John's small surgery is part of a larger church project serving the shantytown area. The church charges just 30p for a consultation and drugs at cost price - a service the state health services could not offer. 'I'm not trying to compete,' John points out, 'simply to provide a cheap and good service, and show people what being a doctor is all about.' Until last year the surgery was just a wooden hut but John now has brick-built, lockable premises where he can leave medicines and equipment.
'In this situation one goes a lot more on clinical judgement,' he admits, 'People cannot afford to pay for tests - and lab results are not always reliable. Most people recover despite this, but I do want to improve the management of things like asthma and diabetes. There's no concept of ongoing care. People lurch from crisis to crisis, receive treatment and then nothing. But it's beginning to become possible, because they are coming back regularly.
'I went out to Peru with a view to doing preventative care, but I found that people had no concept of this. They live from day to day, unaware of how germs are spread or how they get ill. After five years in Villa Marķa, I'm just about at the stage where I've built up enough trust to start health education - informal workshops where people can ask questions. I hope those I've treated will tell their friends, "He's OK."'
As advisor to the healthcare aspect of the project, it's John's task to shape its development. 'I would like to bring in other professionals,' he says, 'to expand surgery hours, and provide a fuller service.'
Reprinted from 'Latinfile', Spring 2001, Latin Link's regular news sheet, with permission.
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