Peru blog - Saturday five weeks ago.

Weather, water and wildlife

Weather is a topic never far from the conversation of most in the UK; what’s it like on the Peruvian Amazon? There are two seasons, the dry and the wet season. This is the end of the dry season and it should have rained more by now than it has. Having said that, we have experienced some periods of sustained rainfall; the first of which was while we were still in Iquitos and it poured, gallons of rain, during our dinner. Umbrellas are necessary, not rain jackets as they are too warm but umbrellas that protect you from the vertical rain. It’s usually only windy as rain is coming in and dies down when the rain arrives.

On Thursday past there was a prolonged storm during which the wind did get up while there were patients still about. The ship was anchored in the middle of the river between villages on each bank and patients were coming and going in the little peca-peca canoes. They kept coming and going and we kept working. The captain ordered the engines started and the anchor raised - he then held the ship steady mid-river. He held the ship so steady that the dentist’s drill didn’t even slip - very steady indeed.

There is high humidity and the daily temperature is in mid-thirties so it’s hot and sweaty most of the time. The best times are dawn and dusk. 6 / 6.30 am and pm - all year round, the days are just about equal to the nights.

During the wet season the river levels rise considerably and floods; hence the houses being on stilts. At those times, river transport can more easily access the more remote villages.

While river levels have always been affected by the weather patterns of El Nino / Nina, climate change is now having a definite impact on the lives of villagers. General supplies don’t arrive when expected, people are not able to access places they used to be able to - and the Vine Trust finds it more difficult to access those who rely on health care from the charity. Challenging.

I don’t know how much the changing river levels impact on the dolphins but I’ve got to mention them. I mentioned that I became the washer woman for the gringas (UK team). Last year, one team of volunteers had clubbed together to finance a washing machine for the ship - what a great idea! Being able to wash clothes properly is a joy, honestly. I’d stuff the clothes into the machine which would then tell me when to return and hang the clothes out to dry. Drying took only a short time - in the sunshine the clothes would be dry in less than a couple of hours. Away from the bustle of clinics it was quiet hanging out the washing and gazing out over the river - and, best of all, there were often dolphins lazily surfacing and gliding in and out of the river. Grey and pink dolphins live in the river and it was greys that were around. A gentle breath of air and they were gone - but left some magic hanging over the river.

Storm coming at night
storm coming at night
Rain clouds over the river
Rain clouds over the river
Quite choppy for the river!
Quite choppy for the river!
One of the large barges that plies the river delivering goods to various rendezvous points. This one consisted of three large flat-beds of goods and one 'cab' to drive it all.
One of the large barges that plies the river delivering goods to various rendezvous points. This one consisted of three large flat-beds of goods and one 'cab' to drive it all.
I wasn't able to get a photo of the dolphins this time - they were too quick and I didn't have the camera to hand - but this is a pink river dolphin in 2016.
I wasn't able to get a photo of the dolphins this time - they were too quick and I didn't have the camera to hand - but this is a pink river dolphin in 2016.

Peru blog - Friday five weeks ago

What do the villagers do to make a living? They work extremely hard and ii takes a toll on their bodies; it’s not easy. The villagers rely on the Amazon for the water for crops, drinking and all personal needs, and for transport, for everything.

Most are subsidence farmers who may sell fish, if they have any to spare. Fish are cleaned and gutted into the river. Barges deliver huge blocks of ice which are then broken down so the ice can be layered in ‘tubs’ with fish. The full ‘tubs’ (I don’t know what else to call the containers) are then slid down the banks onto the barges and boats that take the fish to larger villages or towns, like Requena, to be sold in markets.

Farms are on flat, regularly flooded, areas beside the river and on the banks. Most, if not all, of the fruit and veg eaten in villages comes from these ares. In the early evenings, we saw (mostly) men returning from these fields; some men would have agricultural tools over their shoulders but occasionally they would have guns and be carrying bags that bulged (here I speculate, but not unreasonably) of jungle food.

There is oil refining and also logging. It is convenient to have these on the banks of the river.

Finally, tourism is beginning. On my previous trip on the Amazon Hope II it was very disconcerting to spend time in one of the usual villages then go round a corner on the river and come across the entrance to a luxury spa resort. It can only be hoped that local villagers benefit from employment.

In Iquitos, much of the advertising for tourism emphasised the eco-friendly nature of the business. There does seem to be an ongoing and increasing awareness of the responsibility of environment, at least in tourism. Perhaps the oil and logging industries will become more aware of their responsibilities too. It’s a balance and people need to make a living. It’s easy to judge from the privileged view of someone from a developed country but it’s hard not to be aware of the potential damage these can cause to the environment. The Amazon is such an asset to the country and the world.

I digress and will be back on track with the next entry.

Fish ready to be gutted and cleaned.
Fish ready to be gutted and cleaned
Preparing fish for packing off to be sold.
Preparing fish for packing off to be sold
Ice that has been chipped and ready to be packed with fish for market.
Ice that has been chipped and ready to be packed with fish for market
A slip-way for the containers of fish to be transferred to a boat or barge and taken for sale.
A slip-way for the containers of fish to be transferred to a boat or barge and taken for sale
Flood plain used for farming.
Flood plain used for farming
Fruit trees
Fruit trees
Fruit and veg field
Fruit and veg field
Oil depot
Oil depot
Oil depot
Oil depot

Peru blog - Thursday five weeks ago

Local health care and challenges.

Photos are of a health clinic in a village. There may, or not, be a nurse. Bigger health clinics are in Iquitos and I’ll post photos of them tomorrow.

Getting on board the ship for treatment can be a challenge to those less able - but there are few who don’t manage. Families are made up of all ages groups - there are no care homes so the elder people are cared for by their families. Women are often still teenagers when they start having children. With large families and hard physical work most people are physically worn out by their late middle age.

Children may be a little malnourished, most people have anaemia and adults come weary and with many aches and pains. Most cases are fairly simple but there may be occasions when minor surgery is necessary. Children have been born on the ship.

Dental care is basic, extractions and fillings. One lady needed two teeth extracted, a moral and a front tooth - she decided not to have the extractions, even though she knew it would mean months of pain, because the front tooth would leave a gap and there was no way to get anything to fill the gap. The ship will next visit in about three or four month by when she’ll be in a lot more pain.

Seeing people in pain isn’t easy. The hardest times are when there are patients for whom nothing can be done. Two cases …

One elderly man came complaining of back ache. There was a massive tumour growing between his kidneys and his spine - you could easily see the lump through his tee-shirt. He was sent away with painkillers and warned the pain would get worse. His family brought him and would look after him.

One teenage girl went to the dentist; there was a problem with her tongue. She’d had cancer of her tongue and an operation of some sort (which was unusual in itself) - but now the cancer was back, with a vengeance. Even if she could have had further treatment, what quality of life would she have with no tongue? She was a teenager and would have been unable to speak or eat properly for the rest of her life.

For each of these, further treatment might, only might, have been available in Iquitos but probably Lima would have been better. There are no resources to get them to Lima. >All that can be done is to send them away with painkillers and prayers.

Knowing this, accepting this, processing this - that’s the hard bit.

Reception and records.
Treatment room.
Treatment room.
Delivery bed.
Ceiling in one of the treatment rooms
Store cupboard
Another treatment room.
And another treatment room.

Peru blog - Wednesday five weeks ago

Village life - After talking about the routine on the ship and mentioning the villages it seemed like a good idea to show some pictures of the villages.

Villages inevitably range in size and each has it’s own character. The closer you are to Iquitos the larger the village, much like in any country, the closer you are to a bigger town the larger the villages tend to be.

Access to the villages is by river only. There is usually some sort of canoe for basic transport, the speed boat and bigger barges. Steps are cut into the embankments for access; these can be recut after the floods. Much easier to replace than wooden steps. There are streets, some concrete and some well-trodden mud. Usually a communal sports area - as mentioned before, sport is part of most days, at least for the children. Mostly, now, there is electricity for light. I’m not sure but think the supply is from solar power of some sort. As far as we could see, cooking is done over open fires.

Houses in the remote and the poor areas were made of wood or wiggly tin (corrugated tin), built on stilts to be above the river when it floods and consist of one large room with a kitchen area (set a little back to minimise the fire risk). The poorest houses were simply a platform on stilts, that’s all. The better off houses had external walls and internal partitions to give privacy. Occasionally there were mattresses but often people slept in hammocks. Any possessions tended to be on open shelves, again to minimise the risk of damage from flooding.

Water is sometimes from a well but people are a bit suspicious of these and there is not always a supply of water. More often water is taken from the river: the river is saturated with silt, fish, dolphins and unknown numbers of bugs live in the water and the people wash themselves and their clothes, and to drink from. There is little or no sanitation in many villages so when the rains come the effluent goes into the river. No wonder each person registering on the ship needs a worm and anti-parasite pill.

In the larger settlements there may be concrete shacks and buildings that are more robust. There, however, are not that well built and soon fall into disrepair. Damp and humid conditions make it difficult to maintain buildings very well.

Usually there is a primary school (where most children start learning English at an early age!), occasionally a high school, a little shop of some sort and a health clinic. For more than basic health care people have to travel to Nauta or Iquitos; often even the facilities in towns are beyond the means of people who are unable to afford further treatment. I need to expand a little on this and will do so tomorrow.

Steps to the river and a woman getting water for her family.
Track to a village.
A village main street.
Canoes - they have an outboard on the end of a very long pole which allows for the propellors to be at varying height in the water and adjust to the river level.
Sport's pavilion
Children playing.
Half built house.
Poorer houses by the river in Iquitos
Nice village house with walls and partitions, and cool thatch.
Poorer house, just a covered and elevated platform.
Town houses in the background.
The tub-tuks were carrying a procession that might have been part of celebrations of a girl's 15th birthday, a special coming of age milestone.
Primary school
Village shop - fairly well stocked! It was also the family home
Travelling shop

Peru blog - Tuesday five weeks ago

The medical teams have defined roles: there are various teams. There are a few employed by the Vine Trust, including the lead doctor who has overall responsibility for the work on the ship. Some of the Peruvian volunteers work onboard so regularly there are almost fixtures, eg the pharmacist, one of the chefs, and one of the translators. There are those employed by the Peruvian Health Service. There is also the ship’s crew, the cooks, engineers, captain etc. These all help out with eg registration, on busy days. Add to this mix the translators (English / Spanish / local dialects, talented people!)

The Vine Trust, at first, was the only provider of primary health care in these remote tributaries of the Amazon, and gained the trust of local peoples, while being accountable to the Peruvian health authorities for the care given. The Peruvian Health authorities now have some better funding and are able to send newly qualified medical and dental professionals out on the VT ship to the area.

Add to this mix the volunteers! There are usually doctors, dentists and other medical professionals and then the occasional extra like myself. I was there as ‘pastor’ and general dogs-body. Each morning there was half an hour of devotions; there was singing in English and Spanish, a Bible reading and reflection, which was translated as required, and prayers. I was asked if I might preach in a village one day but that didn’t work out. I also did the laundry for the gringas. Gringas was the name given to the UK medical team on this trip.

This trip, as well as the last, I was taken aback when a Peruvian mentioned how good to was to see a pastor doing the practical work of helping and serving others!

Peru blog - Monday, five weeks ago yesterday.

I stayed on the boat today while the others visited the village school where the gringas (the UK team) learnt Spanish vowels and, in return, taught the children the song ‘Head shoulders, knees and toes’.  In the afternoon there were clinics.  

What’s the ship like, it’s facilities etc

There are two long consulting rooms; one housing two dental surgeries and the other, two medical surgeries.  There is much more equipment on this ship than the previous one, (more about the Amazon Hope II another day).  As there were three UK doctors in total (one had already been on the boat when we joined), the third doctor consulted in the mess area.  There were Peruvian medical staff too, including the lead doctor for the ship.)  Quite often consultations were interrupted by crew going through the mess to the kitchen or others coming in to make teas and coffees and sit for a short break.

Routine - overnight the ship moors up at a village or point along the shore.  It’s dangerous to keep moving at night as sandbanks can suddenly build where there previously were none, and huge logs float down and bash the ship.  In the morning either the ship serves the village where its moored, or we motor up the river to the first port of call.  

Once the ship arrives in a village, the Peruvian medical team go into the village and encourage locals to come to the onboard clinics or find out if there are any people who can’t get there and home visits are arranged.  

There are morning and afternoon clinics.  The ship may, or not, move over lunchtime, depending on demand and schedule.  At the end of the working day, everyone on the ship is encouraged to go ashore (at least one or two stay onboard to ensure safety of the facilities etc) and join in sports sessions; these are routine at the end of the working day for villages and they are delighted when others join in football, netball or volleyball.  Those who are not sporty may stroll in the village; it’s perfectly safe because of the good reputation of the VT and the hospitality of locals.  

Dinner is after we return and sometimes followed by tutorial eg the one tonight was on the tests done onboard on urine samples and what can be deducted from various results.  If the ship is to move after an afternoon session it does so during the remaining daylight of early evening and there are no sports sessions.

Registration area - national ID number, names, height, weight, bold pressure, worming and anti-parasite tablets and basic triage. A quiet day!
Waiting for the dentist or a doctor.
Dental work.
Consulting area for two doctors, one in the picture and one of the translators.
Lab tech in one half of the spacious lab!

Peru blog - Sunday five weeks ago.

Travelling is fine but five hours from home to Edinburgh, a flight to Amsterdam, another to Lima, then to Iquitos, two and a bit hours on a bus then another two and a bit squeezed onto a speed boat was enough.  It was good to get to the boat yesterday; and to meet up with my doctor friend from here.  

What was not good was that I wasn’t well overnight (something nasty I’d picked up somewhere on the journey and I’ll spare you the details) and stayed in the cabin recovering.  The others had emergency drills and started work.

What is the The Vine Trust?  ‘The Vine Trust grew out of a charity gift shop set up in the 1980s in Bo’ness Scotland in response to famine in Africa. Projects in Tanzania and Peru have now helped over 1.3 million people living in severe poverty.

Medical expeditions enable medical and dental volunteers to use clinical skills on the Peruvian Amazon, and on Lake Victoria Tanzania, to provide primary healthcare to isolated and remote communities living in extreme poverty.‘ (From the Vine Trust website).

What’s it like there?  Iquitos, where the boat is based, is over 2,000 miles from the sea - and from there the boat goes further inland, up various tributaries of the Amazon to reach those in need. 

The Loreto region around Iquitos is roughly the size of Germany and it’s 56 districts are all categorises and ‘poor’ with38 districts being ‘extremely poor’ where people live on less that $2 per day - that’s roughly £1.50.  Access to clean water is less that 10% and each person, unless a baby, coming onto the boat is given anti parasite and worm tablets.  Anaemia is rife.  Yet, the people are usually cheerful, resilient and very smiley. 

It’s an awesome and humbling privilege to be pastor to any trip.  

The photos - 

Some of the locals still live on their river boats. The thatched roofs are cooler than tin but having tin over the apex helps keep out the rain.
The Vine Trust's Forth Hope. Home for ten days for me and for 20 days for others. Some Peruvian volunteers go with the boat for many trips each year and the boat really is home from home for them.
Our cabin. It may be compact but it's comfortable, clean and we have all we need. There are the bunks, two large drawers under the bunks, the shelf, reading lights, air-con.
Luxury! Honestly, having a bathroom between two is luxury.  
The corridor to the cabins. There were eight cabins off this corridor. The shoes are those used for going ashore and, usually, had mud sticking to the soles. This was mud that was not wanted in the cabins. Who knows what little bugs were in the mud.
This is a speed boat very like the one we'd arrived on. They go whizzing up and down the river, taking those who can afford it between villages and perhaps even as far as Nauta or Iquitos.

Peru blog - Saturday five weeks ago.

5am pick up for 6am departure to Nauta. The only road out of Iquitos is to Nauta, 80km away. The only road out of Nauta is to Iquitos. The bus was full of people and goods; once you were in, there was no way out. We were so highly packed in that, had there been an accident, we wouldn’t have moved. Health & Safety, what???

At Nauta we transferred onto a speed boat. Like the bus, we were highly packed and whizzed up the river to meet the Amazon Forth Hope just on the left on a bend in the river a few miles short of Requena. After over 5 hours of constant travel, the Forth Hope was a very welcome sight!

At lunch we met those who were leaving the boat after their ten days of work (one the sister of a lady with strong Kilchoan links - small world!). Then we met the Peruvian teams and crew, and settled in as we motored to Requena. We had been due to stay the previous night in Requena but, having seen the town, I’m glad we didn’t.

Speed boat from Nauta to the Forth Hope. There were 24 people and huge quantities of luggage and goods packed into and onto this speed boat.
The driver was very young and the electrics very old.
Entrance and exit ready for travel.
Requena - storm brewing.
Requena market - not for the squeamish.
Requena - shop mannequins - the male mannequins looked more odd!
Requena market - a pet armadillo.
Requena - river-side homes.
Requena - huge barges like this deliver goods and people all along the Amazon.
Sunset on the Ucayali tributary of the Amazon.

Peru blog - Friday five weeks ago

A ‘rest’ day to recover from any travel tiredness and to be ready for early departure tomorrow.

The Vine Trust guild and translator, Ernesto, took our group on a walk through Iquitos, stopping at Parroquial Nuestra Senora de Fatima church to climb the tower and see the panoramic view, and on to Belen market. The market was fascinating, smelly, busy, bustling, and full of unusual sights!

After that we rode in tuk-tuks to the port area and took a water taxi to Pilpintuwasi Butterfly and Wildlife Reserve. The animals there are rescued pets that outgrew their owner’s expectations - although how anyone could think a jaguar would make a good house pet is a challenging thought!

We had lunch on a floating restaurant, which was delicious and inexpensive.
Lunch was shaken down by a bus ride through Iquitos. There is a manatee sanctuary at the other end of town and, when we got back to shore, the guide commandeered a local bus to go to the reserve. The buses are mostly wood which has replaced the metal as the metal rusts away in the damp atmosphere - and made the ride interesting …. The manatee sanctuary was closed.

Somehow, we also visited a museum on a river boat that was full of exhibits from the rubber boom era.

After all this excitement we were ready for a rest and got back to the hotel for a short. We headed out for a snack dinner before an early night.

Above - Iquitos from the church tower
Belen market - plantain roasting
Belen market - turtle eggs
Belen market - roasted grubs
Belen Market - cat fish
Pilpintuwasi - Ukari monkeys
Pilpintuwasi - jaguar
Pilpintuwasi - blue morphu
Pilpintuwasi - blue morphu caterpillars
Pilpintuwasi - macaws escaping

Peru blog - Thursday five weeks ago

Thursday - Lima to Iquitos

Met the other four going to the ship - two doctors, a dentist and a pharmacist. Flight to Iquitos where we were staying overnight.
There is a road that goes from Iquitos to Nauta, 80km away, but neither city / town has a road going anywhere else. Nauta is only accessible from this road or the river; Iquitos is only accessible by plane or river.

A Vine Trust guide met us and showed us round Iquitos.

Because of the developing rubber trade, in the early 1800s, the town grew from a small village to a substantial town. Seeds of rubber trees were taken to Malaysia and the trade transferred there leaving Iquitos, once again, a backwater on the Amazon. Now, it’s the main hub for those travelling on the river - supplies, small hospital, a small university and various other services.

So we would make the connections, we had two nights there.

The first photo is of the traffic in Lima near the airport, the second of the traffic near the airport in Iquitos, then the area round Iquitos and finally one of the houses that used to belong to a rubber baron and is now a cafe.