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This Doctor Can: Stranded in Peru

Fredrika Collins is a junior doctor due to start internal medicine training at Brighton and Sussex NHS Trust in August 2020. In this piece she talks about her FY3 year out of training working in Peru and what happened when she became stranded abroad in a national lockdown as a result of COVID-19.

The city of Puno sits on the southern shores of Lake Titicaca, high up in the Peruvian Andes. Home to the Aymara and Quechua peoples, it is often described as the folklore capital of Peru. I had been living there since October, well before COVID-19 ground the world to a standstill, and was working as a researcher on the Household Air Pollution Intervention Network (HAPIN) trial – a randomised control trial based across four countries, investigating the health impacts of replacing biomass fuel with cleaner gas. The rural population of Puno, along with almost half the global population, largely depends on traditional stoves for cooking. This leaves them vulnerable – especially women and girls - to toxic levels of indoor air pollution.

My time was divided between field visits, office work and Spanish lessons. I lived with several other members of the team, including my friend Dr Claire Scrivener. Last year, as junior doctors together at Croydon Hospital, we created the HEE-approved Croydon Global Health Series, a peer-led training course for foundation trainees that links global health principles to the needs of local populations. An article about the series features in this month’s edition of Commentary.

With less than 24 hours notice, we were unable to reorganise our departure and found ourselves stranded.

Fredrika Collins

Along with many of our FY3 colleagues around the world, our experience was soon to take an unexpected turn. On Friday 13 March, amid growing concerns about COVID-19, we decided to rebook our flights to leave the following week. However, three days before we were due to fly, the Peruvian government declared a nationwide lockdown. With less than 24 hours notice, we were unable to reorganise our departure and found ourselves stranded.

At the time, there were fewer than 40 confirmed cases of COVID-19 in Peru. However, aware of the limitations of its healthcare system and already battling a dengue outbreak, I understand why Peru acted with such caution.

It was an unsettling time. One moment we had our bags packed, ready to fly home; the next moment we were stuck. It was difficult being far away when so much was changing at home – there was talk of food shortages, a rising death toll and NHS colleagues facing ever more dangerous working conditions. We had no idea when we could leave.

Communication from the embassy was initially poor – they closed their offices on the first day of the lockdown and only provided occasional updates through Twitter. Along with hundreds of Britons, we watched as Israel, Mexico and other countries flew their citizens home. Long days were spent glued to our phones —checking Twitter, emailing our MPs and, surreally, being interviewed by journalists.

Towards the end of the second week, when the quarantine was extended by a further fortnight, I contacted the RCP. The response was immediate. I was put in contact with fellow members who offered practical advice and words of support.

it was a huge morale boost to realise there was this amazing network behind me.

Fredrika Collins

I’d especially like to thank Dr Jo Szram, Aimee Protheroe, Professor Donal O'Donoghue and Dr David Martin for their kindness during this time; it was a huge morale boost to realise there was this amazing network behind me.

Soon afterwards we received an email telling us we’d been booked onto a repatriation flight. Although flooded by relief, it was impossible not to think of the millions of people around the world who, displaced due to violence or poverty, are unable to return home.

A police car collected us the next morning.

I never imagined my time in Peru would end like this, and sadly I never got to say goodbye to many of my brilliant colleagues. There was still so much left that I wanted to do and see.

Yet, as this pandemic distorts all of our lives, it reminds us of the truly important things in life. As the plane took off from Lima, all I felt was gratitude to be heading home.