There is a Plan B BAMBULANCE

This is a hospital that was constructed by a group of medical volunteers called the OMG (“Operation Matto Grosso”) in the 1970s. This hospital is funded entirely through donations and fundraising by the volunteers who come to work at the hospital. All the doctors working in the Hospital work there as volunteers.

Currently, the hospital is in great need of a new ambulance for the following reasons:

1. – Patients need to be transferred to other hospitals, because of the lack of specialist doctors ( mainly surgeons/obstetricians) and sometimes lack of equipment needed to help with the diagnosis and treatment of patients.

Clear examples of these are as follow:

a) A patient with appendicitis: the patient would need to be transferred because there is no surgeon permanently in the hospital, or an anesthesiology ( a doctor who can provide anaesthesia for the surgery). A patient with appendicitis who is not operated on soon can develop a ruptured appendix, followed by a peritonitis and die.

b) A pregnant woman who needs an emergency caesarian section: this woman would need to be transferred because there is no obstetrician in the hospital who could perform the caesarian section. If a woman who needs a caesarian section immediately ( for example if her placenta abruptly ruptured and she is bleeding), doesn’t get it within a limited frame of time, she and her baby could die.

c) A patient who suffers a stroke: there are mainly two types of strokes: one in which one artery is blocked and there is no blood supply to the brain, and one in which an artery ruptures and there is a part of the brain that bleeds. Their treatment is completely opposite, and if one is treated as the other by mistake, this can cause the death of the patient. The stroke itself if left untreated or if there is a delay in the treatment can cause death or severe
impairments in the patient such as hemiplegias (where one side of the body is paralysed). The only way to know which type of stroke it is is by getting a scan (CT) of the brain. There is no CT scan in the hospital; therefore patients who suffer strokes need to be transferred for
getting the correct diagnosis and treatment.

d) A pregnant woman who is at risk of delivering a premature baby: if a baby is born prematurely (before the due date), the baby can have complications such as problems breathing (because their lungs are immature), cardiac anomalies, severe bowel problems and others. There are no doctors specialised in the care of a premature baby (Neonatologists), and no equipment required for their care, such as ventilators (a machine that would breathe for the baby) or echocardiograms (a machine that can look at the heart of a baby). So these babies have to be transferred, ideally before the birth.

e) A patient who suffers a severe head trauma (injury): this is a common problem in this area of Peru, because of the nature of the workmen do there and because of the lack of safety measures. Patients with head injuries can die if, for example, they develop a haematoma (collection of blood) as this can cause an increase in the pressure of the brain. The only way to know if they have a collection of blood in the brain is by getting a scan on their head (CT). If they have a collection of blood, only a surgeon can drain it. So, these patients need to be transferred to get a scan on their heads and if necessary, to have surgery under a specialist (Neurosurgeon).

2.-There is no other way to transfer the patients out of this hospital to the other nearest hospitals with the facilities and specialists needed. Because of the difficult terrain in this area, the only way in and out of this town is by road. The high range of mountains makes it impossible for aeroplanes or helicopters to land or to fly at these altitudes.

3.-The long distances to the hospitals where patients need to be transferred makes it necessary for having a safe way to transport the patients, and for the vehicles that are used, to be in good condition.

The hospitals to where patients have to be transferred:

• Hospital “Victor Ramos Guardia” in Huaraz city: at 3050 meters above sea level Distance from town of Chacas: 125km Travelling time by road: 4.5 hours
• Hospitals in Lima ( Peru capital ): at sea level Distance from town of Chacas: 525 km Travelling time by road: 13 hours

Conditions of roads:

• Very poor, not well kept
• Very bendy roads
• Considered as one of the most dangerous roads in the world (BBC documentary)
• Reaches an altitude of 4700 meters above sea level. At this point, weather conditions can be very dangerous, as often enough there is snow, rain and landslides.
• For the first 4 hours of the journey, there are no petrol/garage stations, so no possibility for fixing the ambulance if there is a breakdown.

4.-State of current ambulances:
At present the hospital has two ambulances:

• The first ambulance is a “jeep like ambulance “which is used for travelling around the rural towns around Chacas. The roads between these towns are unpaved roads. Journeys would be long, as long as 8-10 hours. Mainly used to bring patients from their homes or from small medical centres to the Hospital in Chacas when patients are very sick or unable to find any other way of transport to get to the hospital. This ambulance is very unsuitable to transport sick patients all the way to Lima, as it doesn’t have the facilities for the patient to be lying completely and for a health worker to be standing /sitting beside the patient through the whole journey. This ambulance is 15 years old and was a donation from Italian volunteers.
• The second ambulance is an ambulance used for the transfer of patients to Huaraz or Lima. This ambulance is six years old, but unfortunately in 2016, was involved in an accident while transferring a child to Huaraz for a surgical operation for appendicitis. The ambulance rolled down several meters down from a cliff. The ambulance, although in use, is in very bad condition after this accident and is in need of urgent replacement. This ambulance was also a donation from Italy.