Anatomy of a Mission

Quechua Benefit mission participants often leave for Peru excited about the good they are about to do for some of the poorest people on earth. Invariably, at some point in the mission, they begin to realize, almost feeling guilty, that they are the ones who may well be benefiting most from the experience. Missions are often “Chicken Soup” for the participant’s soul. Serving someone in need is powerful spiritual medicine.

This of course does not mean that everything that happens on a mission conforms to a romantic ideal. There are always a few adventures of the digestive tract and the occasional altitude sickness or cold shower to provide reality checks. The hours are long and the food often doesn’t measure up to gourmet standards. Click here to read articles about a representative number of Missions that were sponsored by Quechua Benefit. They will help you set realistic expectations.

It also pays for the mission participant to do a little homework; read the articles in this column about the culture and how to pack; visit the Peru maps section of the website to learn where you are going; and there are also some articles about the history of Quechua Benefit and Peru in the website library.

Then there are the simple practical aspects or logistics of who is expected to do what. The following information is intended to layout what the mission participant is responsible for and what Quechua Benefit provides:

Mission Participant: Each person going on a mission will need to make and pay for their own airline reservations from their point of departure to Lima, Peru. It pays to book early. Every airline that flies to Peru arrives at about midnight in Lima. This is when you will connect with the rest of your team members. The group will stay overnight in Lima and fly to Arequipa the next morning. From the moment you arrive in Lima, Quechua Benefit will make arrangements for all of your needs. The cost of this which includes in country airfares, lodging ( except Friday night in Arequipa, plan on $75 dollars including a nice meal), most meals and land transportation is included in the $750 mission fee which is payable to Quechua Benefit prior to departure.

If you want to extend your trip and sight see in Peru Quechua Benefit will be happy to arrange that for you. Many participants want to see Machu Pichu. There will be a separate charge for this. The charge will include the additional airfare, local ground transportation, hotels, guides, train tickets and park passes. These trips typically take 3 nights and 4 days. You will also have free time to shop and explore in Cusco as.

The end of the trip finds the participants back in Lima for departure to the States. All planes not only arrive Lima around midnight but they also leave around midnight. You should arrive home the next day before dinner.

Quechua Benefit: Quechua Benefit has an office in Arequipa which is staffed by Sandra Carbajal and Alejandro Tejada. They work with the Quechua Benefit BOD to arrange the following aspects of the mission: Ground transportation, hotels, in country airfare, meals, mission locations, government approvals, customs, Peruvian mission participants, security, sight seeing, equipment and anything else that is required during you mission trip. The typical mission lasts for 10 or 11 days and includes at least one day of rest with approximately 3 days of travel.

The Quechua Benefit medical mission director DR Dwight Bailey is an experienced leader with missions to several continents under his belt. He will order the medicine; assign medical teams and generally lead participants through the day to day work of the mission. Quechua Benefit board members, Rhonda Deschner MD, Ursula Munro RN, NP, and Wayne Jarvis DDS are all experienced Peruvian missionaries and will be along to assist in organizing the daily routines.

This information is designed to answer basic questions and give you an idea of who is responsible for what. We recommend that you also read the articles on Travel Tips and Cultural awareness.  We also have a Q&A on Mission trips you can access by clicking here. You should also feel free to email us by clicking here or you can phone anyone of our board members. There contact information is found on the About Us page. We are very excited that you are considering joining us in Peru.

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By Mike Safley

The highlands of Peru are home to the vast majority of all the alpacas in the world. The Quechua Indians, who domesticated the vicuna more than five thousand years ago, are the source of the alpaca which now reside in the outside world. Their world of high plains and harsh environment resists the probability of profit, providing the Quechua only a subsistence level existence. A pair of shoes, an extracted tooth, or a warm blanket is out of reach for many of these people that time has forgotten. Comfort is a luxury experienced by only a few.

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We were invited to the one room home where several of our Macusani patients lived. Note the alpaca meat on the rock table at the right. Photo by Barrie Pedroza

Dr. Mario Pedroza, Russ Gratton, and I formed the charitable organization, Quechua Benefit, in 1996. The charity’s trips to Peru began rather modestly, with the first one based on an invitation by Don Julio Barreda. He asked that we provide dental assistance to the children of Macusani.

His guidance over the years has been unfailing. He laid down one of Quechua Benefit’s early principals – serve the children first. All the shoes, blankets, warm clothes, ponchos, toys, and school supplies that we deliver each year are for children. At the dental clinic, we see the children first, and work on the adults as time permits.

The charity could not operate in Peru without the assistance of the Michell Company and Grupo Inca. Alonso Burgos and Ignacio Garaycuchea are our primary contacts from each company. They provide, free of charge, lodging, transportation, and food for our team when it is on the ground in Peru.

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Young “Elvis” with his tooth pulled, a toy and shoes in hand, sitting on the blankets each patient received. Photo by Barrie Pedroza

Quechua Benefit has been generously funded by alpaca breeders from the United States. The people who have contributed are too numerous to mention, but without their generosity the charity would not exist. They have given tens of thousands of dollars since the beginning, and many breeders have donated the proceeds from the sale of breedings to their stud males, at their affiliate, silent auction events. Others have donated warm clothing and toys. AOBA also helped fund the initial trip to Macusani.

Each year, we send one or two missions to Peru. We concentrate our efforts in the Colca Valley, Macusani and a town named Munani near Juliaca and Puno. Over the years, 18 different people have participated on the trips, most more than once. Mario Pedroza is the leader of our effort. He is fluent in Spanish, sets the schedule, allocates resources, and without him we would not succeed. His wife, Barrie, handles much of the pre-trip planning, and has been a dental assistant on every mission that Quechua Benefit has undertaken.

THE COLCA VALLEY

The Colca River flows deep into the Quechua heart, down through the canyons where the condor lifts their wings on the warm morning air to spirit the souls of the alpaca shepherds who have passed over, to their high place in heaven. The valley has always been there, worked by people with walnut skins and high cheekbones burnished to mahogany by the wind. The Spanish came and conquered, but life today is no different than forever.

The Quechua Benefit crew arrived in Yankue, one of seventeen Colca towns, to a chorus of Buenos Dias, smiles and bright eyes. Mario and Barrie Pedroza, Kate and Dr. Frank Winfield of Oregon, Larry Black of Colorado, and myself had all been on last year’s trip, and the town officials and school teachers remembers us. Mary Jo Sorensen, a dental hygienist from California, and Dr. Curt Gedney of Idaho, were new, and we were joined by Willie (Wilfredo Uscamayta), a Peruvian dentist who grew up in the nearby town of Chivay.

The group stayed at the Colca Lodge, which is owned by principles of the Grupo Inca, Francis and Francois Patthey, and Alonso Burgos. After seeing an average of 165 patients each day, we hit the lodge’s steaming hot lithium baths which were filled with water from the river’s hot springs. Every star in the world shines brightly over the Colca Valley, and the baths were the perfect vantage point for our intrepid group to witness the shooting gallery of stars gone awry as we rested each evening.

The valley itself is one of the most productive in Peru. But rock is more abundant than earth, which is corralled by the stone walls into terraces and tended by hand. Everything in the valley is anti-tech, people walk everywhere, use wooden plows, and irrigate from pre-Incan canals. Many of the women still dress in costumes designed thousands of years ago. No one hurries and little changes.

A Quechua baby on the back of a mother of one of the clinic’s patients. Photo by Barrie Pedroza

A Quechua baby on the back of a mother of one of the clinic’s patients. Photo by Barrie Pedroza

At the clinic the children blink with shy smiles, their eyes downcast avoiding looking directly at the gringos. There is a fleeting connection when I pronounce their names, recognizing the familiar sound of respect that a person’s name being spoken conveys. As they leave we hear a muted gracious. They are no different from you or me.

At the end of our stay we danced with the school teachers, the Mayor, his secretary, and drank a pitcher of the local Chicha beer while the Andean harpist picked a playful melody. We all agreed to meet again next year.

THE INFINITE NEED

As we pulled out of the Colca Valley on our way to Macusani, we crested the pass at 16,700 feet above sea level, and the “Vista of the Volcanoes” came into view. On the left of our panorama, one of the vista’s eight active volcanoes, Misma, appeared. The driver, Luis, told us that Misma is the source of the Amazon.

The conversation in the bus turned to the need we confront in Peru. Our goal was to see one thousand patients, which meant we would extract over one thousand teeth. Since we began in 1996, we have seen thousand of patients, extracted many thousands of teeth and delivered thousands of boots, shoes, blankets, toys, and ponchos. We have supplied schools with paper, pencils, maps, crayons, books, soccer balls, computers and money. Quechua Benefit even financed the construction of a school building in Macusani.

But there is another side to the need which Julio Barreda has called a “dripping faucet.” It never ends. There is always a line of people left which we cannot treat. Our care, delivered over ten days, is a mere molecule in the bulging barrel that contains the Indians’ need. Quechua Benefit could operate everyday of the year, and just like we shear our alpacas, there would be a new fleece of need grown back before we began to address the existing deficit.

MACUSANI

Sister Greta, Rula and Miriam at the door of the orphanage’s dining room. Photo by Mike Safley

Sister Greta, Rula and Miriam at the door of the orphanage’s dining room. Photo by Mike Safley

We arrived late at night; the streets were still and the wind mean. Greta, the Catholic sister from India who runs the orphanage, helped us organize our lodging and unpack the van. For Mario and I Macusani is the touchstone of the Quechua Benefit mission. The need is greater here than at any other place we have been. We were captivated by the plight of the orphanage when we first brought the mission to Macusani. The girls of the orphanage, Mosoq Runa (Quechua for new person), sang us a song which included a verse which went something like this, “we do not want to be a burden, we would rather drink a poison, leave this earth and join our family, than be a burden.”

Greeta (“Greta”) Iscreab was called by God in her native India to serve the poor by joining the Sisters of the Cross of Chavarod. Their order was formed in 1838, and has missions in 12 countries. Her own words, which follow, best describe her work at Mosoq Runa, in Macusani.

“I am mainly engaged with the pastoral for children which includes organizing children’s group in the different streets and in the various districts of Macusani and animating get-togethers for them; preparing children for First Communion and Baptism, animating the children’s choir etc… But what is most demanding is my work as a Directress of the children’s home for poor and orphaned girls. It is equal to being a mother of 24 children attending to all their material, physical, spiritual, educational, psychological and medical needs, besides seeing to the needs of the house. The house is open to other children who come during the day to play, study and to have mid-day meals. Shanty, (another sister from India,) helps out with spiritual and moral formation on Sundays. Though demanding it is fulfilling and enriching to work with the children. It is a joy to see them grow in confidence and freedom and with the joyous sense of belonging. If the cold chills – the children’s warming smiles give life. In them I experience the joy of the innocent and pure of heart.”

There are two girls at the orphanage that tell the story of the children that live their young lives with Greta. (See the accompanying photo.) Rula had been at Mosoq Runa for five years. She is in her second year of secondary school. Both of her parents are dead. Greta remembers her as an introspective girl when she first came to the home, then she began to open up. Today, she is a very responsible leader, and was voted best student at her high school. Greta relies on Rula and sees a bright professional future for her hopefully providing care, in her home town, to those less fortunate.

Miriam, on the other hand, is only six years old. Her mother died, and her father cannot be found. She captured our hearts with her shy, loving nature. She is from a family who owned five alpacas and a small plot for potatoes. All meant to feed a family of eight. It did not, and Miriam was brought to the orphanage by her uncle.

The entire orphanage is run on a budget of $10,000 per year, provided by a Catholic parish in France, which includes feeding the 25 permanent residents and 35 children who come from the outside to eat each day. They also receive donations of potatoes and alpaca meat from concerned relatives of the girls.

Mario and Frank operating with Mary Jo and Kate assisting. Larry at the back scrubbing dental tools. Photo by Barrie Pedroza

Mario and Frank operating with Mary Jo and Kate assisting. Larry at the back scrubbing dental tools. Photo by Barrie Pedroza

Quechua Benefit has purchased a computer and educational CD’s for the orphanage. We purchased two sewing machines, which will be used to make school uniforms on a contract basis for the other schools in Macusani. The children will help with this task, and learn a trade that may be valuable when they leave. There is a long list of needs at the orphanage, and if any of you reading this would like to help, please contact myself or Mario. Please remember that any donations that you make are tax deductible.

The Quechua Benefit crew provided dental services for more than three hundred children in Macusani. We also saw old friends such as the school teachers from the schools where we gave supplies and provided dental care. Don Julio organized the handing out of the blankets we delivered. He brought all the children inside the orphanage, and before he began distributing the warmth he addressed each of us. Here is part of what he said:

“You have come from so far to offer the simple act of charity. To provide shoes, take a tooth and offer a warm blanket, it is as if the grace of God is raining on Macusani.”

The children screamed thank you, and we cried.

THE COST VS. VALUE OF QUECHUA BENEFITS TRIPS

We saw 1,046 patients on our 2002 trip, pulled 1,505 teeth, gave away 1,000 blankets, 300 pairs of tennis shoes, and 600 pairs of rubber boots. The trip cost $18,672, including airfare, supplies, blankets, shoes, boots, toothbrushes, used clothing, toys, and ground transportation, etc. Our crew included eight Americans, three dentists, and one Peruvian, not including Ignacio and Alonso. The value of the dental procedures alone, billed at standard stateside rates, totaled $210,500, and net value of all contributions after expenses was $219,378.00.

Quechua Benefit trips to the highland have not always gone smoothly. On one trip we had almost $10,000 worth of dental equipment stolen at the Juliaca airport. The instruments were all from Mario’s practice and you can imagine the problems, both in Peru and at Mario’s office that flowed from this event. We have had supplies that were held up by customs, generators that would not start, flat tires, diarrhea and altitude sickness. But every year we have succeeded.

This year went very smoothly. And thanks to the generosity of several alpaca breeders we were able to purchase a full set of dental tools. These were left with Michell Company in Peru, along with our dental chairs, compressor, generator and other dental equipment. We no longer travel through the Juliaca airport.

MUNANI

Munani was the last stop on our trip, and our fifth to this town in as many years. When we visit Munani, the group is always the guest of the Michell family at their estancia, Mallkini.

But, for a few hours we were lost in the middle of nowhere. As the men were navigating the group’s fate, which was looking ever more bleak with the sun’s setting, Barrie Pedroza observed, “Men never turn back, it’s too simple.” When we finally found ourselves unable to pass over a muddy stream or move forward, we were rescued by a boy, his father, and a trip through their pasture, over a rock bridge we built to ford an irrigation canal, and finally through a gate preceded by a footpath, which, to our amazement, placed us less than a mile from Mallkini. Thank God for the kindness of strangers.

In front row are patients from the clinic in Yankue; in the second row: Dr. Willie, Kate, Barrie, Dr. Frank, and Dr. Curt; in the back row: Larry, Mario, and Mike.

In front row are patients from the clinic in Yanque; in the second row: Dr. Willie, Kate, Barrie, Dr. Frank, and Dr. Curt; in the back row: Larry, Mario, and Mike.

We unloaded the equipment from the top of our van into the clinic. Each of us has done this many times and the clinic, with its two dental stations was operating in about an hour. Dr. Curt Gedney, an emergency room doctor who also delivers a lot of babies and speaks Spanish, was in charge of the triage desk. Larry Black, geneticist by training and a mountain climbing, alpaca breeder by choice, cleans the instruments, talks to patients in Spanish and hands out pain medicine. Dr. Frank, Dr Mario and Dr. Willie alternately pull teeth; administer anesthetics and rest, seeing more than 20 patients an hour for hours on end. Kate, Frank’s wife and crack dental assistant, teams with Barrie and Mary Jo to see that the dentists operate at maximum efficiency. They also wipe the occasional tear, hold hands and trust with the kids, many of whom have never seen a dentist.

We finished the 2002 trip by seeing 205 patients in one day, a record. The local Mayor, governor of the province and the justice of the peace, presented us with an official document, seals and all, of thanks for our work.

As we ate dinner that night, Moises, the manager of the Mallkini, toasted the volunteers by saying, “I don’t know if it is proper English to call you a group of crazies or a crazy group, but I do know I like being a part of it.” Willie, the Peruvian dentist who had accompanied us, honored the crew when he said, “I have known a lot of gringos who come to Peru as tourists; they take pictures and leave, but you people came to work. Thank you.”

The thanks that each of us felt in our hearts, is for the opportunity to provide care, if only a little. And to all the alpaca breeders whose contributions make the Quechua Benefit missions a reality each year, God bless your generosity.

Exhibit A

Quechua Benefit 2002
Value of Donations

Quantity

Value*

Approximate Number of Patients Examined

1,500

$ 30,000

Total Actual Patients Treated

1,046

$ 180,000

$ 210,000

Quantity

Value

Other Items Distributed:
Full Sized Alpaca/Wool Blankets

1,000

$ 10,000

Leather Top/Rubber Soled Sneakers

300 pairs

$ 6,000

Rubber, Waterproof Boots

600 pairs

$ 6,000

Toothbrushes

1,200

$ 1,200

Superballs

600

$ 300

Miscellaneous Toys

6 bags

$ 1,500

Used Clothing/New Clothing

7 large bags

$ 3,000

$ 28,000

Total Value of Services and Goods Delivered

$ 238,000

Cost

Actual Cost of Distributed Items:
Blankets at Cost from Factory

$ 1,700

Shoes/Boots at Cost from Factory

$ 4,300

Toothbrushes (Purchased)

$ 800

(Donated by Manufacturer)

-0-

Superballs/Toys (some Donated)

$ 150

New/Used Clothing (all Donated)

-0-

Cost of the Trip, including:
Airfare

$ 7,880

Supplies

$ 2,142

Blankets/Shoes/Boots

$ 6,000

Ground Transportation

$ 1,550

Hotels

$ 650

Food

$ 300

Tips

$ 150

Miscellaneous

Total Estimated Cost

$ 25,622

Net Value of Contributions

$ 212,378


* Value of treatment based on U.S. economy.

Quechua Benefit: An Expanding Mission in the Andes

By Mike Safley
July 13, 2011

Quechua Benefit began in 1996 with a modest trip from Portland, Oregon to Macusani, Peru. There were five team members: Dr. Mario Pedroza, his wife Barrie, Russ Gratton, Mike Safley and Barb Lopez, a dental assistant in Mario’s office. Don Julio Barreda organized the trip and arranged for the team to see patients from six local grade schools. The clinic was operated from the front room of Franklin Tejada’s home in downtown Macusani. That first year the team saw 300 patients, delivered clothes for 500 children and school supplies for six schools. Quechua Benefit has returned to Peru every year since 1996 delivering clothes, school supplies and dental assistance. The alpaca breeders of the United States have made this possible with their kind and generous donations. Fundraising has progressed from a few loyal donors to the point today where more than 216 breeders have contributed, many donating thousands of dollars.

WHY PERU?

The motivating principal of the Quechua Benefit charity is to provide a vehicle for American Alpaca Breeders to express their thanks to the Quechua Indians who have domesticated and cared for the alpaca from more than 50 centuries. Simply put we have them to thank for our industry and our opportunity to include alpacas in our lives. Alpacas support many, many U. S. owners in a comfortable life style. Alpacas provide a profitable business opportunity for thousands of families across the United States.

THE NEED

The Quechua, on the other hand, are dirt poor. Consider what the mayor of Macusani had to say about Quechua Benefit and the people they serve after the 2003 trip. “We are the poorest of poor provinces, Carabya, in a forgotten corner of Peru. We are at the end of the road and even our own government does not remember we are here. But you have found us year after year and we, and all the Peruvians in the highlands, thank you for your kindness.” The math behind the charity is simple. For every $1.00 contributed approximately $10.00 worth of assistance is delivered. In 2002 we spent $25,622 on the annual trip and delivered goods and services worth $238,000, (when billed at standard U. S. dental rates). Quechua Benefit’s team treated 1046 people. Each of these patients received: a dental procedure, a blanket, rubber soled sneakers or rubber boots, a toothbrush and a toy; the cost $24.50, per person. Each team member volunteers their time, flies economy and sleeps two or three to a room.

THE NEW AND EXPANDED MISSION

The annual mission has grown from a small team with one dentist to a larger group with 3 dentists. The charity owns all of the dental equipment and miscellaneous support supplies necessary to extend the number of days that it operates in Peru. The equipment is currently stored in Peru at the Michell company office. We intend to expand our mission, providing dental care to 6 new towns and to institute a new initiative: The delivery of meals to families and children who are currently undernourished. Quechua Benefit has expanded their fund raising capacity. Just this year the Rotary Club of Carrol Creek, Maryland led by Scott Grove of New Market, Maryland raised $5,000.00 and received a matching grant for $5,000 from the National Chapter of the Rotary Club. They have donated this money to support a mobile dental office that will move from town to town in the Altiplano delivering assistance to those who have none. As alpaca breeders learn of the charity’s activities their generosity continues to grow. Quechua Benefit has made the decision to enlarge their operations from 3 towns to 9 and from 12 days a year to 135.

FOOD PROGRAMS

The second Quechua Benefit initiative involves expanding two existing soup kitchens or food programs which serve adults and children that live in the communities that the Quechua Benefit serves. Hunger is a reality in the Altiplano. Children grow up with a void in their stomachs that is never quite full. Sister Antonia Kayser is a 79 year old nun from Brooklyn, New York. She and her assistant, Joan Toukig, are Marykoll Sisters of the Catholic Church. Sister Antonia has been feeding 800 people a day since 1983 from the courtyard of the church in Yanque, a small town in the Colca Valley. Antonia and Joan do this five days a week, year in year out. On Saturday they feed 400 more. If you were to do the math you would find that, over the years, the Marykoll sisters in Yanque have provided hungry men, women and children with 4,680,000 individual meals. Sister Antonia is famous in the Colca Valley. Mike Safley and Cathryn Whitman had the opportunity to sit down with Sister Antonia in November 2002. They had a simple question, “How do you feed all of those people?” She had the gardener show them the green houses where the vegetables were grown and she invited Mike and Cathryn back at 5:00 am to witness the preparation and distribution of the meals. It is a very simple operation. A dozen huge black pots are filled with vegetables from the garden, a little meat and water. After simmering for several hours the soup is ladled out to the women and children in the line that have waited patiently for the gate at the entry of the courtyard to open. They each bring a piece of dry dung or a branch from a tree to fuel the cook fire; it is their individual contribution to the effort. They have a notebook which authorizes them to get a ration for each person in their family. They sign in and their pail is filled. Everyone fades into the dawn. Mike asked Sister Antonia how she had supported this program for so many years. She replied, “God provides.” He asked how Quechua Benefit might help and she said, “We could use a little more meat for the soup and some seeds for our garden.” Quechua Benefit, with your help, is going to assist Sister Antonia and Sister Joan in 2004, with a monthly stipend. There is an orphanage in Macusani, Mosoq Runa, run by the Sisters of the Cross. Quechua Benefit operates their dental clinic out of the orphanage. They also have a food program for the children who live outside the facility. They currently feed 50 children a day. Their goal is to increase the number to 100 outside children a day. These kids are the poorest of the poor; all very small and fragile. With your help Quechua Benefit can make that commitment to the kid’s health and well being. As time goes by the Board of Directors intends to support food distribution programs that are already operating and located in the towns that the mobile dental clinic visits. Your donations can make this possible.

LOCAL SUPPORT

The charity is supported on the ground, in Peru, by Michell CIA the International Alpaca Association (IAA), and Grupo Inca. They provide logistical assistance, transportation and lodging for the team while they are in Peru, all at no charge. The mission could not succeed without their generous support. We give special thanks to Alonso Burgos, Ignacio Garaycochea, Sandra Carbajol and Juan Pepper who schedule our lodging, arrange transport and store the dental equipment.

FUNDRAISING

The Internal Revenue Service has certified the Quechua Benefit as a 509(a) (1) non-profit status charitable organization. The federal ID number is 31-1682324. Every dollar that is donated to the charity is tax deductible. The board of directors are not paid any consulting or administrative fees, 100% of all donations go straight to the delivery of goods and services to the Quechua people. Last year Quechua Benefit raised $58,398.00. It now has representatives: Wayne Jarvis in New York, Lindy Huber in Kentucky, Marta Moore and Bonnie Ferrell in Colorado and Jack Armstrong in Washington State, who are soliciting local affiliates to allow donations of stud services and other items to their silent auction’s on behalf of Quechua Benefit. In 2003, the Alpaca Western Extravaganza (AWE) breeders donated goods and services that were purchased, by the event attendees, at the not so silent auction, for a total of $44,868.00. For our new initiatives to succeed Quechua Benefit needs your help and donations. The Quechua Board of Directors has created a new advisory board. Members of this board will be representatives of their respective Alpaca Owners and Breeders Association, (AOBA) affiliates. They will coordinate fund raising efforts at the affiliate level. If you would like to volunteer please call either Daryl Gohl at 503-407-5943 or contact him by email at dgohl@columbiamistalpacas.com, or contact Mike Safley at 503-628-3110 or by email at mike@alpacas.com. If you would like to volunteer your time to join the team on a visit to Peru please contact your affiliate representative. We also need an experienced grant writer to assist us in the process of applying for institutional grants. We hope you are moved to write out a tax deductible check made payable to Quechua Benefit and send it on to the Quechua Benefit team. God bless you.

Quechua Benefit

Team Peru Medical and Social Outreach

Health Beliefs and Characteristics of Latin American Cultures:

Cultural Awareness Tips for Mission Participants:

Titles are extraordinarily important – always error on the side of being overly polite by referring to everyone by their appropriate professional of social title (e.g. physicians – “Dr.” or Dra.”).

Spanish is a second language for some of our clients. They may speak an indigenous dialect or language (e.g. Aymara, Quechua, Ayacuchano).

Most of the patients you will interact with are Roman Catholic; spiritual and religious ideas are a large part of their health beliefs.

Many Peruvians share a belief that illness is due to factors beyond individual control. This is a major reason that prevention and health promotion are not highly valued. Helping to bridge the knowledge gap by explaining the connection between lifestyle choices and physical ailments and disease can be very empowering to patients.

Health is very strongly equated with an absence of pain, and illness with presence of pain. Illnesses that do not cause pain often go undiagnosed and un/under treated.

Family is central to Latin culture, and individual needs may be considered less central than those of the family or community. This can affect the ability of individuals to self advocate and seek health care.

Health and illness are considered to be due to balance or imbalance between “hot” and “cold” elements. A “cold” illness should be treated with a “hot” remedy and vice versa. Illnesses, foods, and treatments are assigned to one category or another differently from family to family. This can be an important element in client compliance with a treatment.

It is common for Latin Americans to simultaneously seek treatment from allopathic healthcare providers and traditional healers. Similarly it is common for an illness (and its treatment) to be seen as having physical, spiritual, cultural and emotional elements.

Patients may complain of somatic related concerns at the onset of the encounter, and develop an entirely different scenario during the intake. It is not uncommon for a patient to manifest physical complaints for emotional or mental concerns.

Be careful not to expand every clinic visit to become a comprehensive medical encounter. We are a limited resource clinic and should avoid providing primary care services. Patients who are in need of longitudinal care should be referred to the mission leader for details.

Do not be afraid to pray with your patients. Peruvians are a very open people and enjoy expressing their spiritual beliefs.

It is very common for Peruvian patients to “demand” medication at the conclusion of a visit, even if it is not medically warranted. We have found it helpful to dispense vitamins and NSAIDs to almost every patient. We will often educate the patient as to the rationale for antibiotic therapy and the difference between a viral and bacterial infection.

Latin American cultures place a very high premium on relationships. Patients will want to talk before they begin the medical encounter. In addition, you may find that patients are prone to loquaciousness. Allowing the patient to describe her or his situation, concern or complaint in “their” terms may be the only way to fully appreciate the full complexity of their presentation and healthcare needs.

Guidelines for Appropriate Healthcare:

Be formal and respectful. Avoid prolonged eye contact. It is very important to establish report by shaking hands with the patient and family members.

Most clients will ask few questions -don’t assume this means everything is understood. Try to draw the patient out.

Some patients will ask many questions – do not be afraid to let them know that there is a limited amount of time available to work with each patient. It may be necessary to have them return to be seen on a separate day, or refer them to see another doctor at the clinic.

Patients can present with very general, vague symptoms (“pain”) -try to move towards specific symptoms that will enable you to rule in/out a diagnosis.

Take time to explain things and ask questions to assess understanding. Do not assume that the person is unable to understand.

Do not assume a particular class or educational background. People immigrate to Lima for a wide variety of reasons and come from all backgrounds.

Do not rely on written handouts or instructions for medications.

It is appropriate for a non-fluent provider to use Spanish in greetings and to create a rapport but not to diagnose or treat a patient.

Ask a few open-ended questions about the illness to learn about the client’s health beliefs and explanatory model of illness. Some examples are:

• What do you think caused your problem?

• Why do you think it started when it did?

• How severe is your sickness?

• How long do you think it will last?

• What is your greatest fear about your illness?

• What kind of treatment do you think you should receive?

Do not be judgmental about traditional health practices, regardless of what you think of their effectiveness. Think of constructive ways to practice harm reduction if you think the practice is actively harmful.

Some Tips for Working Effectively with a Translator:

•Phrase your questions as specifically and completely as possible. Do not put the translator in the position of elaborating or clarifying.

•Remember to direct your questions towards the client even though you are speaking in English. Also remember to use a formal and respectful tone even if you don’t think you are being understood.

•If at all possible, use a translator of the same gender as the client.

•Respect physical privacy, have the translator stand behind a curtain during pelvic exams and other physical exams if the client is uncomfortable.

•Do not use family members or friends as translators if at all possible unless specifically requested by the client. Use of a family member or friend as a translator can be a conflict of interest and cause problems for the client or result in important health information being withheld.

•The translator is an integral part of the treatment and evangelism team. Be courteous and respectful to their needs and talents.

•If possible, use the client’s primary language in greeting.

•Body language is an important part of communication in Latin cultures. Be cognizant of your mannerisms in the clinical interaction with a patient.

Common Cultural Practices in Peru:

• Greetings: Note that men and women shake hands in greeting and parting. Men embrace close friends or pat them on the back. Women often kiss one another on the cheek. In is common that when two women are introduced, they will kiss one another. This is often true for men and women (especially when introduced in social, rather than professional, settings). Titles are very important in Peru – greet officials or elders with their title plus last name. Principal titles are: Doctor, Profesor, Arquitecto (architect), and Ingeniero (engineer).

• Conversation: Expect people to discuss family and occupation as soon as they meet you. Expect people to stand much closer during conversations than in the U.S. or Canada. Don’t back away or others will feel offended. Ask advice on sights to see and places to eat – Peruvians (Limenos) are very proud of their country and will enjoying talking to you about the best places to indulge in local restaurants (Comida Criolla). Don’t make any remarks about Peru’s government, even if you hear complaints and criticisms. In addition, do not make negative remarks about Lima – which has changed considerably in the last 10 years since well-to-do urbanities starting moving to the suburbs.

• In Public: Expect a very warm and inviting greeting in Peru. Foreigners are considered very special people. If you need directions, expect to ask several people before you find where you are going. Even if they don’t know the correct directions, people will pretend that they do – to save face. Don’t be surprised if you see women walking arm-in-arm with other women or men with men – and don’t be surprised in a person of the same sex takes your arm. To beckon someone, wave your hand back and forth while holding it vertically, palm facing down. If you need to use the bathroom, go into a restaurant. It does not matter that you’re not a customer. Don’t put any toilet tissue into the toilet. Put it in the receptacle next to the toilet.

•General information: Note that you will receive a tourist card upon your entry in Lima. Guard it carefully, because you will have to hand it back when you leave the country. Always carry a “copy” of your passport. Restaurants and businesses may ask to see your passport to use your credit card.

•Street Knowledge: Be very careful when crossing the streets. Cars do not respect the rules of the pedestrian. Be aware that pickpockets are often looking to target groups of tourists. Carry most of your money in a travelers pouch or your front pockets. Do not drink the water from the tap in Peru – anywhere in Peru. The city of Lima has (for years) reported to the international community that the water is treated – trust me, do not drink the water!

Peru is an enchanting and wonderful environment. Enjoy you’re stay.

Resources and References:

“Cultural competency in the delivery of health care”

www.musc.edu/deansclerkship/rccultur.html

Kemp, Charles. “Hispanic health beliefs and practices: Mexican and Mexican-Americans” –www.baylor.edu/~Charles_Kemp/hispanic_health.htm

The Cross Cultural Health Care Program –www.xculture.org/

Resources for Cross-Cultural Health Care –www.diversityrx.org

Nuestra Communidad Sana –www.community.gorge.net/ncs/default.htm

INASP HEALTH LINKS: Gateways Latin America – www.inasp.info/health/links/gatela.html#paho

LatinAmericanNetworkInformationCenter, (LANIC) and Indigenous Peoples, Extensive links on South American topics *

Cultures of the Andes –www.andes.org/index.html

Compiled by: Wayne A. Centrone (May 2008)

I have been given the privilege of sharing with the entire Quechua benefit family the joy and success our most recent medical outreach to the Colca Valley this past November. The mission was staffed by 17 American and Canadian volunteers; our largest group of volunteers to date.  We had four physicians, four nurses, one medical assistant, one occupational therapist and seven wonderful helpers that working together at the Health Posts in Chivay and Callilli. But what made this trip truly special was the 18 Peruvian volunteers that joined us making the mission team total 35 committed souls. Our Peruvian contingency consisted of Dentists who made false teeth for the older Quechua most of whom were toothless, interpreters, Peace Corp volunteers, a Gynecologist, a Physician that did ultrasounds and a Nutritionist who conducted clinics for the mothers who brought their children to be treated.

The Quechua Benefit team provided excellent care for over 1300 patients. Because of greater medical specialties being represented, we were able to move from cursory treatment into more comprehensive care. We also are making arrangements for more than 20 patients to receive more definitive care in Arequipa which they could not afford on their own.

This is just the beginning in making a significant impact on the medical care for the Colca Valley. We expect the Snowmass Medical Center, at Casa Chapi, will be finished by the end of April 2011. This will allow us to have a permanent presence in the valley and assist the existing Peruvian health care associates in doing their jobs. We are planning to employee a permanent social worker and hopefully a full time nutritionist at the Medical Center to help people whose current health needs, such as eye glasses, that are not met by the existing Peruvian system. Sometimes this will simply involve guiding or being an advocate for a poor person who is not aware of what is available to them in the local clinics or more advanced treatments in Arequipa.

One of the more important discoveries we made on this trip, which was beautifully organized by the Quechua Benefit staff in Peru, Sandra Carbajal and Alejandro Tejeda, is the opportunity to team up with local health care professionals. In the future we hope to, by way of an example, pair Peruvian Pediatricians with a volunteer Pediatrician from the United States to see patients jointly. We are committed to work with local Peruvian health care professionals. We have Alejandro and Sandra to thank for this insight and opportunity.

Ursula Munro and my wife Deborah also met with local women leaders to discuss how Quechua Benefit can help curb child and spousal abuse that is prevalent in this area. We are truly excited about what is happening right now and the unending possibilities for the future.

We will be having our next medical outreach November 2011. This mission will coincide with the 2011 Alpaca Fiesta in Arequipa when we will be returning to the Colca Valley for another medical outreach and plans are underway to team up, for the second year in a row, with the RAAT’s group from Australia who will be doing more cataract surgeries.

Please consider going with us. If you are a physician we need Pediatricians, Gynecologists, Dentists, Dermatologists, Optometrists and General Practitioners. We can not have too many nurses and if any of you are fluent in Spanish we always need interpreters.  There are thousands of children with no Pediatricians in the Colca Valley. Please feel free to contact me for any information you require, at (need phone number) or email at (need email).

Again thank you to all the supporters of Quechua Benefit. Your sacrificial giving is making a difference right now and will continue to do so in the days to come. Click here to view our mission trip photos.

Quechua Benefit’s first medical mission, involving primarily physicians, began when Dr. Dwight Bailey and his wife, and registered nurse, Deborah approached Mario Pedroza at the 2009 Futurity Show and Sale. The Baileys are veterans of multiple missions to Africa, India, and South America. The proposed a similar mission to Peru. The charity quickly agreed to help organize and support the trip. A team of 15 volunteers was assembled with lightening speed and all of them arrive in Lima on three different flights around midnight on November 6, 2009. It may sound simple, but coordinating two teams, working at 6 different clinic locations, speaking 3 different languages, at 12,000 to 16,000 feet above sea level is anything but.

Dr. Bailey, who is to be ordained as a Christian Minister when he returns from Peru to the United States, takes charge of clearing the thirty bags of medicine through Peruvian Customs in Lima. It takes two hours and Dr. Bailey’s signature and fingerprints pressed in blue ink on countless documents before we emerge from customs into the misty morning air. Each person carefully shepherds two bags full of medicine, which have been donated to or purchased by Quechua Benefit—$250,000 worth.

The team loads the medicine into a bus and heads to the Hotel Melodia, Peru’s version of a Motel 6. After a quick shower they return to the airport for a 5:55 am flight to Juliaca. With no sleep, the group is quiet as they board the plane.

Dr. Bailey and wife Deborah head up the mission team, which meets eleven more local participants, led by Dr. Willy, Quechua Benefit’s full-time dentist, in the airport parking lot. The Peruvian group is made up of interpreters, drivers, and more mission volunteers from Arequipa. The baggage, medicine, and team members are quickly divided and ushered onto two buses. One heads for the Michell farm, Mulkini, and the other to Pacomarco, owned by Grupo Inca. The team has been up for more than twenty-four hours when they reach their destinations at 2:00 pm on Saturday afternoon. We will be reunited four days and four towns later for a trip to Macusani. After fourteen years of dental missions to Peru, this was Quechua Benefit’s first medical mission and their largest to date—twenty-six members. The Mulkini team is made up of doctors Mary Beth and Jim Anderson, Dwanda Emmons, Lindy and Mirian Huber, and Ursula Munro. Dwight, Debbie, Jessica Sullivan, Sean Hommel, Rhonda Deschner, Marilyn Nishitani, and Dr. Willy head for Pacomarca. All have paid their own way to Peru.

Ursula Munro, a registered nurse from Maine, has always wanted to volunteer for a Quechua Benefit mission. As the bus bounced along the road from Mulkini to Muani, where the first clinic will open, all Ursula can think is “what if no one shows up?” Eight straight work days, six clinics, and 2,216 patients later, Ursula is bone tired, her unwarranted fears forgotten.

The second team unloads their gear at Pacomarca, ten minutes from Llalli, a small town visited numerous times by Quechua Benefit’s dental teams. The new mayor has built a huge edifice, the municipal office, which is crowned with a glass dome standing three stories above the simple adobe buildings that make up the rest of the town. The dome glows a surreal blue in the nightscape of the highlands. But during the day, its top floor becomes an intake lobby with three exam rooms, a pharmacy, and staircases full of patients. Outside, a banner proclaims the medical clinic. The team labors from morning to night seeing 816 patients in three days.

Back at Mulkini, the volunteers tear down the Muani clinic, pack the equipment and store the medicine on the bus. The next morning they are off to Picotani, one of the largest alpaca co-ops in Peru. Their herd numbers 50,000 alpacas and they also manage 5,000 vicuñas behind miles of ten-foot-high fences. The co-op headquarters are approximately two-and-a-half hours up the side of a mountain from Mulkini. The team sees more than seventy-two co-op family members who mostly speak Quechua and live much as their ancestors did hundreds of years ago. Only the occasional motorcycle or 4-wheeler betrays any modernity.

The next morning finds the Mulkini team at Mira Sol, an orphanage operated by the Michells and supported by Quechua Benefit. There is a steady stream of children from nearby schools and adults from the town across the river. That night, the two teams gather at Pacomarca. In the morning they begin the climb to Macusani where they will visit Don Julio Barreda’s estancia and conduct a three-day clinic at the town’s hospital.

The group rolls up to the front of Accoyo at 1:30 in the afternoon on Wednesday. Elena Barreda and her sister Guadalupe meet the team, saying they had never seen so many gringos on one bus and certainly not at Accoyo. The farm tour begins with the suris, then the huacaya females, and finally the Plantel males. The sight of so many exceptional alpacas can cause even the most experienced eye to dilate.

Marcus Whitman, the construction manager for Casa Chapi in Chivay, brought his shears for the occasion. The group selects a five-year-old male to shear. A betting pool soon forms, each bettor contributing one dollar and a folded piece of paper with a guess as to the weight of the fourteen-month-old fleece. Marcus hooks the shears’ cables to the truck battery. Accoyo’s cowboys crowd around as the alpaca is stretched out and held with rope handcuffs.

The fleece explodes off the shears. Someone asks if they can change their bet. “No chance,” says the crowd. Thirty minutes later, the fleece has settled down on the scale, and the metal weight comes to rest on twenty-one pounds. Daryl Gohl had guessed 21½ pounds, but Lindy Huber was closer at 21 pounds 5 ounces. She was all smiles as she folded the one-dollar bills into her fleece jacket.

The group of awe-struck alpaca breeders switches tasks to become doctors and nurses once again. They set up a pharmacy and begin to see eighteen of the Accoyo cowboys and their children. Marilyn Nishitani, who is a nurse practitioner in New Mexico, teams with Rhonda Deschner, a pediatrician from Texas. They speak softly to their patients in English, and Inti a translator from Arequipa translates the English to Spanish, Elena Barreda translates to Quechua, and so it goes in reverse. Many of these Quechua patients rarely see a doctor, and the cost puts medicine outside their reach.

Earlier in the day, the patients had been chasing down alpacas, rushing up the hill to bring another group of animals for the gringos to see. A casual observer would pronounce these farm hands fit and healthy. But under the gentle, but persistent, questions of Marilyn and Rhonda, they reveal headaches, stomach aches, leg pain, rapid heart beats, and back problems. One man had been dizzy for more than five years. The ear scope reveals fluid behind both ears and scars on his ear drums. He is given antibiotics, antihistamine, pain medicine, and a worm pill for his aching stomach. Next, a fourteen-year-old girl with worms, neck pain, and a reddened throat is examined; more medicine is prescribed and delivered.

By the time the team leaves Accoyo and arrives in Macusani they have set up and torn down six clinics. Deborah Bailey, CEO of Family Health Care Associates serving about 25,000 people in the Appalachian Mountains, inventories the drugs and files the patient intake forms each evening. She also supervises the pharmacy crew of Dwanda Emmons, Jessica Sullivan, Lindy and Mirian Huber, and Daryl Gohl. Both Dwanda and Jessica work at the Bailey’s clinic in Southwest Virginia.

That night, before the clinic opens in Macusani, Dwight, Willy, Daryl, and I slide furniture into four separate exam rooms where Dr. Bailey, Dr. Rhonda Deschner, General practitioner Marilyn Nishitani, fourth-year medical student Sean Hommel, Dr. Willy, and Dr.’s Jim and Mary Beth Anderson will see patients. Next, we clear out the pharmacy space, unload the medicine, and set up the waiting room chairs. A tent is erected outside, where patient intake forms are filled out by an interpreter and Ursula and Jessica will record blood pressure, and weigh the patients before they see the doctors. It’s ready.

No mission trip is without an “uh… oh… moment,” and our November Mission Mas Grande has its first one as we check into the hotel El Dorado in Macusani just after dark on the sixth day of the trip. The two stars on the sign should be a clue, but the rooms themselves are proof positive. This is not the kingdom of gold from the ancient Peruvian myths. One room has no toilet but does have human feces on the floor. When the problem is pointed out to the proprietor, he argues that it is not human feces. Upon hearing this, Deborah Bailey is uncharacteristically speechless. In the rooms with toilets, they are seat less. Cold water is standard in most of the rooms with baths. The men on the trip spring into action. They locate a clean facility and move all of the women to a new hotel. As mothers often say, all’s well that ends well.

I remain at the Hotel El Dorado, where I have one of my more interesting Peruvian experiences. About 1:00 am, I awake from under seven alpaca blankets that are failing to keep me warm. As I shift to a more comfortable and hopefully warmer position, I feel something fairly heavy, of unknown origin, at the foot of my bed. It shifts in response to my movement. Not quite sure what has just transpired, I wait a few moments to become fully awake. As I roll over again, so does my anonymous companion. Trying to remain calm, I panic instead, kicking with both feet from the prone position. Splat, thud, hissing, and scratching follows; cats, rats, guinea pigs, skunk, and foxes crawl through my mind. I can’t remember the last time I had rabies shots. I resolve to remain perfectly still and not visit the banyo only ten feet away. Hours later, the morning light creeps through the window. I peek out from under the covers—the room is clear. I don’t look under the bed.

The trip, by any measure, was a significant success. The value of the teams’ services in US dollars was at least $212,200 (2,212 patients at $100 per patient), and the retail value of the medicine dispensed exceeded $250,000.

One doctor examined ninety-five patients in one day—the trip’s unofficial record. The oldest clinic visitor was ninety-three years; the longest walk to attend a clinic was five hours by a sixty-year-old man. The last patient, seen on the last day, arrived at 8:00 am and was seen as it got dark that evening.

The prize for the strangest home remedy was given to a patient who told one of the doctors that when her stomach ached, an old Quechua woman told her to drink her son’s urine. She did, and said “I vomited great white worms out of my mouth, but it still hurt”.

The Quechua women wear skirts and sweaters layered over more skirts and sweaters. This makes it difficult for the nurses to take blood pressure readings and for the Doc’s to find their way to bare skin with their stethoscopes. Mary Beth Anderson began counting the number of skirts on her patients. The record was ten; not counting the alpaca knit long johns.

The real measure of any mission is very hard to calculate. How do you put a price on hope? Is there a way to measure the good will generated by volunteers from places so distant that it is incomprehensible to the local Quechua people? A Quechua mother approached me to say thank you during a November dental clinic in Llalli several years ago she said, “My daughter told me her tooth hurt back in August, I told her, don’t worry, the gringos will be here again in November.” For parents who have to wait months before their children can be rid of an aching tooth the gringos are a welcome sight. The poverty of the people seen on these missions is sobering. Many of them are the very people who cared for our alpacas before they came to the US.

The other side of the coin is the corps of dedicated volunteers who put their lives on hold, head off to the uncertain reality of altitude sickness, dysentery, strange food, long days, and roads with potholes from hell, and respond by sharing everything they know. Why do they come home so full of love and happiness for the experience? Why has Ursula Munro, and Deborah Bailey already volunteered to return in March of 2010 for a clinic in the Colca Valley? Once you volunteer you know why.