May 2011
STARTING OFF ON A YEAR OF “FIRSTS”
Our work in the jungle has yielded some exciting first-time events this year. The highlights:
January
Dental care in the jungle – For the first time in their lives, people in the villages received dental care. The NGO Kindness In Action from Canada accompanied us on this trip with 19 dentists, hygienists, and other volunteers. They came prepared with equipment and supplies, and ready to work. They treated approx 600 patients with not only extractions, but fillings and cleanings as well. A local man supplied the only generator for the electricity to do the work. The group set up in San Pedro and people from neighboring villages arrived continuously for 4 days for dental care.
In addition our 9-person medical group treated more than 400 patients, delivering care in different villages each day. Vera Martin MD returned for this trip with us, accompanied by her husband Ken Ault MD, representing Hope for Peru (USA). Through our friendship made working with the Haiti earthquake victims, Ann Griswold RN and Sharon Blackburn RN joined me on this trip, recruiting friends and family to volunteer as well – Tricia Russell RN, Chelsea McEvoy RN, Michelle Whalen. An additional volunteer, Anja Jokela from USA rounded out the group, fitting more than 150 pair of reading glasses.
Another first - the largest group of volunteers that we have had on any one trip – 32 in all.
A special note of thanks and acknowledgment: We encountered 2 terminally ill patients, each presenting a difficult set of circumstances. Vera Martin, along with 2 nurses, Ann and Sharon, went to the hut of one man, Juan, in the end stages of dying, carefully cleaning and dressing the wounds on more than 70% of his body, leaving him most of the pain medicine we had with us. For these 3 women to do this was a true act of compassion and I must acknowledge it here, as it was a sad situation beyond imagination.
Due to the lowest water level in the rivers in 50 years, we could not reach the other man easily in our boat. In a pouring rainstorm, the family of Sr. Sanchez was so driven to have us help their father, that they waded deep into the river and pulled our boat to shore, assisting Drs. Vera and Ken to shore, where they walked through the jungle to reach his hut. He was terminal with cancer, and they left the last of the pain medicine with the family.
During our clinic work, we found one women in need of immediate evaluation. Tanya, a lovely young woman, had a growing breast tumor, so we took her to Iquitos with us and paid for her to see the physician at Ana Stahl Clinic, with mammogram, sonogram and blood tests.
April
Women’s Project – For the first time in their lives, women in the villages received pap smears and breast exams. With our first “all-women” volunteer trip (Renzo good naturedly permitted us to call it that), we provided an educational forum every morning for the women in different villages. Each day provided a challenge and need for extra time to provide proper set-up of exam rooms for privacy in an open village. There was also the concern about whether the women would consent to these exams. We invited a local obstetriz Silvia (Nurse Midwife – 5 years at university) to accompany us from the government clinic in Mazan. She very ably guided us through the understanding of proper paperwork needed for the government. In essence what we were providing with this project was going “to” the women, performing the exam, obtaining specimens, doing paperwork, then allowing government clinic to process specimens and record results of exams in their records in Mazan. This not only helps with sustainability of program, it assures that the government will pay if there is further follow-up needed on positive tests. Because of this, we could only do pap smears on women who were signed up on SIS, the government insurance for the poor. Surprising to all of us, most of the women were signed up, and in all, we collected 27 specimens, some women opting not to have test done, but did agree to breast exam.
Our follow-up with the women will be on our July trip when we return to the clinic in Mazan and then to jungle. In theory the results of the tests should be completed in Iquitos in 30 days. However actual practice may be something else. So part of this project is to determine how testing and communication flows, and what can really be expected in the government system of healthcare.
OB/GYN physician Gretchen Bruno did our teaching, with Renzo as interpreter, and was our lead doctor for the women’s exams. Good friend and medical faculty in Family Medicine, Katie Seitz once again joined us on a trip, bringing 2 residents, Annie Navarro and Neha Shah. Katie took the lead on the medical clinics occurring simultaneously with women’s clinics. More than 100 medical patients were seen. Silvia brought birth control pills and injections, as well as educational materials, and did amazing job at teaching the women the options for family planning.
Another first, and certainly fun for me, was to have 4 women friends from Lima join this trip: Yvonne Galloway (who was key organizer in Halloween fundraiser), Kim Allen-Jones, Heide Shanda, and Pat Adamson. Again Anja Jokela joined our group, after helping me in Lima with the planning and researching for this complicated trip. Lucy Guile, an anthropologist from Cambridge University in England also accompanied us. Every single woman worked long and hard during particularly hot weather, keeping their good humor, and I thank them all.
Amazingly following on the extreme low water in January, April had the highest water since 1999. I personally had never seen it that high and many villages had no dry land. Each hut had water below it and people moved around in canoes.
Follow-up on patients from January:
Juan died a few days after we left in January, leaving behind a pregnant wife with 3 children. We stopped in to visit her, and she had just delivered her 4th baby 3 days earlier. Both she and the baby were listless, and examined carefully by the doctor. We will continue to check on this family.
The son of Sr. Sanchez took Katie and me in a peque-peque boat to visit his hut. He was alert, but much compromised by tumor growth (he had already had several operations and was considered terminal). We left more medicine.
Tanya was diagnosed with cancer of breast by biopsy. In order to receive treatment, she needed referral from local clinic. For some unknown reason the tecnico would not give her one, even with results in her hand. So together we all visited tecnico and Silvia stood over him until he wrote one out. So now Tanya has referral into Iquitos to see oncologist.
I also left written information with the tecnico on other patients we had seen who might need referrals to try to prevent this sad situation from happening again.
How we are guided – one more story to tell:
On the afternoon of the third day, we had time to go check on patient in another village. I asked Ricardo, the guide to take us there. Apparently he forgot or didn’t hear, but I realized that we were returning to the lodge instead. I asked that the boat be slowed so I could think about what to do as we were now too far away to go to village intended. For some reason, I said let’s go to Llachapa. So the boat was turned around and we were on our way. As we pulled up on riverbank, no sooner had we reached the top of the hill, than came running a mother with her toddler, Zoila, who had been burned badly by water from a cooking fire. Katie and others dressed the wounds (about 30% arms, trunk and legs), and Renzo and I contacted Explorama Lodges to ask permission to use their fast boat to take child to Iquitos. Within an hour, Katie, Renzo, mother and baby were on their way in the near dark to Iquitos in an Explorama boat. They went straight to Hospital Regional in Iquitos and the child was debrided and dressed in ER (not a pleasant experience according to Katie and Renzo), but then sent to burn unit where proper standards and caring appeared to be in place. The next day some of our group went to Llachapa and gave the father some money to get to Iquitos to be with his family. When we visited Iquitos later in week, we found the child doing OK and anticipating a 15 day stay in burn unit. This was daughter of Gumercindo, one of our most progressive health promoters, so we will be certainly following up with this family.
The child had not yet been burned when we turned our boat around to go to Llachapa.
At this point I must give proper thanks to Pam Bucor at Explorama Lodges, and the entire staff at ExplorNapo Lodge, who not only helped with this event, but has on numerous occasions assisted with our requests and needs. I appreciate their friendship and knowing that our volunteers are safely cared for with their help available.
Publicity
In January, Living in Peru.com listed DB Peru as one of 5 charities to support, and we are now listed as a recommended organization for volunteers in the new South American Explorer’s Club guide.
Sewing Program
The sewing program in Orellana is in full swing, but we have yet to visit it this year, due to low and high waters. However the program director accepted our donation of fabrics and supplies in April and we hope nothing will deter us from our visit there in July. This program has been given high merit from the Minister of Education with DB Peru being recognized as a key participant.
Scholarship Program
Our first student, Lindaura graduated in December and is finishing her practicals to be licensed as a tecnica in October. Liz and Madila are in their last semester, and Ober and Rick are in 5th semester. All are doing well and each one expresses how pleased they are with choice to be in a healthcare career. Our two candidates entering last year both went to work at the gas company south of Lima. We will wait to start other students as funding is available. The director at the school Reyes de las Americas offers a matching scholarship for each student we pay for, so starting 2 students together is ideal.
JULY Jungle trip
Third Annual Health Fair and Soccer Tournament
With participation of medical students from U. of Colorado and Drexel U.
NGO CONAPAC
Municipality of Mazan, Mayor Dr. Edward Reategui
Centro de Salud, Mazan
Volunteers from USA and New Zealand, and Scholarship students
Midwife Class – 2 days
Follow-up on Women’s Project and patients of concern
On behalf of the people of the villages, a huge thank you to all our donors and volunteers.
WE COULD NOT DO IT WITHOUT YOUR SUPPORT!
Diana Bowie, President / Renzo Pena, Vice President
www.dbperuong.com
