tag:blogger.com,1999:blog-47489977946561297662024-03-05T16:14:13.684-08:00Santa Clotilde Mission, PeruFollow their journey to providing health care to those in most need! Unknownnoreply@blogger.comBlogger131125tag:blogger.com,1999:blog-4748997794656129766.post-57668895757399642282023-04-24T09:13:00.000-07:002023-04-24T09:13:00.040-07:00Development Center for Children and Pregnant Women<br />
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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. <br />
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-91267894473398742112023-04-24T09:11:00.000-07:002023-04-24T09:11:01.535-07:00Holiday Traditions<div class="separator" style="clear: both; text-align: center;">
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-50461111867529698492015-02-26T18:55:00.001-08:002015-02-26T19:19:55.221-08:00Kittens and Coconuts<div class="separator" style="clear: both; text-align: center;">
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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.</div>
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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!</div>
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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.</div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-61174812995561556142015-02-26T14:55:00.001-08:002015-02-26T14:55:12.329-08:00More fish please!<div class="separator" style="clear: both; text-align: center;">
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Are you serious dada? We finished that whole fish?!</div>
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Fish is Charlie's favorite food! Teeth and all.</div>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-48598698296460734252015-02-25T19:37:00.003-08:002015-02-25T19:37:41.258-08:00Hugs!<div class="separator" style="clear: both; text-align: center;">
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-60256218712436739932015-02-25T19:35:00.002-08:002015-02-25T19:35:37.297-08:00Gramama and Granpapa<div class="separator" style="clear: both; text-align: center;">
Charlie had a blast with his abuelos, hammering away with grampapa...</div>
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Posing for a pic with daddy and gramama...</div>
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Trying to sneak home in their suitcase, where he suspects </div>
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there's an endless supply of double stuffed oreo cookies.</div>
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Thanks for the visit and for all the treats!</div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-86058339837245924752014-12-31T20:27:00.001-08:002014-12-31T20:27:43.825-08:00Christmas Pageant<div class="separator" style="clear: both; text-align: center;">
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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!</div>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-74693926602395174362014-12-31T20:23:00.000-08:002014-12-31T20:23:17.001-08:00Tongue Growth<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjw3eDRCxwLHR8C1sqNUa_aMnNYK_CN562vxL5bteBBgMJHl0KUavMGU0WN2Kbb30Bwb3OOVawcuFhSxGb-G01vAri06cxg78_TFU2cYLrEn1E-sYvrbxPNwOUWY5o3uJDij4L_UIeMA0/s1600/IMG_7689.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjw3eDRCxwLHR8C1sqNUa_aMnNYK_CN562vxL5bteBBgMJHl0KUavMGU0WN2Kbb30Bwb3OOVawcuFhSxGb-G01vAri06cxg78_TFU2cYLrEn1E-sYvrbxPNwOUWY5o3uJDij4L_UIeMA0/s1600/IMG_7689.JPG" height="300" width="400" /></a></div>
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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!</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-51086298052403390552014-12-31T20:12:00.003-08:002014-12-31T20:12:41.587-08:00Brain Bleed<div class="separator" style="clear: both; text-align: center;">
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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! </div>
<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-22730769187277683742014-12-31T20:02:00.002-08:002014-12-31T20:02:35.622-08:00Guess the fruit<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtNJippsdnYyD0JRdIiCcL_33SMqK3UazZj72g7VhY7WujJQAMDhRMp1B-K_esqFLq_UR-7I_MiWhN8EjYAyZJRApJr4ouH26qYT9RoOrFRRZVrK3qUErkqr6-61_PpPhDzDHM3glEobk/s1600/IMG_7660.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtNJippsdnYyD0JRdIiCcL_33SMqK3UazZj72g7VhY7WujJQAMDhRMp1B-K_esqFLq_UR-7I_MiWhN8EjYAyZJRApJr4ouH26qYT9RoOrFRRZVrK3qUErkqr6-61_PpPhDzDHM3glEobk/s1600/IMG_7660.JPG" height="327" width="400" /></a></div>
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I was amazed to learn that this beautiful fruit growing an the bushes in front of the franciscan mission</div>
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!Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-53697183231882106142014-12-31T19:58:00.003-08:002014-12-31T19:58:54.090-08:00Feliz navidad 2014<div class="separator" style="clear: both; text-align: center;">
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. </div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXjIX2wUFX_1HOQybaxm7VY50xGy-mdfi4wZma_nQdWFTXTG5K-P9TH19c2MhC4kiMjTlQpo85X1q6x3zW4Q6kUobN8a0ru62vE_dFekvyTF6qFL20JRTpJQBUcg3e-bXAAby2glnC_Jo/s1600/IMG_7611.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiXjIX2wUFX_1HOQybaxm7VY50xGy-mdfi4wZma_nQdWFTXTG5K-P9TH19c2MhC4kiMjTlQpo85X1q6x3zW4Q6kUobN8a0ru62vE_dFekvyTF6qFL20JRTpJQBUcg3e-bXAAby2glnC_Jo/s1600/IMG_7611.JPG" height="266" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPX0Jug3VHKLUvt_j6INW9uJEs6E3r6bGChQGbYGcHo8nVZJwAWv8xRQaxYW_LuYycInHGrR-BpZurpiSGo4JUkseUoODZol6abv-DLPjUQiZigit2mnSJV8AYZuaWH_HmA6HDK04XFYg/s1600/IMG_7617.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPX0Jug3VHKLUvt_j6INW9uJEs6E3r6bGChQGbYGcHo8nVZJwAWv8xRQaxYW_LuYycInHGrR-BpZurpiSGo4JUkseUoODZol6abv-DLPjUQiZigit2mnSJV8AYZuaWH_HmA6HDK04XFYg/s1600/IMG_7617.JPG" height="240" width="320" /></a></div>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-55158316479078120492014-10-21T12:32:00.000-07:002014-10-21T12:32:04.283-07:00I'm 15 months old!<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheOo4AyrGK-BRBO6jjGF8im4fwky-QhzWHrbH6ZNQyoJyJTPuacDrGbMvWtvdFZazXM0Fz2xX70hmDqNTMpnJbVH_hxU9NMegM_6ti1k3bq8APzPHr-e2c6RIUgLQ2mOyVvtHhPb2ARw/s1600/DSC00236.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheOo4AyrGK-BRBO6jjGF8im4fwky-QhzWHrbH6ZNQyoJyJTPuacDrGbMvWtvdFZazXM0Fz2xX70hmDqNTMpnJbVH_hxU9NMegM_6ti1k3bq8APzPHr-e2c6RIUgLQ2mOyVvtHhPb2ARw/s1600/DSC00236.JPG" height="252" width="320" /></a></div>
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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.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmzUkZNFgfsfXmFbUb682d6tMl3gaCsVHwxyZzlPd7N4qQFK0Ntvv4v4zoY-C1GjmeDpOvFlVR_oOrcTnXDTzo7_LybzB3f-mjAw0KLgLUPBAa67Q_UdptDOe4AQHWwMeou0w87dzzuA/s1600/DSC00514.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmzUkZNFgfsfXmFbUb682d6tMl3gaCsVHwxyZzlPd7N4qQFK0Ntvv4v4zoY-C1GjmeDpOvFlVR_oOrcTnXDTzo7_LybzB3f-mjAw0KLgLUPBAa67Q_UdptDOe4AQHWwMeou0w87dzzuA/s1600/DSC00514.JPG" height="213" width="320" /></a></div>
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!<br />
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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.</div>
Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-12286387329671800072014-07-03T09:58:00.001-07:002023-04-24T09:09:47.833-07:00Charlie's favorites<span class="Apple-style-span" face="Calibri, sans-serif" style="font-size: 16px;">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.</span><span class="Apple-style-span" face="Calibri, sans-serif" style="font-size: 16px;"><br style="text-indent: 0px;" /></span><br />
<span class="Apple-style-span" face="Calibri, sans-serif" style="font-size: 16px;">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!</span><br />
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<span class="Apple-style-span" face="Calibri, sans-serif">-Antoinette</span>Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-62652484307809004592014-07-01T10:08:00.000-07:002014-08-30T10:13:53.152-07:00<br />
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!<br />
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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.<br />
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Pray for Margarita (a sick patient who passed this week) and here family.<br />
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Wish: allergy and lubricant eye drops, a physical therapist who speaks spanish<br />
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-AntoinetteAnonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-45834666796022236822014-06-26T10:04:00.000-07:002014-08-30T10:07:57.038-07:00The tightrope<!--[if gte mso 9]><xml>
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26 June 2014<br />
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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.<span style="mso-spacerun: yes;"> </span>We do our best to support to each
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I grew up in a group called Lasallian Youth during my high
school years, which was a service organization responsible for many of my life
long friendships. It was a formative supplement to the great life example set
by my parents, and no doubt part of the inspiration that lead me to Peru for three
years.</div>
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<br /></div>
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Today is a big deal here, the feast of St. John “Juan.”
Everyone celebrates by making “Juane’s,” which is a piece of chicken, egg, and
olive in a ball of rice, all wrapped in a banana leaf and tied tight at the top
to keep everything inside. It’s then boiled, which makes it also a “safe” food
to eat on the street since it’s well sealed. It is supposed to be
representative of John the Baptist’s head… post guillotine. It’s easy to forget
that gruesome detail while eating this delicious meal!</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi88AuqRVvHHfKwSs9F7EUBmqUbh5tBGo-BdXBOmzmImFHMHqXXXnq3Cl24T_N7i3BMVUKz-4Nl13Ft33Na4BVi7A3hgWk0pMSDiCM2jrMooj8AeL5XJ07S6TrCDqYryTOqxJuy1KNXkQ/s1600/juane_de_gallina_misrecetasperuanas_comida_de_la_selva_tingo_maria+(1).jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi88AuqRVvHHfKwSs9F7EUBmqUbh5tBGo-BdXBOmzmImFHMHqXXXnq3Cl24T_N7i3BMVUKz-4Nl13Ft33Na4BVi7A3hgWk0pMSDiCM2jrMooj8AeL5XJ07S6TrCDqYryTOqxJuy1KNXkQ/s1600/juane_de_gallina_misrecetasperuanas_comida_de_la_selva_tingo_maria+(1).jpg" height="320" width="207" /></a></div>
<!--EndFragment-->Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-83101417994682706382014-05-15T10:00:00.000-07:002014-08-30T10:19:08.302-07:00Love of his Life <img height="300" src="webkit-fake-url://E7AEBF93-1E19-446C-9FE2-71FBBADBA551/application.pdf" width="400" /><br />
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anoint him. The plans changed and he decided instead that he wanted to marry
his partner of over 40 years! Right there, 30 minutes after the decision was
made, Brian and I were witness to the marriage of this beautiful couple and
stood by their side as Godparents. He later started to talk incoherent for a
short time, and when he returned to his normal state, he said that he saw a set
of stairs with a bright light at the end, but nobody was there so he decided to
turn around. Apparently the angels were also celebrating this union before God.
He will share the rest of his days with his “new” wife and life partner.</span><br />
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<br /></div>
Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-33328448955617302622014-02-06T14:15:00.000-08:002014-02-06T14:15:35.327-08:00<span style="font-size: small;">We now have a new blog. </span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifixNHU0_q00-r3VtyNzWXy95DNQ6vqM582KE-KjQyeQfdGwLRGzZjCh792FkFKFZ1yG3rLvDS0GJ5wAasJ6lqBEvJqZc_J8cAsU4jmoiT_Uuya1hcwtWNjWDU4tciK52EirbtCcnRIew/s1600/Toni+and+Brian+Blog+Banner5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEifixNHU0_q00-r3VtyNzWXy95DNQ6vqM582KE-KjQyeQfdGwLRGzZjCh792FkFKFZ1yG3rLvDS0GJ5wAasJ6lqBEvJqZc_J8cAsU4jmoiT_Uuya1hcwtWNjWDU4tciK52EirbtCcnRIew/s1600/Toni+and+Brian+Blog+Banner5.jpg" height="120" width="400" /></a></span></div>
<span style="font-size: small;"><br /></span>
<span style="font-size: small;">Follow us at Santa Clotilde Mission</span><br />
<span style="font-size: small;">http://santaclotildemission.blogspot.com/</span><br />
<br />
<br />
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Speaking of Santa Clotilde, the work carries on! I would like to thank Fr Jack, Dr Juan and Dr Julio along with all the midwives, dentist and staff for continuing the good work while we are gone, as well as the volunteers and students from Mission Doctors, Loyola, UBC and U of Minnesota. Some exciting news comes back to us from Peru such as: a visit from the national Ministra of Health who sat down and had a conversation about our reality. Progress is being made on our x-ray machine slowly but surely, and another doctor from El Salvador, Cuban trained is also working on the river. Our logistics coordinator Javier and Padre Moe are working diligently to restore in working fashion the barcasa, our barge that will be able to make trips up and down the river, even all the way to Iquitos for vaccines, supplies, patient transport, and our Amazon experience for visitors.<br />
We are in training until the end of May and then back to Chicago for a while, then back down to the selva which I think about daily. Keep us and all on the Napo river in your prayers!<br />
<br />
Brian<br />
April 21, 2013Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-50282411753150070142013-02-03T17:13:00.004-08:002013-02-03T17:13:53.859-08:00Italo<div class="separator" style="clear: both; text-align: center;">
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiB7IIhd6SwzPwKUCXnbbsIZOHqMEZvWw8hITsm6MqeulidkVyf8FZ8gTWgGsGvDJsMomWz2O3vrG5A3z-NUOorFj-KHxDnPs2bVCXTNonPYYyT-FcY4zFhcu7IDlTtV5YOImTNqEvz4zs/s1600/IMG_2775.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiB7IIhd6SwzPwKUCXnbbsIZOHqMEZvWw8hITsm6MqeulidkVyf8FZ8gTWgGsGvDJsMomWz2O3vrG5A3z-NUOorFj-KHxDnPs2bVCXTNonPYYyT-FcY4zFhcu7IDlTtV5YOImTNqEvz4zs/s320/IMG_2775.jpg" width="320" /></a></div>
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Italo was a 5 yr old with difficulty breathing and swollen lymph nodes in neck. I've never seen such an impressive X-ray. He had Leukemia or Lymphoma. Pray for Italo and his family.</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-5675433250176504642013-01-20T13:04:00.000-08:002014-01-11T06:47:32.920-08:00The fragility of life We have our trip planned home to start our formation for 4 months with Mission Doctors Association in Los Angeles, but the last week in Santa Clotilde kept us more than busy with an in your face view of reality here in Peruvian Amazon. The week was non-stop as several emergencies came in to our Centro de Salud. The first was a child from Cabo Pantoja, the community on the border between Ecuador and Peru, six hours up river in speed boat from our hospital. Italo, a very smart and pleasant 5 year old boy came in with several months of fevers and night sweats with swollen lymph nodes on exam. His likely diagnosis was a lymphoma. We performed a lymph node biospy and sent the sample to Lima for pathology. He was stable during the day but at night due to the compression of the swollen glands in his neck had some difficulty breathing but his oxygen saturations remained within normal range.<br />
On Wed morning began a 3 day series of difficult stories that I am now reflecting on exactly everything that happened. We recieved a call from our nurse tecnico stationed in a small community 4 hours up river in Rumi Tuni, he had a pregnant lady come in with difficult labor in her 10th pregnancy, she had labor pains for 2 days but came in because of an acute worsening of pain the night before, he felt the baby's head and a tense abdmonen, we knew the patient would need a c-section. So immediately Toni and our midwife left Santa Cloilde in our emergency boat, a delivery kit, and our USB adaptable echo and laptop. They arrived to find a woman in distress with a stillbirth and hemorrhaging, on the echo Toni saw an unusual thing, bubbles inside the abdominal cavity. They started a second IV and pushed fluids and pain meds and started on the way back to Santa Clotilde. Toni called me just prior to departure and we started to prepare the OR for an emergency c section and found donors for blood that was awaiting in the fridge for their arrival. When they arrived we went directly into the OR after she received 6 liters of fluid on the trip down, we started her blood transfusion, antibiotics and a 7th liter, awaited her labs to ensure she did not have signs of severe infection and bleeding issues (DIC in medical speak) and proceeded with spinal anaesthesia and the c section. As Dr. Juan Jon and Toni entered the abdomen they found the bag bulging into the abdominal cavity, a uterine rupture with bleeding, the baby was a stillbirth as expected. The mother tolerated the procedure well and after a difficult repair a tubal ligation was performed to prevent a high risk of death for mom if there were to be another pregnancy. A baby lost but a mother of a large family saved.<br />
Shortly after Toni left a health post in the town of Tacsha Curaray, that is 2 hours down river from us, came in their emergency boat bringing a gentleman with a right femur fracture. This man was on his farm with his cattle when a rope tied to one of his cattle was on the ground looped loosely by his foot, the cattle startled and stampeded and the rope pulled the man's leg and he was dragged for a short distance. His leg is stable as is his blood count, he will need to go to Iquitos for an operation when we have the means, a doctor free and our emergency boat ready<br />
That same night, Wednesday, night Dr. Juan was on call and it was busy, 6 admissions, including two very sick children. Juan had a 18 month old child come in with severe dehydration. He started fluids and she started to respond, but still very sick. At 5am another child entered with seizures that were controlled with diazepam and lumbar puncture performed to rule out meningitis. Meanwhile Toni continued her travels as she left a day early on Thursday morning to Iquitos with Italo whose airway compression from his lymphoma worsened and was more critical. After rounds the child with dehydration continued to worsen developed a fever and then started also having seizures. As we tried to look for papilledema we noted cataracts and with mom's history of weight loss (40% of her weight, supposedly) we were unsure if this was a congenital malformation, brain tumor or metabolic disorder leading to the illness. Shotly after we were able to stop the seizure the child went into arrest and despite CPR, ambu bag for air with oxygen and atropine and epinephrine this child died. Our other child from 5am with seizures was getting better. We also had another elderly gentleman with likely lyphoma also head to Iquitos for a consult with the oncologist and a bone marrow biopsy, we also did his lymph node biospy earlier in the week.<br />
We thought all was settled, I was preparing for my trip to Iquitos to meet Toni for our flight to Lima. I was bringing down 3 more patients to the regional hospital, one as an emergency as he had an open fracture of his arm and two others who had their outpatient appointments, one for vertebral tuberculosis and the other for basal cell carcinoma on the face.<br />
I was finishing up paperwork and packing when I recieved a phone call at 1am from our nurse Elita in Iquitos saying she was just notified from the hospital that Italo, the child who went with Toni had died in the hospital. Toni arrived with the patient in the ER and he was stable, attended to by medical interns. Toni was helping them by presenting the story and making recomendations. However there is NO DOCTOR in the emergency room at this regional referral hospital for a city with a population of 180,000 people. The pediatricina did not show up for several hours, meanwhile Toni stayed with the patient this whole time. The chest x-ray of Italo was heart breaking he had a very large chest tumor (mediastinal mass), when he cried his compression was worse and his oxygen dropped. He went to CT accompanied by Toni, no other doctors, nurses nor pediatricians, but he could not lie flat on his back due to his oxygen and shortness of breath. The radiologist was upset he could not lie flat and just told her to "get him out of here" She went back to the room with him and advised the nurse not to agitate him as his oxygen drops and that he needs to be seated not lie flat. He as watching sesame street on her laptop, coloring when she left him. He was dead an hour and a half later. We know he had a very bad, aggressive disease and we are not sure if he would have lived, but he certainly should not have died in a hospital supposedly with the resources of a surgeon to do a tracheostomy an ICU and ventilators. We are glad to be coming home for a break to mentally recharge before we head back to continue to fight in Peru.<br />
<br />
Brian<br />
20 Jan 2012Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-7002042852912920422013-01-20T09:25:00.001-08:002013-01-20T09:25:32.066-08:00Toni's brithday<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6Zp2mZdz3TLZtxH9_44IGpexf2PkR_bvN5mGDJcco2km80NdMeojxNPz-SqOF-sHRZt3l26ttXwlOFZmevhOlLyBCUte7nOOtGl6Td_4MI1tWfqtXD-4uRNNZd_9JkrIWqYgc8oVhng/s1600/DSCN2470.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6Zp2mZdz3TLZtxH9_44IGpexf2PkR_bvN5mGDJcco2km80NdMeojxNPz-SqOF-sHRZt3l26ttXwlOFZmevhOlLyBCUte7nOOtGl6Td_4MI1tWfqtXD-4uRNNZd_9JkrIWqYgc8oVhng/s320/DSCN2470.JPG" width="240" /></a> Just after Christmas on Dec 28th is Toni's birthday. To celebrate I wanted to throw a party and following tradition provide a nice meal for our guests. Since Antoinette is allergic to poultry; the food staple of chicken was out. I decided to buy a pig to serve. However, here in the jungle buying a pig is not as simple as going to the grocery store and buying a ham, or pork chops or ribs. One of our co-worker's mother raises pigs about 45 minutes up river. The morning of the 28th he left and picked up a pig, i thought a 30-40kg pig would suffice, he came back with a 62kg pig, and although it cost more than I was expecting to spend it was very cheap in comparison to the same amount of meat back home. He came back in the early afternoon with the hog tied and hanging froms it legs on a post. We carried it outside of the kitchen and then proceeded to prep the pig. It was the first animal i have ever killed (other than a bird with our BB gun a long time ago...even then i think it was my brother that pulled the trigger- we both felt very guilty afterward for killing a living animal). They first boiled a huge pot of water then showed me where to stab the heart, after a few loud wails from the pig he took his last breath. (warning some more graphic pictures below) I felt as if i was re-enacting images that were evoked while reading "The Lord of the Flies" in high school. Then the other guys teaching me the ways of butchering and preparing a pig did the rest. They poured the boiled water on the pig and scraped off all the hair leaving only the skin, then they opened up the underside from neck to rear and took out the viscera. Then we sectioned the pig and cut away the fat. That night we prepared a rub and let it sit overnight in various fridges as it was a large amount of meat; the next day the whole pig was cooked for the party on Sat night.<br />
It was a much different feeling eating this food, as i think about the whole process, i did not feel guilty as I did with the small bird killed during childhood. People here learn to hunt, butcher and prepare food out of necesity, and it is a ton of work. I reflect on the way of life for the Native Americans in our country who hunted buffalo in a group and working as a community to butcher the meat and drag it back to their camps. How the government and white people took their way of life away from them by killing all the animals for sport or fun. Here it is a pure form of living, one much more atuned to nature and the abundance the earth can provide.<br />
The pig tasted as delicious or better then the meat back home. At the party, we ate the pig, drank some beer and danced; it was a fun night and I think Antoinette liked the present of a pig. It is a present neither one of us is soon to forget.......yes I also bought her a nice new umbrella, not just a pig. Below are some pictures, some a little graphic<br />
<br />
Brian<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwlPPcY0pA4vH41eTlU2vdLHlpEvfOKvWLTLoLCkxI7reF9vSDR4ksuBNjbuD-9uUUl2bivkVYgYbfKb1Rf3fS6UDKwpR5q6B7H1ZMEALT_8V6O6aRGUEZUG1FiKRZgco7_mA88TvDMg/s1600/DSCN2459.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwlPPcY0pA4vH41eTlU2vdLHlpEvfOKvWLTLoLCkxI7reF9vSDR4ksuBNjbuD-9uUUl2bivkVYgYbfKb1Rf3fS6UDKwpR5q6B7H1ZMEALT_8V6O6aRGUEZUG1FiKRZgco7_mA88TvDMg/s320/DSCN2459.JPG" width="320" /></a>Anonymoushttp://www.blogger.com/profile/05281859607580448424noreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-63024947823991302172013-01-06T09:15:00.001-08:002013-01-06T09:15:08.154-08:00Christmas Celebrations<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiiEoy375We_vp57laASnZuUvrTHLW1U3vAyI055BQF6lkFXE7qLIkDZchs6PopyX-5LHTVClipDRZvLjSxLyM7Y5WN9zW7qA9kZdhjRMLk-FvTdqC7z4wzshkztHm4HJ8836wUW94ni_s/s1600/IMG_2566.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiiEoy375We_vp57laASnZuUvrTHLW1U3vAyI055BQF6lkFXE7qLIkDZchs6PopyX-5LHTVClipDRZvLjSxLyM7Y5WN9zW7qA9kZdhjRMLk-FvTdqC7z4wzshkztHm4HJ8836wUW94ni_s/s320/IMG_2566.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Padre Jack with Christmas Dinner, very happy about his catch!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Here are the kids from Sargento Lores, a 10 minute boat ride upriver, who volunteered to come to Santa Clotilde to sing carols a few days after christmas. There were 7 close communities who participated, and Sargento Lores came in second place. I traveled to Sargento Lores two days before the competition and the day of, I presented them to a church full of people. Sargento Lores is an indiginous Kichwa community. The leader of the community more than anything to provide a good education and opportunity for their children. They are an agricultural community and grow yuca, plantains, and lots of fruits. They also have some cows, buffalo, pigs and chickens that they raise. They are artisans and make baskets, crafts of balsa wood, and bags. They wish they had a market for their artwork, produce, and animals. </td></tr>
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<!--StartFragment--><span class="Apple-style-span" style="font-family: inherit; font-size: small;">Then Liz, Paul, and Josia
invited us over, along with Padre Jack and Erik, the visiting student from
Canada. Liz was raised in Africa by missionary parents and made a traditional
holiday meal of curry lentils and rice, and 10 different toppings including
nuts, raisins, coconut, papaya, and banana. It was delicious! Then we watched
Andre Rieu Christmas Carols with a japanese children's choir! The music and
company were beautiful!</span><!--EndFragment-->
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<tr><td class="tr-caption" style="text-align: center;">Christmas Mass with an artistic musical culturally-relevant reenactment of the Nativity Story, including accents about caring for each other and for the environment. It was amazing and really emphasized the true joy and meaning of Christmas. We have lots of talented youth here in Santa Clotilde!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Our Nativity Scene, built from scratch by our maintenance men with a traditional leaf roof, bamboo walls, and sod floor. All the animals resting on the sod are fashioned facing the crib of baby Jesus, who appears on Christmas morning. Complete with musical christmas lights, garland, and ornaments it keeps many kids occupied in awe. Traditionally all Christmas adornments are taken down on Jan 7th. One more day of festive music and decorations!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Our Secret Santa Gift exchange in the hospital kitchen, our usual reunion area. We each described our "secret friend" until the group was able to guess who it was. My "secret friend" was a dead giveaway since she is know for being the best volleyball player in all of Santa Clotilde- Lleni Guerra. It was such a warm, happy celebration! Nothing replaces our own family, but I could say that our family in Santa Clotilde is a close second! </td></tr>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-75763197382141334382013-01-05T07:49:00.001-08:002013-01-05T07:49:11.985-08:00Feliz Merry Christmas<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
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<!--StartFragment--><span style="font-family: Times;"><span class="Apple-style-span" style="font-size: small;">Christmas Season 2013
started off with Brian and I cooking dinner for our compadres, our
godson Sander and his brother Jack. More than the stuffing dinner and pistachio
pudding for dessert, they loved the balloons with a string attached!</span></span><!--EndFragment--></td></tr>
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<!--StartFragment--><span class="Apple-style-span" style="font-size: small;"><span style="font-family: Times;">Then Liz, Paul, and Josia
invited us over, along with Padre Jack and Erik, the visiting student from
Canada. Liz was raised in Africa by missionary parents and made a traditional
holiday meal of curry lentils and rice, and 10 different toppings including
nuts, raisins, coconut, papaya, and banana. It was delicious! Then we watched
Andre Rieu Christmas Carols with a japanese children's choir! The music and
company were beautiful!</span><br /></span></td></tr>
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<tr><td class="tr-caption" style="padding-top: 4px; text-align: center;"><span class="Apple-style-span" style="font-size: small;"><span style="font-family: Times;">L</span><span class="Apple-style-span" style="font-family: Times, 'Times New Roman', serif;">os Posadas... for 9 days before Christmas, signifying Mary's 9 months of pregnancy, carols are sung by a group at houses around town. They carry a statue of Mary and Joseph as a re-enactment of their search for lodging. Centro de Salud Santa Clotilde is the final stop on Christmas Eve for over 500 kids, where we the "innkeepers" finally let them in... </span></span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span class="Apple-style-span" style="font-family: Times, 'Times New Roman', serif; font-size: small;">Once everyone enters, Padre Roberto has a Children's mass in the lobby of the hospital. He emphasized the details of Christmas... Where is Mary from? Where was Joseph from? Where was Jesus Born? Etc. The kids cooperate and know the answers... </span></td></tr>
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<tr><td class="tr-caption" style="text-align: center;"><span class="Apple-style-span" style="font-family: Times, 'Times New Roman', serif; font-size: small;">Answers: Mary of Nazareth, Joseph from Belen, and Jesus was born in Joseph's home town of Belen. And the children are welcome to partake in hot cocoa, panetone, and candy from Santa Clause.</span></td></tr>
</tbody></table>
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<br />Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4748997794656129766.post-80794539890946233462012-12-23T07:42:00.001-08:002012-12-23T07:42:52.243-08:006th Grade Graduation<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJ5LUnCDgUp2j3R3wUol-3-5WxyFUsGnt9hS3zbbJP32EeIiPAp7-AC0HvwyhjOyE8ZVReNVnLY9kLsFwklbuiwKZ_xXxwxfaZN8E0HDKEgdg0VK8k4f-U6TCIR-iKHKbxHyUr3vf4fRY/s1600/IMG_2493.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJ5LUnCDgUp2j3R3wUol-3-5WxyFUsGnt9hS3zbbJP32EeIiPAp7-AC0HvwyhjOyE8ZVReNVnLY9kLsFwklbuiwKZ_xXxwxfaZN8E0HDKEgdg0VK8k4f-U6TCIR-iKHKbxHyUr3vf4fRY/s320/IMG_2493.jpg" width="320" /></a><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjizwtxKKqHBtSdl6zgLWV2BZFRk2RdL-r-47B5irtq30Yvsu2rUkpz0QFgkvVJC1Q_BUFMvm_TVLhB4oDdy0knSjEuvr_YvwlwttIU0UYq-Sw15L25H2-uwc_619nk_2C691E05bnzWhQ/s1600/IMG_2491.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJ5LUnCDgUp2j3R3wUol-3-5WxyFUsGnt9hS3zbbJP32EeIiPAp7-AC0HvwyhjOyE8ZVReNVnLY9kLsFwklbuiwKZ_xXxwxfaZN8E0HDKEgdg0VK8k4f-U6TCIR-iKHKbxHyUr3vf4fRY/s1600/IMG_2493.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><br /></a>Happy 6th Grade Graduation! The largest class of 102 kids graduated on December 9th. All graduates wore elegant ivory dresses with fancy silver heels or white shirts and a tie. For the ceremony, all the females are paired up with a male and they danced together the entire evening. They have "fill-ins" if there is an uneven number of males and females, and these kids wear different color dresses or shirts. There was a "godfather" of the ceremony, a doctor from the city, who financially supported the party. The kids desks and chairs were pulled out onto the sidewalk between two school buildings and they were all dressed with white tablecloths. Families chose a table as they arrived. Each family brought their own pitcher and cups and filled up with juice in the kitchen before the plate of chicken, rice, potatoes, and olives were served. Each table also received a couple bottles of soda and beer, and then for dessert a "brindis", or alcoholic toast with coffee, milk, sugar, and aguardiente (local potent sugar-cane alcohol that tastes a little like tequila). Seeing adults sit on little chairs with little desks made me laugh, but that is how things are done here. While graduates' names were being called, they stood in two lines of partners and advanced over the sidewalk dividing the grass. Meanwhile, the "security guards" were chasing down dogs who snuck in to the party to kick them out. Wawki (our dog) managed to get in a couple times but was quickly hunted down. Dinner was followed by disco lights and really loud music, and almost everyone danced. I showed some of my american moved and had everyone laughing. Brian and I were invited by Victor Hugo and Leynis who's son Victor was graduating. We knew that of people and had a really fun time dancing and sharing stories. The festivities lasted six hours, but we didn't make it to the end and headed home. <div>
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