The Unmentionable

There are common medical complaints in every society, and the Amazon basin is no exception. Most common here are headaches, backaches and parasites. Medical teams would be overwhelmed with these complaints without good triage. If everyone in a village of 400 people needed to see the doctor to be treated, it simply couldn’t be done in a day. Even with a three or four doctor team.

So triage might start like this: “How many of you have a headache, a backache or parasites? Oh good, that looks like most of you, and we have brought medicine for you. I want all of you who have a headache, a backache or parasites to come over to this side of the room. Thank you; you will get your medicine as quickly as our team can help you. Now, if you have another problem besides these, you can go back to the other group.” So this common complaint group, the majority, will queue up to be seen by the nurses and pharmacists to get appropriate medicine and teaching about preventive care. Those in the group with “other complaints” are screened, given numbers, and will see a doctor.

Doctors, working in makeshift treatment rooms, usually in the village school, get a variety of complaints, including whatever is “going around” the village right now. These are things people talk about, with just about anyone who will listen. But there are also unmentionables. Many of the men hang back and wait for others to clear out before coming in to be seen. Danze’s father was one of these. His complaint was vague: his son, back in the hut, hurt too much to walk; - for several days now. Dr. Andy Knaut, Emergency physician at Parker, Porter and Littleton hospitals, got this one. He made a “hut call.”

Danze’s condition was very painful, a condition peculiar to little boys who are not circumcised. (Parental Warning: skip the rest of this paragraph if you're concerned about graphic language) Over a period of about 5 days his foreskin had retracted and trapped the head of his penis, causing severe swelling, this making the foreskin even tighter; this self-perpetuating cycle had become so painful that Danze could not walk. So Danze’s father took Dr. Andy to his hut to examine the boy. Yes, the examination confirmed that he had developed a phymosis, a condition easily corrected when treated in its early stages, but which in this case had advanced to the point where standard treatment was ineffective; it could not be treated in the village. It would require an anesthetic and a procedure much like a circumcision. Without it Danze’s life would be severely changed.

Now there are many things that just aren’t available in such a village on the banks of the Amazon, including facilities for such treatment. But things are quite different from the days when Fernando and Ana Stahl started their clinic in Iquitos, and when the Haliwells plied the Amazon in their fleet of “Luziero” clinic boats. Communication has changed: cell phone service is available along the Amazon, which is the highway through the jungle, virtually the only transportation route. So Dr. Andy could call the folks at Clinica Ana Stahl to arrange treatment for Danze. At the end of the day, Danze’s father carried him to the medical team boat and they rode to the clinic with the whole team, glowing with a look of great appreciation and hope on their faces. They rode up the river to the dock across the street from the clinic, stepped across the plank to the shore, and climbed nearly a hundred steps up the bank of the great river, crossed the street to the clinic, while the team packed medicines for the next day in another village. Next day Danze was treated and released to return to his village, fortunate that this had been the day Porter’s Village Team had visited their village.

Who knew when the team made plans for this trip that Danze would need our presence so badly? Who knew when Dr. Andy Knaut signed up that we would need all his experience with tropical and emergency medicine? Who knows what gifts, knowledge or talents will be needed next year in Peru, or in a village in Africa or Nepal? Perhaps it will be yours.

Be Blessed and Be a Blessing,
From the Porter South Campus, in Peru,
Glenn