Arts and Sciences
Peru - Cardiopulmonary complications among high-altitude urban dwellers in Peru
Altitude-related illnesses is an important field of investigation relevant to the 140 million people worldwide who live at high altitudes. The most commonly fatal altitude-related illnesses are chronic mountain sickness (CMS) and pulmonary hypertension (PH). It had been estimated that 5–15% of high-altitude residents may develop CMS; however, the prevalence of altitude-related cardiopulmonary illnesses is not well characterized neither the influence of other risk factors such as exposure to biomass fuels. In rural populations of the Peruvian Andes, the use of biomass fuels for cooking is highly prevalent if not exclusive. Biomass fuel exposure has been shown to increase the risk of pulmonary and cardiovascular diseases, but its effect on the risk of altitude-related illnesses has not been previously investigated. Since 90% of rural households worldwide use biomass fuels as the main source of domestic energy, the population attributable risk may be of public health significance. We seek to characterize the prevalence of high-altitude related cardiopulmonary illnesses in individuals exposed to daily biomass fuel smoke through the development of a cross-sectional study of 400 high-altitude dwellers in Puno, Peru (3825 meters above sea level): 200 subjects who live in rural households exclusively using biomass fuels and 200 subjects living in urban households exclusively using propane or electricity.
I was very fortunate to be given the opportunity to work with Dr. Checkley in Peru this past summer. Not only was I able to hone in on my future career goals, but I was also able to learn a great deal of how research is carried out on the ground in resource-poor settings.
Puno, Peru is at an altitude double that of Denver - approximately 3800m. The population is small, and there isn’t much to do. Every morning, I woke with the field workers at 4 am to go out into the field. We were completing a project researching the influence of biomass exposure during cooking on chronic lung conditions. Taking a local colectivo out to el campo was cold and uncomfortable, smashed between large Peruvian women transporting out for their daily work in the fields. The upside of this, however, was the warmth I was able to glean from simply too many people in too small a space.
Once we reached our destination, we would disembark and walk (at least) a mile to the clients we were serving. After installing several machines, one to measure carbon dioxide, one for particulate matter, and the last for humidity and temperature, we would depart only to return the next day to retrieve the machines. Usually we did two trips a day.
Returning around noon that day - already with 8 hours of productivity under my belt - I began working each day on the next project. This project was to figure out how to use a new hemoglobin measuring device that essentially is a pulse oximeter. This reduces the amount of invasiveness in taking hemoglobin measurements, and we were the team that was to test their accuracy within this patient population.
More startling than these projects, though, was the way of life in this resource poor area of the world. After travelling around the world, and once even to Peru, I gained a new understanding of the people as I shared my life with theirs. Practically absorbed into my boss’s family, I shared his home, his food, his family, and all the pain and happiness that comes with these.
I would have to say to any students looking to apply to the program that this was the most rewarding experience I have ever had. The work is interesting and enjoyable, and if you truly put yourself out there, and immerse yourself in a culture that is strange and different, you will be rewarded as equally as was I.