The Amazon Medical Project

August, 2006

One young man came in with a high fever, headache, and shaking chills, but had a negative malaria test. He had obvious inflammation of the conjunctiva (red eyes), and as he was leaving, mentioned having passed some blood in his stools. I am wondering if he may have leptospirosis (although if he is passing blood in his stools, he may be in for a hard time even with the medication I gave him to treat the lepto).
Then, a three month old infant was brought in with a huge (plum-sized) abscess on his chest wall. Juvencio opened it and drained more than 10 ml of pus out of it, which is a considerable amount for anyone, let alone such a tiny person. Fortunately, he is healing nicely with antibiotics. He doesn’t like us much, though (draining the abscess meant cutting it open, which hurts).

In the midst of all the other activity, on July 15 we had Vaccine Day. In developed countries, children are likely to receive their routine vaccinations when they come in for well child care, but Peru cannot afford single-dose vials. The government here provides vials of usually five or ten doses, and many of these must be used up within a few hours of their being opened. So, each month we have Vaccine Day, when we try to get everyone lined up at once for their immunizations. These days are always exciting, to say the least, what with shrieking children and stoic moms and fathers hiding out by the edge of the river, fearful that if they venture into the clinic, they might get a shot, too. In July, things were especially lively because Edemita was on vacation, and Marvis was in Iquitos for her days off. This left me, Dr. Yuri, and Juvencio, and although both of the men are well acquainted with the theory of vaccines, neither has much experience with their actual administration.

As we raced around the clinic, trying to get the measles vaccine mixed and administered before the intended recipients caught wind of what was up and made a break for it by running out the clinic door, all of a sudden the vaccine refrigerator door would not close. I looked hastily at it, fiddled with it a bit, then had to slow down and look more carefully, and still could not figure out the problem. Finally, I had to leave off vaccinating altogether, get a screwdriver, remove the door latch, and examine it closely. It appeared to have somehow gotten itself stuck, probably due to rust settling into the spring on which its latching mechanism depends (we received this refrigerator in 1999, so I suppose it is entitled to a little wear and tear by now). I knew I have some replacement parts somewhere in the clinic, and frustratingly, could remember having recently -- very recently -- put those parts somewhere.

But could I find that somewhere, at that moment? Of course not. I dashed from one end of the clinic to the other, pawing through the dental materials piled on the shelves where the fridge parts used to reside, climbing the stepstool to scrabble through the far corners of the top shelves in the pharmacy where I store other mechanical parts, pulling out two long-dead CB radios and a collection of other antiquities from the lower shelves, looking through the instrument closet and the kitchen and the lab and the tool room and everywhere else I could think of -- all while worrying about the vaccines that we would lose if the refrigerator warmed up, and leaving all the screaming children to Juvencio and Yuri. We found that the tall stool from the lab, when leaned against the refrigerator door, effectively closed it, but needless to say, this could be no more than a temporary measure.

I finally did find a replacement latch (tho not the other parts that I KNOW exist), only to discover that it, too, was frozen in place. Rats.

I did have a few bungee cords, and those seem to be serving as an adequate temporary door closer. The temperature in the fridge is remaining at its usual level.