Project Outline

Thank you for the opportunity to outline this project to you, BAM and its subcontractors.

I notice from your CSR policies that this commitment to future generations is at the heart of what you do, as is your commitment to society as a whole. It is for this reason that I wondered if BAM and perhaps its subcontractors would support the purchase of an ambulance for a children’s health facility in Peru?

This ambulance project is led by Irish /Peruvian Dr Jackie Pando Kelly who is a Clinical Lecturer at the Department of Paediatrics & Child Health and Out-patients Paediatric Doctor at CUH/ UCC. She is originally from Lima- Peru where she did her undergraduate medical training. She completed her Paediatric training in Ireland in 2010. (Jackie’s Dad is from Peru and Mum is from Limerick)

As a medical student in Peru, she became involved in the problems of poor communities, particularly the “Mama Ashu” Hospital in the rural town of Chacas, 11,000 feet above sea level. The hospital has 40 beds, an emergency room, two delivery rooms, two surgical theatres and a small laboratory and radiology department. Funds for medicine and other necessary supplies are now raised by volunteer groups in Ireland and Italy. The hospital depends entirely on doctors and nurses, Italian, Peruvian and Irish who volunteer their time and services. The hospital provides health services to over 8000 people, who without the help wouldn’t have any medical care.

Dr Pando Kelly continues to work at the Hospital as a volunteer each summer. In 2010, she obtained funding from the International Society of Nephrology to start the first Screening Program in children for prevention of Renal Disease and Hypertension in the Peruvian Andes. Populations that live at high altitudes, such as the Andean communities of Peru are exposed to many of the factors that can trigger Chronic Kidney Disease such as being born with low birth weight, raised in low socioeconomic conditions and being exposed to chronic hypoxia (because of the altitude), which has recently been recognized as a factor responsible for renal injury.

Since the Screening Program started in September 2010, with the aim to identify children and adolescents at risk for Renal Disease, based on an early detection of urinary abnormalities, over 800 children in the Peruvian Andes around the town of Chacas and surrounding areas have been screened and those with evidence of renal injury are being treated and monitored closely.

Since 2012, Dr Pando KellyKelly has been taking UCC Medical students to the hospital to do an elective rotation during the summer, while Dr Pando Kelly works as a Paediatric doctor there. She is the only Paediatric doctor who volunteers in the hospital, so children have to wait for her annual visit every July to be seen if they have specific Paediatric conditions that other doctors cannot resolve for them. (4 weeks, working 7 days a week, see 30+ children per day, 800 plus children over the 4 weeks’ rotation).

Before travelling every year, Dr Pando Kelly and the Medical students do fundraising activities to purchase medicines for the hospital. Dr Pando Kelly has also been able to take junior doctors to Peru who are doing their paediatric training in Ireland. Dr Pando Kelly has identified that the hospital is in great need of a new ambulance. 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. One example would be patients who suffer a severe head trauma, this is a common problem in this area of Peru because of the nature of the work locals carry out there and because of the lack of safety measures.

At the minute, there is no other way to transfer 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. 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 each way.

Hospitals in Lima ( Peru capital ): at sea level
Distance from town of Chacas: 525 km
Travelling time by road: 13 hours each way.

At present the hospital has 2 ambulances:
The first ambulance is a jeep like an ambulance which is used for travelling to 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 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 several metres down 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.

Our hope is now to get them a more road-worthy and appropriate ambulance. We estimate this will cost € 40,000.

If you would like more information regarding Dr Pando’s work in Peru, please contact her at j.pandokelly@ucc.ie