sunset on the rio orosa. view from our boat. lovely.
overall, i am so glad i had the experience to visit peru. my group went to the northern part of peru, started out in the city of iquitos, and then sailed along the amazon and some of its rivers and visited a bunch of different small villages. we all worked so hard, seeing hundreds of patients and then trying to figure out transportation for a select few who needed extra help.
some general observations:
- kids in the amazon get viral colds just like kids in the usa. and their mamas all want antibiotics, just like mamas in the usa. and we educated a ton about viruses vs. bacteria. some people got it. most didn't.
- the most common adult complaint was "mareos y dolor in me cabesa". dizziness and headache. you see, we had ibuprofen and paracetamol for aches and pains. drugs that we can buy OTC very easily here. but in the jungle, they were some powerful drugs, and people would lie to try and get the drugs. to them, dizziness and headache was their way of trying to get pain meds, when really they were just dehydrated. and then they'd laugh at us when we told them to drink more water. we would even have a liter-sized bottle of water on the table and say "drink at least this much everyday". most couldn't fathom drinking HALF of that in a day! they would say "i'm not a frog!" honestly, if people would just come and say "i get headache sometimes, and backache, etc, and i just need some pills to get through it", i would give them medicine in a heartbeat. but as it was, a lot of people just lied, couldn't answer questions like "when does it get better" (yes), or "when did it start" (it started when i was born), etc. so if you lied, well, how can i help you? if you are blatantly telling your child what to say to "score some drugs", how can i trust you? and yes, i may be using a translator, but i understand spanish well enough to know that you are feeding words, ha. i'm not that stupid. plus you don't want to just give people drugs willy nilly, because that leads to my next point...
- a lot of people had NO IDEA how medicines should be used. a lot of folks relied heavily on herbal medicines, which are fine. but when they had a stash of ibuprofen, they would use it for ANY kind of ache or pain. we had several children that reported months of stomach pain. so the parents thought was "my child has stomach pain, let me give them adult strength ibuprofen to relieve pain". very bad idea. so we did a lot of educating. (then come to find out, a lot of church groups go to the area to mission-ize, which is ok i guess, but then they would just shower people with meds to get them to come to the sermons. well, thank you for dispensing medicine without sound medical advice because now you've enabled these people to give their children stomach ulcers. extreme example, but it's true. thank goodness we didn't see any kids actively vomiting blood or peritonitic.)
- lots of babies, lots of pregnant women. i loved how the women were not shy about breastfeeding in public. baby is crying, pop out that breast and voila! happy baby. not that i would advocate the same amount of "exposure" in the usa, but wouldn't it be nice that mothers could breastfeed in public and people wouldn't gawk or stare or say mean things?
- the river is everything. people bathe, wash clothes, drink water, clean meat, poop, pee, etc, all in the same place. very little awareness of latrines, or "go downriver for pooping", etc. no wonder everyone had "bichos" or worms in their poop. we saw many huge-bellied children full of worms. lucky for them, everyone got a mebendazole tablet at clinic check in to at least reduce their parasite loads.
- i am amazed at the number of people who initially would say "i have a headache and dizziness" to try and score some pain meds, and then would turn out to have a nasty STD or UTI, or maybe a huge abscess, or some other major problem. why didn't you tell us about your vaginal discharge x 3 months? or about your chronically infected leg wound? aaaah!
- but even with the craziness, overall i think we helped a lot of people who truly needed it. for every 4-5 people complaining of HA secondary to dehydration, we helped 1 person who really needed to get their ear infection cleared. or their UTI fixed. or anti-inflammatory meds to relieve them of their chronic arthritis pain. etc etc. such is the nature of these things. and then everyone got medicine for worms. good stuff.