Date: March 27, 2017
Author: Justin Choi, MD; 4th year Med-Peds resident
Photo: At El Colegio Médico. From left to right: Rosa, Kelsie, Michael, Dr. Santos, Justin, Anita
A team from the University of Illinois at Chicago is currently exploring a partnership with Iquitos, Peru. Their intent is to work alongside community partners there in line with the framework proposed by Peace Care. Follow along with us as we hear about what they are up to…
¡Hola! Thank you for joining us on our trip to Iquitos, Peru.
We arrived in Iquitos yesterday around noon and were warmly welcomed by Anita Soluna, the director of Selva in Action. During our brief conversation on the way to our hotel, we could feel Anita’s passion for improving health care in the town of Iquitos and the nearby villages. Soon after arriving at our hotel, we decided to take some time to recharge/ nap before reconvening with Anita as we were quite exhausted from our traveling.
For dinner, we were joined by Anita and Rosa Aranzabal, project coordinator for Selva in Action, at Pili’s café. We discussed a general overview of health care in Iquitos. There are two main public hospital systems. One is MINSA (Minister de Salud), which offers services for those who cannot afford medical care. The other is Es Salud, which provides services for those who work for or are affiliated with the government. Theoretically, everyone in the community can receive health care, including those who can’t afford it – if they can provide their DNI (documentation of their nationality), something similar to a U.S. social security card. Without this documentation, it is close to impossible to receive health care. We also learned that there are several health posts, each covering a specific area/ community, including the villages along the river. These health posts are staffed by “técnicos,” described to us as a person with medical training in between a paramedic and a nurse practitioner. If patients need a higher level of medical care, they are referred to the associated medical clinic with a “hoja de referido” (required referral form). The next level of care after clinics are one of the two hospitals in Iquitos. Outside the public health system, there are several private clinics that are available for those who can afford them.
After the tasty meal and informative discussion, we walked around Malecon, the river front, for a little while then called it a night.
Fast forward to today, which was quite busy. We started off the morning meeting with Dr. Wenceslao Santos, director of the Bellavista Nanay clinic in the Punchana district. The purpose of the meeting was to introduce ourselves as representatives of UIC global health and inform him of what we were about. He was very receptive and agreed with what we were trying to build – a partnership with the community. He made it clear that there is a definite need for health education and prevention. One of the biggest challenges though, is addressing people’s perception of certain health issues. Take parasite infections for example. Many people in the community believe that treating parasite infections is not a high priority in their lives. As such, water filters go unused in homes and boiling water becomes a rare occurrence despite past attempts at health education.
For lunch, we went to Mishquina and each ordered a different preparation of paiche, a large freshwater fish found in the Amazon. Whether steamed, grilled, fried or in ceviche, the fish was delicious. After lunch,
we met with Nolberto Tangoa, a laboratory technician in the San Juan clinic. He gave us an overview of the different laboratory tests that are available in the clinic – basic biochemistry, peripheral smears, blood cultures, urine culture, urinalysis. He also showed us several microscope slides containing malaria (both p. vivax and p. falciparum), trypanosoma cruzei, filariasis, and leptospirosis.
Finally, we met with Dr. Stalin Vilcarromero, an infectious disease physician. He was very pleasant and enjoyable to talk with. He has a bright personality and we could tell right away that he is passionate about what he does. His work involves leading Dengue research at the Iquitos naval base and teaching at El Colegio Médico, the medical school in Iquitos. Like Dr. Santos before, he very much agreed with our goal. He understands that the community should dictate what we collaborate on. We have a lot to learn from Dr. Vilcarromero, and I believe he will make a strong partner in the future.
Tomorrow, we’re excited to take a boat to the nearby river villages/ communities and talk with them. I don’t really know what to expect. It will be interesting to learn about their day to day, their health status, and what they believe could use improvement, if at all.