Calvario

Tested my FWD today, by accompanying a team of 2 doctors and a nurse out to a village called Calvario (the name may or may not be correlated with the huge blazing-white cross visible on the cliff across the valley, a strange sight when everything else in view is swallowed by the jungle), about 30 minutes from Tena. Well, it would have been 30 minutes if one of the bridges hadn’t been closed to vehicle traffic so they could replace some of its termite-eaten planks. Fortunately, instead of having to hike the rest of the way, we managed to hitch a ride with the guys bringing the wood down from somewhere up in the hills (the only vehicle I saw on the road all day, though that may or may not have been because people knew the bridge was out). It was a bumpy, uneventful trip- except for when the trailer decided to suddenly unhitch itself. After arguing in Quichua for a while, our hosts re-attached the trailer, secured it by lashing it together with rope, and we continued on our merry way- three in the cab, myself and two others hanging off the back of the jeep, and three riding on the trailer.

Our task for the morning was to inspect the situation of the water storage/treatment jugs that had been previously distributed to the community in an effort to reduce the prevalence of water-borne parasites and, of course, diarrheal infections. The protocol is as follows: fill the big blue tank (clearly labeled with the Ministerio de Salud Pública (MSP) logo of which I’m becoming so fond) to the top with water, add two bottle capfuls of bleach (which, being photosensitive, must be stored in an opaque container, otherwise it quickly becomes useless), secure the lid tightly, and let it sit for half an hour before using. Simple enough, right? Welcome to community health.

Out of the 16 houses we visited, 7 were unoccupied, the family likely at school and at work in the chakra. Of the nine homes we did inspect, only one had been storing the bleach properly- the rest had it sitting around in clear plastic water or Coke bottles (in one case, sitting on a shelf in the sun!). Nobody had an opaque container, so we had each mother wrap a bottle in a black plastic shopping bag, and filled it part way from the bottle we carried. In none of the homes did we find the jug with the lid firmly secured, probably due to poor design- we could only seem to get them shut properly with two people pushing on it, imagine a Tupperware with a poorly fitting lid, one side popping out as soon as you secure the other. One tank had a broken lid, another was filthy, and the only evidence we could find of the tank in one house was a shard of blue plastic in the dirt. One woman was in the process of washing hers as we approached- likely having been forewarned of our visit by her neighbors. She properly added the bleach we gave her, but had contaminated the jug’s spigot on the slimy concrete slab underneath the faucet (another design flaw- the mouth of the spigot is flush with the bottom of the jug, so that it touches the ground unless placed on an elevated surface like a shelf or countertop [Edit: I got the chance to examine one of the jugs in the clinic the other day, and I had remembered this point wrong: the spigot does indeed have a couple centimeters of clearance]).

The only occupants of one house we visited were the grandmother, who only spoke Quichua, and her 5-year-old grandson, whose bloated abdomen displayed a textbook case of intestinal worms. Through the grandmother’s feeble attempts at Spanish, and the grandson’s translation, we determined that the mother was currently in Tena at the hospital because of some condition with her head. When we asked to open the water jug, we discovered it was being used as a vat to ferment chicha (the traditional alcoholic drink made from ground yuca, a somewhat distant relative of the potato).

And there you have it: my first ever real community health experience.

Semi-unrelated anecdotes from the day:

1) During our walk through the village, we came across the pre-school, which didn’t have an MSP jug but the teacher said she boils water for the kids. I’m inclined to believe her, if only because there was a functioning stove with large metal cauldrons. We also went over to the primary school, where most of the 36 students who attend 1^st through 7^th grade were out in the field, training for the Tena youth athletic competition this weekend by running barefoot in the rocky grass.

2) At one house we visited, I counted 23 beer bottle caps in the dirt between the gate and the front door.

3) I learned some indigenous medicine: apparently if you have a stomach-ache, you should boil tobacco in some water, and rub the solution on your belly to make it go away.

4) We didn’t have a ride back down the mountain, so we ended up walking in the sun for about an hour. On the way I counted 19 species of butterfly (though that number is likely inflated if males and females of the same species have different morphologies), including the spectacular Blue Morpho, and others with combinations of neon colors I never would have imagined to exist in nature .

5) I fell in love with the countryside. I wish I had brought my camera (will not duplicate that mistake); I’m too poor of a writer to adequately describe the breathtaking views of forested valleys, or the way life seems to spring from every inch of soil, saturating the earth with green in the never-ending struggle to survive and reproduce. Living in the city, it’s easy to forget the ferocity of that conflict, or the frailty of our own existence, but we are all part of it every day, all the same.