The Amazon Medical Project

January, 2009

One day late in July, Jorge came racing up to my house early in the morning, to breathlessly ask permission to collect a team of young men to move the stairway leading from the river up to the clinic. He reported that another big hunk of Armando’s cane field had fallen into the river, and there were deep cracks in the bank near the steps, signaling where the next piece would break away.

When I got to the clinic, I could see the damage. Once again, a large crescent chunk had been taken out, with the innermost edge not 15 feet from the leading corner of the hammock house. For those who have not seen the Amazon River at work, it may be difficult to envision the nature and extent of the changes in its course. In our part of the Amazon Basin, there is no rock at all; and the river rises and falls every year by at least 20 or 25 feet. Especially when the river level is falling, and especially when it rains, chunks of land are bitten off.

When the clinic was built in 1993, it was maybe 150 feet, maybe more, from our front door to the river’s edge. It now looks likely that we will be out of space within a year or two, possibly even less. So, I decided it was time to build again.

The first step was to contact Jon Helstrom in Duluth, Minnesota. Jon is the architect and Rotarian who master-minded the current clinic. I did not want to ask him to do all that again, but since he had given us such a good, workable floor plan the first time around, I hoped he would allow me to impose upon him to repeat that feat. He did, willingly, and despite his avowal that he was not going to become so deeply involved this time around, he immediately set about drumming up funding from his and other Rotary Clubs, gathering the names of people interested in coming to Peru to work, and generally organizing a new project.

The next challenge was to find a place to put the new structure. I did not want to build again on the banks of the main river, for the obvious reason. Golbert, one of the clinic’s huatchimanes, came to the rescue. He lives along the Yanamono Stream, across the water from my house and the Lodge, and he has a piece of unused land that he offered to the clinic for its new home.

As far as funding goes, I figured that if we decided to build, the money would turn up. Costs of everything from food to building materials are skyrocketing in Peru, and the value of the dollar is falling -- but we will re-use the doors and some of the ceiling boards, and the solar system, and of course the furniture will come with us. The Clinica Yanamono was built with a waiting room, an office, pharmacy, overnight room for patients, small kitchen, two exam rooms, bathroom, shower, laundry room, and two sleeping rooms for clinic staff. A hammock house was added soon after, to provide space for patients’ families to sleep. In 1995, four rooms were added in the back to house the doctor from Iquitos, the nurse from Iquitos, whichever night watchman is on the sleeping shift, and a tool room. Then, last spring, we built a kitchen/dining area, in order to accommodate the Iquitos staff, who live in the clinic for two to three weeks at a time, before returning to the city for their days off.

The new clinic floorplan has all the above components, but they will now be in one building. We have also added a second office, which will provide room for our ever-growing rank of file cabinets and the computer (now stashed in the patient overnight room), and will give me a place to work on administrative chores, handy to the clinic but out of the direct stream of patient traffic. There will be an extra bathroom, there will be a small office space for our Iquitos doc, and there will be a more distinct separation between the working part of the clinic, and the space where the clinic staff will sleep.

Jon will try to get down to Peru in January, to lay groundwork and purchase items such as table saws and drills, and generators to run them, and lumber and roofing and other supplies necessary for the job. And then, in early February, with luck, the New Peru Crew will show up, and build us a new clinic. The clinic may or may not continue for many more years. But if we do not move, then continuing will not be an option, period. Even if I did decide to run off with Jerry soon after it is built (and I am not planning on doing that), the new clinic might well continue to serve the surrounding communities with the help of Edemita, Carmen, and possibly an Iquitos physician.

I have pasted in the floor plans of the current and proposed clinics, so you can have fun imagining it all, too. The scale on the current clinic drawing (on the right) is a little larger, and that plan does not show the hammock house, sleeping rooms out back, or kitchen/dining area, which were all added after the original building was constructed. In the new clinic, all that will be on one platform. But at least this should give you some idea, and then we can all be excited together ….