Iquitos and Napo River Region of the Amazon
Division of Global Health – Peru partnership project. Dr. Kerry Telford believed global health work “should be a mandatory part of medical training”. Her work in the Peruvian Amazon has been the catalyst for the creation of a network of friends and colleagues in Peru and Vancouver to begin the St. Clotilde Health Centre, Peru – UBC Division of Global Health partnership project. It is hoped that this new project will be a fitting tribute to Kerry’s passions for global health and teaching.
A UBC Medicine graduate and family physician, Kerry Morrissey (Telford) inspired many by her gracious and warm personality which she extended to anyone in her presence. She created a diverse medical practice, working at the Vancouver Bridge Clinic and volunteering at a rural medical hospital in the Peruvian Amazon. Sadly, she and her six-month old daughter, Sarah Morrissey, died in a seaplane crash near Saturna Island, BC on November 29, 2009. She is survived by her husband and daughter, Patrick and Claire Morrissey, as well as many friends and family members.
A year later, Kerry’s has continued to be an inspiration to her friends, classmates, colleagues, and family, with her dedication to caring for the underserved. Her UBC Medicine classmates rallied to create the Kerry and Sarah Morrissey (Telford) Award which will provide field travel support for Residents in the UBC Family Practice Enhanced Skills R3 Program in Global Health. Kerry’s husband, Patrick Morrissey, and her physician colleagues at the St. Clotilde hospital in Peru, Dr. Maurice Schroeder and Dr. Jack MacCarthy, have been leading an initiative to honour Kerry’s commitment to helping the indigenous population in the Upper Napo River region of Peru at the Centro de Salud Hospital in St. Clotilde. A close friend and Medicine classmate of Kerry’s, Dr. Joan Bratty, introduced Kerry’s Peruvian colleagues and Vancouver-based network, “Friends of Kerry”, to the Division of Global Health to develop a partnership that will support the work of the health care team at St. Clotilde health centre.
Dr. Jack MacCarthy, Dr. Kerry Telford, Dr. Maurice Schroeder
Originally established by an Order of Nuns from Quebec in the 1960s, the St. Clotilde Health Centre, located in the Amazon region of northeastern Peru, has been run by Dr. Jack MacCarthy and Dr. Maurice Schroeder, both Catholic priests and physicians, for the last 30 years. Dr. Schroeder is originally from Saskatchewan and completed his MD and Family Practice training at the University of Calgary. He also completed a Diploma in Tropical Medicine in Belgium. Dr. MacCarthy is an American-certified internist who came to St. Clotilde when it was only a 2-bed hospital. The health centre now provides in-patient care, outpatient clinics, and outreach services to 20,000 people living along a 400 km stretch of the Napo River. Outpatient clinics run Monday to Saturday and include a dental clinic and infant nutrition/vaccination clinic. There are 30 in-patient beds at the hospital and doctors rotate on-call for evening and night emergencies. Basic surgical and obstetrical (including C-sections) are done at St. Clotilde hospital and most laboratory investigations are done on site (including TB microscopy). However, patients are sent to Iquitos, the nearest city and referral centre, for radiological investigations because there are no xray facilities. About once a month, patients who require higher level care, are sent to Lima. Dr. MacCarthy and Dr. Schroeder have developed 12 outreach health posts “Postas” along the Napo River which are run by a nurse or healthcare worker.
Medical problems include: malaria, diseases relating to poor water and sanitation (intestinal parasites, and other diarrheal disease), respiratory illness (asthma and pneumonia), HIV, injuries, diseases relating to poor nutrition and maternal health, and inability to access care due to the remoteness of the villages and the burden of transportation. Most of the population relies on subsistence farming and fishing, but some locals are leaving to work in the mines.
Because of its remote location, St. Clotilde has difficulty in recruiting Peruvian physicians to work at the health centre. Medical Residents from Iquitos and Lima come for one year of rural training, but they leave for more inviting positions in Lima or Brazil, so physician retention is an enormous problem. Dr. MacCarthy and Dr. Schroeder have trained nurses and would like to train more healthcare workers for the outreach health posts in order to increase the sustainability of health services along the Napo River.
The Division of Global Health is working with the St. Clotilde Health Centre to find ways to support existing health services and develop sustainable solutions to improve access and delivery of healthcare. Initially, the Division will facilitate elective placements for medical students and residents and volunteer placements for practicing physicians which will provide medical service support as well as assist in training local healthworkers. In collaboration with the local community, we will look at ways to address linked causes that impact health and disease prevalence such as poor water and sanitation, nutrition, and health knowledge. A long-term goal is to develop relationships with the medical training institutions in Iquitos and Lima in order to further strengthen the capacity of St. Clotilde to be a sustainable health centre run by Peruvian physicians and the local community.
Bedside teaching
The Division of Global Health has been working with the UBC Global Health Initiative to develop global health curriculum for undergraduate and postgraduate medicine. One of the key components of global health training is service-learning opportunities with identified learning objectives. One of the former R3 graduates of the Enhanced Skills in Global Health program will be conducting a needs assessment of the St. Clotilde Health Centre in January 2011. Students and Residents on elective placements will be working under the supervision of Dr. MacCarthy at a level appropriate for their level of training. Practicing physicians who wish to volunteer will require a temporary license granted by the Regional Director of Health.
If you are interested in a volunteer placement or elective please review the following placement details: http://www.familymed.ubc.ca/ghed/recordDetail.php?id=33
Dr. Kerry Telford loading up with supplies for St. Clotilde
St. Clotilde is located on the Upper Napo River in Northern Peru