DB Peru

June 2007

This trip was impacted by the events of occurring in a Third World country as much as any other I have taken.  And as such, it provided much frustration.  I do feel the documentation is important as it continues to give a picture of life that affects not only the people trying to improve conditions, but also shows how people living in these situations become conditioned to react in certain ways, which many times are foreign to us who have lived in the Western culture.

From our March trip, we had learned that there were 12 people in the villages we visit who have cataracts.  We contacted an eye surgeon in Iquitos, Dr. Maruja Limachi, who will do the surgeries for free, except for the cost of the eye drops.  So after contacting her about her schedule, we planned our trip for early June to try to make these surgeries happen.  She would no longer be available after the end of June, and her replacement was not named.

However right before we bought out airline tickets, we found that Iquitos was planning a 3-day strike for June 4, 5, and 6.  I knew from my previous experience several years ago that this is not where you want to be during a strike.  The streets are strewn with broken glass, debris and whatever, including kitchen sinks, to prevent vehicles from passing.  Angry people roam the streets to make sure no businesses remain open.  The airport closes and basically, people stay put.  In my case, on the first day of that strike, I remember running down the sidewalk with my bags, trying to catch the last bus to the airport.  The driver had said he would wait while I went for my things, but of course everyone else on the bus wanted to get going.  So I ran, caught it at the last moment, as we drove through and around glass and tires and people shaking their fists.  Thankfully I got on the last plane out.

As it turned out, this strike was the worst in 16 years – no one left their house, according to my friend Raul Pettit, who lives there.  The matter at hand is a chunk of land between Ecuador and Peru.  It belongs to Peru at the present, but Ecuador wants it back.  The only people affected would be the natives who live in that part of the jungle, hence the anger from this region of Peru.  And I expect that if I had to change my nationality due to what must seem like a whim or political ploy, I might be angry too.

Anyway, we did not get tickets to go to Iquitos during that time.  But then air fares skyrocketed due to everyone waiting to travel and we actually didn’t get to Iquitos until June 13.  Due to the delay, our window of opportunity with the eye surgeon changed.  After several meetings with her, she finally said that she could help us on June 26, but not before – almost 2 weeks away. 

Meanwhile, while walking the streets and boardwalks in Iquitos, we saw teachers on strike.  I really was not clear about the reason, except they never completely got the raise they were promised with the previous election.  They were camped out on sidewalks, but seemed quite peaceful, just making a statement.  We didn’t have to worry about our downtime very long since we were told they were planning another 3-day strike for June 18.  At this point we decided to go to the jungle during that time and hopefully miss it.  We left on our boat June 17.

Accompanying us on this trip was Donna Tish, from Washington DC, who is spending a year in Lima.  Donna was delightful and did an excellent job of documenting the trip in photos, as well as helping with different jobs.  She gave us medical instruments donated by a friend. 

We visited 12 villages, talking to all the people with cataracts and making sure that they would agree to go to Iquitos for an eye evaluation, with the possibility of eye surgery.  An evaluation of each person was the first step, as they might not all be candidates for surgery.  The doctor had cautioned us saying that usually people in the jungle would find reasons not to go (like they needed to take care of their animals) and we would be lucky if half of them wanted surgery.  But in our case, every single person (11 of them) was anxious to be evaluated.   So we set up the date of June 24 to return in our boat to pick them up.  Thankfully every person had relatives or friends in Iquitos where they could stay – no out of pocket money from us for their food or lodging.      

We delivered 500 doses of anti-parasite (worm) medicine for all the children.  That seemed to tremendously please everyone, and the adults of course asked for it too.  So next time we will be sure to include enough doses for everyone, children and adults alike.  Children seem to be more at risk for worms as they are playing in dirt and with animals and are swimming in the river for fun.

We have received another grant from Miracles In Action for a midwife program so we were able to communicate to all the villages that the course would be in September.  Nurse midwife Jessica Portocarrero from Mazan has agreed to teach the class.  The villages without midwives promised to identify people who could be trained.  Several promotores indicated that they would like to be trained as midwives.  I had not heard of this before and was quite pleased that the men would see their lay health care role to include this.  They seem to taking their education quite seriously. 

We are going to try something different this time and hold the classes in the jungle village of San Alejandro.  The local women will cook and the men will erect a structure where the midwives can sleep.  The class itself will be in the school house.  I do believe that everyone looked relieved to be able to attend these classes where they are in their own environment, and certainly closer to where they live.

Two days after we arrived back to Iquitos from the jungle, we found out that the Minister of Health in the entire country of Peru had gone on an indefinite strike.  This was involving the two types of workers:  Those without contracts who worked directly for the Minister of Health and receive very low pay, and those with renewing one-year contracts who receive no benefits.  No one appeared to be happy with either situation. 

But our immediate problem was that there were 11 people expecting us to pick them up in 2 days from their villages for their eye evaluations.  We were unable to contact the eye surgeon, so we had to make a decision – and it was to cancel the pickups.  We went to a local business that had a radio and tried to reach the villages.  This was not successful as the villages only man the radios during certain hours to receive calls.  So we called the only working phone in the area and asked a man to take his personal gas and boat and make the trip around the Napo River to tell the people that we were not coming.  He didn’t hesitate and said he would do it immediately.  Then we sent gasoline back to him on a big slow river boat that would arrive days later.  Phew!

And on that next Monday when we reached the eye doctor, she did confirm that she would not have been able to do the evaluations.

The health care strike affected us in other ways as well.  With the intention of buying medicine from the Minister of Health, we had received our medicine price list from them the week earlier.  But now we could not deliver our formal letter of intention to purchase, as the sign on the office said “Closed indefinitely”.   In the future, we will probably buy at least some of our medicines from them because, for example, 100 tablets of Doxycycline (an antibiotic) is about $2.  And their list contained many things we have been using. 

Thankfully we had made our medical supply donation to the Hospital Apoyo before the strike.  

We also were not able to take baby Roldan and his mother back to Iquitos for another cardiac evaluation during our pick up trip.  As a follow-up note, when we arrived to the Centro Unido village where they live, the mother was waiting with Roldan, his hair combed neatly.  Roldan looked or acted no different than a few months ago, but apparently still not eating much and is still being carried around.  But at a year and 8 months, this child is not progressing normally, and probably losing ground.  We also sadly found out that during the mother’s stay with relatives in Iquitos in March, they had no money to feed her and she was barely eating once a day.  We must remember not to make any assumptions in the future.    

The promotores told me that in many villages there has been an increase in malaria, but they had no slides to do the blood smears.  So we made a short stop at the puesta (small clinic) in Mangua and were given slides and lancets, and we delivered these back to one of the villages.  On the next trip we will take a big supply to everyone since the technique of making blood smears on slides was taught in our classes and can save time in the treatment of malaria.

We met with Nila Flores, the teacher of the sewing classes in Orellana.  The grant was approved by Miracles In Action to buy 2 sewing machines so they will be delivered on our Sept. trip.  She has 20 students, far more than we realized, so we may be working with others on how to further augment the program and help these young women provide clothing for their families and support themselves.

Intermingled with the strikes in Iquitos were the celebrations of festival occurring the third week in June. Some businesses were closed, and due to the popularity of our usual hotel, it was completely booked.  Not only were we were scrambling to find a place to stay, causing us to move to 3 different hotels that week, we missed seeing some contacts.

We did see Monty Eggett again, President of the Hope Alliance charity, who was in Iquitos working on a micro loan project of theirs.  We regrettably had to decline their offer of sending a medical student to accompany us.  Until the strike is over, there is no use planning a trip that may not happen.  

But due to Monty’s sharing the information about DB Peru with another man, we may have had the best news of the entire trip.  A man named Greg Hodgson met me in the lobby of the hotel about an hour before we were due to leave.  He introduced himself as from a health system in Colorado called Centura.  He went on to say that they are interested in doing work on the Napo River, and was wondering how we might work together.  He also said they bring surgeons to a private clinic in Iquitos to do free surgeries and this can be made available to us.  After a trip filled with disappointments, this seemed like a great note to leave on.

For those who are interested in what we are doing to preserve traditional healing methods, we did meet with a local shaman.  I took voluminous notes about which available herbs and plants are effective for which problems.  We wouldn’t actually be teaching anything like this since you definitely need to know what you are talking about – you don’t want to overdose and you don’t want to use something ineffective.  But he did agree to come to the villages to teach.  We will only be considering this, as his tribal ways are not necessarily those adhered to by the villagers where we go.   And the health promotores are geared toward using Western methods of healing.  But since many of our medicines are derived from these same herbs and plants grown in this area, it bears considering.  I am sure an anthropologist would be most helpful.

I want to thank la Doctora Linnea Smith for patiently answering my all medical questions, which I tend to spring on her unexpectedly.  Her clinic is on the Amazon River, about 2-3 hours downriver from Iquitos in a fast boat.  She has been a good friend, and we try to stop for short visits when we pass her clinic on our way to the Napo River.  As a correction to my last letter, Linnea reminded me that cataracts are not caused by the sunlight.  But the sun can contribute to pterygia, an overgrowth of conjunctiva that can cause blindness by burying the pupil.  So those sunglasses are a good idea.

Diana Bowie – President

Renzo Peña – Vice President