Hermilio Valdizan Hospital, Lima, Peru
Ayacucho, Peru, was the birthplace of the Shining Path terrorist group, and nearly 70,000 people were killed by the Shining Path and the Peruvian military during the 1980’s and 1990’s. The Mental Health Commission of Ayacucho (COSMA) (www.ayacuchomentalhealth.org) was founded in 2003 to serve the survivors, and it remains the only mental health clinic in the Peruvian Andes. Yale psychiatrists James Phillips and Mark Rego established a collaboration with COSMA shortly after its creation, which includes traveling to Ayacucho twice yearly to provide direct patient care, as well as classes and supervision for the clinic’s psychology interns. The most common diagnoses include depression and schizophrenia.
In addition, the Peruvian American Medical Society (PAMS) runs a two week long medical clinic in July. Students interested in all disciplines of medicine can spend time at this clinic, though which PAMS members decide to volunteer for that particular trip will determine what specialty specific care will be available.
UPCH is a medical school associated with a number of hospitals in Lima Peru. Students can choose among many specialties or disciplines for their clinical elective. Dr. Alfredo Massa, a Yale fellowship trained addiction psychiatrist who lives in Lima) serves as a cultural mentor for all students and clinical mentor for those students interested in mental health or substance abuse disorders.
At COSMA, students will interview patients alongside Dr. Massa or other Yale psychiatrists. They will also attend home visits with the psychiatric nurses, who assess patients’ response to treatment, check their adherence to medication, provide support, and answer questions.
At the PAMS clinic, students will be able to observe physicians working with a largely Quechua and Spanish speaking population. The ability to do home visits with the COSMA team is open to all students attending the program.
At UPCH, students have the option to rotate through various services, including the emergency room, inpatient wards, and consultation services. Activities will include participating in team rounds and interviewing patients.
Students should have an advanced intermediate Spanish fluency though special arrangements may be able to be made for those students who have less advanced Spanish fluency.