Peru contains such a vast variety of ecosystems - dry tropics in Lima, high jungle near Cuzco, mountainous Andes, and the Amazon rain forest. We traveled to each of these regions as part of our tropical medicine course as different tropical diseases flourish in different climates. Last week was one of my favorite locations - the jungle on the Amazon River. There are no roads to Iquitos. Thus any traveler (or vehicle) comes in on a boat or a plane. We flew and then traveled around in these moto-taxis once we got there - they offer a great breeze in the heat and opportunity for fully experiencing the sights, sounds, and smells of the city. Not so great in a downpour, but better than walking!
One of two hospitals we rounded at in Iquitos. Much more limited resources than in Lima, especially as this is the maximum care available for these patients. Many have traveled hours by boat (one patient traveled 24 hours on a boat!) to get there. Flying them out to Lima is too expensive.
Boy with Dengue Fever (mosquito borne illness)
Boy who needed mechanical ventilation for several days in the ICU for severe chicken pox (no varicella immunization available in Iquitos). Despite the limited care available, though, thankfully the boy was improving by the time we saw him.
Following are pictures from the market in Iquitos. We learned about some of the herbal remedies patients usually try before seeking medical care.
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| Fish or bananas? |
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| Fried maggot. Evidently if it moves, you can eat it in the jungle. I decided no thanks on the maggot, though! |
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| Herbs |
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| Sumona and I with jaguar skin |
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| Live monkey (just a few booths down from a dead howler monkey that was being sold for meat) |
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| Slums of Belen in Iquitos |
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| These kids are having a great time swimming, but unfortunately are exposing themselves to all sorts of diseases in this water mixed with sewage, animals, etc. Maybe I know too much now! |
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| Waiting for rounds at the second hospital we visited in Iquitos |
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| Faculty members: Dr. Gotuzzo, Dr. Freedman, Dr. Barros, Dr. Legua, Dr. Montes, Dr. Warrell |
Little boy with leptospirosis - probably from swimming like the boys in the above picture were doing in water mixed with rat (or other animal) urine. He's improving with treatment, though.
Rounds with Dr. Legua
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| Deformities in a leprosy patient. It's very rare to see these deformities now as treatment options have improved. This patient was treated almost 50 years ago. |
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| Another leprosy patient (with a different type of leprosy). This patient is currently undergoing treatment and likely will recover fully. |
Even now, leprosy carries a stigma in the affected communities around the world. I don't really understand why. It's not very contagious. It's not sexually transmitted. Now it's treatable. Thankfully, Jesus didn't care about stigma - that carried by leprosy or by any one of us when we feel shame for things beyond our control, or even for things we feel responsible for. He proclaims good news to all. He experienced the shame of the cross so we don't have to.
"And behold, a leper came to him and knelt before him, saying, “Lord, if you will, you can make me clean.”And Jesus stretched out his hand and touched him, saying, “I will; be clean.” And immediately his leprosy was cleansed." Matthew 8:2-3
And Jesus answered them, “Go and tell John what you hear and see: the blind receive their sight and the lame walk,
lepers are cleansed and
the deaf hear, and the dead are raised up, and the poor have good news
preached to them. Matthew 11:5
We visited a malaria study village. I liked this educational decoration - the mosquito will find you! With our new tropical medicine knowledge, we applied and reapplied more insect repellent than I've ever seen a group use before! No dengue for us!
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| We visited the Amazon during the rainy season and flooding was evidently at its worst in decades. This standing water is of course ideal for mosquito breeding leading to increased rates of dengue and malaria in the community. |
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| Note the outhouse building on the left - draining directly into the river. These houses are built on stilts but you can't see them cause the river is so high. |
Boat parking lot
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| Looking at a slide from a malaria patient in the malaria study village |
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| Papaya tree |
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| Jungle! |
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| Flooding - don't think this moto-taxi will be used anytime soon! |
I had a few hours before my flight on Saturday, so some friends and I went to an animal shelter for injured or at risk manatees. The manatees are transitioned gradually until they are released back into the Amazon River.
Manatees evidently enjoy papaya - so cool!
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| Jaguar in the Iquitos zoo |
Capivara - otherwise known as R.O.U.S. for you Princess Bride fans (Rodents of Unusual Size)
Another photo of the Belen slum. Belen means Bethlehem in Spanish. Reminded me of Jesus humbly coming to an impoverished, dirty stable because of His love for each of us - from the least to the greatest. "Your attitude should be the same as that of Christ Jesus: Who, being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death--even death on a cross!" Philippians 2:5-8. Great reminder for each of us this Passion Week.
Amazon River
