Clinic Day in an Amazon River Village

View from village hall, now serving as a clinic for today. Typical thatched roof home across the village green in the background.

"Yesterday we went up the Amazon River to a village called Canaan. Going up the river means going south. Today we will be going north, or as they say 'down the river. ' It took us a 2 hour boat ride from Iquitos to Canaan. Once we arrived at the village we had to hike in a short distance. At Canaan we saw 201 patients. We have three doctors and seven nurses on our team. Many meds were given out to most patients, a lot of antibiotics and vitamins, shampoo, nail clippers, toys, and eye glasses.

I went in one of the homes. Pretty primitive to say the least. The cook stove was located on the side of the porch. It consisted of bricks stacked about 4 high on two sides. Then a couple of pieces of rebar laid across the bricks....not exactly temperature controlled. They hang their laundry on fences after they have washed them in a creek. They take a bath in the Amazon river which is the color of chocolate milk. Some of the kids had shoes, but most of them walk around bare footed.

We have a couple of translators with us. Hand gestures still work fairly well. The kids gather around in masses because we hand out toys. However, they will look at you and not take things until you nod your head. The temperature is sweltering to say the least. You all need to appreciate how good you have it!!! Have a great day, gotta go off to the jungle again today.

Sam & Carol Miller

Life on the River

A scene from the boat ride going up and down the streets of the Belen neighborhood in Iquitos; These houses appear to be floating on water, but are actually built on stilts 10-15 feet high. In low water season people use the lower level for outdoor living like a covered lanai.

"The humidity is very high here; about 15 seconds out of the hotel and your clothes are soaking wet. The rainy season has just ended here and a lot of huts that are normally on dry ground are floating on logs.We took a primitive boat ride on a river today, when I say primitive.... I mean a wood slat to sit on, and trust me is was not a very secure feeling. Of course, there was a bucket to bail out any water that we took on. Oh, and the motor was teeny tiny...I couldn't believe that these people think these boats are fabulous.

The food is very different. We only drink bottled water. We do not drink anything with ice because of contamination. They grow over 2,800 different types of potatoes here in Peru. Let's just say that we eat only at certain places that we are told the food is safe. I have washed my hands quite a bit more often here. A person can buy all types of food from street corner vendors. I would not advise eating any of it, due to the flies and other critters swarming all over it."

Sam & Carol Miller


In "low water season" the stilt houses look quite different as a previous Porter group tours the same street in Belen.

Getting Acquainted with Iquitos

Belen Market - Iquitos, Peru

"Flew from Denver to Atlanta and then Atlanta to Lima, Peru on Friday.
Sabbath we toured Lima and saw lots of sites, churches, and catacombs.
Late Sabbath afternoon we flew from Lima to Iquitos.

This morning some of us went to the Belen Market. The smell was terrible with all the dead fish, piranhas, dead gutted turtles, turtle eggs, monkeys, birds.....you name it....they sell it. The have over 8,000 people selling everything. One of the locals hired by Centura Health took us to the market, but because it is so dangerous, we had two police escorting us through the narrow isles...

Tomorrow I go with the Village Team. We have 2 doctors and several nurses on this excursion. We see patients with medical needs, give out vitamins, school supplies, nail clippers, flip flops, ink pens, and all sorts of fun stuff. You all need to realize how blessed you are to live in the USA. These people are so poor that, when a person dies, they sell all of their clothes and shoes to anyone willing to buy them. There are tons of orphaned children that sleep on the river banks."

Sam & Carol Miller

Yolanda’s Thanks

Yolanda

Yolanda is beaming! “Thank you very much” she says in very good English.

“Thanks to Him” she says pointing toward the sky with both hands “and to him,” pointing to eye surgeon Chris Allen, “and to him,” pointing to Dane, “and to all of you, I can see again!”
I complemented her on her fine English. The smile split her face even wider. “I am so grateful. This is too big for me. This is too big for me.” Yolanda can hardly take it in. Full of appreciation, she hugs Dr. Allen. She hugs Dane, then dances a couple steps with each of them. All this is happening in the morning clinic where all yesterday’s eye surgery patients return for a follow-up visit. They are getting their eye patches removed, to see for the first time the results of their operation.

I’m fascinated by Yolanda’s vision, both kinds. Her physical vision needed to be improved, and thanks to Centura Health’s Mission program, we were able to help with that. In her expression of thanks, she saw the obvious, the team that came from Colorado to restore eyesight. I wish she could have seen all of the folks at Porter that have helped support this mission. Some who donated various supplies for the trip. Some who adjusted work schedules to allow colleagues to travel to Peru. Some who have worked for years in Porter’s eye service, known for decades as the “best in the west,” known well enough to draw patients from a large surrounding area. Yolanda’s thanks is for all of you, too. You are part of the not-so-obvious, larger community of support that has restored her eyesight.

Yolanda’s spiritual vision was quite intact, in no need of improvement. Even without good eyesight, she saw well beyond the obvious. That’s one definition of faith: the ability, the willingness to see beyond the obvious. She hadn’t lost that at all. In acknowledging God and in saying “This is too big for me” she demonstrated both facets of the dimension of faith known in spiritual assessment as “A sense of the Holy.” One facet is having a place in one’s life space for someone who is greater, by whatever name one may have been taught or discovered through personal observation. The second facet is being comfortable in one’s own skin as a human being, or, as one historian observed about the great discovery of the founders of AA, the understanding that “I am not God.” “There is a Higher Power, and I am not it. There is something much bigger. I am a part of it and so are you.” Yolanda is thankful for all who are part of this “something bigger” that Porter understands as its reason for being.

Yolanda thanks you all.

Dane is another story. Actually, he’s part of the same story. If you’ve never seen a tall blonde teddy bear, meet Dane. Dane, joining the team from San Francisco, calls Diane ----- “Mom.” Diane is a Porter eye surgery circulating nurse. You may have seen Dane’s handiwork in San Francisco: he designs and tends flower gardens along the famous winding Lombard Street. Here he’s been helping patients wind their way through the preparation for surgery, literally leading the blind to a hopeful destiny.

“The gift of sight – what a gift!” Dane exclaims, describing his experience with a 40-year-old patient. “She hugged me! She hugged me on the way in, all the way to surgery. I have to be there to see her tomorrow in follow-up. Her whole family hugged me after surgery. I told her “I want to see you again tomorrow, when you’ll be able to see me better.” He did; she did; it was all smiles and more hugs all around.

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

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

The Color Purple

Everyone is in purple today. Purple robes with white sashes, purple ties with suitcoats, purple dresses, purple baloons. If it can be worn, someone is wearing it in purple today. And it seems all 3 million residents of Lima, the capital of Peru, are out here filling the squares and parading in the streets. The festival of the God of the Earthquake runs through October. Two of Peru's davastating historical earthquakes have happened in October. After one, a house with a particular representation of Christ, stood firm while the others around it crumbled. So that representation of Christ is now displayed as a thanks and a prayer for continuing safety from earthquakes. Families come out, grandfather and grandson alike arrayed in purple robes with white sashes; neighborhood groups come out; even pets are dressed in purple.


Feliz Sabado! It's Sabado/Sabbath in Latin America (Saturday in the US) and our day of recovery from a 20 hour air journey from Denver to Lima. So we take time to view the processions and visit the Cathedral of San Francisco.

Tonight we fly over the Andes mountains, down to Iquitos and our mission destination in the Amazon basin, Clinica Ana Stahl. Still shlepping our 49.5 pound equipment bags in addition to personal luggage, we are tired but full of anticipation for the opportunity ahead.

Blessings and Benvenidos from the Porter South Campus in Peru.

And the word of the day is...Adjustment

Oops! Rolando’s passport is missing; the trip leader can’t take the trip! He recruits Glenn to pinch hit as second team leader. Glenn no habla espanol; never been to Peru, either. Never been on any mission trip, actually. No problemo. The team is strong. Dr. Eric Bascunon, the other team leader, has lived, trained and worked in Peru; his family is in Lima. Centura’s mission support team has set things up well in advance.

If you get Jennifer McConnell, Porter Emergency Nurse, talking about adjustment, she will tell you something many people have spent a whole life learning: "I've discovered that life works much better since I realized that I'm not in charge here. God is in charge, so I'm much better off when I go along with the program, with what's actually happening, than if I try to be in charge."

On the airplane as the sun sets over the Gulf of Mexico, Dr. Bascunon expresses his concern about several patients he will follow up from prior procedures. Then Pedro gets his attention. “Pedro” is a representative of all the little boys who live in villages along the Amazon and Nampo Rivers. Pedro is bothered by parasites. We will be able to give him some medicine to kill the parasites, but what then? Pedro will, after we leave, drink again from the river. Pedro will eat with dirty hands and grungy fingernails. And he will have parasites again. Another organization will bring medicine, and another, but Pedro will have parasites again. He will almost always have either too much, or not enough medicine, because the medical visits are random. And Pedro will drink again from the river… Dr. Bascunon has a passion to make a difference for Pedro, to work with the government and other agencies to develop an effective public health program for Pedro’s village and the others along the river.

In fishing language, on this trip we will give Pedro a fish; thanks to Dr. Bascunon and his efforts with the Ministry of Health, we may soon help Pedro learn to fish.

Blessings from Porter’s South Campus, Iquitos, Peru,

Glenn