Fourth year students, Chloe Pinto, Dominic Razon, and Justin Hylaride are currently doing a clinical clerkship in Belen, Peru. Here, Justin shares is a snapshot of their experience.
First week in Belen. They call it the “Venice” of Iquitos, minus the tourism or any sense of luxury. On our first day a couple nurses escorted us through the Belen market, rows of tightly-packed street vendors with tarp coverings, to introduce us to the neighborhood clinic. We descended several flights of concrete stairs slickened by fish entrails and crossed through a district with entire families living in tin-roof homes on stilts. Plastics and garbage were strewn in every corner under each home where dogs lay sleeping: I felt like we arrived at the Amazonian wild west.
Dr. Carlos Rios Andes is a family practitioner in charge of primary care for the district of Belen where we are rotating. The Peruvian government in recent years has been advancing primary care in its rural sites, and Dr. Carlos Rios believes the overall health of Belen has improved in the past ten years (apparently it was an absolute disaster before interventions). In the 1970s, Belen had existed as a simple port for houseboats and transformed into a neighborhood composed of stilt homes, likely owing to its proximity to the bustling Belen marketplace. Every year, the neighborhood is subject to seasonal swelling of the Amazon and its tributaries which brings variable levels of flooding during the rainy season (now). These floods bring all sorts of unique health challenges including dengue and leptospirosis outbreaks.
There are kids everywhere. Most very cute, some screamers and a few appeared neglected. I’m getting great experience in well-child checks and seeing how primary prevention projects are carried out in a poor neighborhood like Belen with very limited resources. As an aspiring primary care doc, I was impressed to see in this context that a devoted practitioner can really make a difference in a community. I keep hearing variations of this idea from doctors here: “medicine isn’t that hard…you just have to be passionate about [helping your patients] and you’ll want to learn/give them the best care.” I believe the physicians in Iquitos really live this mantra.
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