Development Center for Children and Pregnant Women

We are in the process of starting a Development Center for Children and Pregnant Women here in town. It is a collaborative effort between the Centro de Salud, the municipality, the local school, and the community. Yoli (our one Registered Nurse) and I have been going neighborhood by neighborhood to do a community presentation and discussion. The communities are very excited about this project and many women have come forth to be volunteer health promoters at the Center. The goal of this project is to improve Maternal and Child health and specifically improve high rates of anemia due to low iron intake and parasitic infections. 

Holiday Traditions

Kittens and Coconuts

Charlie LOVES all animals! He'll approach cats and dogs... and turtles, chickens, etc to share a hug. He's was especially excited about this kitten who was having fun playing with him.

Visiting friends, they offered us a coconut. It had two glasses of milk inside, and Charlie drank every drop! He was thirsty after playing with his stick in the plants, and couldn't pass up this fresh cool drink!

This generous family also sent us home with their best sugarcane, which Charlie chewed to a pulp, and a clothes rack that Grodier (a carpenter) made. He is the neighborhood president and often offers coconut to dehydrated kids in town.

More fish please!

Are you serious dada? We finished that whole fish?!

Fish is Charlie's favorite food! Teeth and all.

Hugs!

Gramama and Granpapa

Charlie had a blast with his abuelos, hammering away with grampapa...

Posing for a pic with daddy and gramama...

Trying to sneak home in their suitcase, where he suspects 

there's an endless supply of double stuffed oreo cookies.

Thanks for the visit and for all the treats!

Christmas Pageant

The Christmas Pageant at the Parish! All 10 communities put together a skit to two local Christmas carols. This group (along with a couple others) has a young girl carrying a LIVE baby Jesus. The kids were so enthusiastic and put a ton of work into this evening. As one of the judges, I has a front row seat. While I wanted to help this young girl support the baby's head a little better, I left that up to the parents who partook in the skit. Happy Birthday Baby Jesus!

Tongue Growth

A 7 year old came in with this firm growth on her tongue, since birth. It's not painful but recently has gotten somewhat bigger. She also has a fullness under her left jaw since she was 3 months old. The mass is firm and looking close, clear fluid filled vesicles are evident. It seems to me to be lymphangioma circumscriptum, a cystic benign hamartoma of the lymphatic system. Any other ideas? We have worked with an amazing ENT from colorado who will be here in September and has agreed to remove it. Thank you Dr. King!

Brain Bleed

This 44 year old man came in to our hospital on Christmas day after falling backwards, hitting his head, and not waking up. He has a wonderful wife and five children, the younger of whom is 5 years old. He had pinpoint pupils, decreased reflexes, and only responded to strong sternal rub. He had course breath sounds and a fever. We evacuated him on a hydroplane with the diagnosis of brain trauma, skull fracture, and aspiration pneumonia. This is what we found on the CT scan hours after his arrival. That same night, the neurosurgeon on call put two bore holes in his occiput and drained the large white hemorrhage. He's recoveing well, talking, eating, and very stable. Thanks to all our staff and to Padres Jack and Moe for always going above and beyond to provide the best care for our patients! 

Guess the fruit

I was amazed to learn that this beautiful fruit growing an the bushes in front of the franciscan mission

is a cashew!! The nut is inside the green kidney looking structure on top, and the fruit is actually refreshing and juicy! One little cashew from each fruit helps me understand why they are so expensive!

Feliz navidad 2014

Charlie was unhappy and shaking with fear at this plastic Santa Clause! I don't blame him. We were at a Christmas party a few days before Christmas and he had the same terrified reaction to a santa pinyata that was pulled up and down as children swung at him. He's a bit sensitive past his 8pm bedtime. 

I'm 15 months old!

I'm working on my 7th tooth. I like to chew on my frozen teething ring for 2 minutes. Then I get bored and find other fun things to do, like play with spatulas and ladels or kick around the soccer ball.

Today I decided that my peaches and cheerios would taste much better if I were just half dressed. So I pulled my arm out of my shirt. To my surprise, they tasted just the same. Live and learn!

I LOVE to lay on the cool tile floor in the afternoon jungle heat. I stare for a while at the lightbulbs on the ceiling, then flip over and find tiny ants to squash with my extremely accurate pointer finger. I beat on my chest and pretend I'm a gorilla, or make elephant noises, or yell as loud as I can to remind mommy and daddy that I need all of their attention.

Charlie's favorites

We had six months back in Peru, this time with a baby. Before we left we wondered.. What will life be like with a baby in Peru? Family time might be nice... with our own house and our evenings together. I arrived in Santa Clotilde with few expectations. I decided not to not take call, and worked from 8-2. I went home to nurse charlie at 11 every day, and then took care of him and prepared dinner in the afternoons. At first, life felt like it had a good balance. The first time charlie met Zulma his nanny, at 6 months old, he gave her the biggest hug I've ever seen. She cared for charlie and played with him while we worked. We came home in the afternoons and to a perfectly clean, organized house, Charlie bathed and fed and rested and playing with her on the floor with a few toys, laughing and enjoying life. He was happy, stimulated, and ready to cuddle and nurse. I remember the first time he tried chapito- boiled and blended ripe plantain with a little milk... he was about 8 months. I gave him a little cup of it, and he chugged it down, and boy did he yell when I tried to take the cup away from him. He LOVED it! The only food that competes with chapito was Lily's aguaje curichis. This is a frozen popsicle of a local fruit aguaje, with milk and vanilla and sugar. He sucked the sweet treat down out of the bit off corner of the plastic bag and practically inhaled the whole thing, despite brain freeze and frostbit hands. Most of my memories revolve around Charlie learning to crawl and chew and cruise, and be amazed by the birds and jump up and down at the sight of the dog or latin music.

Work is a bit of a blur.  I do love work and the satisfaction that comes with seeing kids and adults alike return to health. And I love the intellectual stimulation that comes with complex presentations and being present for baby births. I love teaching on rounds, and learning from both patients and colleagues. I love to hear about natural remedies and local beliefs around the causes of different illnesses. The balancing act of life does not stop in Peru! Enjoy the journey!

-Antoinette

In the hospital now are 3 babies with pneumonia, a little boy who burnt his hand in hot oil, another who burnt 15% of his body with boiling water, a girl with a snake bite, another with cerebral malaria, a mom and baby we delivered by cesarean section (her third c-section). We have a woman with cognitive delays and severe anemia, one with pyelonephritis, and two patients with paralysis who have been living here because they have no place to go. My wish for this week to have a visit by a physical therapist who speaks spanish for a month or a few months. The need here is great!

Charlie is walking (with lots of support), crawling like a worm around the floor, jumping and patting his chest to the rhythm of music in his jolly jumper... or on our laps. He love to listen to music and has overcome his fear of the very loud blender. The wandering chickens, dogs, birds, occasional monkey, and tall trees blowing in the wind never cease to amaze him. He LOVES bath-time, like everyone here who's hot and sweaty. I fed him chicken liver for the first time, smashed up with boiled potato. There is not easy access to iron fortified foods here, so liver is one of the only options... He ate it. I tasted it... I taste all the food I feed him...  and did not like it. He loves mashed spaghetti, lentil soup, cream of broccoli soup, sweet potatoes, boiled plantains blended with milk, oatmeal drink, and carrots. This his is usual diet. He's growing like a weed. He smiles when he wakes, smacks his lips when he wants to eat, and laughs our loud at animal sounds. He has four teeth and has left bruises on my legs with them. Luckily I still have all my body parts... his teeth are as sharp as razors.

Pray for Margarita (a sick patient who passed this week) and here family.

Wish: allergy and lubricant eye drops, a physical therapist who speaks spanish

-Antoinette

The tightrope

26 June 2014

For most of the beginning of May, we’ve had over 20 patients hospitalized and a record number of emergencies and transfers to Iquitos. We’ve sent many patients home healthy, including a boy who got shot accidently in the side of his back/neck/face by an animal trap. All bullets are permanently embedded in his body, luckily having missed all vital organs. We also have watched many kids recover from asthma, pneumonia, diarrhea, tropical myositis, malaria, orbital cellulitis, and neonatal sepsis. Adults have stabilized with heart failure and heart attacks, liver failure, kidney stones and urine infections, dengue, HIV, and severe anemia. We have transferred patients to Iquitos with testicular cancer, stomach cancer in a pregnant women, tuberculosis coughing up lots of blood, a kid with bilateral arm fractures who fell from the top of a tree, a guy with a spinal cord injury and paralysis of his legs, and most recently, we sent a kid today by float plane to Iquitos who had sepsis, pneumonia, meningitis, osteomyolitis, and anemia. It’s 9pm and we’re waiting for two patients from 12 hours upriver, a young woman with severe anemia (a hematocrit of 3) with probably leukemia, and the other an older woman coughing up blood with probably tuberculosis. Brian and I have two young Peruvian doctors here working with us, doing their obligatory year of service. We’ve also had wonderful volunteers walk this journey with us. We’re tired, we give our all to Charlie and to our patients, and while it’s amazingly rewarding, we end up sitting at our dinner staring into space, being too caught up in the wave of patients to be able to even process the experience.  We do our best to support to each other, laugh together, ensure proper nutrition and attempt for good nights sleep.