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Winter 1998
Hearts Afire
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But the focus here is not on updating outmoded equipment, but on refining technical skill. And for the Peruvian doctors, having the UCLA medical team in their hospital is a godsend.

"We are 20 years behind the times in our surgical techniques," says Rafael Guerrero, a cardiothoracic surgeon. "It is impossible to learn everything that we need to know in just a few days, but the most important thing is for the nurses and doctors in this hospital to learn as a team so that everyone -- the surgeons, the cardiologists, the anesthesiologists and nurses -- know what is being done and why."

One of the most serious problems facing doctors in Peru who want to gain more surgical experience is monetary. Because the medical system is so financially strapped, families of patients must on their own purchase the necessary supplies for surgery -- everything from bedsheets to anesthesia -- at a cost that easily can exceed a year's wages. This is true even in a public hospital such as the Instituto del Niño, which is operated by the Ministry of Health. Only 10 percent of the population has the wherewithal to readily afford such treatment. As a consequence, critically needed care often is delayed months or years while families raise the necessary funds.

"There aren't enough patients whose families have the financial resources, so we are unable to do the operations that are necessary to increase our skills," Guerrero adds. "When there is no money, we have to swim against the tide. It is exhausting."

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