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Late April 2013

If you live in the Northern hemisphere, and if Spring is actually arriving in your neighborhood, Spring greetings to you; otherwise, just plain greetings to everyone --

We have once again completed a year, and in fact are well into the next one. I don't know why I should be surprised by this, since it happens so frequently, but the years do seem to roll by with increasing rapidity. The "new" clinic is now five years old!
It is thus time to account to you, all our Clinica Yanamono/Amazon Medical Project supporters, for what we did in the year past.
In 2013, we cared for a total of 2815 patients, about 200 more than the year before -- probably because we did not have to close during the annual flood (which as you may recall set a new all-time record high water level in 2012). The water still reached far higher than normal flood levels, and our patient census drops when the clinic is standing in water (people's homes are also in water, meaning that, if there is but one dugout canoe, and someone takes it to the fields where they are growing their crops, there is no way to get to the clinic until the worker returns home), but at least we were able to remain open throughout the year.
We supplied family planning to 276 people, all but a handful of them women (a few men requested condoms, but they were a very small minority); and vaccinated nearly 600 persons, against the usual culprits -- tetanus (a common and deadly disease, easily preventable by immunization), measles/mumps/rubella, pneumococcus, yellow fever, Hepatitis B, polio, rotavirus (which causes diarrhea), and influenza.

We treated 60 people for malaria, more than in recent years, probably due to the high water level. One can only surmise that the snakes are being driven back into the forest by the slowly but steadily growing human presence in the area, since we saw only two poisonous snakebites all year, one to an 11 year old girl who stepped on the serpent, the other to a 24 year old man who found a viper awaiting him inside his bed. Both patients recovered, but I would not be surprised if the young man now has insomnia.
Respiratory and diarrheal illnesses continue to be a mainstay of our practice -- nearly one out of every ten of our patients suffers from diarrhea. Fortunately, most cases are treatable, and awareness of the importance of clean drinking water is slowly growing. We also took care of about 30 patients with pneumonia, all of whom survived (without treatment, the fatality rate for small children is horrifying), and 119 patients with reactive airways disease -- wheezing due to closure of the small airways in the lungs (and many of these probably also have had pneumonia).

Skin problems are always a common complaint, and this year was no exception, with 164 patients in this category. Ailments are mostly fungal infections (athlete's foot, ringworm, etc.), scabies (miserably common among the very young), impetigo, allergic reactions, occasional cases of chicken pox or herpes zoster (shingles), and one case of alopecia areata, the loss of hair in coin-sized areas on the scalp. This usually heals eventually by itself, but no one knows what causes it and although it is not deadly, the cosmetic effect is discouraging to the person who has it.

Juvencio performed 25 dental extractions, and thanks to a rotating cast of visiting dentists, his skills have expanded to enable him to fill some cavities, and even to sometimes repair a chipped tooth.
Trauma cases included the customary complement of machete and chain saw cuts, burns (due to cooking fires or kerosene lanterns), sports injuries, and pokings by sticks or nails, which not only cause wounds but also pose the risk of tetanus. An older woman from the Yagua village came in after being struck in the head, but she was not really seriously injured, just seriously frightened -- she and her husband had been passengers on a launch that burst spectacularly into flame while floating downriver. They like most of the other passengers escaped basically unharmed, but were pretty shaken by the experience. Several people, both locals and tourists, fell and sustained contusions and/or abrasions, while one little guy who lives in the Yagua village and seems very prone to all sorts of illnesses managed to get himself stung multiple times in the face by bees or wasps. His face swelled up but his breathing passages did not, and he did fine with antihistamines. And the eight year old boy whom we saw in late 2012 with a finger laceration came back having succeeded in crushing and partially amputating the same finger. This time, we had to complete the amputation, rather than just sew up the cut.


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