Dr. Buck’s Experiences in Peru with the Flying Doctors of America
May 23, 2016
UPDATE FROM DR. BUCK AND CARILYN:
The Flying Doctors of America Mission is about to begin! Carilyn and I (Dr. Buck) left MQT at 6:20 AM on Saturday. After transferring in Detroit and Atlanta, we flew to Lima, Peru (6.5-hour flight) and arrived around 11:30 PM (Lima is on Central Time).
Our plan was to stay at a hotel at the Lima Airport, however, I made the reservation for the wrong date! Thankfully, the nice gentleman at the front desk offered us a space to lie down in a side room and told us that he would let us know if some guests don’t show up. Around 1:30 AM, we were allowed to check into a room and got a nice, solid 3-hours of sleep in preparation for our early morning flight to Cusco.
Our team leader met us at the airport in Cusco (short 1-hour flight from Lima) and we began our preparation for Monday’s mission. We checked into our hotel, met the rest of the group and ate lunch. The group consisted of 20 people: 4 dentists, 2 dental assistants, 8 doctors, 2 nurses, and 4 auxiliary members. Then the medical team sorted medications and the dental team sorted dental supplies into rations for each day of the mission.
After a quick stroll around the neighborhood, we came back to meet the translators and had some questionable pizza (trust me, anywhere outside the fabulous US of A, the pizza has a high probability of being mediocre or just plain weird!).
We’ve been staying hydrated and drank some tea which is specific for altitude sickness prevention (Cusco is at an elevation of 11,000ft). We can’t tell if it’s the lack of sleep or the altitude that causes us to have a few weak moments or very slight headaches, but overall, we are doing very well. Carilyn and I got into bed earlier than we can remember (7:30 PM) to catch up on some sleep for Monday’s mission. We’ll keep you posted on how it goes—we couldn’t be more excited!
May 24, 2016
UPDATE FROM DR. BUCK AND CARILYN:
For our first day of the mission, we set up at the main market of downtown Cusco. This market is the original indoor market in the city, and we were told the same architect who designed the Eiffel Tower also designed the trusses in the roof. The people of the market coordinated tents just outside for us.
The medical team setup a triage station, pediatrics, dermatology, ob-gyn, and two internal medicine stations. The dental team had a larger tent to share (maybe 10′ X 30′ or so) and we all got to work.
Working without electricity does require many adaptations from dentistry in the United States! We sterilized our instruments by washing them in water, then two changes of cold sterilization solution, followed by another wash of water. For extra visualization, we used headlamps. We were limited to only extractions, checkups, fluoride treatments and cleanings. We performed many of each of these.
Having done very few cleanings since dental school, I was out of practice, and boy, did my ring finger get sore! I already appreciate our incredible hygienists, Amanda and Kim, but that helped me to appreciate them even more. Thank you for all that you do, ladies! I did notice at one point when music was playing near the market that I was humming to it. I guess you can’t stop me from humming while I work (but please feel free to stop me from singing—it’s not pretty!).
Much of the general population in many Third World countries, including Peru, often make only a few dollars per day or per week. Toothbrushes cost a lot here, around one dollar or more, so it is understandable that many people do not even own toothbrushes. It was wonderful to be able to distribute toothbrushes to so many people (especially seeing the children smile with excitement when they received them!).
One memorable experience was having to use the bathroom in the market. It costs 50 Soles (Peruvian “suns”-about equal to twenty cents) to use the bathroom. This was a dirty room with stalls and urinals all in the same location. And guess what? There’s no toilet in the stalls! Carilyn and I had the pleasure of peeing in a hole jaggedly cut into the tile of the floor. I’ll tell you what, these Yoopers prefer the woods over the hole in a floor any day!
We did unfortunately have a team member fall ill due to altitude sickness. She was nauseated in the morning and got worse throughout the day. They tried to give her oxygen, but the hotel’s oxygen tank (which they keep for foreigners not used to the altitude) was empty due to another guest recently using it. By evening, she was starting to feel much better, but she might not be able to join us on Tuesday’s mission. Carilyn and I are doing well adjusting to the altitude (taking our Diamox for altitude sickness prevention helped us I’m sure), with very minor symptoms, at times no symptoms.
Given that we are in the Southern Hemisphere, the seasons are switched, so it is nearing winter here. The sun began to set shortly after 5 PM. We had to start wrapping up by 5:15, otherwise, without electricity, we wouldn’t be able to see enough to clean up. After a tour of the market by the workers learning about local food and products, we ate dinner and went to bed, satisfied with all we did and experienced.
Tuesday’s mission will take place in a town about 45 minutes away from Cusco. We are ready for another hard day’s work! Stay tuned for the next update of the mission!
May 25, 2016
DAY 3 UPDATE FROM OUR PERUVIAN TRAVELERS:
“No comer ni beber durante mediahora por favor.”
This translates as: “No food or drink for a half hour please.” We’ve been practicing this phrase mucho! Tuesday’s mission was spent in a municipality named Poroy, 20 minutes away from Cusco by bus. Since the schools were involved in organizing this event, many more children were seen this day than Monday. Over 100 fluoride treatments were done for the children of Poroy.
Each child was such an individual; some were shy, some were outgoing, some were brave, some were not. In general, the children seemed very happy. I often think about happiness and what a person needs for it, and often, it isn’t much. People might not have electricity, glass in their windows, toothbrushes, or lots of money, but happiness, a feeling that is as impermanent and fleeting as any, can be found in a sunrise, a wonderful bite of food, or in a child’s laughter. We are each the masters of our own happiness, no matter where we live.
The mission was a lot of hard work, a lot of fun, and very interesting on Tuesday. Although most people spoke Spanish, some people were not fluent in Spanish. They were “Andinos” meaning from the Andes mountains. A few people we saw spoke the language Quechua. The Spanish translators (we shared 2 among the dental team) relied on a third person to help us. Imagine, translating from English to Spanish to Quechua, and then the other way around!
Most of the treatments other than fluoride were extractions. I only did one cleaning on Tuesday and thank goodness, because my fingers were very sore from no practice! We learned phrases like “Buen Trabajo!” (Good job!) and “Muy Valiente!” (Very brave!). The mayor of the town thanked us at the end of the day, bringing us to the town building and feeding us coffee and sandwiches. Everyone was so thankful.
On the bus ride back to Cusco, Carilyn and I spoke about what we were both feeling observing the people of Peru. Each human wants similar things: Food in our bellies, a roof over our heads, the best for our children. How different would life be if I had been born here? How would my life outlook be different? What choices would I make? What opportunities would I have? We pondered this as we watched the beautiful lights from houses twinkle in the mountains as we returned from the town of Poroy.
We ate dinner at our hotel and got a chance to speak with the team about their other missions. Almost everyone had been on numerous missions previously and it was interesting to hear about them. Syrian refugees in Jordan, Israel, Ecuador, Honduras, jungles in Peru, Africa. It has me excited for my next mission already. I can’t wait to do more. So many people in this world have it tougher than the least fortunate American.
Wednesday will be spent in a village called San Jeronimo, near their market, in similar conditions as Monday and Tuesday. Carilyn and I made sure to get tons of sleep!
May 26, 2016
DAY 4 UPDATE:
“Dame cinco!” This translates as “Gimme five!”
Wednesday’s mission was in a municipality named San Jeronimo. We set up inside a fenced cement soccer field. Mary, who couldn’t join us on Tuesday, is mostly recovered from the altitude and was able to rejoin the group. Many senior dental students and three of their professors joined the dental team. The students had an entire presentation for preschool children, dressed up as Olaf, Anna, and Elsa. Don’t worry, they didn’t play “Let it go.” They had a cute act and dance about sugar bugs and brushing your teeth.
They also asked the children dental questions and gave out toothbrushes for the right answer. For the third question, one little boy was so excited, he ran up before he was called. “How many days per week should you brush your teeth?” And he had the best answer! He said ten!
Many fluoride treatments were done, cleanings and some extractions. The first little girl I had, an 8-year-old, was so afraid. A dental student set up a selfie stick with her phone playing cartoons for the girl, and we got through gently wiggling out three baby teeth. At the end, when I was giving her a toothbrush and stickers, she surprised me by lunging in for a big, long hug! My favorite moment of the day!
The largest celebration of the year in Peru, Corpus Cristi, lands on Wednesday and Thursday this year. Due to all of the celebration, there weren’t as many people as we had hoped at the clinics. However, we made the most of it and helped everyone we could. While Carilyn was doing an excellent job at cleaning one woman’s teeth, we noticed that she might have lice, so we brought the dermatologist over. He said there might be louse eggs in her hair and he gave her some shampoo and instructions for her and her family. Keep your fingers crossed for Carilyn and I!
For dinner, we got a chance to try a traditional Peruvian restaurant. The goal was for us to be able to try “Cuy” (pronounced Koo-ee), which is guinea pig. Funny, but because of the holiday, it was very, very difficult for our leader to track down any Cuy in the entire city of Cusco! But with perseverance, we found an excellent place with traditional dancers and a Peruvian flute band. The guinea pig was roasted and presented to us with the head still on! Yes, it does taste like rabbit. We also got to try beef heart (thumbs up) and cold pig feet (thumbs down).
An artesian market was near the restaurant, so we had the chance to see some hand-made artwork before heading back to the hotel. There were blankets, masks, wooden carvings, trinkets, hats, scarves, purses and backpacks, all with such detail and so many vibrant colors around.
Before traveling home (a 30-hr journey), we will visit one of the Seven Wonders of the World, Machu Picchu. So, to bed early again for Carilyn and I!
May 8, 2023
The mission to Peru 
began with our team of 14 meeting in Cusco, Peru and driving an hour up to Huaro. We’re staying in a neat complex that’s kind of a mix between summer camp and dorms. It’s used as a parochial school and for other community needs.
The first day of each mission involves organizing all of our supplies and meds 
The meds were divvied-up before we left the US between all of the non-dental team members to try to spread out the weight of all the meds (dental team has to take all of our instruments, anesthetic, etc). We packaged the meds in appropriate dosages and got to know each other while doing it. What a great crew we have!
This is the first mission that I’ve repeated. All of the other missions have been to different countries. I liked the area of Cusco, Peru because the altitude is so high it won’t get too warm here. Contrast that with Guatemala and Columbia and this Finnish Yooper is a happy camper in Peru 
Peru is also a country with a lot of biodiversity in the rainforest area (like, a bunch of cool frogs and thousands of varieties of potatoes) and some amazing places like Macchu Picchu the salt flats and the Rainbow Mountains. Even though the culture in this part of Peru is similar to Bolivia 
with the women wearing llama wool, colorful clothing and Bolo hats, and many people speaking Quechua (a very popular native language), Peru is my choice because of its other awesome attributes.
I’ve also tried to improve my Spanish on each mission. So far I’ve learned grueso (thick) and agarrarlo (hold this) and paracaídas (parachute). It’s extra fun and rewarding sometimes when I understand a joke in Spanish 
Can’t wait to start helping these beautiful people!
May 9, 2023
We had a great first day of our clinic 
The entire team took care of 350 people! We had family physicians, an Ob-Gyn nurse and physician, a pediatrician, a geriatrician, an ICU nurse, two dental assistants and 5 dentists on our team! One dentist even took a bus 17 hours from Bolivia to help out!
The first two days of our clinic took place in Huaro, outside of Cusco, at an altitude of 10,000 feet! 
I could definitely feel the altitude when I would climb a flight of stairs or carry heavy bags. I took some altitude sickness prevention medication before coming and made sure to stay hydrated as well. I found my normally reliable appetite was also not there 
Must be the altitude.
Tents were set up outside the mayor’s office and the medical team used 1 for triage, 4 for the doctor’s 
stations, and 1 for pharmacy. Patients would usually get a prescription from their medical exam and the pharmacy would fill it if possible. If we didn’t bring the medicine with us, we write it down for the patients to bring to a local pharmacy. Many medicines that are prescription-only in the US are available over the counter in other countries. Even if the medicine is only available by prescription, it could very possibly be filled with our Flying Doctor’s of America Rx forms.
We found a big room for the dental team to work in. It was great to not have a dirt floor. It took some time to get set up, but once we did, we were rockin’! Some patients had a lot of decay and wanting extractions, but some people wanted a cleaning and you could tell that they do their best to take care of themselves. Fluoride was also very popular (el flúor) and I was glad to do that. But the best help is when we can do an extraction of an infected tooth 
I found I only needed a translator 3 times throughout the day, and I was happy to be able to communicate with my bad Spanish 
I was reminded of the Peruvian word for “cool,” which is different from Mexico and other Hispanic countries. It’s “chévere,” which I learned in 2016 when I came on the mission here with Carilyn, but had forgotten. They also use “bacón,” which I don’t remember learning at all! These mission days, I learn so much and hear so many great stories. It’s pretty amazing how much can happen in a single day! 
May 13, 2023
Day 2 of clinic in Huaro
Dentistry without electricity is a fun challenge! We take instruments and all of our supplies with us such as gauze, anesthetic, sutures, gloves and masks. Dentists also need to bring a headlamp 
to see well inside patient’s mouths, especially if the clinic is outside due to the bright sunlight. Gauze is used as our “suction” and patients are given a little Dixie cup para escupir quando necesitas (for when you need to spit 
).
Although bleach could be use to sterilize 
our instruments, it corrodes them. So we used a more modern cold sterile solution and put the instruments through a series of water, cold sterile, another cold sterile, then water 
We were so lucky to have two amazing dental assistants with us, both fluent in Spanish! They kept an awesome sterile technique for our patient’s safely.
The main focus is to help patients with dental infections 
or other dental pain by providing a gentle extraction. Sometimes if a patient really didn’t want to lose a we could provide a temporary filling with the hope that the patient could find a way to see a dentist locally for a regular filling. There was only one dentist in town, and there must be large barriers to getting care because we saw so much need 
We saw all ages of people, cute kids and cute old people. Every once in a while, a mom or spouse was nearby and I asked the family member to hold the patient’s hand 
during difficult parts of the procedure. People were very thankful, and our team was very thankful to help. Our team took care of over 400 patients the second day! It was really tiring, but really rewarding 
May 18, 2023
Day 3 of clinic:
The 3rd day of the clinic took place at a different location in a small mountain 
village called Sullumayo. This was higher than the previous clinic, which was at about 10,000 feet. Sullumayo is at 14,000 feet altitude, where it snowed the night before several inches! We stopped briefly on the way up to the village to make snowballs 
but we were too excited to get to the mission to make a whole snowman 
The trip 
was about 1hr 40 min from our base, only about the first 5 minutes being on a paved road. I’m always thankful for the skilled drivers who get us safely around the mountain roads-so glad I didn’t have to drive! Before the vans 
would go around a corner, they would honk their horn in case someone was coming the other way 
There WAS a traffic jam just before the village, though it was with 
not cars We used the school in the village for our clinics, which we were told is la peor escuela in el distrito (the worst school in the district).
Since the village is more secluded, there is less Spanish spoken and more Quechua. Quechua is a very widely spoken tribal language throughout the Andes mountains 
in Peru and Bolivia Some of the volunteer translators knew Quechua and our team picked up a couple words. For instance, I saw the oral surgeon saying “Nanay? Nanay?” Meaning “Hurt? Hurt?” As he would go around a tooth, confirming the patient was numb before he started treatment. It’s fun to try to overcome these challenges that are so different from our normal daily lives.
The people in this village also had more traditional handmade 
clothing (wow, the skill!). We were told a woman cannot get married without knowing how to weave 
and make clothes 
There is also unfortunately more violence against women in these towns, so we were told, and more rape and consanguinity (such as marrying your first cousin, which can cause birth defects for their children, which was saw). There were also a couple girls who were cross-eyed (medical term is strabismus) and though it’s only a 10 minute surgery, we did not have the equipment (general anesthesia is needed) nor a physician present who could do the surgery. We were told that these women would not be able to be married if they were cross-eyed. We wished we could have helped them more
The village and surrounding community’s population was around 600 people. The dental team set up in a classroom (actually they were having class when we arrived and interrupted). There was what seemed like a huge line of people waiting for treatment. We had to end the clinic the third day around 3 PM because there are no lights to get around the mountain in the dark. But we actually got to see everyone in line! It was a successful day of hard work 
We went back home to 10,000 feet, tired and happy. I slept in my winter coat that night again because it was so cold and there was no heat in the parochial school dorm 
I didn’t notice this until someone mentioned it afterwards: the children were having classes in their 
winter coats. The school has no heat at 14,000 feet
May 30, 2023
The wonderful people of Sullomayo, Peru (~14,000 ft elevation) make most of their own clothing. If you click on more photos, you’ll find the moment where we interrupted class to start the medical/dental mission I didn’t notice until someone said it later, but these kids are having school in their winter coats because the school has no heat 
Can you imagine? This year so far in this location it snowed January-May. Brrrr! Let’s take a moment to appreciate our little first-world 
problems, eh Yoopers?
