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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.

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