Thank you for your interest in A Promise to Peru, Inc. and our cataract surgical and medical mission to the Sacred Valley region in Peru and other regions in need. This is a project that is constantly evolving as we face challenges in helping improve the lives of people who live in medically underserved areas. Case Western Reserve University Medical School and the Cleveland Clinic in Ohio originally started serving the Sacred Valley region with a medical mission of their own. Dr. John Shanley and a few medical students from Stony Brook Medical School in New York joined their team in 2010. John Shanley, MD, Debra Messina, MD and Natalie DiGioia, MD subsequently established A Promise to Peru in 2011 and it is now a 501 (c)(3) non-profit organization. These three physicians are on the Board of Directors along with George Coritsidis, MD, Michael Sable, MD and Catherine Roberts. The group has completed their seventh medical mission and their fifth year of providing cataract surgery to the severely visually impaired. Our organization has established a collaborative effort with healthcare professionals and physicians in Peru as well as non-profit organizations such as the Foundacion Niños del Arco Iris, Surgical Eye Expeditions, Peruvian American Medical Society, FNE International: Facilitate Network Empower, Asociación Wiñaypaq and Blanca’s House. Together we are working to improve the lives of indigent people in South America. Furthermore, through screening patients for advanced cataracts and providing cataract surgery free of charge, the project continues to build and advance towards sustainable care. Since its inception, this project has been made possible by hours of work and dedication by students, physicians, families and friends who have found a common goal of reaching out to those in need and also learning from them the challenges and the joy of providing care to a medically underserved populations.

We are truly grateful and humbled by the kindness and warmth we have received from the communities both in Peru, Ecuador and in the U.S. and the friendships we have formed over the years. Our hope is that you can bring your unique talents, skills, and passion to making this project even more fruitful and that you will gain invaluable experience through this effort.

Dates & Location of our next mission:

June 9– 17, 2017; Sacred Valley, Peru

Our medical team will host internal medicine, gynecology, dermatology, pediatric, nephrology and ultrasound clinics. It will also be the location where our optometrists and ophthalmologists will provide a full service eye clinic and where the ophthalmologists will perform cataract surgery. All of these services will be provided free of charge to the patients. Our team consists of physicians, nurses, allied health care professionals and medical, optometry and allied healthcare students from across the United States who dedicates their time and talents. Since the inception of our organization in 2011, our portable eye clinic and operating room has examined over 4,000 patients, distributed 6,700 pairs of prescription glasses/sunglasses and performed close to 400 site restoring surgical procedures. The portable medical clinic has administered health care to approximately 7,850 patients to people and performed approximately 250 portable ultrasound examinations.

You are required to leave with the mission group from JFK International Airport, NY on June 9, 2017, in order to pass through U.S. and Peruvian Customs. You may wish to travel to Machu Picchu with other members of the mission after clinic ends on Friday evening, June 16 for one night and either join the rest of the group traveling back to the USA in June 17 in the evening or you are free to travel around Peru.

About the ProjectWhat do we do?

• A Promise to Peru, Inc. has established an annual mission to the Sacred Valley of Peru and other regions in need in an effort to provide the people in these areas with health care and address public health issues. The mission takes place for one week in June with the dedication and efforts of volunteer physicians, nurse practitioners, nurses, allied health professionals from around the USA, students from Stony Brook School of Medicine and other medical schools, Masters In Public Health students, SUNY Optometry students, Allied Healthcare students and undergraduate students. The medical mission offers general medical care as well as sub specialty care such as dermatology, infectious disease, gynecology, nephrology and diagnostic ultrasonography.

Where are we going?

Centro de Salud de Calca will be our primary base. The nearest major city is Cusco, which is about 1 – 1-½ hours away by car. It is close to where Machu Picchu, the beautiful Incan ruins and one of the Seven Wonders of the World, is located http://whc.unesco.org/en/list/274. The image below is of the town of Urubamba, the Sacred Valley village.

Who is running the project?The Board of Directors of A Promise to Peru, Inc. runs the mission in conjunction with the assistance of the graduate students from various disciplines (medical, physician assistant, nursing, optometry, etc.) and our mission participants. (FNE International) Facilitate Network Empower, a Boston-based non-profit is also supporting the project by providing services regarding travel logistics, community development, project sustainability, and institutional collaboration (http://fneinternational.org).

We rely on the assistance of the volunteering physicians and allied health professionals to actively participate in the preparation required for the trip, inclusive but not limited to preparing lectures for the medical students on a topic relating to the conditions commonly seen in Peru. The students are provided with a series of didactic lectures with topics ranging from Diagnosis and Treatment of Cataracts, Common Eye Diseases, The Work Up of Abdominal Complaints, Basic Principles of Ultrasonography and hands on experience to name a few of the topics. We receive our funding primarily through A Promise to Peru’s multiple fundraising efforts and the generosity of local businesses and medical practices. These funds are used primarily for purchasing medications, supplies and equipment for the cataract surgical and medical mission, which are then transported directly by the participants of the mission to Peru. We have had several of our participants host fund raising events in places such as Chicago and Connecticut to assist A Promise to Peru, Inc. in raising awareness of our organization as well as funds. If any of you are interested in hosting a fundraiser please contact one of the members of the board!

Why Peru?Peru is a beautiful country with rich cultures and warm-hearted people, and we have been fortunate to work with wonderful community leaders throughout the project. We chose the location because one of the medical students who started the project got in touch with a Colorado-based, family run NGO called Peruvian Hearts (www.peruvianhearts.org). Peruvian Hearts offers support for orphanages and schools, providing nutritional and educational support to people in the Sacred Valley region. They expressed the need for healthcare for the medically underserved, and so a project was initiated to work with them. Peruvian Hearts has introduced us to the mayor of Lamay, and community leaders in the area, such as Edwin Gonzales, owner of one of the hotels where we stay, and also a generous philanthropist. We have also receive great help from Dr. Victor Rozas from the Peruvian American Medical Society in obtaining our letter of invitation from the Peruvian Minister of Health and the temporary medical licenses to practice in Peru. Helena Van Engelen and her team at Foundacion Niños Del Arco Iris (kuychi.org) have been instrumental in providing logistical support with the cataract surgery mission and medical mission. Her foundation provides education, medical care and daily meals to many uncared for children in the Sacred Valley. Dr Frilo Silva and the Caprece Eye Clinic in Cusco offers support as our host ophthalmologist. Dr Silva and his team provides the long term postoperative cataract eye care that is crucial to our mission’s success. Dr Francisco Morales a local internist aids our team in locating the patient communities that are in need of health care and cataract surgery. Our physicians participate in an International Health Symposium for local health care providers that Dr Morales and his organization, Asociación Wiñaypaq coordinates while we are in Peru. SIMPOSIO INTERNACIONAL DE SALUD EN EL VALLE SAGRADO https://www.facebook.com/media/set/?set=a.266859543498322.1073741856.100005228343422&type=1

Patient Care

What kind of patient population do we serve?

The majority of patients who come to us are farmers with limited access to medical care. We see a lot of chronic diseases, such as musculoskeletal pain, as well as women’s health issues, malnutrition, gastrointestinal complaints, skin problems and vision problems. Upper respiratory infections are also common during the season we travel to Peru (it is winter in the Southern hemisphere). Unfortunately, we also face many psychosocial issues, such as depression, alcoholism and domestic violence. We manage these issues in collaboration with the local health care workers, who understand the local culture and can provide long-term follow up. We also rely on local doctors and nurses for acutely ill patients who require hospitalization.

What languages do patients speak?

Most of the younger patients in the clinics speak Spanish, but many of the older patients from the mountain villages speak a local language called Quechua. Foundacion Ninos del Arco Iris provides personnel to translate between Quechua and Spanish. Spanish fluency is very welcomed from our participants.

What medical resources are available?We work in a very resource limited setting. For the most part, all we have is what we bring with us in our own suitcases.

The medical diagnostic tools you have for the most part are what are in your white coat pocket – stethoscopes, ophthalmoscopes, otoscopes, and good history and physical exam skills. We bring blood pressure cuffs, thermometers, glucometers, and medications with us for the medical clinic and we transport an entire operating room and eye clinic to treat common eye diseases and perform cataract surgery.

Imaging: We don’t have access to imaging facilities. Through the generosity of SonoSite, we are able to transport two portable ultrasound units with us. This has enabled our physicians to better diagnose the etiology of patients’ abdominal complaints as well as for gynecological and obstetrical patients.

What do we do if the patients are really sick?

Depending on the site we are at, we are about 1 -3 hours from the major hospitals. If a patient needs emergent medical attention, such as surgery, IV rehydration, etc, then we would work with the local physicians to get them to the nearest hospital.

What if I get sick?The diseases you are most likely to get are common colds and traveler’s diarrhea. Also, since we are in a high altitude, there may be a need to take acetazolamide (Diamox) for the first few days. Please make sure you have international health insurance coverage.

What would my role be in patient care?

This is flexible, depending on who else is there (or isn’t there) and what the staffing needs are. We’d like everyone to use all your talents and make the patient care as efficient, safe, and comprehensive as possible. To give you an idea, these are some examples of tasks you would do:

Pre-clinical med students (1 st year students): Assist with vitals, intake, taking history and performing physical exam with either senior med. student or a physician. Help with other areas such as the pharmacy or ultrasound. Present cases with the help of an attending or a senior medical student. The student will be involved with the preoperative and postoperative medical assessment of the patient, they will be able to observe cataract surgical procedures and be involved in the pre operative ocular evaluation and post operative care and management of the patient.

Senior medical students: They are precepted by a physician. They will supervise junior medical students. Organize case presentations. They will also will be involved with the preoperative and postoperative medical assessment of the patient, they will be able to observe cataract surgical procedures and be involved in the pre operative ocular evaluation and post operative care and management of the patient.

Physician advisors: See patients in various settings, precept students in clinic, help coordinate didactics prior to departure, provide verbal/written feedback to students.

Nurses: Help with triage of patients, develop patient education material and programs, and help with patient record keeping.

Non-medical support staff: Assist with translating, record keeping, educational material, taking visual acuity, coordinating patient registration.

Please ask specific questions with regards to what your level of training and experiences are, and we can answer case by case what you can do.

Eligibility Who is this mission open to?

The trip is open to all medical, optometry, allied healthcare professional students, undergraduate students, physicians, and allied healthcare professionals. Examples of people who we are recruiting include but are not limited to:

• Eye specialists (optometrists, ophthalmologists, ophthalmic technicians)

• Anesthesiologists

• Family Physicians, Internists

• Pediatricians

• Emergency Medicine Physicians

• Women's health specialists (Ob/Gyn physicians, midwives)

• Ultrasound Technicians

• Surgical Technicians trained for eye surgery

• Physical therapists

• Dermatologists

• Pharmacists

• Nurse practitioners/registered nurses/Operating room nurses

• Spanish translators (English-Spanish, Quechua translators)

What are the requirements for going this year?

• Attend the scheduled meetings

• Join at least one of the committees / projects in preparation for the trip.

• Work on improving Spanish skills as much as you can

• Be nice to the coordinators and submit documents / deposits / travel itineraries on time…please!

• Act responsibly and professionally throughout the preparation, time in Peru, and afterwards

Do I need to be fluent in Spanish?

The patients speak Spanish or a local language called Quechua. Although you do not have to be fluent, all students are required to have basic Spanish skills. There is no Spanish language requirement for physicians and other health care professionals. However, we strongly encourage you to study as much Spanish as you can prior to the trip to be able to provide the best care to patients.

Getting InvolvedHow do I apply to go on the next trip?

• Visit our website http://apromisetoperu.com/get-involved/

• Deadline for application submission was December 1, 2016

Travel LogisticsHow much would it cost?

You are responsible for the cost of your travel, lodging and food. The estimated cost of the trip for one week is $1,500 -$2,000 depending if you share a room with others & if you opt to travel after the mission. A Promise to Peru, Inc. is not directly involved with the travel arrangements, Elena Meehan of CD Travel Planners, 37 Polly Drive, Huntington, NY 11743, 631-673-7930, cdtravel@optonline.net is the agency we are asking you to use. They will book your flights for the mission. One of our volunteers will book your hotel from June 10-16, 2017. You are required to leave with the mission group from JFK International Airport, NY on June 9, 2017, the group needs to travel together in order to pass through US Customs and Peruvian Customs. You may wish to travel to Machu Picchu with other members of the mission after clinic ends on Friday evening, June 16 for one night and either join the rest of the group traveling back to the USA in June 17 in the evening or you are free to travel around Peru. Each participant is required to transport a piece of mission luggage, that will be packed by all of the participants during several packing events at our headquarters in May. Exact dates TBD. The airline allows two pieces of checked in luggage, as long as it weighs 50 lbs. or less no additional fee is incurred.

Registration Fee: non refundable fee, check to be made out to A Promise to Peru, Inc. (includes lunch Sunday to Friday, transportation from Cuzco airport to Calca)

$150 Physician and Optometrist

$100 Non physician, Non student

$75 Student

Estimated Food Costs: ~$10/day (dinner), breakfast included with hotel and lunch is included in your registration fee.

Lodging: Hotel Qasana, Calca http://www.hotelqasana.com/ Our entire group will stay there from 6/10-6/16Rates:

double or single, 140 sole/$41 per night (total not per person) quad 180 sole/$53 per night (total not per person) includes buffet breakfast

Air Travel:

Elena at CD Travel has reserved group tickets at $882.07 per ticket. This includes RT non-stop flight on LAN Airlines from JFK to Lima and then to Cuzco. (see details below). All participants (even if you are living in a different state) will meet at JFK on June 9, Friday @ 6:30pm (the luggage needs to pass inspection from U.S. Customs office) for the 11:45 pm departure and have a choice of returning back to NY with the main group on June 17 or you may return after that date. ( there is not a group rate ). Elena will be coordinating the air travel. Contact her directly. Elena Meehan of CD Travel Planners 37 Polly Drive, Huntington, NY 11743 631-673-7930, cdtravel@optonline.net

Several points:1. It is important to travel as a group when entering Peru and their Custom’s office. If there are any fees incurred, our organization will pay for them. We have had instances where participants traveling alone were not able to bring in the mission supplies and the customs office kept the suitcase. It is important to understand that each piece of luggage transported by our team is necessary for the success of our surgeries, for example if a suitcase carrying the surgical instrument trays is lost in transit or prevented to enter by the customs office, we have no mission. 2. We have secured these prices in December 2016 please know that we are trying our best to keep your out of pocket expenses to a minimum. Deadline to cancel without any penalty is 3/1 should we find a cheaper flight.3. There will be two options to choose from for the return flight: Option A: If you choose June 17th, this is the least amount of days you can stay with the mission and you will miss 5 days of work, since we leave after work hours on the 9th. There

is the opportunity to visit Machu Picchu if you take the train on Friday 16th after 4pm. That is when the OR and clinics will be finished packing. NO ONE will be permitted to leave earlier than that time. Typically about 15 people from our team will travel together. Arrangements can be made through Luis Loayza luisgodiswithme@gmail.com for train travel, ticket admission to MP & hotel stay in Agues Calientes on Friday night. That same train also can take you directly to Cusco on Saturday in time for the 7:40pm flight. You will need to arrange for transportation to take you from the train station to the airport. Or you can travel to Cuzco and stay there Friday night. There will be a large group that will be doing this, hotel to be determined.Option B: You can choose to return on your own, but again, you need to fly on the exact flights listed below for 6/9 and 6/10.

Flights On LATAM Air:6/9 Flight #531 JFK-Lima  1120P  600A  10JUN J  6/10 #2049   Lima-Cusco 1005A 1140A        6/17 #2068 Cusco-Lima 740P  910P 6/18 #530 Lima-JFK 1215A  850A

Required by A Promise to Peru, Inc.:

Due by January 30, 2017:

• Physician Volunteer Registration Form or Non-Physician Volunteer Registration Form click on link under Volunteer tab

• Signed Waiver of Liability click on link under Volunteer tab

• Signed Code of Conduct click on link under Volunteer tab

• Scanned copy of your passport picture page (YOUR PASSPORT MUST BE VALID FOR AT LEAST SIX MONTHS AFTER YOUR SCHEDULED RETURN

• Supporting documents necessary for Temporary Medical Licenses (required for physicians & listed on Physician Volunteer Registration form)

• Full payment for airfare, check made out to A Promise to Peru, Inc

• Administrative Fee: $75 for students, $100 for non students, non physicians, $150 for physicians check made out to A Promise to Peru, Inc.

• Evacuation Insurance is required, submit the Evacuation Insurance Information click on link under Volunteer tab to Cathy Roberts; cmroberts3@aol.com Suggestions include, but are not limited to: https://buy.travelguard.com and http://www.csatravelpro.com/comparepolicy.do

Snail Mail all of the above, Administrative fee and Airfare (TWO SEPARATE CHECKS) by January 30th to : Cathy Roberts, 6 Sage Brush Ct, Setauket, NY 11733; Check to be made out to A Promise to Peru, Inc.; the fee is non refundable and the airfare is non refundable.

Due by March 30, 2016:

Full payment for hotel. Check to be made out to A Promise to Peru, Inc,, Mail to Cathy Roberts, 6 Sage Brush Ct, Setauket, NY 11733

Vaccinations:

Do not delay in obtaining your vaccinations, we strongly advise you to initiate this process in January/February.

Please discuss any necessary travel vaccinations with your primary care doctor who may recommend consultation with a travel medicine physician based on your insurance coverage. Travel vaccine recommendations can change from year to year and every participant's health history is different.  Please also visit http://wwwnc.cdc.gov/travel/destinations/traveler/none/peru

Vaccines recommended are Hepatitis A, Hepatitis B, diphtheria/tetanus/pertussis, typhoid and Yellow Fever (if you are traveling to the jungle or to other South American countries). People usually don’t need malaria prophylaxis unless you plan on going to the jungles before or after your time in Urubamba.

What do we do once we arrive in Peru on June 10?

Once our group arrives in Lima, we will go through Peruvian Customs and board the next plane for Cuzco. We have 4 hours in between these flights because it can take us 2 hours to pass through Customs and we cannot risk missing the flight to Cuzco. Once we arrive in Cuzco, transportation will be provided to the hotel in Calca (about 1 ½ hours away). A small group will drop off the mission luggage and the rest of us will check in to the hotel. You will have the rest of the day and evening to relax.

On Sunday June 11, 2017 at 10:30am we will meet at the Centro de Salud de Calca to have a group meeting to review the itinerary for the workweek and eat lunch. After that all of the team will unpack the 50 pieces of luggage and set up the clinics and the operating room. Our eye team will also be screening patients from our previous surgical expeditions. These patients will be examined, measured for their implant and cleared for surgery so that there will be patients ready for surgery on Monday morning.

How can a participant offset the costs of the trip?

The members of the board of A Promise to Peru recognize and appreciate the fact that you are donating your time and talents to assist us on the mission, in addition to taking vacation time and paying for your trip.

Below are some ideas/suggestions and options for partial funding for all participants:

• Create a Crowd Rise https://www.crowdrise.com/fundraise-and-volunteer/signup-select or Go Fund Me page https://www.gofundme.com for Friends and Family members to support your philanthropic work!

• John Shanley, M.D. M.P.H Global Initiatives Award $500 link will be posted in mid December 9, 2016 on website Application due by: on January 15, 2017

Applicant must meet all of the following criteria: non physician, a non student and a previous A Promise to Peru mission participant

• A Promise to Peru, Inc. Travel Award $250 link will be posted in mid December 9, 2016 on website Application due by: on January 15, 2017

Applicant must meet all of the following criteria: non physician, a non student and a previous A Promise to Peru mission participant

• The Global Health Faith Award $250 sponsored by Anonymous Supporter

Criteria: Non-physician, link will be posted in mid December 9, 2016 on website Application due by: on January 15, 2017

For Stony Brook Medical Students Only:

• Stony Brook School of Medicine Alumni Association International Travel Award $500, Application due by: January 9th.

https://alumniandfriends.stonybrook.edu/document.doc?id=1227

• Drs. Richard and Philip Messina Award for Excellence in Global Initiatives

http://medicine.stonybrookmedicine.edu/global_medical_education/application $500, Application due by: January 9, 2017

• Spatz Foundation Award for Interdisciplinary Team $750 contact Dean M. Sedler

For Stony Brook Nursing and Physician Assistant Students:

• Spatz Foundation Award for Interdisciplinary Team $750 students have been selected by their Deans

For Stony Brook Ophthalmology Resident:

• Drs. Richard and Philip Messina Award for Excellence in Global Initiatives

http://medicine.stonybrookmedicine.edu/global_medical_education/application $350 Application due by: on January 9th, the award is matched by the generosity of the Stony Brook Department of Ophthalmology. Total amount:$700