Vaccine campaign

Our vacccine boat and home for 11 days
Dry river bed as we walk an hour to the community of Puccabaranca
In mid September I went on a campaƱa or vaccine campaign in the middle Napo River we went to 16 communities in 11 days and I saw over 300 people. We vaccinated around 250 kids and attended around 100 OB visits.  I was able to learn a little bit more about the people and their situation/life on the river. First thing that I learned is that life is tough! They work hard to produce the little food they have, often working on their chakras or farms, which are actually about 30-60 minute walk from their houses. These walks are in the mid day sweltering heat and often away from running water. They then use their machete hunched over to cultivate and clear land, then carry their food for an hour to arrive home. It became very clear to me why over half of my patients came in with headache, dizziness and back pain. Often they eat only twice a day and only drink 3-4 glass of liquids a day.
I also learned that the level of the river makes a HUGE difference in their lives. When the river is high, usually from Nov-Dec until May you can take the big boats, commercial rapidos and lanchas right up to the ports in almost every town. However, when the river is low it creates a dessert like setting in the riverbed as the water level goes down about 30-40 feet, and you may have to walk over an hour to reach the main river (see photo). I also learned that nature has changed the course of the river naturally. Our driver, Hernan who is in his 60s remembers when areas of the river ran a completely different course often passing between certain communities and was used on prior trade routes. Now all that runs in these areas is a small creek as the ebb and flow of the river during the rainy and dry season have changed the Napo’s course. I cannot explain in words nor photos the impressive changes in the river depths between the two seasons. I have included a picture as an example where you can see one community in the distance and us walking to provide care. We are walking on an area that will be about 30 feet below the surface of the river come January. This particular community is “close to Santa Clotilde” compared to several other communities.    
Close is a relative term as I want to give an example of their life; let’s say you have a 4 month child who has a cough and fever. To get to Santa Clotilde you need to walk an hour in the heat to a canoe on the river (if you own one) then if you have a small outboard motor called a peque you can drive up to Santa Clotilde for about 5-6 hours to get care. This will cost about 2 galloons of gas, which is around 20 soles ($8.00), most people do not have 8 dollars. If you have no motor you are rowing, likely with your 4 month baby in your lap against the current of the river for a full day. When you arrive in Santa you have to pay 3 soles for a consult and the doc might just say it is a common cold, here is some Tylenol. This occurs on a daily basis when patients arrive. They are happy to have the opportunity to have access to healthcare, but at the same time often wait until children or family are gravely ill due to the efforts to reach Santa Clotilde. Think of this next time you wonder if there is access to healthcare for all in the U.S. Also is access to healthcare a right????? I think it is an innate human right to have access to care and treatment, not just for those with money or insurance.

Brian Medernach
09 October 2012

Fresh Fish

Local fisherman bring us lunch!

RJ sells bracelets

One of our patients with paraplegia and a chronic ulcer has been in the hospital for over a year. He makes beautiful bracelets to try to generate a bit of income to buy daily necessities like soap and toothpaste. His mom is also creative and makes very nice comfortable hammocks out of plastic bags!

Another Classic Ulcer

Cutaneous Leishmaniasis
Can you find the amastagote?