visits, and we would record the symptoms there.  Together, the doctor and I would examine the patient and come up with a diagnosis. The diagnosis and any prescribed medicine would be recorded on the patient’s medical chart, and also in the computer’s medical database. Often, the doctor would order various lab tests, and when the patients returned we would analyze the results before prescribing medication. Because there is usually only one doctor working at Es Salud, when emergencies came in we would have to stop the consultorias and attend to the emergency patients. I was able to assist the doctors in giving stitches, mending broken bones, and dealing with all manner of other emergencies.  I also learned how to take ultrasounds and EKGs.  Because the consultorias can get tedious after a few hours, and some doctors are less enthusiastic about having volunteers, I would take breaks and work in the medicinal plant garden outside Es Salud. This garden was planted by ProPeru volunteers, but no one has been taking care of it since, so there was a lot of weeding and general upkeep that was needed. At times I would work with the Es Salud staff, and other times I worked alone. 

Roles and Responsibilities:

The Volunteer: I was able to learn about many different kinds of illnesses. I had the chance to interact with patients, ask them questions, and come up with a diagnosis. I examined patients’ eyes, mouth, throat, chest, stomach, back, arms, legs, and genitals and worked with the doctor to figure out what the problem was.  I also helped when emergencies came in, and I went on rounds to visit the hospitalized patients. I learned how to take their vital signs, temperature, pulse, blood pressure, exc. I also learned how to take ultrasounds and EKGs. One day I helped when Es Salud was having a yellow fever vaccination clinic. I was treated as a medical student, and often the doctor would go so far as to tell the patients that I was a doctor too.

Fernando Pozo: Director of the hospital, also occasionally did consultorias.

Javier, Miguel Escalante, Miguel Aragon: the doctors that did consultorias on a regular basis. Dr. Escalante doesn’t like having volunteers watch, so the days he was working I would usually work in the garden or help the nurses in the emergency room instead.  Both Javier and Miguel Aragon were really great about letting me interact with the patients and help them with the examining.

Carmen: The head of the nurses. She would administer medicine to hospitalized patients, check their vital signs, and help in the emergency room when it was needed.

Berta: Would check the patient’s height, weight, and blood pressure, and note the information on their charts before they went into consultoria with a doctor.  Also helped in the emergency room.

There were several other nurses that I didn’t work with closely, who would do initial examinations, work in the laboratory, check on the hospitalized patients, exc.

Vision:  I chose this internship because, although I am pre-med at Dartmouth and have worked in a lab, I have never had the chance to work in a hospital or interact directly with patients.  I wanted to see if I enjoyed working in this environment before I took the MCATs and started applying to medical schools.  This internship exceeded my expectations. I thought that I would just be watching the doctors, but wouldn’t be able to do much myself. Things started out this way, but once I became more comfortable with my Spanish and more comfortable working at Es Salud, I was given more responsibility.  By the end of my two months, I felt very at ease talking to the patients about what was bothering them, examining them, and making a diagnosis. My Spanish had improved to the point where I was usually always able to understand what the problem was.

I think that future volunteers could continue watching consultorias, but they should also have an independent project. The medicinal plant garden needs a lot more work, in terms of weeding and purchasing new plants, so future volunteers could work with the doctors in this area. I also feel that there is a great need for more education about preventative medicine. It seemed like we would see patients with the same problems over and over, especially urinary tract infections and gastrointestinal ailments. Usually the doctor would make the diagnosis, write a prescription, and the patient would be on their way. There was hardly ever a discussion about how to prevent the problem from occurring again in the future.  This is partly because there are many consultorias every morning and the doctors are busy, but I still think there is much room for improvement in this area.  I also think that patients would benefit from more natural, holistic medicine in addition to their prescribed drugs. The medicinal plant garden is an amazing resource, yet it seemed that most of the doctors never used it.  A possible future project for a volunteer could be making a book with all the plants at Es Salud, their pictures, and a brief description of what they’re used for.  If this information was made readily available to the doctors, maybe they would be more willing to incorporate the medicinal plants into their treatments.

Special Considerations: I think that if a volunteer is going to be here for more than a month, it would be best to combine these two projects the way that I did. I enjoyed both, but I feel that if I had been doing either one every day for two months, I would have wanted a break from it.  Working in Es Salud half the time and working with stoves the other half of the time was the perfect balance. 

Also, I know that some other volunteers didn’t enjoy their time at Es Salud.  I would advise any future volunteers to go into the experience with an open mind. Know that it takes time to cultivate relationships with the doctors, but once they see that you are committed, they are willing to give you more responsibilities.  And it helps to have an independent project going for days when there are doctors working who don’t want to have volunteers watching consultorias.

 

Stoves Project:  Cocinas Mejores

Internship Dates:  10/6/04-11/29/04

Timeline:  Every Monday and Thursday from 8:30 am to around 2 pm I would work with Javier and the other volunteers, going to a community and checking on the stoves.

Project Summary:

Cocianas Mejores is a project between the Rotary Club of Cuzco and ProPeru.  It is an ongoing project, but when I started in the beginning of October we were just beginning to distribute stoves to the community of Yanahuara.  The first day we did a demonstration showing the people how to build there stoves, then we carried the stoves and chimneys to each family’s house.  The next few weeks we would go from house to house, checking on the stoves.  When families hadn’t made their stove yet, we would work with them to install it.  Often we would have to cut the chimneys or add more mud where the stoves had too much open space.  We would explain to the families the correct way to use the stove: with small pieces of wood, always using the door, and with all the holes covered, and we would teach them how to clean the chimneys.  At some houses we could check the lung capacity of whatever family member did most of the cooking. This is part of an ongoing project to see how these cocinas mejores improve lung capacity. In a few months, Javier will return to Yanahuara to measure the improvement.  Yanahura has four different sections, and we were finished with all of them by mid November. We then moved on the community of Chicon. The families in Chicon have had stoves for about five months, so we were mostly going from house to house and measuring the improvement in lung capacity. In almost all cases where people were using the stoves correctly, there was a dramatic improvement in lung capacity. The people in Chicon also told us that they were using up to 50% less wood with these stoves. We finished checking the families in Chicon in late November and had just distributed 50 stoves to a community near Chinchero when I finished my internship.

Roles and Responsibilities:

The Volunteer:  I learned how to assemble the stoves, using adobe bricks and mud.  I spent time with families in Yanahuara and Chicon, working with them to install stoves. I also cut chimneys and measured lung capacity in the women who used the stoves to cook. I learned how to explain to the families how to make a stove and the proper way to use one. 

Javier: The head of the project. He was responsible for keeping track of which families had stoves and which houses we had checked already.  When we went to each new community, he would explain the project to the families and help teach them how to make the stoves. Because this project involves the Rotary Club, Javier had to keep careful records of each family that had a stove.

Men in Javier’s workshop: Made the stoves and chimneys.

Vision:  I didn’t know I would be participating in the stove project until I arrived in Peru, so I went into the experience with no concrete expectations.  Once I learned the details of the project, my vision was simple: to help improve the lives of the families in Yanahuara and Chicon by installing the cocinas.  I felt that this project provided a perfect compliment for working at Es Salud. Working with Javier, I was able to work for an hour or two making a stove, and leave knowing that I had immediately improved a family’s quality of life. 

I felt frustrated at times, because more families wanted stoves than there were stoves to give away, so usually we had to resort to a lottery system to raffle them off. Often, it seemed that some families who received stoves were ambivalent about getting them. We would return to their homes a week later, and the kitchen still wouldn’t be made, or they would be using it incorrectly, in spite of our demonstrations.  In Chicon, Javier instituted a contest to see which family is using their stove the best. The winners are going to receive either an oven or a water heating system. Hopefully, the incentive of a reward will help the families use their cocinas more effectively.

This is an ongoing project. The Rotary Club in Cuzco is giving stoves away to many more communities, so there will always be more work for future volunteers.  Knowing Spanish helped me in terms of working with families while installing the kitchens and explaining things to them, but it is absolutely not necessary to know the language going into things. I learned the words for stove, chimney, and mud pretty quickly! One of the best things about this project is getting the chance to work with Javier. He always made working with the stoves a lot of fun, and was incredibly patient when it came to explaining things, either in Spanish or in English.


Katherine Racicot is an ’06 History major with a minor in Chemistry. Since her arrival at Dartmouth she has taken pre-med classes every term, as she pursues her interest in healthcare and her dream of becoming a doctor. She tells us that her interest in healthcare began when she watched her father, who is an emergency room physician, treat patients. She is passionate about her work and driven by the desire to interact directly with people. In addition to community service projects, her activities at Dartmouth have included participating in the Women in Science Program during her freshman year and more recently participating in a Presidential Scholarship with a doctor at DHMC.