Adventures of a Mt. Airy medical student in Peru: strike, riot, malaria, etc.

by DOUG BERNSTEIN

Last summer, we published some evocative e-mails that Mt. Airy resident Doug Bernstein sent home from his post-college summer journey in Southeast Asia. This summer, having completed a year at Johns Hopkins Medical School, he is working on a research project in Peru where the lab is primarily studying the health effects of deforestation. His first note below, responded to a query sent to the project secretary from his mother, Pam Rogow, after she’d not heard from him for several days following his arrival in Peru.

June 30, 2004 - Iquitos, Peru

I just wanted to reassure you that I’m fine and well settled. It has been harder to communicate than I thought. While the phone system is fairly easy if you buy a phone card, you have to contend with the majority of phones that are broken in one way or another. In our casa, about half the buttons stick down when you press them, making dialing a hassle that can take half an hour. E-mail is easy if I get to the lab, which doesn’t happen that often, although more in future. I’ll get you updated contact numbers soon.

However, I think the reaction to not having contact info has been unnecessary and unfair. You need to chill out and realize I’m in the Amazon. I know what I’m doing to stay safe, but I can’t just phone home and sit around writing e-mails all the time.

Living in a house with a bunch of other first-year med students and public health people. One other guy, four girls. I commute from this city to the rural village where we collect samples and interview people. It’s a 30-minute trip over paved and nasty dirt roads, and I need to be there by 6:30 on some mornings, 8 on others. I go alone, as the other students have different projects. As soon as I arrive, we start walking for three to six hours, depending on how many families we need to see. It is hot and humid but not quite as bad as I was expecting. Malaria is totally endemic in the village, so I’m on guard for that. We collect stool and blood samples from about 20 people a day, and we carry a small backpack full of canned milk to bribe them, so the walks are brutal. My Spanish is improving very slowly; rains come in really fast, pound the hell out of everything for about five or ten minutes, and disappear. I go home with my PI (principle investigator) Margaret, in her 44-year-old jeep.

July 8, 2004

Things have slowed down a bit. My “field work” hasn’t been all that rewarding, at least not yet. I get up at 6:30 almost every day, walk around with the women through mud and blazing tropical sun, and collect a few samples. Then I have to kill three full hours every day waiting for them to prepare the samples so I can bring them to the lab. During this time I try to study Spanish, which is a plus. But it is very hot there, and I’m often tired by 10, so it is hard to focus.

The lab work is kinda cool. I collect flies in people’s homes and take them back to the lab to look for e coli. This requires washing and/or crushing the flies, then straining them in a filtering device I made out of rubber bands, a colander, and some gauze I bought from a fabric store. Then I suck the filter water through sterile collecting fiber, and see what grows on the filter after 24 hours. It tells me how much of a role house flies play in spreading e coli, which is the main cause of diarrhea.

I wash my hands frequently …

July 11, 2004

A classic Amazon weekend. Woke up at 6 a.m., breakfast of fresh papayas, avocados and bread, then jumped into a motorcar. We headed to the port, where we jumped in a small wooden boat and headed to the confluence of the Amazon and Yarapa rivers. There one can see the famous pink dolphins, or “bufeos colorados.” When I heard the dolphins were pink, I figured they were probably a bit less gray than normal dolphins or maybe had some pinker shading on their bellies. Wrong. These are a saturated Barbie pink over most of their bodies.

We also look for birds, which flock to the same schools of fish on which the dolphins feed.

From there we went to an island and took a dugout canoe to fish for carnivorous piranhas. As you would expect, you use meat to fish for them. Then it was a traditional Iquiteno lunch of Juanes, tamalitos, aji and refresco. Juanes consist of a pile of rice, chicken, olives and spices, all wrapped up and steamed in banana leaves. It’s wrapped to look like the head of a scarecrow (stuffed with your food) with a neck of banana leaf stems.

This design is no coincidence; Juanitas get their name from San Juan Bautista, the patron saint of Iquitos, who was beheaded by a jealous princess. Tamalitos have corn and meat, also wrapped in banana leaves. To both of these dishes you add aji, a catch-all term for many types of spicy and savory garnishes and sauces. Refresco is just juice, but you never know if it will be from the camu-camu, macuna, cocona, manzana, maracuya, durazno or some other delicious tropical fruit.

We spent the rest of the day tooling along the Amazon River, spotting iguanas in the trees and birds in the air.

Getting back after sunset, I had to hit the lab for a rousing Saturday night of steaming and straining houseflies to see how much human excrement the flies were carrying. We’re having trouble with the protocol right now, so I haven’t had any good results, but I’ll let you know what we find when things smooth out. The dean was right about my work down here; it is a bunch of crap — runny, bloody, with mucous, without mucous, with worms, with amoebas.

July 13, 2004

First things first. Don’t panic, but there is a country-wide strike/riot going on as I write. The communist-led “General Confederation of Peruvian Workers,” the country’s largest labor federation, began organizing the strike last month to demand higher wages, especially for teachers, bus and truck drivers, and others. They are also expressing their disapproval of President Toledo’s government. (His approval rating has dropped to less than 10 percent.) The timing was organized to coincide with the Copa America, the biggest soccer tournament of South America, which is being held this year in Peru.

Last night, at least every other intersection in our city had piles of burning tires and garbage, and tons of glass was broken in the streets. The people are actually quite amiable. Some Peruvians escorted me to a corner where they knew the people who were burning the tires, so that I could get some photographs safely. Today we are all holed up in the laboratory. I hid my passport in our house and turned on our electric fence. The streets are actually very calm right now, with most stores closed for the day, and you can walk everywhere safely (more safely, in fact, since the thousands of motokars that are constantly trying to run you over whenever you cross the street are off today).

The entire city is very quiet right now. Motokar drivers who work today have a very high risk of having their motokars overturned and their tires slashed. Plus, the barricades and glass are pretty effective at stopping traffic. Later this afternoon there is supposed to be a big march at Plaza 28, which is three blocks from here. It is supposed to be fairly dangerous, so we are just staying holed up with the doors and windows shut. Despite all this, the streets feel very tranquil and friendly right now. The strike is much more about protesting the government than about looting and attacking people, so there is very little violence that I can see or have heard about.

Also, the Peruvians who escorted me to take photos last night were very friendly. One is a forestry/conversation student at the local university, and he’s taking me out this Sunday for a trek in the jungle.

Don’t worry about us. We really are quite safe. Will keep you posted.