After a 6 day adventure in two very different villages, Tin, Natalia and I (Sonja) are back in Iquitos for a few days of recovery before we venture out again for our next and last village visit. We are sad to have Natalia leave our team to go back to the U.S. after her 6 weeks of hard work in Peru, but look forward to our next community visit where we are joined by Shelby Kemper. Our time in these communities flew by, and it was full of new learning experiences of all of us.
We departed Iquitos early last Wednesday morning on a Rapido to Mazan, where the Health Promoter from Nuevo Tiwinza, Rene, met us. We were very thankful to have had him as a guide to our desitination, because getting to Nuevo Tiwinza entailed not only taking an hour-long Peke Peke (small wooden boat) ride on the Mazan River, but also more than an hour hike deep into the jungle with all of our gear, food, and water. We spent three days in the village of Nativo Tiwinza with Rene and his wife Sonia, conducting surveys and home visits within homes in this unusually rural and spread out community of 13 families (70 people). The days were tiring as we had to walk up to 6 km to get to the various houses in the blistering heat and humidity of the jungle. However, it was worth the trip to see this unique village because the households were very friendly and we were able to learn a great deal abou the major concerns within the community. These include: the lack of access to health care because the community is so far away from not only health posts and clinics, but also from any transport to these facilities by boat; snake bites and other injuries; lack of law enforcement; and lack of organization in the community for services like emergency preparedness. Almost none of the houses had latrines, and their water came from wells and was treated by Sonia with bleach, when she visits each house personally every 3 days (very impressive). We were also invited to an Education Committee meeting because Rene, along with being the Health Promoter, is also the Head of Education in the community. At this meeting, we got an inside glimpse into the education system in this community. We spent the evenings talking with Rene and Sonia about their experiences as Health Promoters and learning more about the history of the community, as well as doing some online casino teaching out of the book “Where There is No Doctor” (Sonia and Rene have a voracious appetite for learning), reviewing vital signs with Rene and Sonia, and playing with their sweet children.
On Saturday morning we hiked back to the river and returned to Mazan on a Peke Peke. Our second community, Arturo Rios Arana, was actually a part of the town of Mazan. We met the Health Promoter, Cesar, and got to work immediately, conducting surveys in five different households that day. Arturo Rios Arana has access to a clinic just on the edge of the village in Mazan, so the health concerns and Health Promoter´s role was very different from what we had seen in Nuevo Tiwinza. On Saturday night, we had a meeting with members of the community (about 20 people turned up) where Tin, Natalia, and I taught a lesson on diarrheal illness and how important basic hygiene and healthy practices in the home are in preventing these illnesses. Cesar had asked us to present on this topic to use it as an introduction to conducting home visits in the community the next day. Although we received less feedback from community members during that meeting than we had hoped for, the homes we visited with Cesar the next day were much more receptive to our visits and the suggestions Cesar gave them, than the response we had gotten the day before while conducting the surveys unanounced. Because the homes were much closer together in this community than in Nuevo Tiwinza, we were able to help Cesar with 10 home visits on Sunday, during which he gained confidence and skill, and we were able to learn a lot about the community as we visited with these households.
One of the major major we learned during our village visits this week is that it is important to be flexible and adapt our approach to surveys and home visits depending on the community, because these communities that we visit are far from uniform. We are gaining so much knowledge as a group from these amazing Health Promoters and the community members we talk with during the village visits. I have no doubt that our project and curriculum will continue to grow and adapt with every community we are allowed to visit.