arrived at Santa Clotilde

Thursday afternoon, August 16

We have been in Peru for more than a week now, and this is the first time I have fired up my laptop. It’s been really great, a little bit overwhelming at first, but amazing.

When we first arrived in Lima, Manuel picked us up and brought us to the patient home. It’s almost like a halfway house for patients who have come from Santa Clotilde for some type of treatment not available in Iquitos. Patients who do not have family in Lima with whom they can stay while they are receiving specialist treatment can stay in this patient home.

There was a woman named P___, who is being successfully treated for lymphoma. Toni was so happy to see P___ alive and well; she worried that this 32-year-old mother of four that she had seen earlier in the year would not be alive the next time Toni came to Peru.

There was a 15-month-old baby, who had been there for almost a year, waiting for some kind of treatment for his tricuspid valve problem. I don’t know why the whole process took so long; I’m sure they had to do lots of tests and maybe look for a blood donor and maybe wait for him to grow bigger, but it seems like such a long time, a year waiting for something to happen, living among strangers.

There was a man named R___ who has been at the patient house for several years. He had gotten drunk one night and fallen and broken his back, falling off a bridge. Apparently, he was not usually a big drinker, but this one night of celebration left him paralyzed. They are unable to take care of him in his village, where he needed a ladder to get to his house. He developed bedsores which did not respond to months of treatment, so he was brought to Lima for a skin flap which was successful. But now there’s nothing for him to go back to, he sits in the first floor of the patient house, talking to the other patients, reading on his phone, and helping us with the Internet passwords.

Toni said that at some point patients were given individual rooms, but they were so accustomed to living in close quarters with their large families that they all ended up coming together to sleep in the same room. They have installed bunk beds in the rooms so that patients can be together.

But then we left the patient house with the sad stories and took an Uber to a fancy restaurant called Huaca Pucllana that is built up around some ancient Incan ruins, 1500 years old. The ruins are literally steps away from the sesame-encrusted tuna and the malbec.

We flew to Iquitos the next day. Iquitos is the largest city in the world that cannot be accessed by road; you have to fly there or drive there. As a result, there are very few cars, but a crazy amount of moto-taxis, a sort of motorcycle rickshaw with three wheels that will take you anywhere for three Peruvian soles. We stayed a day and two nights in Iquitos, changing money, stocking up on groceries, visiting the Hospital Regional, and setting up an account at the Vicariate. The Vicariate is responsible for a number of health posts along the Napo River. Patients from Santa Clotilde who need specialist treatment in Iquitos may stay at the Vicariate if they have no family in Iquitos. Elita is the nurse that helps coordinate some of their care, and she introduced us to some of the patients who were boarding at the Vicariate. One 18-year-old woman had been raped by her schoolteacher and had given birth to twins, two months ago. She was still in Iquitos because of lack of family support and because of the need to do all of the paperwork related to the rape and the paternity test. There was a six year old girl who had broken her elbow a few months back and is being seen by the orthopedist. She had already been in Iquitos for a few days but had not yet been able to obtain an Xray. There was a 5 year old girl whose tiny belly was swollen with a massive liver, a woman with mental retardation who had been raped, and more. Elita is the person who takes care of coordinating all the details for these patients; she is bright, cheerful, organized, and energetic. We saw the Hospital Regional de Loreto and met more patients there.

We had a nice dinner with Leo, the engineer who has set up a telemedicine project along the Amazon, and also with William, 33-year-old doctor was trying to be a nephrologist but is going to work in Amazon for a bit. The telemedicine project is awesome; the reason that I have excellent WiFi here at the Centro de Salud Santa Clotilde is because of the telemedicine project. More importantly, the internet connection between the remote villages and Santa Clotilde, and between Santa Clotilde and the referral hospital, allows for real telemedicine communication. We had dinner in a café that had many paintings depicting ayahuasca visions. Iquitos styles itself as the gateway to the Amazon; many people come here seeking the healing powers of the hallucinogenic ayahuasca plant. The menu lets you know which of the selections were appropriate for an ayahuasca diet. Because ayahuasca induces vomiting and diarrhea, it is best to avoid things like sugar,fried food, salt, spices and sex prior to the spiritual ceremony.

Declan was very interested in the ayahuasca and the visions that it provided. He wrote about in his journal.

We rose at 5 am the next day to begin our journey to Santa Clotilde. All the boats leave early in the morning; there is no light on the Amazon at night; no one would pilot a boat on the Amazon at night except in a grave emergency. 45 minutes to the town of Indiana, then a 20-minute mototaxi ride to the town of Mazan, then another five hours upriver to Santa Clotilde. The boat ride was long, and boring; it made me think how far it was for people to have to travel to Iquitos for specialist treatment.

Everyone is so nice and kind here. Zenith has done a lot of work with domestic violence in in the outlying communities. She told me that although domestic violence is quite common, the perpetrators often have no consequents because the courts are all far away in Iquitos. Recently, with increased awareness about domestic violence, the communities have begun to mete out their own “community justice” by whipping the perpetrator with some kind of stinging nettles. The sentence must be agreed upon by the community elders, and it is the oldest man in the community who will do the whipping. The nettles are very itchy and painful and will provoke several hours of fever.

OK, I have many more things to write, but I will post this just to get things rolling.

xo
Juliet