Wednesday, September 9, 2009

Clinic days in Iquitos--Belen

Medical attention with our Soy Capaz banner in the background

an HIV lecture


Belen

Belen



HIV prevention team at its desk

This week, Amazon Promise continues its free medical attention in the poorest part of the city of Iquitos, Belen. We have eight great medical students from Yale and the King's College in London who work with a staff of Peruvian doctors. It is humid and still very hot, but everyone works at full speed regardless, from eight in the morning till eight in the night, attending to the underserved population of the "city on water" of Belen (its proximity to the river causes that during winter, the water reaches all the way to the doorsteps that are actually six or seven feet above ground, and so each house stands on pylons. We usually find a place for our clinics underneath the houses at this time of the year.)
Public HIV prevention lectures are an integral part of the health care Amazom Promise provides, and so we are on the grounds each day early in the morning. Our promoter works with promoters from a local organization, Lazos de Vida that consists solely of people living with HIV. These local heroes and heroines go out to lecture, do outreach in hospitals, lead support groups, and constantly appeal to the local government to support the fight against HIV. Some positive changes have been made: free condoms are available in the medical centers and hospitals in the city if Iquitos. Last month, for the first time, HIV testing occurred at some of the medical centers (HIV testing is performed regularly and for free now in the two state hospitals). Nevertheless, we are faced with a full-blown HIV epidemic here in the city of Iquitos. Amazon Promise thus not only organizes public lectures, but also performs HIV testing, counseling, and does referrals to hospitals for antiretroviral treatment.
This time, it is Victor from Lazos de Vida together with Elena from Amazon Promise to do the work, together with Puanch, an Achuar tribe Health Promoter who is continuing his training with our team. His presence here is very exciting, since when he is trained in HIV prevention, he will be able to convey the message to his people in their own language. We see many STD infections, and we test those patients for HIV. We did have a fourteen-year-old girl at our counseling table...

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Patient Stories

Juan: A Patient’s Story

During an Amazon Promise clinic in the village of Jerusalen, we met a desperate, emaciated man who was holding the hand of a four-year-old boy with cutely unkempt hair. Having been sick for some time, Juan had come to the village from Iquitos in the hopes of finding some healing in traditional jungle medicine. He was a very humble man who never looked into anyone’s eyes. His son was the shyest of kids. There was tenderness between them. The AP clinic doctors could not find the source of Juan’s fatigue, but suspected that he was in the end stages of HIV/AIDS infection. We offered to help him get back to Iquitos for HIV testing.

In Iquitos, Juan tested HIV positive and broke down. We counseled him about the free antiretroviral treatment he could receive from one of the hospitals. Still, he was convinced that an HIV diagnosis meant certain death. Juan then revealed he had a wife and another child. In fact, he was not afraid to die, but he was petrified that they too might be infected. At the San Juan Health Center in Iquitos, Juan’s wife and their children tested negative, while Juan’s tests confirmed his HIV infection. Again Juan cried, but this time with relief. Nevertheless, his joy was short-lived: he now perceived himself a burden to his family, and craved death. At that point, he could hardly walk. Together with his wife, we counseled him and finally convinced him to start treatment. His wife was very strong, forgiving and caring. They decided to make it together.

Juan entered the free antiretroviral treatment program at the Hospital Regional. Because he was too ill to work, his wife took on an extra shift at her job to make ends meet.

A year later, while we were visiting the same village, an elderly woman spoke without stopping about how fat her son Juan was getting. Then one day Juan rang the bell at the Amazon Promise house in Iquitos. He walked in with muscled arms and a protruding belly, holding his youngest child in his arms and the boy with unkempt hair by the hand. Juan has a full-time job now. He looks people straight in the eye, and talks with great concern about the growing number of HIV patients he sees in the hospital where he receives his treatment. At the moment, he is training to become a volunteer HIV-prevention counselor. Welcome back to the world, Juan.

(The patient’s name has been changed for the sake of confidentiality)

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