Monday, April 1, 2013

Inicio: Child Psychiatry In Peru


My welcome to Lima was a little rough (or more depending on the prism of previous experiences). I was en route to my lodging from the Lima Aeropuerto. I was offered help by a psychologist from Lima who I happened to meet in the airport. I took a cab after much skepticism.  As my cab was standing at a stop-light a young guy seemingly (and wrongly) looking at my red flashy backpack thought I was a rich tourist and broke the cab’s window glass. There was no loss of life limb or property, but it was the first time I was attacked in my life. The first times are always cherishable and sometimes not so cherishable like this one, but nonetheless stay with you for a long time.  Anyways after recovering from the shock of being attacked I collected myself and reached my University on Monday morning. I met with my contact person Marilia who had been a big help thus far, and continued to be till the successful completion of my rotation.  My first day in UPCH and more specifically at the National Mental Health Institute a.k.a Instituto Nacional de Salud Mental of Peru was February 18th.
I was escorted by Dr. Chiarella from the university proper to the Mental Health Institute. Just like any other part of the world Mental Health is given a side clinic, and an oft not travelled street. In this case there was a shiny universidad and then Dr. Chiarella took me to a side street that lead to the not so beautiful corner, which was not even physically connected to the university proper. This was the Peruvian National Mental Health Institute. I was introduced to Dr. Herman Tovar my mentor for the upcoming two weeks. 
Pic 3: Myself (right ) with the Director of INSM (center) and Dr. Herman Tovar (left)

Incidentally I had the great pleasure of working with my mentor who not only taught me all the things I could learn about psychiatry in two weeks, but also told me so much about Peru in general and Lima in particular. I have always believed that travelling teaches you much more than any book can ever do. Dr. Tovar is himself a well travelled person, and we both agreed how travelling and knowing the unkown just broadens the horizon in so many different ways. I couldn't have asked for a better mentorship. Incidentally he was also the person who officially introduced child psychiatry to Peru. In the 90’s the nation decided to send somebody overseas to gather more information on the mental health problems for children. Dr. Tovar went to Japan to learn more about child psychiatry.  He came back and the first thing he did as he returned was close the children’s inpatient unit for psychiatry.
 Pic 4: The picture above indicates the stacked remenants of the inpatient bed parts

We are seeing a lot of closure of inpatient psychiatry units here in the US but for altogether different reasons.  He instead developed a program ETG for the children, a partial hospital/day program which has been a success story so far, even with the limited resources. The first question I had for him was how does the country manage crises.  They told me that actually you can be in observation in the Emergency room for up to 3 days (reminded me of the average inpatient hospital stay these days here in the US), and when the crises is resolved kids are sent back home. Dr. Tovar also started the first training program to train child psychiatrists for the whole nation, and I had the great pleasure to meet with many residents and fellows during my rotation.  In the next two weeks I got a chance to see the oldest mental health inpatient hospital and an orphanage in Lima.


Más psiquiatría peruana en los próximos días
Pallav

No comments:

Post a Comment