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and thorax for more thorough cleaning and examina3on Must clean intes3nes
Anatomy Lab Lasts from Oct -‐ Feb Occurs underground Educa3onal mo3va3on
Goals My goal was to develop a curriculum teaching basic anatomy and physiology, integra3ng this learning into the common experience of alpaca butchering.
Alpaca Matanzas Last approximately one
hour
Occur in many seAngs across the district of Nuñoa, both indoors
and outdoors
Life Cycle Es7mated Prevalence in the
Area
Pathology and Associated Symptoms
Diagnosis and Treatment
Cys7c Echinococcosis (Hida7dosis)
A recent study of 150 schoolchildren in Nuñoa showed a prevalence of about 7%
Cysts in liver, lungs, and symptoms associated with the affected organs
Dx: Ultrasound and CT/MRI/serology Tx: Surgical removal of cysts, PAIR procedure Preven3on: albendazole deworming of dogs
Fasciola Hepa7ca (Common liver fluke)
In Puno: 15.64% (hYp://www.who.int/bulle3n/archives/77(4)340.pdf) Carniceros I spoke to thought that levels were rising in Nuñoa, although this has not been studied
When flukes migrate up bile ducts, symptoms from fever to abdominal pain, anemia, ascites, etc. may occur
Dx: Fluke eggs in stool ELISA Western blot Tx: an3helmin3cs (triclabendazole)
Curriculum
Prepara7ons: • 4 days of observa3ons in the “camal,” where most
of the alpaca butchering (“matanza”) occurs in town every Thursday
• Observa3on of two home “matanzas” and par3cipa3on in one
• Interviews with two veterinarians in town and conversa3ons with several people who work with alpacas
• Research on local zoonoses • Ini3ally programmed sessions at the camal, later at
schools and an ar3san alpaca kniAng group
Outcomes • 6 classes with a total of about 125 students:
• 4 school groups, ages 11-‐15 • 1 women´s alpaca ar3san group • 1 group of carniceros (alpaca butchers)
• With 2 groups, I administered brief evalua3on before and acer the class • I lec copies of the teaching materials with the president of the camal, the
health center, and a local NGO
Background Nuñoa, Peru is a community in the al#plano of Peru, located midway between Cusco and Puno, at an eleva3on of about 14,000 feet. I traveled to Nuñoa in 2010 and 2012, ini3ally for fieldwork for my undergraduate thesis in anthropology. This year, I returned from June 23rd -‐ August 5th, with the goals of con3nuing my rela3onship with the community, assis3ng with ongoing bicultural anthropology projects there, and exploring some aspects of the interac3ons between animal and human health in the region (the focus of this poster).
Anatomía en los Cerros: Compara7ve Health and Anatomy Project
in the Peruvian Andes
Alyse Wheelock MS2, University of MassachuseQs Medical School
About Nuñoa Over the years, this rural community has been transformed by many of the widespread historical and social changes affec3ng Peru -‐ from the agrarian reforms in the six3es to the Shining Path terrorism of the eigh3es to the neo-‐liberalism that followed President Fujimori’s policies in the nine3es. Nuñoa remains a predominantly Quechua community with a livelihood based on livestock, in par3cular, sheep and alpacas, which are used both for their fibers and meat. The years since the six3es have brought many changes, including running water and electricity across much of the district and the crea3on of a Ministry of Health network providing basic health care.
Both Midline dissec3on
Use planes of fascia to facilitate the dissec3on
Remove
organs in the abdomen
Alpaca Matanzas Last approx. 1 hour
Occur in many seAngs across the district of Nuñoa, both indoors
and outdoors
Cardiovascular system: • Basic anatomy of the heart, path of blood
through the heart • Atherosclerosis and the stressed heart • Stethoscope basics • Heart-‐healthy diets
Lungs:
• Basic anatomy and physiology • Changes to the lungs due to chronic
smoke exposure (e.g. use of tradi3onal kitchens without chimneys, as in the image to the right)
Liver: • Basic anatomy and physiology • Effects of alcohol on the liver (a common
health problem in Nuñoa) • Effects of fasciola hepa3ca and cys3c
echinococcosis on the liver (see image to the right from cal.vet.upenn.edu)
I. Basic anatomy and physiology, focusing on heart, lungs, liver II. Common zoono3c diseases in the area III. Mapping the Body
PuTng it all together: Mapping the body
Graci
Acknowledgments Gracias a: MVP Alexis Pérez Dr. Moises Sierra Zuñiga Dr. Louis Fazen Drs. Chin and Moormann Dr. Brooke Thomas and Dr. Tom Leatherman Morgan Hoke, Meagan Mazzarino, Samya Stumo, and Madison Edens
Obstacles and Feasibility
The camal leadership was ini3ally very interested in hos3ng a talk, but canceled several 3mes, based on 3me constraints during the Thursday matanzas. Ul3mately, we were able to coordinate a brief talk, but outside the camal, using the internal organs of the alpacas instead of the en3re animals. I also lacked transporta3on to more rural parts of the district, where I would have liked to do more classes. The organs for the classes cost approximately $1.50 for each class. I believe these classes can be con3nued with the materials I lec behind.
Pre-‐test Post-‐test
Aggregated responses to body mapping exercise (ar7san group).
Lungs Heart Liver Stomach
0
1
2
3
4
5
6
7
8
9
10
0 1 2 3 4 5 6 7 8
Num
ber o
f stude
nts
Score (out of 8)
Paired Pre-‐ and Post-‐test Scores for 2 Groups
Before
Acer
n = 32 One-‐tailed paired t test: p = 0.0033