How Things Really Work: Lesson One

January 31, 2012 - Had a productive meeting today with Doctor Alfonso where we reviewed my analysis so far and he seemed pretty happy with what I had done and answered some of my lingering questions and guided me in a few areas. It seems like my client satisfaction survey may also be turning into a lifestyles survey (to find out, for example, what our clients eat, how many sexual partners they have, how often they exercise, etc.), which likely means two separate surveys so I have to think about the logistics for that. The good news is that the majority of the women in Puno can read and write Spanish.

Perhaps even more productive was the talk I had with Angie after where she explained how things really work with regards to patient follow up. I have seen how difficult follow up can be in other countries and suspected it was a problem here just from looking at the statistics (for example they have rates of how many positive PAPs but not actual cervical cancer diagnoses). I also know that Pro Mujer is relatively new to Peru (compared to the other countries it works in) and is still ironing out processes. So that is what Angie is focusing on for her internship. But I was shocked to learn that there really isn’t a formal referral process if a woman has a positive PAP or if the obstetriz notices anything in her breast exam. So basically they find out they might have cancer and then they have no idea what to do. If any of you are as shocked as me, don’t worry, we’re working on it. I suggested a “coupon” idea like PSI used for IUDs in India, and Angie has some other great ideas too. Another reality check is that currently Pro Mujer offers no family planning. They “consult” with women about methods, but can’t prescribe, insert, inject, etc. any methods. We’re working on that too, but in the meantime, I’m curious and plan to include in my research where else the woman are getting family planning methods, if anywhere.

On a lighter note, had a great lunch today at a restaurant that is very popular with the staff – Ukuku’s. They have a fixed menu for 10 soles that includes a starter (today a dip similar to guacamole), soup (quinoa of course), main dish (chicken stuffed with spinach, peppers, and cheese in a sweetish sauce with rice and fries) and dessert (a fruit dish – all peeled thanks goodness!). One funny cultural thing I’ve noticed with every group of people I’ve eaten with is that they all want to talk about how much obesity there is in the US. Which is ironic when we are eating a huge, not so healthy lunch. Also ironic because the three Americans who work at Pro Mujer are all skinny. But always interesting to hear how Americans are perceived in other countries.

This weekend is shaping up to be quite fun with one other staff birthday and a going away party!