Saving Mothers and Babies, Temple Ruins of Kotosh, and View of the Andes

17 June 2018

Each year we present training to healthcare professionals to improve maternal and infant survival in poor and remote regions of Peru. This past week we helped with the courses designed to save lives of mothers and babies on the Pacific Coast and in the Andes Mountains.

Remote areas of Huánuco Region with health posts scattered in villages at high altitude throughout the Andes Mountains.

Imagine giving birth in remote places where the nearest hospital is more than a day's travel away by car on dirt roads.  Most babies in remote regions are born in poorly staffed public health posts. If the doctors and nurses have problems during the delivery, either the baby or the mother (or both) may die. These courses teach ways to save both the babies and mothers in remote places.

Courses: "Helping Babies Breathe" and "Helping Mothers Survive"

The Peruvian Ministry of Health works with us each year to select two remote areas in order to teach these life-saving courses. This year they chose Cañete (on the coast) and Huánuco (in the Andes Mountains).

This year's courses were taught along the coast and in the Andes Mountains in areas of the greatest need.

Our job was coordinating the visits of four U.S. doctors and nurses, along with four Peruvian doctors and nurses who were teaching the courses. This was the second time during our mission to participate in these humanitarian training courses.

Teams of doctors and nurses came from long distances to learn the life-saving techniques taught in the courses.

About 100 health care professionals came to the training in the two cities (50 came per city). Some had to travel for up to a day and a half from remote health posts just to get to the training.

Jennifer Smoot, neonatal nurse from Provo, Utah, teaching life-saving resuscitation techniques using baby simulators and hand-held respirators.

Dr. Mark Bitner from Layton, Utah, overseeing the students practicing on the baby mockups. Many babies are born without knowing how to breathe. The hand-held respirators (in properly trained hands) can mean the difference between life and death for newborns in remote health posts.

Nurse Vilma Baldeon from Lima, Peru, has been teaching these courses with us for several years. The simple manual respirator she is demonstrating can be a life-saver for a newborn in respiratory distress.

These courses are always a major undertaking for us, and they involve lots of logistics and coordination on our part, including:

• Arranging all in-country travel for the U.S. and Peruvian instructors (airlines, shuttle vans, and taxis).
• Arranging meeting locations (typically one of our church meetinghouses in each city).
• Ordering lunches and refreshments for 70 people in each of the two cities where the training is held.
• Sorting, shipping, and then dividing over a thousand pounds of teaching supplies, mockups of babies and mothers, and other basic items such as hand-held respirators.
• Cleaning and preparing the buildings during the courses.
• Serving as the support staff to make sure the courses move ahead without a hitch.

Once the courses got started, we spent part of our time dividing up the thousand pounds of course materials and mockups. The 50 students in each course then take these supplies back to their remote health posts in order to repeat the training with their colleagues.

During the courses, we sorted and divided a thousand pounds of manuals, baby and mother mockups, and hand-held respirators that we had previously shipped to the training sites. Course participants then took back the supplies to their health posts.

Set of training materials, mockups of mothers and babies, respirators, and other supplies that students took back to the remote health posts to use in deliveries for mothers and newborns and for further training.

Letting out a sigh of relief once the courses are underway and running smoothly.

The second day of the 2-day course taught ways to save mothers' lives. Women who die after giving birth often die from uncontrolled hemorrhaging. This part of the course used strap-on modules that simulate ways that hemorrhaging can be stopped. 

(Note that most of the instructors strapped the modules onto men in the class since that is the only time they might experience that end of the treatment).

Strap-on mockups are used to simulate childbirth during the courses. Note the baby mockup that they delivered (along with the cord and placenta).

Strap-on simulators come complete with the baby mockup, placenta, and fake bleeding that students had to stop in order to practice saving the mother's life.

These training courses have now been presented in many cities around Peru over the past 15 years. We are grateful we have been able to play a role in taking this critical knowledge to those who can now save lives with the training and equipment they have received.

Course graduates in Cañete, ready to return to their health posts and save lives.

Courses successfully completed - thanks to everyone's help.
Right to left: Mary and Dr. Jeff Zollinger (U.S. team leads), Dr. Mark Bitner, Neonatal Nurse Jennifer Smooth, Marshall and Sandy (in-country coordinators), Obstetric Nurse Judith Palomino (Huánuco Health authority lead) and assistant Carlos Mendoza.

Getting around Huánuco and Cañete

Both Huánuco and Cañete are smaller Peruvian cities. Each place has one or two malls (which are the pride of each city). Due to the small size of these cities, the easiest and cheapest way to get around is using the ultra-small motor taxis. 

The cost of a ride is about $0.60 to $0.80 - it feels like a fun ride at an amusement park!

View of Huánuco with tiny motor taxis ready to give you a lift.

The motor taxis in these two cities are much smaller than the larger ones in the jungle cities. These are basically tightly enclosed fiberglass shells propelled by tiny motorcycle engines. They are efficient for getting around the small towns. You can't beat the price.

Just hop in these 3-wheeled go-cart motor taxis for a cheap and fun ride anywhere in town.

Temple Ruins of Kotosh

We had a few hours free after the last training course, so we took a taxi to visit some temple ruins just 15 minutes from Huánuco at a place called Kotosh. The Kotosh ruins were built by a civilization that flourished 3,000 years ago, long before the Incas.

Kotosh Ruins - site of multiple temples from ancient pre-Inca civilizations. Note how one temple is built on top of the next one down. Three layers of temples are shown here.

The ruins of Kotosh were first excavated about a hundred years ago, and the excavations are still on going. They have uncovered multiple stone temples, each one built on top of a previous one. At the very top of all the stacked temples is one they call "Temple of the Crossed Hands". This ruin is named based on the two sets of crossed hands made out of clay that were found on the interior walls of the temple.

Interior view of the clay images inside the Temple of the Crossed Hands

The two sets of hand images are embedded in the walls at the front of a ceremonial chamber. One set shows bigger hands representing male hands. On the other side at the front of the chamber is another set representing female hands. 

Close up of the set of male hands. The female hands are on the other side, also at the front of the temple chamber.

While archaeologists are not certain, they believe the images were used as part of ritual ceremonies, possibly marriage ceremonies. These sets of hands put a very human touch on the ruins that otherwise might just seem to be a collection of rocks with little human connection.

It is easy to imagine ancient people placing these two crossed hands on their temple as a symbol of worship or unity. It was a beautiful symbol, whatever it represents.

The image of the crossed hands found in the temple chamber is famous in Peru. The government even included the image on one of their 1 Sol coins to commemorate this touching image.

Crossed hands from the temple at Kotosh Ruins - Peruvian 1 Sol coin.

Time to go Home - Over the Andes

With the week of training courses finished, it was time to return to our home in Lima. We got to the airport, expecting to take a jet back home, but a turbo-prop propeller-type airplane showed up instead. 

We had to cross huge mountain peaks in the Andes Mountains on our return journey. We just hoped the propellers would make it back over the tall peaks.

Getting onto our propeller plane to take us home - over the Andes Mountains.

The Andes Mountains form the longest continuous range in the world and run the length of South America. Most peaks in the Andes Mountains are snow capped year round, even those that sit right at the equator in Ecuador. The tallest peaks in Peru are around 19,000 elevation, directly on our return path to Lima (therefore, the concern over making the journey in a propeller plane).

Spectacular 19,000-ft peaks in the Andes Mountains - photo I shot from our propeller plane during the journey back to Lima. 

Even though we are technically in the tropics, these peaks remain snow capped year round due to the altitude.

People live on mountains throughout the Andes, but these snow-capped peaks are uninhabitable.

And so we made it back to Lima without incident, happy to be finished with another exhausting week of training and travel. 

We should now have about 2 weeks to recover before our next (and final trip) up north to Tumbes near the Ecuadorian border on one of our last wheelchair projects before our mission comes to an end.