IQUITOS
Photos:
*Setting up the computer and projector in preparation to begin the training course.
*The students working on the "Neo Natalies."
*The doctors and nurses were all tested in the information and techniques learned during the course and had to complete the course and pass the test in order to receive certification. It was exciting to see and share in their enthusiasm.
*Instruction on the importance of using hand sanitizer.
Iquitos is the first city where the Newborn Resuscitation Training teams taught the two-day course for 50 doctors and nurses from health facilities throughout the Department (like a U.S. state) of Loreto, deep in the Amazon jungle of Peru. Loreto accounts for about one-third of the land area of Peru, but this area is very sparsely populated which makes health care a significant challenge.
The team members were comprised of four doctors from Lima, Peru and three from the United States. Participants from Loreto were selected by their state health officials to represent a geographically diverse group who would then take the knowledge and the training materials donated by the LDS church and the donated medical equipment back to their areas to then replicate what they learned and teach it to others and then apply that knowledge to save the lives of newborns with breathing problems.
The contract the government signed with the Church requires that the 100 doctors/nurses trained at our courses teach at least 400 other doctors in the next six months, thus magnifying the impact of what was taught this week. There are enough training materials to permit the course to continue to be taught for several years into the future.
One of the doctors in the course shared that she had to travel three days by fast boat (8 hours/day) to arrive in Iquitos and attend the course and then the same to travel home after the course. She was so excited to be able to learn techniques to be able to save additional lives and was eager to return to her health post to be able to share that newfound knowledge with the health care workers there.
We found it interesting that the mannequins used in the training simulations are called Neo-Natalies (the name is actually printed on the box). We thought of our daughter Natalie as we were setting up and working with them.
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| Instruction on the importance of using hand sanitizer |
More about Iquitos(the land of the motorcycles and moto-taxis)
Photos:
*Steel building designed by Eiffel (as in the Eiffel Tower).
*All of the houses down by the water float when the river rises during the rainy season.
*The last two photos are of Iquitos in General with mototaxis and Rob strolling along the walkway behind one of our neo-natal trainers, Andrea Driggs.
Iquitos was built during the "rubber boom" and rubber plantations were the main economic driver of this city. The buildings from this period are preserved and most have ceramic tiles covering the exterior that were imported from Spain or Portugal. Many of these buildings with beautiful blue ceramic tiles in a myriad of patterns make this a unique city in the Amazon Jungle. One interesting building found at the Plaza de Armas (main town square) is a steel building reported to have been designed by Mr. Eiffel of France (of the Eiffel Tower), built there, disassembled, carried into the Amazon, and reassembled in Iquitos. It is still in use today.
The jungle surrounding Iquitos is fairly flat so flying into the town it is just jungle as far as the eye can see. While there are undoubtedly variations in the contour of the land, the jungle canopy makes it appear to be much the same height into the distance except where the even carpet of green is broken by rivers, of which there are many. Two other major rivers join the Amazon at Iquitos.
Because the only way into Iquitos is by air or by boat, there are very few automobiles or trucks. There are however lots of moto-taxis and motorcycles. Also, since it is hot in Iquitos all year long, the moto-taxis create a nice breeze as one drives along. They are quick, inexpensive, and the breeze blowing while driving is quite nice. Some of the moto-taxis are modified to have a truck-type bed instead of passenger seats and are used for hauling. We did see one moto-taxi loaded with re-bar dragging and sparking behind the vehicle. Moto-taxi's are used for hauling everything.
I loved what the local tourist paper said about the golf course in Iquitos. “This 9 hole 2,500 yard course is beautifully landscaped with lots of palm trees, sand traps and water traps. Visiting golfers are advised not to try and retrieve balls from the water traps unless they are really keen on feeding the local wildlife.”
During the rainy season, the Amazon River increases greatly in size and rises enough to cover the land in the foreground and background lifting homes which are anchored in place, but built on top of large logs that permit them to float. The Amazon River is seen in the distance at the top of the photo. Travel to many villages is done by water both upriver and downriver from Iquitos. Downstream eight hours in a fast boat is a location where Colombia, Brazil, and Peru join at one place. (It takes 12 hours to come back in low flows, longer when flows are higher.) The health facilities near that place send their serious cases downriver to a hospital in the Brazilian city which is much closer than the long ride upriver to the hospital in Iquitos.
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TARAPOTO
Photos:
*Three people from our team trying to fit into a moto-taxi that is just a little bit too small.
*We held our training in this beautiful chapel. Everything was so clean and the air conditioner worked perfectly (100 degrees outside). We are so grateful to the church members in Tarapoto who prepared the building for our training. Without their help and care, our job would be so much more difficult.
*Registration table.
*Before they could be trained, they had to prepare the "babies."
*At the end of the course, everyone was tested and received a certificate. Now they should be ready to help train others and to use their new skills to save lives.
*The participants -- well at least most of them. Some had already left the building before we could get a photo.
*The training team -- includes three medical professionals from the US and four doctors from Peru.
We returned to Lima from Iquitos Tuesday night and spent the night at home in Lima before flying to Tarapoto (also in the Amazon jungle) Wednesday morning. Tarapoto is found in the department (state) of San Martin. Unlike Iquitos, Tarapoto is surrounded by mountains that reminded me very much of the mountains on the windward side of the island of Oahu in the Hawaiian Islands. A beautiful landscape and a very different jungle than what we experienced in Iquitos.
Infant and maternal mortality in San Martin (where Tarapoto is located) is among the highest in Peru, which is why the training in Helping Babies Breathe was performed here. There have already been 92 newborn infant deaths this year in San Martin, so we know there is a great need for this training. While we were there the coordinator for the regional health department asked if there were any other courses like this one taught by the Church in its humanitarian efforts. When I mentioned that this year the Church had added some modules to this training related to maternal health, including bleeding problems at birth she was very excited and hopes to solicit that course for the future here because they have a high number of maternal deaths in the Department of San Martin. They have had 15 mothers die at birth this year already. That rate is about 1/1,000 births. For comparison, that is about four times higher than the U.S. rate. What we are involved with here is truly meeting needs and blessing lives.
Eight hours left before the flight
*All suited up and ready for the chocolate factory tour
*A view point from the factory. This photo does not do the valley behind us justice. It was breath taking!
*Inside the store at the factory. Those are the different types of chocolate bars for sale, of which we bought almost every type they make.
*Dusk in Tarapoto -- Rob and our moto-taxi driver who drove us around to see the city.
We had about 8 hours after the course ended until we were to catch our late-night flight back to Lima so we decided to explore a little bit. Our main destination was to visit a chocolate factory. This small factory produces Orchidea chocolate which is a Fair Trade chocolate. The company pays a fair price (which usually will be higher than the market price) to allow farmers to have a reliable source to sell their product. The factory employs primarily single mothers and other women to allow them to have a secure job to provide for their families. This company also has worked to provide farmers an economic incentive to grow a crop other than coca leaves (raw ingredient for cocaine), helped organize them into three large grower cooperatives, trained them in sustainable growing techniques (help preserve biodiversity of the rainforest), and taught them how to consistently produce high quality cocoa beans.
We were impressed by what they have accomplished and been able to sustain. Providing a market for something other than coca has reduced the violence and other social ills that accompany the drug trade. Having the factory here in Tarapoto and producing the chocolates with locally sourced ingredients allows the economic benefits to remain in this area rather than simply exporting the cocoa beans to a factory in another country where the benefits of jobs will be transferred.
It was interesting to observe and learn of the process for making chocolates and these artisanal chocolates had a naturally occurring breadth and depth of flavors that was amazing when we ate this delicious chocolate. Since this company has worked hard to produce a significant positive social outcome in this area, we felt compelled to purchase quite a bit of their product for future personal consumption to help contribute to the well-being of this society.
More details of the interesting story of this company can be found online at: http://www.orquideaperu.com
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