Our brief trip to a community of about 250 people an hour´s peque pèque ride from Mazan was a whirlwind of lessons for my group of 3 CU Peru members. The challenges faced by some of the communities we work with can seem impossibly daunting at times, and our intervention – training volunteer health promoters – can seem like a drop in the bucket. It feels silly teaching hand washing when the school doesn´t always have water near the bathroom (because people living nearby use the school´s water to bathe with instead of walking down to the river), there´s no soap (because it”s one of the many essential school supplies overlooked by the government) and there are no lights in the school at night (because someone stole the school´s solar panel installed by a NGO several years ago). There are innumerable problems that we´ll probably never be able to even touch as a group of foreign students with limited Spanish coming for 1-2 months a year, but every once in a while we stumble into a situation that makes it feel like we´ve made significant inroads into very real problems.

I was reviewing and revising the community health survey we´re hoping to use in future years with the community´s health promoter when Jess interrupted us – there was a sick child whose mother was looking for some guidance. We could not have asked for a more perfect test of the material we had taught one week before in our promoter training, which focused on vital signs and diarrhea. The 2 year old had been ill with diarrhea for 2 days, and she´d been eating and drinking less in the last day than normal. Her mother was concerned that she was getting lethargic as well.

The promoter got a history of the current illness that any medical student could be proud of frequency of stools, color, presence of blood, energy level, oral intake, subjective fevers, and remedies given were all covered online casino before he started his exam. He started with vital signs, which he was successfully able to check on his own, and while he initially misjudged the pulse as being high, a review of the information in the educational materials given out in the training showed that the child´s pulse, respirations and temperature were normal. He checked for skin tenting, sunken eyes and abdominal discomfort, which were also negative. Finally, he reviewed his assessment: non-bloody stools, normal vitals and a reassuring exam, but poor oral intake – oral rehydration therapy would probably be sufficient for the time being, with re-evaluation in the morning and plans made for a trip to the health center (in Mazan, an
hour boat ride away).

It was incredibly gratifying to see our brief training on diarrheal illness triage, treatment and prevention implemented so effectively. We were fortunate enough to work with a highly adept promoter who had worked to become a respected educator in his community, and in conversations with other members of the community, it sounded like our visit boosted his credibility. While I consistently felt like we were only making a dent in the community”s problems, it did feel as though we had done something positive, however modest, during our brief stay.