Dental Project Peru 2009 Trip

In 2006 I volunteered to travel to Peru to work for a week with the Scottish based charity Dental Project Peru (DPP). The project was set up in 2003 by a Scottish dentist who, whilst on her travels, recognised there was a severe dental need in the remote parts of the Apurimac region of Peru.

The Apurimac region is a day or so drive west of Cusco and is in the high Andes with villages between 2800m (9200ft) and 4500m (14800ft) in altitude. It is a remote, harsh environment with a mainly indigenous population. Most still speak the Incan language of Quechua.

In 2008 I became more involved in helping with the running of the charity and in October 2009 I went back to Peru as part of a volunteer team. Since I first volunteered the charity has expanded to two 4x4 trucks and was able in 2009 to take up to 6 volunteers per trip. This allowed the Project to expand its remit from emergency pain relief to include starting a preventative programme of fluoridation and offering more teeth to be saved with fillings (electricity permitting). This expansion of the Project has been wonderful to witness.

Days 1-4

After international flights, all the volunteers met in Lima for the night before transferring to Cusco the next day. The October team composed of myself, Roisin- a dentist from Northern Ireland, Nat - a dentist from Harvard University, U.S.A., Marie-Ann - a dentist from Shropshire and Chris - a dental nurse from Wrexham - and Marie-Ann's mother! Unfortunately we were one team member short due to illness preventing travel. In Lima we were met by Daniel, our guide, translator and chef for the trip. Daniel turned out to be a pivotal member of the team managing to link the western volunteers with the Peruvian members of the team; explaining the culture, history and environment with passion and warmth. He managed from day 1 to make the volunteers feel 'special' and that they were providing a very welcomed and highly needed service.

Once we had arrived in Cusco we made our way to the DPP volunteer flats that were to be our base. We then met rest of the Peruvian team. Yesenia, a dentist and full time Project co-ordinator in the region, Leo, a long standing DPP driver and Educator/Quechua speaker and Pepe, a driver and helper. Over the next few days we gradually acclimatised to the altitude by enjoying the sights of Cusco and its surroundings. Daniel had put together a good program of sight seeing so that the team members who had not been to the region before could look at the history and scenery. As Cusco is at 3395m (11138ft) this program is very important. Headaches, dizziness and nausea are not uncommon effects on arrival in Cusco and it is important to take it slowly.
Over the next few days we enjoyed time to bond as a team. We took in the archaeological sites of Moray, Q'enco, Tambo Machay and Sacsahuaman. We saw the Inca saltpans at the Sacred Valley and toured the Inca parts of Cusco learning of their history and the effects of the Spanish Conquest.

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The Inca site of Moray

Finally the night before the trip arrived and we got an early night, as the hard work was to begin

Days 5-8

After and early start the team convened at the DPP flats to load the equipment onto the 2 4x4 trucks. This is a precise process that Leo has perfected over the years as there is a lot of equipment to pack into not a lot of room. Once all was secured in place we left Cusco for the 6-hour drive to our stop over at the small town of Cotabambas. This is a wonderful scenic journey, mainly on rough surfaces, crossing the Apurimac river valley - a descent and climb of about 1800m (6000ft) to cross one valley.

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The road across the Apurimac gorge.


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The Apurimac region.


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The Apurimac region.

On arrival in Cotabambas we spent the night in two rented dorms in a Convent. The following morning we started early again to reach to reach our first village. Another 2 hours in the trucks and we arrived at Nahuinlla, a central village to a network of smaller villages on a high altitude plateaux. Nahuinlla is at about 4200m (13800ft) and we pulled up to Health Post with the usual pre- work jitters. What would be in store for us over the next few days?

Once we had unloaded the trucks and found the facilities (the toilet was a hole out the back and to wash we had a stand pipe in the court yard) we set up our accommodation. This was a couple of outbuildings, with some old beds in one, and enough floor space in the other to sleep, cook and eat. Finally we set up the dental rooms. This Health Post offered us three rooms with the potential of electricity (during the trip this proved intermittent). We decide on one filling room with two chairs, one extraction room with two chairs and one sterilisation/medication room. By late morning we were in the thick of it working. We organised ourselves into 2 teams. One team would go with one truck to the outlying schools to provide an educational talk, apply fluoride to every child's teeth and give out toothbrushes and toothpaste and show the children how to use it. The remainder would provide the clinical dentistry rotating between extractions and fillings to try to avoid fatigue. Every day we rotated the 'school' team with the 'clinical' team.

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One of the treatment rooms at Nahuinlla.


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The room where we cooked, ate and slept.


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Leo giving an educational talk at a nearby school

Once word spread we has arrived over the next few days we were very busy and had to work late into the evening to cope with the demand. Long days at altitude after a night sleeping on the floor started to take their toll. We were so busy on the final day we were meant to be leaving we decided we decided to continue and get up the next day before sunrise to get to our next destination. For the first time volunteers, this was a baptism of fire and emotions flowed! Seeing the need of the population, especially the children, working at altitude, and feeling the warmth of their spirit returned can be physically and emotionally draining but very rewarding

Nahuinlla Statistics

Days 9-12

After a very early start we arrived in the next village of Pfaco. This was only 3 hours drive from Nahuinlla but it was a very different landscape. Pfaco is at 2800m (9200ft) and has a semi-tropical feel. Much more vegetation, animals including green Andean Parakeets and warmth! Nahuinlla had had an average temperature of 0 - 10 C and Pfaco must have been at 25C. Quite a shock! Off came the fleeces and thermals and out came the T-shirts and insect repellent. We quickly located the Health Post (they are all painted blue) to find it was closed for refurbishment. The Health post had been relocated to the village hall so we set up there, one large room for everything - including the local nurse. We were up and running by lunchtime. We quickly settled into our routine, sending a team out to the schools and the remainder working clinically. Heat was to be the problem here over altitude - we were already tired and this did not help. One member went down with a stomach bug and we all had to keep hydrated to keep going. However to our relief Pfaco is within 1/2 hour drive of a small town called Coyllurqui and our evening accommodation was based there in the hostel. A bed! A welcome relief, and it even has a cold shower!

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The village hall in Pfaco.


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The facilities in Pfaco - it had a great view however.


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The rogue lamb.


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Finally our last clinical day arrived. We were visited again by a local lamb that had decided it would be great fun to keep running around our clinical area. It was a welcome relief to the dogs, I suppose. By 5pm on the last day we had finished our last patient and we decided to pack up the trucks and head back to Cotabambas.

Pfaco Statistics

Three hours later we were back at the Convent and setting up for the night. The following morning after another very early start we were on the road across the Apurimac river valley back to Cusco. The feeling of putting the wheels back onto tarmac 1 hour outside Cusco was a delight to our jolted bones and we were back at the DPP flat by late morning. After unpacking the trucks and washing all the equipment, the first warm water shower for a week was heavenly. Many comments were made over the next few days about never taking for granted our western luxuries again!

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The journey home.

That evening we had our end of trip meal with the whole team. We had all got on so well together it was clear good friends had been made. Emotional words were said as we all gave a small speech of thanks and many tears were shed.

Days 13-14

A final relaxing day was spent in Cusco, a little more sight seeing, some shopping for gifts for loved ones back at home. The next day we all went our different ways. Some went to Machu Picchu and I took a flight back to Lima and caught my international flight home. Again the Dental project Peru had affected my life, I had made great friends, hopefully relieved a lot of dental pain and given me another life affirming experience that makes me appreciate what I have to come home to - and I could not wait!

I would like to give thanks to a number of people. Local dentists who kindly donated fluoride varnish, Green Lane Primary School for donating toothbrushes and producing educational t-shirts to give to the schools, Ravensworth Primary School for donating toothbrushes, my patients for their interest and understanding and my friends for their help. Without Jacqui's and Clark's foresight, leadership and hard work this would not be at all possible, and I am very grateful to her and Clark for giving me these experiences.

Finally thank you to my family - Helen for her huge support and help when I am away from the practice and to Jack, Amy and Nina for being there to come home to.

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Please visit www.dentalprojectperu.org for more information.