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Fellowship Site: Peru
The Universidad Peruana Cayetano Heredia
(UPCH), founded in 1961, is a private non-profit university. It is the premier
Science University in Peru and houses the Infectious Disease Laboratory in the
Department of Microbiology. The university and its affiliated hospital are located
in San Martin de Porres, a neighborhood of Lima easily accessible by bus. The
university is committed to promoting social change and contributing to the scientific,
political, economic, cultural, and social development of Peru and the Andean Region.
The Peru-Johns Hopkins site has numerous laboratory and field facilities.
We are based in Lima but have research projects throughout the country. Our main
laboratory is the Laboratory of Infectious Diseases (LID) at UPCH, which includes
a level 3 tuberculosis lab, PCR and immunohistochemistry technology, and extensive
computer resources. In their first month in Peru, students do a lab rotation to
learn basics techniques of parasitology, bacteriology, mycobacteriology, immunology,
molecular biology, and tissue/cell culture. We also have a laboratory in Iquitos
and work with local university and Ministry of Health laboratories in Arequipa.
The Hospital Dos de Mayo is a large public hospital in central Lima that serves
Lima's poorest citizens and is one of the oldest hospitals in the Americas, founded
in 1538. The infectious disease ward includes a 32-bed HIV/TB ward that is a resource
for research projects and clinical educational opportunities for visiting students.
AB PRISMA, a Peruvian non-governmental nonprofit organization, has been
the base for much of the epidemiologic studies we have done over the years, helping
students coordinate with field sites such as Las Pampas in a Lima shanty town
and our Chagas field sites, Arequipa and Santa Cruz, Bolivia. This NGO is the
largest Peruvian health and microcredit nonprofit in the country. AB PRISMA also
assists students with living issues and travel. Our largest field site
is in Las Pampas de San Juan de Miraflores, one of Lima's poorest neighborhoods.
The 40,000 residents of this neighborhood have collaborated as participants in
a variety of studies for more than a decade. The field site has an office with
computers and copiers for research purposes. We have smaller sites in other areas
of Lima that study tuberculosis and diarrheal diseases. We also have established
urban and rural field sites in the cities of Iquitos and Arequipa supported by
collaborations with local academic and health institutions. Other projects outside
of Lima include cysticercosis on the northern coast and throughout the mountains
and high altitude physiology in Cerro de Pasco at 16,000 feet. The collaboration
between the Johns Hopkins University (JHU) Bloomberg School of Public Health,
the Universidad Peruana Cayetano Heredia (UPCH) and AB PRISMA has provided a rich
environment for research and training for more than 20 years. We have wide
access to clinical facilities both in Peru (Infectious Diseases, Cardiology, and
Gastric Cancer) and in Bolivia (Cardiac and Congenital Chagas Disease). In Lima
we have collaborated with the Dos de Mayo Hospital for the last 12 years especially
in collaborative studies in HIV and tuberculosis at their infectious disease ward.
We also have studies in diarrhea , nutrition, Helicobacter pylori and Cysticercosis
and Chagas disease. We have field sites for population based epidemiology
studies: - Lima, Peru - The Pampas de San Juan is a peri-urban shanty town
of 40,000 individuals that has served as a population based research site for
over 20 years in tuberculosis, Helicobacter pylori, and diarrheal research studies.
- Tumbes, Peru - is a rural northern Peru site of 150,000 people which
is the center of our research work on eradication of cysticercosis.
- Arequipa,
Peru - is an urban and rural population based center for studies in Chagas disease.
- Puno, Peru - is a rural site for studies in Taenia solium.
- Cochabamba,
Bolivia - is both a hospital and population based site for the study of congenital
and cardiac Chagas disease.
The NIH-funded clinical research
includes the following projects: - An
Integrated Approach for Control of Taenia Solium Cysticercosis-In collaboration
with physicians and veterinarians, we are studying diagnosis, epidemiology, and
control of cysticercosis, the most common cause of seizures in Peru.
-
Tuberculosis-The lab has developed MODS, a rapid technique to culture Mycobacterium
tuberculosis and perform sensitivity testing. Tuberculosis projects include development
of improved diagnostic methods, laboratory research, epidemiology, prevention,
and HIV/TB.
- Chagas disease-Based in Arequipa and currently expanding to
Santa Cruz, Bolivia, this project includes projects examining epidemiology, focusing
on the urbanization of the disease, risk factors and entomological aspects of
the disease, congenital transmission, clinical manifestations of latent infection,
and improved diagnosis.
- Helicobacter pylori-The majority of the Peruvian's
are colonized with H. pylori by adulthood. This is a multi-faceted project that
includes diagnostic techniques, molecular and genetic characterization of the
bacterium, and clinical manifestations of colonization by H. pylori. This project
is based in the communities and hospitals of Lima. In addition, we are currently
finishing a project with indigenous populations.
- Malaria-This project
is based in Iquitos and focuses on the ecology and molecular epidemiology of malaria
and its vectors in the rain forest.
- Diarrheal diseases-Projects in this
field stem from established work in Las Pampas and other neighborhoods of Lima
with a focus on molecular epidemiology of intestinal pathogens including Giardia,
Cryptosporidium, Cyclospora, and Microsporidium. Other recent work has examined
the effects of childhood diarrhea on children's nutrition and development.
Please
see the CRISP database
for more information about NIH-funded projects at our site. Possible
additional research:
Cardiology Additional research conducted at
the site may include the following projects: 1. Chagas disease studies
in cardiac conditions associated with this disease as well as early warning signs
and autonomic dysfunction.
2. Transition disease in pueblo jovens including
hypertension, coronary artery disease and CHF and associations with obesity and
diabetes. These will be both community and hospital based studies. Oncology
Project example: Premalignant disease associated with Helicobacter pylori
and gastric cancer Esophageal and colon cancer. Housing Availability:
We have two apartments available for students - both are located in safe areas
of Lima. We also have apartments in Arequipa, Peru and in Santa Cruz and Cochabamba,
Bolivia. When students first arrive they are placed in one of the Lima apartments
or in known hostels initially. The student apartment in Lima has internet and
is located near stores. Students need to take buses to get to UPCH or other hospitals
since these are usually located in neighborhoods that are not optimal. Monthly
costs for housing and food and transport generally range from $600 to $800 a month.
Health Issues and Immunizations Needed for this Site:
We have
an excellent network of foreign physicians and public and private hospitals available
to the students. See the Centers
for Disease Control and Prevention Web site and The
Yellow Book: Health Information for International Travel. The FICRS
program mandates that all Scholars see a physician prior to their assignment abroad.
The site will require a formal letter from your physician stating that you have
received the necessary immunizations prior to the start of your fellowship (diarrhea
prophylaxis, hepatitis A, yellow fever, typhoid fever). Safety and Danger
Issues:
The situation in Lima and Arequipa are quite stable. There is petty
crime and we now suggest that students take registered taxis as often as possible.
See the U.S.
State Department Web site for information. While pick pocketing and other
petty crime are common in Peru, students using common sense will rarely find themselves
in personal danger. Language Requirements Other than English:
We prefer students who are fluent in or have a working knowledge of Spanish. We
do not however restrict our choices to students without these skills since some
of our best students have come with a minimal knowledge of Spanish. This does
however limit their first several months in Peru. We are encouraging students
without Spanish language to take a language course in Cusco for three weeks before
coming to work with us.  What
is it like to live in Peru?
Peru is a beautiful country with a geography
that contains sea shore, mountains and the Amazon jungle. The people are open
and friendly. Lima is a large city with all its advantages and disadvantages.
Living in Peru is a diverse, fascinating, challenging, and fun
experience. The country is divided into the coast, the mountains, and the jungle,
each with unique culture and geography. A large portion of Peru's population lives
in poverty, and the poor housing conditions and presence of beggars and conspicuous
child labor may be discomfiting to those with little experience traveling in the
developing world. Peruvians are an outgoing, warm, and friendly people who are
invariably curious about Americans' lifestyles and often want to share their life
experiences with visitors. Family is highly valued, many young adults live at
home until marriage, and marriage and children are frequent topics of conversation.
Although women are respected in the workplace, there is a strong culture of "machismo,"
and women often find themselves attracting unwanted attention and comments; however,
Peruvian men are rarely aggressive and ignoring these comments, as Peruvian women
do, is sufficient. Peruvian food is among the best and most varied in the world,
with each part of the country having its own distinctive cuisine. Seafood such
as cebiche, made of fresh raw fish marinated in lime juice, is ubiquitous on the
coast while pork, alpaca, and guinea pig are common dishes in the mountains. Travel
is easy and safe throughout most of the country, and Peru's tourist industry is
constantly expanding. Almost a third of Peru's 27 million people live in
Lima, and as such, it is the cultural and political center of the nation. Lima
and the neighboring city of Callao were developed as the colonial capital and
port and today are a fascinating mix of colonial and modern architecture interspersed
with ancient temples and fortresses. The wealthy neighborhoods of San Isidro and
Miraflores are filled with parks, restaurants, nightclubs, and shops comparable
to those in the world's other great cities. Central Lima is the seat of the national
government and site of myriad colonial churches and mansions. On a bus ride through
the chaotic streets of the city, you can pass from skyscrapers overlooking the
Pacific Ocean to shantytowns built along unpaved roads on the hills outside the
city. The weather is cloudy and cool (about 55 degrees) from May to November and
warm (85 degrees) and sunny from December to April, when the city empties to the
nearby beaches every weekend; it almost never rains in Lima. Arequipa,
site of the Chagas project, is Peru's second-largest city with a population of
about 850,000. It is a unique and beautiful city seated at the base of an active
volcano in the southern mountains. Arequipeños are somewhat reserved and
conservative but generally welcoming; they are fiercely proud and independent
and love to show off their city. Arequipa is cool, dry, and sunny for most of
the year, and the little rain it receives falls from December to February. Iquitos,
our jungle site, sits on the Amazon and is said to be the world's largest city
that remains inaccessible by car-visitors must arrive by boat, or more commonly
these days, by plane. The approximately 400,000 residents of Iquitos are outgoing
and fun-loving. The city is noisy due to the innumerable moto-taxis that race
through the streets. The climate is hot and humid year-round, and the city's location
on the Amazon makes it a good starting point to explore the surrounding rain forest.
We have projects in many other sites as well in the northern coast, the jungle,
and throughout the mountains. |
