Private Hospitals for Undergraduate Medical Training

Private Hospitals for Undergraduate Medical Training Private Hospitals for undergraduate medical training an untapped resource in Ireland. Introduction Undergraduate medical education and training is a subject of considerable importance in relation to the quality of learning and teaching opportunities for students, and the ability of the learning environments to support the development of clinical skills and knowledge, professional practice and patient-focused high quality care delivery. The Irish context presents a particular challenge due to changes in the organisation and delivery of medical care into two distinct sectors, private or public, which alters the opportunities offered for medical student experience and focuses services in different ways. While the acute care sector (public) is the one in which most medical students train, it is apparent that there are opportunities to be gained from utilising private hospital and medical locations as well, in order to expose medical students to the widest possible and available medical expertise. However, the quality of the experience in such locations may be questionable, and the ran ge of experiences available may be severely limited A review of the literature pertaining to the title will demonstrate some of the key issues around this topic, drawing on literature from the UK and internationally, due to the commonalities in medical education structure, form and pedagogy that are found globally, and in particular, referring to the UK model as being the one which dominates still even in the Irish medical education sector. Discussion Due to changes in the healthcare structure in Ireland private, there has been a split in the way that doctors provide acute medical and surgical care services. Within Ireland in the healthcare model which has evolved, there are now public only or private only contracts for consultants, meaning that consultants cannot work across both sectors. Prior to this change, a doctor could work across both sectors, meaning that while they could engage in the public sector work that is the meat and drink of medicine and surgery, most consultants made their money in private hospitals, leaving their NCHD team to do their public work. However, the challenges this change poses for the way in which medical education is delivered in Ireland have not really been picked up on in the literature, and so an exploration of pertinent literature, in the light of the author’s contextual knowledge, is important, to explore this impact and to appreciate the scope and opportunities inherent within the new structure. There is some evidence that the changes to medical education, whilst global, are very real in the Irish context. The issues affecting medical education include â€Å"increasing service demands on clinical teachers, the need for shared teaching among different health-related disciplines, the need to incorporate modern educational principles and technologies, adapting to changing societal views of health and disease and the demand for health professionals to be more accountable.†[1] Issues such as professionalism and widening understanding of diversity are inherent in these issues. What this suggests, among other things, is that in order to make best use of the existing resources, areas still untapped need to be accessed, and at the same time, the way that medical ‘education’ is delivered needs to evolve.[2] Up until the present day, the private hospitals have not really been involved in med education. However, now they are currently making associations with universities who are eager to tap this resource, in order to make use of the private hospital setting for clinical experiences for medical students (and other healthcare students). It could be posited that these hospital present a hitherto untapped resource, full of opportunities, but also as a point of great scope for development of new ways of thinking about and providing more appropriate forms of education. As a public private system becomes more defined we need to start using the private sector to teach medical students. This is particularly important as there have been, recently, significant increases in the numbers of medical students[3], with public sector hospitals overwhelmed by medical student numbers, exacerbated by graduate entry into medicine adding to the larger and more diverse pool.[4] This may be affecting the qualit y of their learning, and also the quality of care provision.[5] There are, however, challenges, because as an unused resource, and an untested learning environemtn, there are not the internal resources, skills, systems and the like already in existence to support the influx of medical students. Similarly, there are lots of new private hospitals opening that are not used for teaching, and these hospitals are not equipped for teaching. This is something to bear in mind, and there is a need to identify the requirements of a hospital being equipped for medical student teaching and learning. Basic needs would be structural, such as the provision of a student centre, student accessible IT services, student support, changing rooms, training laboratories, and the like. Some of the major concerns are that private hospitals not equipped and did not make considerations for medical student education at the design phase, meaning that making them primary locations for medical student clinical experience could be very challenging and costly. There is also the issue private patients may not welcome students, particularly as they have paid for their care and so want complete control over it. This may mean students being excluded from key experiences. However, all patients in public sector healthcare have the option to not have students present, so this may not be insurmountable, but it would require rewriting protocols, mission statements, and the like to include an educational component. Another concern is the fact that private hospitals have not yet got to the same level of provision or range of clinical disciplines as public ones. For example, very few have intensive care departments, full time 24/7 consultant cover, emergency departments or major trauma units. Therefore the casemix of patients is elective, and limited, and students if only placed in private hospitals, will not be exposed to emergency. However, the contrary is also true as public teaching hospitals are now getting less elective patients for routine surgeries such as cholecystectomies and hernias. There is evidence to suggest that the relevance of the training medical students receive is of some importance to the quality of their experience and their future skills.[6] There could, therefore, be an argument for cross-sector placements, on rotation, with students doing different placements in different hospitals. This may have the advantage of exposing students to a wider socio-cultural mix of patient s as well as a wider pool of medical expertise, both of which may be of significance in the requirements of medical staff in the current climate.[7] Certainly, there is an emergence of a need to develop more creative approaches to clinical medical education which address the social and societal issues affecting health and illness as well as the medical knowledge itself.[8] This is evident in the emergence of debate around professionalism and professionalisation/socialisation of medical students into their profession, but also into the wider healthcare workforce. While traditionally, medicine has enjoyed a hegemonic position with near godlike autonomy[9], things have changed and new ways of viewing the medical profession have emerged. This has included a demand for more transparent, ethical practice, for doctors to view patients as individuals within their personal, social context, and the need for doctors to demonstrate respect for others, teamworking skills, and more self-awareness and increased awareness of social responsibility.[10] It also includes the reflexivity and awareness required to underpin the development of clinical decision making and problem solving skills, in general, and in application to particular disciplines and cases.[11] These notions of professionalism and reducing the divide between physician and patient are deemed important fo r the profession, as long as professional standards are also maintained.[12] This is where the challenge seems to reside, in providing medical students in Ireland with the scope to develop their professional knowledge and skills, along with the development of themselves, and their professional role, across two radically different healthcare provision domains.[13] Yet the research shows that it is the quality of the clinical or practical experience that medical students have which affects both aspects of their development, their clinical skills and their professionalism.[14] Medical education has moved away from the didactic forms that have characterised it for centuries towards a more interactive, student-centred type of training, although not as far as the other healthcare professions have.[15] Therefore, developing the private sector provision could serve a number of purposes, not just providing a useful place for the runoff of extra students currently flooding the public sector h ospitals. It could provide the opportunities for students to be assessed in skills and attributes relevant to each sector, as well as each individual case they are addressing. This would represent a more individualised approach to medical education.[16] There is a high likelihood of a considerable amount of resistance to such a reorientation, however, because the traditional, hierarchical and hegemonic structures of the medical profession will not be easily overcome.[17] What changes there are may not be fully bedded down within the Irish healthcare sector.[18] There is also the challenge of ensuring that there are adequate clinical educators available or even employed within this sector.[19] However, it would also be important to consider the impact of a large amount of private sector clinical experience on the professional development and socialisation of medical students, because much of this occurs within the institutional setting and is affecting by that setting, by the organisational culture, and by the behaviours of others within that setting.[20] Therefore, if students are modelling themselves primarily on what they are seeing within the private sector, this exposure could be detrimental, in the long run, to their professionalism, their awareness, and the ways that the work with others.[21] The nature of medical education itself is one which may need to change, to reorient itself to a different model of teaching and learning which is more appropriate to modern day medicine[22]. â€Å"Continued efforts are needed to reduce the factual load of the curriculum.†[23] It is apparent that in the current climate, with rapid developments in science and technology applied to medicine, and the increasing speed of these developments, that delivering a didactic curriculum is not practical, and instead, medical schools need to be able to â€Å"equip students with the skills and attitudes needed to cope with rapid change and lifelong learning.†[24] This includes students learning how to learn in a self-directed, more autonomous way,[25] which would then help to overcome the differences between the sectors and support students in cross-sector working and identifying the learning and development opportunities specific to each. However, the literature shows that in Ireland (as in many other places), the nature of medical education remains quite didactic and offers only limited opportunities for students to work in alternative ways. Yet the requirement for personal and professional development has already begun to be realised in the UK and Ireland, and as such the groundwork has already been laid.[26] Similarly, literature shows that medical student learning differs depending on the clinical environment,[27] which may be related to the culture of the environment and the purpose of the medical provision,[28] and if this is the case, then a great deal of research will be needed, along with ongoing evaluation, in order to assess the impact of the use of private sector hospitals within Ireland. The literature demonstrates that new ways of learning can be developed and implemented, based on more social, interactive, collaborative models[29], such as the development of communities of practice.[30] In this case, such communities would need to span the different sectors effectively, and overcome the differences between them, but these could expand to make better use of and collaborate more effectively with the training of interprofessional colleages[31]. This raises the question of whether there are the skills, capacity and even inclination to develop medical education along such lines, a lthough the ongoing benefits of communities of practice would be exponential.[32],[33]. The need for medical students to emerge as knowledgeable professionalss with the requisite understanding and skills must not be overlooked.[34],[35] Conclusion It would appear that there is a great untapped potential in the use of private sector hospitals in the Republic of Ireland to supplement medical student education by providing clinical locations for practice-based learning. However, this learning may need to be located in a different paradigm to the traditional medical apprenticeship model that has dominated this sector to date. The private sector hospitals would need to be come part of the partnership teams with universities and public sector hospitals. They would need to develop the facilities and infrastructure to support medical students. Medical students would gain a lot from such placements, but it would appear to be best that these form part of a cross-sector rotation of placements, rather than a private setting constituting their dominant clinical learning setting. The ways in which medical students are ‘taught’ would also need to change, to become more focused on personal and professional development, self-directed learning, and on all the elements of being professional in relation to current definitions of the word, and the social expectations placed upon healthcare professionals. Research is required into how private sector hospitals can be used, how medical education is changed by this and will change the nature of these locations, and how different approaches to new pedagogies will benefit medical students overall. The impact of these changes on professionalism, and the resistance from the profession, will also need to be considered. Ultimately, private hospitals can support the current provision, but the nature of the healthcare provision in Ireland would have to be considered also in the light of international models and how it intersects with these. Anything which improves student development and the skills and capabilities of newly qualified doctors must be a positive move, but research is needed to demonstrate that this would be so. References Arnold, L. (2002) Assessing professional behaviour: yesterday, today and tomorrow. Acad Med 77 (6) 58-70. Bligh, J. (2004) More medical students, more stress in the medical education system. Medical Education 38 460-462. Chastonay, P., Brenner, F., Peel, S. and Guilbert, J-J. (1996) The need for more efficiency and relevance in medical education. Medical Education 30 235-248. Cruess, R., Cruess, S. and Johnston, S.E. (1999) Renewing professionalism: an opportunity for medicine. Acad Med 74. (8) 878-884. Currie, G. and Suhomlinova, O. (2006) The impact of institutional forces upon knowledge sharing in the UK NHS: the triumph of professional power and the inconsistency of policy. Public Administration 84 (1) 1-30. Department of Health (2004) Medical Schools: Delivering the Doctors of the Future London: Department of Health. Dogra, N., Conning, S., and Gill, P. (2005) Teaching of cultural diversity in medical schools in the United Kingdom and Republic of Ireland: cross sectional questionnaire survey. BMJ 330 403-404. Dowton, S.B., Stokes, M-L., Rawstrong, E.J. et al (2005) Postgraduate medical education: rethinking and integrating a complex landscape. MJA 182 177-180. Dornan, T., Hadfield, J., Brown, M. et al (2005) How can medical students learn in a self-directed way in the clinical environment? Design-based research. Medical Education 39 356-364. Epstein, R.M. and Hundert, E.M. (2002) 287 (2) 226-235. Defining and assessing professional competence. JAMA 287 (2) 226-235. Finucane, P. and Kellet, J. (2007) A new direction for medical education in Ireland? European Journal of Internal Medicine 18 101-103. General Medical Council (2002) Tomorrow’s doctors: recommendations on undergraduate medical education. London: GMC. Gordon, J. (2003) Fostering students’ personal and professional development in medicine: a new framework for PPD. Medical Education 37 (4) 341-349. Hilton, S.R. and Slotnick, H.B. (2005) Proto-professionalism: how professionalisation occurs across the continuum of medical education. Medical Education 29 58-65. Howe, A., Campion, P., Searle, J. and Smith, H. (2004) New perspectives approaches to medical education at four new UK medical schools. BMJ 329 327-331. Irvine, D. (1999) The performance of doctors: new professionalism. Lancet 353 1174-1177. Littlewood, S., Ypinazar, V., Margolis, S.A. et al (2005) Early practical experience and the social responsiveness of clinical education: systematic review. BMJ331 387-391. Lloyd Jones, M. (2005) Role development and effective practice in specialist and advanced practice roles in acute hospital settings: systematic review and meta-synthesis. Journal of Advanced Nursing 49 (2) 191-209. McMahon, T. (2005) Teaching medicine and allied disciplines in the 21st century lessons for Ireland on the continuing need for reform. Radiography 11 61-65. Medical Council (2001) Review of medical schools in Ireland Dublin: Medical Council. Moercje, A.M. and Elika, B. (2002) What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process. Medical Education 36 472-478. Norman, G. (2002) Research in medical education: three decades of progress. BMJ 324 1560-1562. Nuffield Trust (2000) University Clinical Partnership: Harnessing Clinical and Academic Resources London: Nuffield Trust Working Group on NHS/University Relations. Ostler, D.T., (2005) Flexner, apprenticeship and ‘the new medical education.’ Journal of the Royal Society of Medicine 98 91-95. Perkins, G.D., Barrett, H., Bullock, I. et al (2005) The Acute Care Undergraduate Teaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom. Intensive Care Medicine 31 1627-1633. Rogers, J.C., Swee, D.E. and Ullian, J.A. (1991) Teaching medical decision making and students’ clinical problem solving skills. Medical Teacher 13 157-164. Satran, L., Harris, I.B., Allen, S. et al (1993) Hospital-based versus community-based clinical education: comparing performances and course evaluations by students in their second-year pediatrics rotation. Acad Med 68 380-382. Sinclair, S. (1997) Making doctors: an institutional apprenticeship Oxford: Berg. Smith, T. and Sime, P. (2001) A survey of clinical academic staffing levels in UK medical and dental schools: a report to the Council for Heads of Medical Schools London: Council for Heads of Medical Schools. Stewart, J., O’Halloran, C., Harrigan, P. et al (1999) Identifying appropriate tasks for the preregistration year: modified Delphi technique. BMJ 224-229. Swick, H. (2000) towards a normative definition of medical professionalism. Acad Med. 75 (6) 77-81. Thakore, H. and McMahon, T. (2006) Sink or swim: the future of medical education in Ireland. The Clinical Teacher 3 129-132. Wenger, E.C. and Snyder, W.M. (2000) Communities of practice: the organisational frontier. Harvard Business Review 78 (1) 139-147. Williams, G. and Lau, A. (2004) Reform of undergraduate medical teaching in the United Kingdom: a triumph of evangelism over common sense. BMJ 329 92-94. Worley, P., Esterman, A. and Prideaux, D. (2004) Cohort study of examination performance of undergraduate medical students learning in community settings. BMJ 328 207-209. Footnotes [1] Finucane, P. and Kellet, J. (2007) [2] Thakore, H. and McMahon, T. (2006) [3] Bligh, J. (2004) [4] Thakore, H. and McMahon, T. (2006) [5] Bligh, J. (2004) [6] Chastonay, P., Brenner, F., Peel, S. and Guilbert, J-J. (1996) [7] Dogra, N., Conning, S., and Gill, P. (2005) [8] Department of Health (2004) [9] Hilton, S.R. and Slotnick, H.B. (2005) [10] Hilton, S.R. and Slotnick, H.B. (2005) [11] Rogers, J.C., Swee, D.E. and Ullian, J.A. (1991) [12] General Medical Council (2002) [13] Arnold, L. (2002) [14] Littlewood, S., Ypinazar, V., Margolis, S.A. et al (2005 [15] Norman, G. (2002) [16] Ostler, D.T., (2005 [17] Williams, G. and Lau, A. (2004) [18] Currie, G. and Suhomlinova, O. (2006) [19] Smith, T. and Sime, P. (2001) [20] Sinclair, S. (1997) [21] Swick, H. (2000) [22] Howe, A., Campion, P., Searle, J. and Smith, H. (2004) [23] Medical Council (2001) [24] Medical Council (ibid) [25] Dornan, T., Hadfield, J., Brown, M. et al (2005) [26] Gordon, J. (2003) [27] Worley, P., Esterman, A. and Prideaux, D. (2004) [28] Satran, L., Harris, I.B., Allen, S. et al (1993) [29] Perkins, G.D., Barrett, H., Bullock, I. et al (2005) [30] Wenger, E.C. and Snyder, W.M. (2000) [31] Lloyd Jones, M. (2005) [32] Wenger, E.C. and Snyder, W.M. (2000) [33] Nuffield Trust (2000) [34] Moercje, A.M. and Elika, B. (2002) [35] Irvine, D. (1999)

My Experience in Jaffna

My experience in Jaffna. – Sandarangi Perera. For three long decades Sri Lanka was torn apart by a malicious war between the country’s majority and minority. This war made the northern part of the country inaccessible to most of us; its citizens. I myself thought that the people, culture and beauty of Jaffna and its surrounding areas would forever remain a mystery to me. However once the war ended the north opened its doors for the rest of the island to come witness all it has to offer.Even with this great opportunity at my grasp, yet I was not capable of visiting northern Sri Lanka as I simply never had the chance to. Luckily this chance was given to my fellow college mates and me by our college, the chance to see and experience the post war north. After much planning, excitement and enthusiasm we set off to Jaffna hoping to gain new experiences, to learn new lessons and to make memories as young individuals aspiring to be future journalists. Our purpose of going to Ja ffna was to collect information that was needed to write the stories that each of us were assigned.The general topic assigned to the particular group that I belonged to was â€Å"agriculture†, and we were given the full freedom to choose a story we preferred under that wide topic. The task was to choose a story which has a news value. I instantly decided on writing my story about the grape cultivation in Jaffna, considering my love for the fruit and my curiosity about the process of its cultivation. On my first day in Jaffna I arranged an interview with a few government officers at the Ministry of Agriculture Northern Province. The interview was rather successful and proved to be both knowledgeable and interesting.I learned much about the history of grape cultivation in Jaffna, its plight during the war, its status after the war, the different typed of grape fruit grown in Jaffna, the problems and threats faced by the farmers and last but not least the future plans and goals set for the growth of the grape farming industry in Jaffna. Day two and three were spent visiting grape farms and interviewing the farmers to gain a much more practical knowledge about the cultivation of grapes. I must say that the grape farms we visited were by far one of the most beautiful things that I have ever witnessed.Entering each grape farm felt like walking into a land that simply was far away from Jaffna. Greenery was rare in the North. The long stretched roads often had nothing but brown, open and empty lands on either side that often felt quite dead. These farms were the absolute opposite. Every inch of the mesh above our heads was covered with light green grape vines that blocked away the scorching sun that we could not flee from the rest of the time. What looked lovelier than the grape vines themselves were the grape fruit hanging from them.Standing under those vines I couldn’t help but feel happy and refreshed. One grape farmer that I spoke to expressed to me how growing grapes was very much similar to bringing up a child. He spoke of the dedication, caring and nurturing it took to maintaining a grape farm. There were many traditions and rules entwined with this trade, there was a specific way in which every move was to be made and this made it seem to me that grape cultivation was more of an art than a business and the farmers also went on to say that sadly it is an art that is slowly dying.Our third day in Jaffna was spent visiting onion farms and Palmyra plantations and other industries related to the Palmyra plant such as handicrafts and food and drink items made out of it. Out of the places visited on that day one place in particular that I found to be interesting was a small-scale workshop where Palmyra handicrafts were made. There were about five to six women there who were weaving pretty and colourful baskets and bags and on display were the most delicate little ornaments made from various parts of the Palmyra tree.These women ma de weaving look rather easy as they sat there, smoothly and artistically moving their fingers creating beautiful patterns. Being a crafter myself I wanted to sit with them and try weaving, and so I did. An elderly woman offered to show me how it was done and I tried to grasp as much as I could by watching her fast moving fingers and yet when I tried to weave I failed miserably. I discovered that it wasn’t nearly as easy as they made it seem to be, yet it was quite the enjoyable experience to try anyway.Along with our busy schedules, tweeting, blogging and all the other work assigned to us we still found time to experience the beauty of Jaffna while at work. Many of the places we visited, such as the Jaffna library and religious sites had a certain calmness and beauty about them that I had not experienced prior to that. I found this experience to be one that educated me much about the practical aspects of being a journalist; making contacts, setting appointments and interviews , researching into stories and their details, checking and crosschecking, finding reliable sources, team work and so on.These lessons could not have been taught to any of us in a better way, therefore I believe I speak for all of my college mates when I say our field trip to Jaffna was a priceless experience in more ways than one. The open blue skies, the beaches, the breeze, the late nights and early mornings, the joyous moments shared with friends, the delicious food, the traditions and culture of the north and more than anything the kind people of the north have been etched into my memory never to be forgotten; and this was my experience in Jaffna.

The Importance of Samples Essay Writing

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Biography of Pedro Alonso Lopez, Monster of the Andes

Pedro Alonzo Lopez (born October 8, 1948) was responsible for the murders of over 350 children, yet in 1998 he was set free despite his vows to kill again. Rumors regarding his whereabouts have swirled since the late 1990s. Fast Facts: Pedro Alonzo Lopez Known For: Serial killer, responsible for the brutal murders of over 350 childrenAlso Known As: Monster of the AndesBorn: October 8, 1948Parents: Midardo Reyes, Benilda Là ³pez De CastenedaNotable Quote: They Never Scream. They Expect Nothing. They Are Innocent. Early Years Lopez was born on October 8, 1948, in Tolima, Colombia, a time when the country was in political turmoil and crime was rampant. He was the seventh of 13 children born to a Colombian prostitute. When Lopez was eight, his mother caught him touching his sisters breast, and she kicked him out of the house forever. Trust Me, Trust Me Not Lopez became a beggar on the violent Colombian streets. He was soon approached by a man who sympathized with the boys situation and offered him a safe home and food to eat. Lopez, desperate and hungry, did not hesitate and went with the man. Instead of going to a comfortable home, he was taken to an abandoned building and repeatedly sodomized and returned to the street. During the attack, Lopez angrily vowed he would do the same to as many little girls that he could, a promise he later kept. After being raped by the pedophile, Lopez became paranoid of strangers, hiding during the day and scavenging for food at night. Within a year he left  Tolima  and wandered to the town of Bogota. An American couple reached out to him after feeling pity for the thin boy begging for food. They brought him to their home and enrolled him in a school for orphans, but when he was 12, a male teacher molested him. Shortly afterward, Lopez stole money and fled back into the streets. Prison Life Lopez, lacking in education and skill, survived on the streets by begging and committing petty thievery. His stealing advanced to car theft, and he was paid well when he sold the stolen cars to chop shops. He was arrested at the age of 18 for car theft and sent to prison. After a few days of being there, he was gang-raped by four prisoners. The anger and rage he experienced as a child rose inside him again, consuming him. He made another vow to himself; to never be violated again. Lopez got his revenge for the rape by killing three of the four men responsible. Authorities added two years to his sentence, deeming his actions as self-defense. During his incarceration, he had time to revisit his life, and a quiet rage toward his mother became monstrous. He also dealt with his sexual needs by browsing pornographic magazines. Between his prostitute mother and the pornography, Lopezs only knowledge of women fed his demented hatred for them. Release and Rearrest In 1978, Lopez was released from prison, moved to Peru, and began kidnapping and killing young Peruvian girls. He was caught by a group of Indians and tortured, buried up to his neck in the sand, but was later freed and deported to Ecuador. Experiencing near death did not influence his murderous ways and his killing of young girls continued. The increase of missing girls was noticed by authorities, but it was concluded that they had likely been kidnapped by child peddlers and sold as sex slaves. In April 1980, a flood exposed the bodies of four murdered children, and the Ecuadorian authorities realized there was a serial murderer at large. Shortly after the flood, Lopez was caught trying to abduct a young girl after the child’s mother intervened. The police could not get Lopez to cooperate, so they enlisted the help of a local priest, dressed him as a prisoner, and placed him in a cell with Lopez. The trick worked. Lopez was quick to share his brutal crimes with his new cellmate. Lopez Confesses When confronted by the police about the crimes he shared with his cellmate, Lopez broke down and confessed. His memory of his crimes was very clear, which was remarkable since he confessed to killing at least 110 children in Ecuador, more than 100 more in Colombia, and another 100 in Peru. Lopez admitted that he would walk the streets looking for innocent girls who he would lure away with the promise of gifts. Lopez often brought the girls to prepared graves, sometimes filled with the dead bodies of other girls he had killed. He would calm the child with soft reassuring words throughout the night. At sunrise he would rape and strangle them, satisfying his sick sexual needs as he watched their eyes fade as they died. He never killed at night because he could not see his victims eyes and felt, without that element, the murder was a waste. In Lopezs confession, he told of having tea parties and playing morbid games with the deceased children. He would prop them up in their graves and talk to them, convincing himself that his little friends liked the company. But when the dead children failed to answer, he would become bored and go off to find another victim. Monster of the Andes The police found his ghastly confession hard to believe, so Lopez agreed to take them to the graves of the children. More than 53 bodies were found, which was enough for the investigators to take him at his word. The public renamed him Monster of the Andes as more information about his crimes became known. For his crimes of raping, killing, and mutilating over 100 children, Lopez received a sentence of life in prison. Lopez never showed remorse for his crimes. In a prison interview with journalist Ron Laytner, he said if he ever got out of prison he would happily return to killing young children. The pleasure he received from his demented acts of murder overpowered any sense of right from wrong, and he admittedly looked forward to the opportunity to wrap his hands around the throat of his next child. Second Release No one was concerned that Lopez would have the opportunity to kill again. If paroled from the prison in Ecuador, he would still have to stand trial for his murders in Colombia and Peru. But after 20 years of solitary confinement, in the summer of 1998, it is said that Lopez was taken in the middle of the night to the Colombia border and released. Neither Colombia or Peru had the money to bring the madman to justice. Whereabouts Unknown Whatever happened to The Monster of the Andes is unknown. Many suspect and hope that one of the many bounties offered for his death eventually paid off and that he is dead. If Lopez has escaped his enemies and is still alive, there is little doubt that he has returned to his old ways. Sources Pearson, Nick. â€Å"Worlds Second Worst Serial Killer Walked Free from Prison.†Ã‚  9News Breaking News, 9News, 5 Dec. 2018.Serena, Katie. â€Å"Serial Killer Who Murdered 300 People Was Released From Jail, And No One Knows Where He Is.†Ã‚  All Thats Interesting, 30 Nov. 2018.â€Å"The Monster Of The Andes: South American Serial Killer Pedro Lopez.†Ã‚  Did You Know?, 17 July 2017.