The Amazon Medical Project

December 2010

            For years, I have written blithely of Juvencio and Edemita, assuming that everyone else knows them as well as I do, and since I have been writing about them for so long, that may be true. However, perhaps it is time to introduce them more formally.
            Juvencio began working with me even before the original clinic was built. Jon Helstrom and Joe Leek came to Peru in early 1992 to meet me and decide whether they should expend the effort necessary to convince their Rotary District to build a clinic in the Amazon. At the end of their visit, they promised that they would work on my behalf; but their timetable would be a year or more. I was working alone, and was beginning to be overwhelmed. Each morning when I came to the room that served as my clinic space, I pulled the plastic sheet off the bed (I did not yet have a real exam table), dusted the shelves (a lot of miscellaneous stuff, some of it still moving, falls out of a thatch roof), and swept the floor, before I began to see whatever patients were waiting for me. And the number of patients showing up each day was slowly increasing – one day, there were sixteen, and I felt swamped. I whined and moaned and looked forlorn, and Jon and Joe generously agreed to provide the money to hire someone to help until the new clinic could be constructed.
            Juvencio at that time was 22 years old, with a wife and three young children, and one or the other of them always seemed to be ill. One day, he showed up in the waiting area. When I asked which of his kids was sick this time, he replied they were all well. He had come simply to thank me for being there and helping his community.
            This impressed me, and he also impressed me as being pretty bright. I had no idea whether he might faint at the sight of blood, or whether he would have any interest at all in medical work, but I asked him, and he accepted. I began training him, and he proved to be an amazingly quick study. Soon, when I came to the “clinic” in the morning, he had the floor swept and the papers sorted, and the patients lined up in order of urgency. One morning, he knocked apologetically at the door of my room to tell me that there was a baby that he thought was too ill to wait until after I ate breakfast. I accompanied him back to the clinic quarters, and it was obvious that his assessment of the child was exactly correct.
            Once the clinic was built, it became clear that one assistant was not going to be enough, so I looked around for another. The first candidate was Juvencio’s sister Esperanza. She was also a very quick learner and worked with the clinic for a year or so; but when she sent her children to school in Iquitos, she soon followed them. Next in line was Edemita, Juvencio’s older sister. She quickly mastered pretty much every aspect of the clinic’s day to day operations, and continues to keep the files in order, the medicines restocked, the patients triaged, and my lost glasses found. Juvencio has now worked with the clinic for 18 years, and Edemita for over 15. They have both continued to add to their stores of medical knowledge, and both now have official nursing degrees from the Universidad Nacional de la Amazonia Peruana, a national-level university in Iquitos.

            For the first decade or so of the clinic’s existence, I lived pretty much full time in Peru, going back to Wisconsin once a year or so to visit family and friends, and of course, to eat cheese. Juvencio, Edemita and I were the clinic staff, and we were able to keep up with the demands of our growing patient population. However, once I decided that I needed more time in the U.S. in order to fulfill my own needs for rest, modern medical work, gainful employment, and time with friends, we needed another medical doctor in the clinic. As you know from these letters, those docs have generally stayed a year to a year and a half, usually early in their careers and usually leaving the clinic to move on to the next stage of those careers.
            Our current Peruvian doctor is Doctora Yasmina Cabello Quispe, who worked with us a year and a half ago, immediately after she finished medical school. When she left to do a year of national medical service, she was replaced by her older brother Wilbert, who is familiar to you all. Wilbert left the clinic in mid-2010, just at the time when … what luck! Yasmina happened to have completed her latest contract and was looking for work for the coming year.
            We have also added a nurse from Iquitos, although this required quite a bit of trial and error. We tried several nursing school recent graduates, including one billed as the top student in his class, and found them not only inadequately trained, but also manifestly un-teachable. We attempted one or two others who had more experience, and they turned out to be unsuitable for personality reasons. Finally, a year and a half ago, Edemita mentioned that a neighbor in Iquitos was a newly hatched nurse, and seemed quite bright. I agreed to meet with her, found her to be all Edemita had claimed, and gave her a trial at the clinic. She has been great, and that is how Carmen came to be part of the clinic.

So, while I am busy enjoying autumn and Jerry in Wisconsin, our Peruvian staff is managing the clinic. I could not do it alone even when I am present, and when I am out of the country, it would be impossible to keep the clinic open without their work.