The Amazon Medical Project

19 Nov 2006

Dear gang - We did something a little different this past summer, and I am still mulling it over: instead of treating patients at the clinic, we went to their villages. This is an activity which appeals to many people, these days. There are a lot of folks, it seems, who would prefer not to merely visit Peru (and I'm sure, many other places as well), but would like to actually do some good for someone while here. Thus, medical mission trips are very popular.

Our first hands-on experience with this was with a wonderfully compassionate dentist, her husband (also a dentist), their two late-adolescent daughters, and a crew of people associated with a group in Iquitos that organizes this sort of expedition. Jerry, Juvencio and I joined the group on a clean but crowded pamacari -- one of the wooden, thatch-roofed boats that we used at Explorama until they were replaced by faster aluminum boats -- and went about four hours upriver from Iquitos to a rustic camp that made me appreciate the luxuries of my home in Yanamono.

From there, we went out to the village of Justicia where our boat driver had grown up. We landed the boat on the receding shore of the river, hiked up the drying bank and walked about fifteen minutes through caza brava, the 15-foot tall wild cane plants that populate the edges of islands, to reach a small village. This consisted of a grassy open area cum soccer field, a few houses scattered around the edges of the open space, and a dirt-floored municipal building whose walls were of rudely cut planks with substantial interstices. After introducing ourselves to the village leaders and receiving their blessing to proceed, we unpacked our boxes and set up shop.

One rough table was assigned to be the pharmacy. There, we sorted the medicines by categories: vitamins, pain relievers, cough medicines, antibiotics, etc. At one end of the dirt floor, where there was a sort of elevated stage area, we fashioned a medical clinic by pushing a blackboard around to form one wall, using a corner of the building to supply two more walls, and hanging a borrowed blanket over the remaining open side to create a semi-private room furnished with one chair for me, a small table for our instruments and gloves, and a little bench which would double as seating for our patients and an exam table, if one was needed. Simultaneously, the dentists set up their portable chairs at the other end of the building, unpacked their heavy boxes of tools, gloves, cotton balls, and so forth, and set to work, Juvencio working along with them. Someone else interviewed prospective patients and assigned them to dentistry or medicine. Soon a growing line of medical patients sat patiently on benches outside our blanket curtain. Since I spoke Spanish, I interviewed one patient (or family; sometimes a mother would bring several children) at a time, and Susan, a nurse from the U.S., performed the exams. We then did what we could to provide diagnosis and treatment -- with no lab, no running water (we used that alcohol based gloppy stuff to clean our hands between patients), very little light, and a limited amount of time per patient.

By early afternoon, we had seen about twenty patients, one or two with pneumonia, one or two with urinary tract infections, but most simply wanting worm medicine and vitamins. Every mother we saw claimed that her children all had diarrhea, but there was no way to know if that was true (it certainly could be), or if that was just what they figured was the key word to convince us to offer worm medicine. We broke for a box lunch, then started up again, and by the time we reached the end of the waiting line, we had seen around 30 patients. The dentists meanwhile had extracted many, many teeth. Juvencio didn't get to treat many patients on this first day, but the two U.S. dentists did allow him to work on one tooth that was so badly deteriorated that neither of them wanted to tackle it -- and he succeeded.

The next day, we took on another village, which had only recently emerged from three months of flooding (we had a relatively high annual flood this year, and the village was on very low-lying land). To get there, we waded through about a half-mile of sloppy black mud, causing us to be very grateful for the tall rubber boots that our Iquitos organizer had thoughtfully brought along. We again set up a rough clinic and the dental chairs, and saw about the same number of patients, with similar complaints; while Juvencio was occupied pulling five teeth from a single patient, plus of course many others from other patients.

The last day, we repeated the performance at an island village that actually had two hand operated water pumps, which was impressive. The "clinic" space there was shared with a shopping bag containing a gaggle of baby green parrots, which were inclined to hop out and try to join the proceedings, until a cute-as-a-button toddler dashed in and claimed them, bag and all.