Medical care in Chiclayo Peru

On Thursday October 14th I experienced what was initially diagnosed as a stroke. For informational purposes I thought readers might be interested in the process I’ve gone through since then together with the costs incurred, as well as an assessment of the quality of health care received. Healthcare was a subject important to me prior to deciding to move to Peru.

Thursday Oct. 14 – I experienced stroke-like symptoms in mid-morning. I delayed seeing a neurologist until early evening when it became apparent my thought process was not clearing up and my speech remained slurred. The doctor listened to an explanation of the symptoms and concluded that I had a stroke. He wrote orders for a CAT scan and EEG. His instructions were to come back when we had the results. His manner was casual with no sense of urgency.
Clinic: Salud Vida
Doctor: Neurologist Carlos Rocha
Consultation cost: $7.20

Tuesday Oct. 19 –We visited an otolaryngologist, wondering if perhaps what I had experienced was actually a problem caused by the severe head cold/allergy symptoms I’ve been having. After listening to an explanation of the ‘stroke’ incident he said the issues were “independent” and suggested I continue seeing a neurologist. He diagnosed me as having chronic rhinitis and prescribed loratadine tablets and mometasone furoate nasal spray.
Clinic: Clinica del Pacifico
Doctor: Otolaryngologist Jorge Melendez Tuesta
Consultation cost: $28.80
loratadine cost: $0.72 each
mometasone furoate cost: $43.20

Later that day I had a CAT scan and EEG done at a different clinic. I was impressed with the professionalism of the technician who did the scan and the neurologist who performed the EEG. Waiting time was only minutes and the procedures were done back to back.
Clinic: Hospital Metropolitano
Cat scan cost: $86
EEG cost: $54

Wednesday Oct 20 – We returned to the above clinic and decided to have the neurologist who performed the EEG do the analysis of the EEG and CAT scan rather than return to the original neurologist. The results of both procedures were completely normal. His conclusion is that I may or may not have had a stroke, but based on three separate experiences I’ve had he is convinced that something is restricting blood/oxygen flow to the brain. He wrote orders for comprehensive lab work involving blood and urine samples, and prescribed two medications; ginko biloba extract to open vessels in the brain and citicoline to repair any undetected damage.
Clinic: Hospital Metropolitano
Doctor: Neurologist Ricardo Mallorga Velasquez
Consultation cost: $28.80
citicoline cost: $3.60 per tablet
ginko biloba cost: $0.72 per tablet

Thursday Oct 21 – Visited a third clinic where blood and urine samples were taken.
Clinic: Integra Salud
Lab cost: $25.20

Saturday October 23 – Returned to the clinic Integra Salud for lab work results. Clinical analysis of complete blood count, complete urine, glucose, cholesterol and triglycerides showed all results to be within normal ranges. The cause of my episodes remains undetected. Recommendation is to continue with present medication, monitor blood pressure twice daily, and return in 30 days.

Observations:

Doctor availability is a problem. They may have an office at one or more clinics, but they ‘float’ to wherever the patients are. Their scheduled hours at each clinic are limited, not reliable, and vary from one day to the next. Also, the concept of a central coordinating doctor does not exist. For example, a neurologist, cardiologist and otolaryngologist treating the same patient do not seem interested in what treatment is being given by the other doctors or why, or what medications are being prescribed by each.

Family or patient health history forms do not exist to my knowledge, nor were any questions of that nature asked of me. Medical professionals are not accustomed to having the patient be a part of the diagnostic or treatment process. They listen only until they think they have a grasp of the symptoms and then reach for the prescription pad. You need to be assertive to make them listen.

The physical facilities and most of the medical equipment resemble vintage 1950s in the States, even in a clinic that was built just two years ago. The administrative systems and procedures are cumbersome and inefficient.

But the end result is what counts, and in my opinion the health care I received…from diagnosis to treatment has been of excellent quality. I would not hesitate to recommend the clinics and doctors I visited to anyone, provided you follow my advice and insist on being involved in the process. That includes not having a procedure done until you’ve researched it yourself and are confident it makes sense given your symptoms. The same for medications…I researched all of the drugs mentioned above before buying them. Learning that the procedures and drugs did make sense given my symptoms reinforced my confidence in the competency of the doctors.

One final comment based only on impressions. I was not involved in the emergency response system but have observed scattered pieces of it during my two plus years in Chiclayo. The system…from the initial 911 call through transport and reception at an emergency facility is slow and basic. For example, ambulance personnel I’ve seen in action more resemble furniture movers than trained medical technicians. In my opinion, if a situation is life threatening and minutes count you’re probably going to die. If time is not an issue, you have a good chance of receiving excellent medical care.

Tom