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Vine Trust Amazon Hope

Medical & Dental Project

Information Pack

2014

The Vine Trust is a volunteering charity with a vision to see communities transformed. Our volunteers work to bring opportunity, health and hope to disadvantaged communities and marginalised people, with a particular concern for vulnerable children.

In 2001, an ex Royal Navy Fleet tender was sent by the Vine Trust to assist in the

development of relief work amongst the marginalised communities in the Peruvian Amazon. Since that initial journey much has been achieved to the extent that our project is now at the heart of an initiative to deliver a basic health service for up to 100,000

people in rural Amazonia. Health education, training local workers, providing access for government anti-malarial teams and providing clean water and sanitation are all part of our strategy.

Many of the remote communities in the Amazon have little or no access to healthcare provision. This results in high infant mortality rates and debilitating diseases in the

community, many of which can be easily treated by modern medicine. Medicines we take for granted, such as antibiotics, analgesics and anti-malarials, can make a massive difference to the health of the population. The services of a dentist also make an

extremely significant impact in alleviating chronic pain and building better health. Medical teams go out to work on the Amazon Hope 1 and 2 medical ships throughout the

year. The ships act as floating health centres providing basic health and dental care to the people of rural communities on the Amazon and its tributaries. Each trip lasts two weeks; the team usually spends about nine days working on one of the ships assisting the

project’s Peruvian medical personnel. We send teams to the project every two weeks from throughout the UK and beyond. Medical and dental teams are made up of 6-8 people. Normally each team consists of at least two doctors and one or two dentists, the balance

of the team being made up of other health professionals. This work in Peru is carried out in partnership with Scripture Union (SU) Peru (Unión Bíblica Perú).

The Project works closely with the Peruvian Ministry of Health, who provide malaria and immunisation teams on various trips. Currently we serve 160 river communities which we aim to grow to nearer 200 in the next 18 months. Our aim is to provide quarterly visits to

communities on the Tigre, Nanay, Ampiyacu, Maranon and other rivers which will impact on chronic illnesses such as asthma, diabetes, epilepsy and on dental health. In addition, we will be able to identify those in need of secondary care, such as cataract surgery and

hernia repair, and either arrange for this work to be carried out in the small operating theatre of one of our medical ships, or at the District hospital in Iquitos.

The Vine Trust aims to encourage UK health professionals to use their skills and part of their annual leave to help the poor of this Amazonian region.

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Clinical work After arriving on the Amazon Hope there will be time to settle in, meet the crew and just enjoy sailing on the Amazon, before any clinical work starts.

Medical work Much of the work is Primary Health Care, with some minor trauma. However, anything

could present as these people have nothing, so be prepared. You will be issued with ‘Guidance Notes for Medical Teams’ once your place on the team has been confirmed. The pharmacy is stocked with routine antibiotics, analgesics, NSAID’s, preps for eye

/ear infections, PPI’s., some dermatological preps. and dressings and there is some suture material. The formulary is included in the ‘Guidance Notes’.

Dental work Equipped with a dental surgery, the main work provides a basic filling and extraction service. Dentists who have been before are happy to discuss the work with any dentist

interested in going. Please ask for contact details.

Ministry of Health There has been an agreement signed between SU Peru and Ministry of Health to

coordinate the work and allow overseas professionals to take part. It is advised by the

Vine Trust that professionals inform their Defence Body of the nature of this work and ask for suitable cover. (The MDDUS in Scotland has agreed to cover its members in the

UK teams so far, free of any extra charge, but each member has to contact them

individually).

Please note that proof of your current registration with the appropriate professional body is also required, and we ask for a photocopy (or scan) of that document along with your application.

SU Peru Staff The Head of Medical Services for the Amazon Hope Project oversees all aspects of the

health side of the project and strives to ensure a meaningful experience for visiting health professionals as they participate in the project.

There are medical and dental professionals employed by Unión Bíblica (SU Peru) who work on the Amazon Hope ships. The salaries of all the staff are underwritten by the Vine Trust.

Life on Board Amazon Hope On board, there is a Peruvian doctor, dentist, nurse and pharmacist, and occasionally a midwife and lab technicians for malaria testing, all of whom are very helpful. There is also

the Captain, pilot, translators, a children’s worker, caretaker and chef. The ship is usually busy with as many as 30 people living on board! Everyone is very friendly and welcoming. Catering is very good, with lots of chicken, fish and rice.

Accommodation on board is in air conditioned, shared cabins. The air conditioning makes it very difficult for the insects to fly. However it is advisable to have a mosquito net on the

off chance that the air con breaks down. The Amazon Hope Medical & Dental Project is a flagship project of The Vine Trust. The

work in Peru is carried out in partnership with Scripture Union Peru. There will be optional devotional times each day (usually before breakfast, to which everyone is invited), as well as Outreach to the communities we visit (by SU Peru staff). An applicant does not need to

be a Christian to be accepted. However, we do ask that you support the humanitarian work we are undertaking and agree to abide by the Code of Contact (part of the application process).

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Medical & Dental Trips - 2014 Schedule

Trip Reference

Trip Name

Arrive Lima

Depart Lima

Notes:

PM14011 Jan (1) 10-Jan 24-Jan

1) Medical teams are made up of 6-8 people (consisting of at least two doctors and one

or two dentists; the balance of the team being made up of other health

professionals.

2) All trips, with the exception

of Apr(1), Jul(1) and Oct(1) arrive in Lima on a Friday. (Day 1, in the table below).

3) Apr(1), Jul(1) and Oct(1)

trips arrive in Lima on a

Thursday. 4) After ALL trips, depart from

Lima on a Friday.

PM14021 Feb (1) 24-Jan 7-Feb

PM14022 Feb (2) 7-Feb 21-Feb

PM14031 Mar (1) 28-Feb 14-Mar

PM14032 Mar (2) 14-Mar 28-Mar

PM14041 Apr (1) 27-Mar 11-Apr

PM14042 Apr (2) 18-Apr 2-May

PM14051 May (1) 2-May 16-May

PM14052 May (2) 16-May 30-May

PM14061 Jun (1) 6-Jun 20-Jun

PM14062 Jun (2) 20-Jun 4-Jul

PM14071 Jul (1) 3-Jul 18-Jul

PM14081 Aug (1) 1-Aug 15-Aug

PM14082 Aug (2) 8-Aug 22-Aug

PM14091 Sep (1) 29-Aug 12-Sep

PM14092 Sep (2) 19-Sep 3-Oct

PM14101 Oct (1) 2-Oct 17-Oct

PM14111 Nov (1) 24-Oct 7-Nov

PM14112 Nov (2) 7-Nov 21-Nov

Draft Itinerary (This is provided as an example only.)

Day No Day of Week Activity

1 Friday (Leave UK in the morning) Arrive in Lima later same day. Some people may choose to arrive earlier (tourist activities).

The team will gather and stay in a Lima hotel overnight. (Name & address of hotel will be advised).

2 & 3 Saturday &

Sunday

Fly to Iquitos on Saturday morning. There will be the

opportunity to visit some other Vine Trust projects in and around Iquitos and to have a team meeting (with Peruvian medical staff).

4 Monday Travel onto Ship.

13 Wednesday Leave Ship and travel back to Iquitos (Stay overnight in

Iquitos).

14 Thursday Fly back to Lima. We would anticipate arrival back in Lima by

early / mid afternoon. In some cases this would allow people to start their journey home or to start any tourist activities arranged. Otherwise stay overnight in Lima.

15 Friday Leave Lima – travel home or start tourist activities.

16 Saturday Arrive in the UK

NOTE: Apr(1), Jul(1) and Oct(1) trips are slightly different: arrive in Lima on day 1 (Thursday), fly to Iquitos on day 2 and travel onto ship on day 3. These trips leave the ship 11 days later (Wednesday). Thereafter, itinerary is the same as above.

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Cost The cost of a trip in 2014 will be £950 plus the cost of international flights (Vine Trust

will book international flights to your specification – when your place on a trip has been confirmed, we will contact you to arrange flights).

Included in the £950 are: Taxi Pickup at Lima (if you arrive on Day 1). Hotel accommodation in Lima (Day 1 & 14).

Travel Insurance. Internal flight (Lima to Iquitos). Accommodation in Iquitos and trips to see other VT Projects.

Travel from Iquitos onto Amazon Hope. Food and Accommodation on the Ship. A contribution to the Medical and Dental Project.

Excluded from this cost are:

Required vaccinations and personal medicines.

As a result of the increased cost of internal flights within Peru (Lima to Iquitos) and the

drop in the exchange rate from GBP (£) to PEN (Peruvian Soles), we have unfortunately had to increase the cost of our trips.

The cost of our trips reviewed in light of changing air fares and exchange rates. However, the above price will be FIXED for all trips in 2014 booked before 30th June 2014.

Payment Schedule

A deposit of £250 is required on application (to reserve your place). The balance of £700 should be paid 3 months before departure. International flights should be paid when booked by Vine Trust.

Gift Aid As a charity we can claim tax relief on the funds that you send us if you are a UK taxpayer (A Gift Aid Declaration form is contained in the application form). The amount that

we ask for towards Trip Costs covers your participation on the trip and we use the Gift Aid reclaimed to further the work of the Vine Trust’s projects.

Where possible please encourage anyone who is contributing to your trip financially to give under the Gift Aid scheme.

Fundraising

We would encourage team members to try and raise additional funds for the Medical and Dental Project. This money will be used for medical equipment, drugs and to keep the ships operational.

It is anticipated that in most cases, the cost of the trip will be borne by the volunteer. However it is recognised that in some cases, fundraising will be used to cover part of the

cost / flights of your trip. Please make it very clear to all donors the purpose of your fundraising i.e. for the ongoing work of the project or for your personal trip expenses.

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Peru Locations Map

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Peru: Safety Information

We are very grateful for your support and willingness to be part of a Vine Trust trip to Peru. To

ensure you have a safe and enjoyable trip we ask all our volunteers to familiarize themselves

with this safety information sheet so that you are aware of the potential hazards and dangers

you may encounter in Peru.

Peru has a different safety culture compared to that in the UK; precautions we take for granted

are not necessarily in place. For example, standards of food hygiene and health care are lower

and there are risks from dangerous creatures and tropical diseases.

You may want to bring this document with you when you travel to Peru.

1. FLIGHT TO LIMA

Risk of deep vein thrombosis (DVT) is now well established and the following precautions

are recommended:

Wear flight socks.

Drink plenty of water on the flight. Coffee, tea and alcohol cause dehydration so drink a

pint of water or fruit juice every three hours

If you have a past history of DVT you should consult your GP for further advice.

Walk about the plane regularly to exercise calf muscles.

Exercise your calf muscles whilst in your seat.

The use of aspirin is a matter for discussion with your own GP, as taking aspirin is not

risk free.

2. TRANSPORT IN PERU

The transport you will use in Peru is basic and considered reasonably safe. However, you

should be aware of heightened risks, namely:

Many vehicles do not have seatbelts

Many vehicles are over twenty years old and some are dilapidated

Road accidents occur more frequently

Road surfaces are often poor

Road side protection is often rudimentary; crash barriers are not universal

Driving standards are lower than in the UK

Rickshaws are very open with little passenger protection

3. HYGIENE

Where possible, always wash hands thoroughly but take anti-bacterial hand wipes or

alcohol hand gel as an extra precaution. Standards of cleanliness in restaurants are lower

than in the UK. As a general rule of thumb:

Drink bottled water

Eat in SU Peru’s approved restaurants or hotels or take lunches provided by SU Peru.

It is sensible to wipe cutlery clean in restaurants before eating

It is not advisable to eat food from street vendors

Pork should never be eaten in Peru as there is a parasite which causes brain damage

Salad should not be eaten due to the risk of food poisoning

Ice should not be used in drinks due to the increased risk of food poisoning.

Water borne disease can cause illness such as: Gastroenteritis, Hepatitis A, Typhoid,

Hepatitis E,cholera, E Coli, amoebic dysentery, giardiasis, intestinal parasites

(worms), Leptospirosis.

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4. INSECT BORNE DISEASE

Insect borne disease is a risk, especially in Amazonia:

Dengue fever is prevalent in the Iquitos area and on the rivers.

Malaria is a constant risk, prophylaxis is essential, as are insect repellents.

Yellow Fever -- make sure vaccination up to date.

Sand Fly Bite -- Leishmaniasis.

5. DANGEROUS ANIMALS (low likelihood hazards with high harm potential!)

Snakes: Snakes are to be found in Amazonia and other parts of Peru. The likelihood of a

snake bite is very low but the harm is potentially fatal. However, a few careful

precautions reduce the likelihood significantly. To avoid snake bites it is sensible to

check your sleeping bag at night and make sure your bedding is tightly tucked into

your mosquito net. Always check that shoes are empty too!

Scorpions: Bites can be very painful. Again, a few careful precautions reduce the likelihood

of scorpion bites. Always check that shoes etc are free of unwelcome guests before

putting them on.

Bats: Bats in Peru can be infected with rabies. The main precaution here is to sleep

indoors, preferably in a building with Mosquito mesh on the windows. A mosquito net

is also the best bet here.

Dogs: It is sensible to avoid dogs at all times.

6. AMAZON HOPE

Safety information is given on board the Amazon Hope Ship and this should be adhered

to at all times. It is possible to slip on the steep stairs, especially if wet or if footwear is

wet. Descending backwards is safer.

7. SWIMMING:

The Vine Trust policy is that our volunteers should be aware of the dangers of swimming.

Swimming is dangerous due to strong currents, the risk of infection and dangerous

creatures. You should not go swimming alone.

8. PERSONAL SAFETY

In Amazonia

Do not go alone into the village, especially if you are female.

Do not wander off alone to the jungle.

Avoid dusk to dawn even in the villages.

In the cities

It is advised that you do not go out alone, but always in small groups

Theft is a problem in Peru, mainly due to poverty; keep a close watch on all your

personal belongings.

9. IMMUNISATIONS

Please discuss your trip with your GP/practice nurse to ensure all your UK immunisations

are up to date and to advise you on necessary immunisations for Peru.

We recommend: Polio/Tetanus/Diptheria/Hepatitis A and B/ Typhoid/ Yellow Fever/ cholera

and rabies. Rabies is indicated because you may be more than 24 hours away from

immunoglobulin should you be bitten.

10. CONSTANT IMPROVEMENT

The Vine Trust is committed to continually evaluating and trying to minimise the risks to its

volunteers. The above document is comprehensive, but not exhaustive: please take care

while in Peru.

Should you identify any potential hazard not included in this document, please let us know as

soon as possible so we can evaluate the problem and minimise the risk.