Home Biography Donations Annual Report Letters La Doctora Contact Us

January, 2014

I am struck by the perpetual circus of Iquito's street life. I arrived on the city's 150th anniversary, and although they celebrate every year, I guess a sesquicentennial is something special. A huge stage was erected at the corner of the Plaza de Armas and musicians were already hard at it when I walked past on my way to dinner. As always, but especially on weekends and holidays, families, couples, teenagers, and tourists strolled the plaza, entertained by jugglers, clowns and stiltwalkers , and wooed by sellers of balloons, popcorn, candy and handicrafts. The balmy air makes it easy to be outdoors, and everyone in Iquitos lives a good part of their lives on the street.
This was even more evident on the way to Pam's house after supper. Couples mooned or argued at sidewalk café tables, men sat at the tables and drank beer and talked, more people strolled, older folks slouched in rocking chairs in their doorways, observing the passersby, televisions glared inside living rooms, restaurants were packed, motorcycles and motokars kept up their relentless movement. Near the produce market a bus was stopped, empty, with a crowd of mostly young men gathering in front. An accident? Who knows? -- some sort of street drama, anyway.
And the next morning, I woke with a faint sheen of sweat on my face despite having slept with the fan blowing across me. Back on the street, there were plenty of folks up and moving around at 6:30 a.m. Although many revelers were still sleeping it off (at the coffee shop, Pedro complained that the music from the stage at the corner of the plaza boomed on till 4 a.m.), even on a Sunday morning, many people are up and about their daily chores.
It is easy to know when one is in the tropics.

When women come to the clinic to give birth, it is almost always because they tried to have the baby at home, and something seemed to be going wrong. Thankfully, they are usually mistaken; most deliveries are normal, it is just that the women involved in them get pretty tired of the whole thing, and it can seem as though the delivery is taking forever even though it is in fact following the usual pattern. Diana is 31 years old, and this was her seventh pregnancy. She had one miscarriage, and one baby who died a couple of weeks after birth, so this child would be joining four siblings. She was hardly inexperienced, and she said this did not feel like her other pregnancies. And me, I always worry about obstetrics.
Her blood pressure was slightly high -- 130/90 -- and when we did a urinalysis Carmen reported a little protein, though not much; thankfully, she had no ankle swelling. We would have to watch for pre-eclampsia, a potentially life-threatening condition, but at the moment she seemed to be ok. Her husband reported that her labor had begun the night before, but the usual round of repeated questioning yielded the information that her real contractions had started that afternoon, so it sounded like normal progression. I performed a vaginal exam and could easily feel the fetal head, which is good. We got out a speculum and I was able to see the intact amnionic membranes, so I ruptured those, and she continued to have good contractions every couple of minutes.
She was sure the baby was not descending, and kept repeating that this was not like her other deliveries. But Gregorio thought the baby's head was slowly coming down, and from my place at her side, my hand resting on her swollen belly, I cheer-led vigorously each time I felt her uterus tightening in a contraction. After a while, she indicated that she would like to get up and walk around, and Edemita asked if she would like to give birth in a squatting position, to which she agreed. So, an hour or so after my arrival, squatting on the clinic floor with her husband behind her, his arms around her ribcage and his hands attempting to push down on her enlarged uterus, a lovely baby girl slid out into Gregorio's waiting hands.

When I was in Wisconsin, Ari, Golbert and a small work crew of local men performed a necessary repair on my casa. The house is after all twenty years old, which is a long life for a rainforest house built of wood rather than brick, with a thatched roof. There is a maze of orcones, or support pilings, beneath the floor, and along each of the two long edges of the house there are four poles which go all the way up to the roof structure, which is essentially a house of its own. Most of these pilings are in good shape, but I had noticed that both the corner posts on the south side of the house had deteriorated. One was whittled away at its base, leaving only a narrow center to bear the load, and the other was hardly touching the ground at all. All those annual floods have taken their toll.
Replacing these pillars was going to be a job which I did not want to witness. I could picture the roof sagging, the house collapsing, people being injured, and none of it was appealing, so I was relieved to have them undertake the repair while I was gone.
First, they had to harvest and install a temporary support from the ground all the way up to each of the two involved corners of the roof. Then, they had to dig out the buried portion of the original orcones, these being sunk about a meter into the ground. After that, they needed to insert the replacements. On the back corner, they removed the entire post, which was well over four meters in length (a meter buried in the ground, about five feet between ground level and the floor, another two meters above the floor to the rafters), and substituted a sturdy four by four in its place. I have no idea how they managed to dig it into the ground and run it up through the floor to support the rafters, without dismantling the entire corner of the house, but they did the job. On the front corner, evidently they decided that much of the wood was still good, and there, they planted a new segment which is buried in the ground, then notched above ground to join with the remaining portion of the original orcone, with heavy six inch long bolts uniting the old and the new sections.
Both repairs were accomplished without injury or mishap, and the house and roof appear level and good. Thank goodness.


Next Page


All Content Copyright 2008 Amazon Medical Project