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Diarrheal
afflictions accounted for only 162 cases this year, down from over 200
in each of the previous years. I
believe this reflects rising conscientiousness in boiling or adding chlorine
to the river water prior to drinking it. There
are also a couple of towns along the river where community water tanks,
complete with chlorination, have been set up by visiting foreigners,
and these are a good project, I think. We have not seen cholera for several
years, nor have there been any outbreaks recently of typhoid, so maybe
we are making progress.

We
performed 39 dental extractions in 2007, and Juvencio received
additional training from visiting U.S. dentists, in the art of filling
dental cavities. He is still
in the training stages, so we are not offering this service on an official
basis, but he has filled several cavities for friends and family members,
which has been great. He
also accompanied a visiting dentist on a trip in June to visit several
communities, where dental hygiene teaching and toothbrushes were provided
to several hundred school children; and on his own initiative, made a
similar foray into a couple of local villages in September.
The
downer for the year was the clinic's vaccine refrigerator, which in April,
after years of faithful service, gave up the ghost. The vaccine refrigerator is a whole nother story,
which has already been told in part and will be recounted in more detail
later; but the bottom line is that we were able to vaccinate only 138
people last year, down by almost two thirds from the over 300 for whom
we provided this (free) service in 2006. The
good news, however, is that the fridge is once again running, and in
2008, we are gonna do better.

Finally,
the clinic has two programs aimed at children, one for treatment of the
all-too-common diarrheal and respiratory illnesses which ail them, and
one for preventive health care. In
the Diarrhea/Pneumonia program, we provide complete care for any child
with any diarrheal or respiratory illness, whether minor (such as a common
cold) or major (such as a life-threatening pneumonia or diarrhea with
dehydration) for S/ 2.0 (around $0.65 US), which is a very reasonable
cost even for Peru. Of course, we would (and do) take care
of these children anyway, whether or not their parents can pay, but offering
the low price service tends, I think, to encourage parents to bring their
children in BEFORE they are gravely ill. Over
300 children were brought for this service in 2007.
Then,
the Well Child Care program offers, gratis, a full exam (with the side
benefit of weight and height data for children of our area), dental fluoride
treatment, worm medicine, a toothbrush, and (as long as the tourists
have brought them) multivitamin supplements for a month. Parents
love the free medicines, and the 190 children who received them got a
little boost in their struggle with borderline malnutrition, as well
as encouragement to their parents to bring them in for vaccines, and
to boil or chlorinate drinking water.
The
remainder of the clinic's patients came for a variety of other illnesses,
and as always, many patients receive more than one diagnosis. We cannot save everyone, but we do try,
and of course many illnesses are minor or self-limited. And our Special Patients fund enables
us to offer care to patients whose needs are beyond our scope, such as
the young girl with juvenile rheumatoid arthritis, for whose specialty
care we are paying, and for whom we are providing the necessary medicines
to enable her to walk.
On
to the financial side of things
I
divide clinic expenses in Peru into several categories: Medicines and
medical supplies, Clinic operations, Salaries and benefits, the Special
Patients fund, and Bank fees. U.S.
expenses are likewise divided into Clinic expenses, Medical supplies
purchased in the U.S., my salary and benefits, and U.S. Operating expenses. Before we start in on that, however, I need to make a note
regarding money in general.
I
keep our records at the clinic in nuevos soles, the
Peruvian currency, but I translate all these expenditures into U.S. dollars,
which is of course also the currency used for our U.S. costs, and the
currency in which we receive most of our income. The
exchange rate is the rate at which I can purchase soles, using U.S. dollars. In the beginning of 2007, the exchange
rate was about 3.20 soles to
the dollar, dropping not long after to around 3.13 and remaining there
until about September. In
September, as the housing crisis hit the U.S. markets, the value of the
dollar plunged, down to 2.70 in October. By
the end of the year, it was about 2.95, but it has continued to slide,
down now to around 2.60.
 
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