The trip to Peru for our Urogynecology Project took place during the last two weeks of September.  The project is the result of a partnership between The Urogynecology Clinic, Sombrilla  and Andean Alliance in Huaraz, Peru.  The project has as its primary goal, the introduction of conservative (non-surgical) treatment of pelvic floor problems to the medical system in Peru. Until now this conservative treatment has been non-existent in Peru and many other countries. Pelvic floor problems affect many women around the world and significantly impact quality of life for those women. In Peru, surgery has been offered as the only treatment and access to such treatment is limited for indigenous and poor women who may not be able to afford surgery. Conservative treatments are in general safer and less expensive that surgery.

Our project started in 2015 with a needs assessment in two communities in Peru, Ayacucho and Huaraz. In 2016 the team returned and started working with Peruvian medical professionals, treating women and introducing conservative management. This year's visit built on the work done in previous years.

The team included - from the clinic, Dr Flood- Urogynecology, Donna Wilson- Nurse Continence Advisor and Sarah Kalinoka- pelvic floor physiotherapist; from Sombrilla Sarah Cashmore, trip organization and Laura Osorio, translator; Dr Mayo- former Peruvian OBGYN- sponsor and organizer of the Lima portion of the trip; Elina Koivula-Herrera, Huaraz project manager and translator and translator; Gladys Jimenez, English, Spanish Quechua translator; Fransisca Robinson, Pelvic Floor Physiotherapist, from Lima and Franklin Guzman and Carlos, both residents from the medical school in Lima.

We spent the first three days of the trip in Lima where we toured the medical school and some of the hospitals, and met with some key people from the medical school. The medical team made some good connections and gained support for the project from some of the directors of the Peruvian medical school.
While in Lima the team presented to over 100 medical staff and students, introducing the concept of conservative management

In Huaraz, the team worked in 6 different health posts over the course of six days. Some of the health posts were in busy city clinics and others located in rural settings. All work was done with poor and indigenous women, who because of this project are the first in Peru to benefit from this treatment.  At each health post the medical team worked with local doctors and nurses to teach pelvic floor health and conservative management. The plan is for the workers in the health posts to become independent in non-surgical treatment of  pelvic floor conditions, and for them to start to teach their colleagues. 

The goal of the Urogynecology project is sustainability within Peru, with these practices being in use throughout the country and being taught in the medical school. This year the team made great progress toward that goal both with the university in Lima and in the rural health posts. They are planning to return in 2018 and with the help of Franklin and Carlos, the two residents from the medical school, the hope is to add two new cities, Cuzco and Cajamarca. With each visit the team is engaging with more Peruvian professionals, broadening the reach of the project and making life so much better for the women who receive treatment as a result of the project..  

In 1981, El Mozote was the site of one of the largest massacres to take place in Central America, part of a “scorched earth” strategy by the Salvadoran military to remove villagers who supported the insurgent groups fighting for land reforms and other human rights that the ruling oligarchy had denied. Almost a thousand villagers were killed, many of them young children. The bones of many children were found beneath the site of that very church.

Following the massacre, these atrocities were covered up by the Salvadoran Army, with support from the United States government. Then, in 1993, the Salvadoran government passed the General Amnesty Law, which made it illegal to investigate, prosecute, or jail people for war crimes or human rights violations, such as those committed at El Mozote. For the most part, evidence of past crimes was buried until July 2016, when the Constitutional Court in El Salvador declared the General Amnesty Law unconstitutional, opening a way for the story of El Mozote to be fully uncovered.

In 2010, I traveled back to El Salvador, where I met a man named Henry Chicas, who as a child had lived in a region near El Mozote that was severely affected by the civil war. Today, he is a beneficiary of a partnership between the Alberta-based Sombrilla International Development Society and the Christian Based Community of El Salvador Perquin (CEBES Perquin) — an organization that confronts the civil war’s legacy while promoting peace and justice. CEBES Perquin also contributes funding for educational scholarships and programs that provide training for post-secondary students to encourage them to become involved in their local communities.

Henry is among many young community leaders in El Salvador who, supported by Albertans, have completed professional degrees and brought their expertise in business, agronomics, psychology, and law to promote both human rights and the SDGs within their communities. Henry now uses his accounting skills to document the victims of the massacre so that the government can properly compensate family survivors. He also supports community members to develop local microenterprises, giving the families of victims an opportunity to make a living wage.