Worms in the Rainforest -- A Trip to Tarapoto
I just returned from my fourth and last "side trip" while we're here in Peru. This week I was in the city of Tarapoto, a rainforest city in the northern part of Peru. Tarapoto is a wonderful place -- nice weather, relatively quiet (population of city is about 64,000 with about 118,000 in the broader area), friendly people and an amazing environment. While in Tarapoto I visited with an NGO named URKU Estudios Amazonicos (www.urkuperu.org) which works in several indigenous communities in the area, investigating possible ways that Wabash students could learn about issues surrounding the parasitic / infectious disease problems which exist in this area.
Like many places in rainforest regions, many of the people who live here suffer from a variety of parasitic diseases. There is a very high level of helminth (worm) infections in the people and, like many of the rural places I've seen in Peru, anemia and malnutrition are real problems; a local physician told me that malnutrition rates are about 50%.
Visiting with this physician (Dra. Rosa Giove, who happens to also be the mother of the director of URKU!) was very interesting -- sitting in her office late one night she brought out the medical histories of folks she had seen just in the last few days (a stack about 2" high). She was explaining that many of the people carry Ascaris infections (this is a large roundworm parasite) in addition to pinworm and other problems. She was very open to the possibility of helping teach visiting students and having guys help to document some of these problems. Moreover, she has some good ideas for health campaigns that could be done in the area, including education materials that could be developed as students learn about the different levels of health issues.
In addition, she's also very active in using tradition medicines to treat her patients, in combination with more "advanced" drugs. There is a vast amount of ethnobotanical knowledge which is being lost from indigenous communities in this region. Many people use different plants to treat ailments and infections, including their parasite problems even though there is a realization that these treatments are insufficient in the face of the problems (more on this below).
Probably my most memorable experience of this trip was a visit to an indigenous community near the town of Sisa (called Kawana-Sisa). We traveled there by motorcycle with Carlos (Daniel) Vecco, the Director of URKU, who holds a special place in this community. There my colleague and I received an incredibly warm welcome. We met in an open-air meeting house where the president of the community (and of others, as well) officiated at a meeting of the community leaders. We were served a drink known as masato in half of a coconut shell as the leaders took turns speaking words of welcome and thanks to us for our visit. (By the way, masato is alcoholic and made from manioc, or yucca. The traditional way this was prepared was for the 'cook' to chew the manioc -- the saliva moved the process along and reportedly improved the taste. We were told by Daniel later in the day that our batch was a non-saliva one, so we'll just go with that.)
After the folks in the community welcomed us, they spoke passionately about how their health (and the health of their children) is their biggest concern. These people do not have ready-access to health care; the hospital is a considerable distance away and there is no medical clinic in their small town. They spoke of how the hospital will often not examine their children unless they are extremely ill and about the parasitic infections that they have (but about which they know relatively little). Because of this and other reasons, they typically treat themselves with natural products unless it's an emergency. For example, for one of their ailments they use something from a boa (yes, the snake) to treat themselves. Conveniently, they had about a 5-foot live boa on a leash on a tree behind one their houses. An interesting cultural experience, to be sure.
After the meeting we were presented with special gifts (that we wore with pride) before we were invited to eat a special meal that the leaders had prepared for us. We retired to one of the homes to eat juani, an ancestral meal made of manioc and fish (along with some more masato!). This was a special honor. Many of the kids and others were gathered around just to see what was going on, and one of the women who had helped prepare the meal stood nearby simply to fan away flies while we were eating with some of the other men. Afterwards we participated in "sobre mesa" -- a culturally-important time of conversation around the table following the meal. The men of the community continued to speak of some of their struggles and the difficulty they are currently having with a petroleum company that is trying to take over some of their land. URKU helps this community in part by offering some legal advice and some large context for them as the community leaders prepare for upcoming meetings.
From my perspective, involvement with this community would be an amazing experience for students. There is a great deal to be learned here -- from information about various diseases and infections to ethnobotany to the tension that isolated local communities have with the regional and national government here. Moreover, the relative impact that students and the College could have on this area is significant. The shared involvement of students, other faculty (both from Wabash and potentially other institutions) and alumni -- including physicians -- from Wabash could result in great things. There's much to work on and to think about here.