As a first year pharmacy student who has previously done medical related work in impoverished areas of Latin America I thought I had a good handle of how I would be spending my time in Peru. I am surprised to find that it is quite different than I had expected.

“Wear something nice tomorrow” said Igor, a fourth year med student and current president of CUPeru, before clicking off the light and climbing into the crisp clean sheets at our hotel in Iquitos. “Tomorrow is our meeting with Dr. Ferruci (the director of the ministry of health for the Loreto region), it’s an important meeting.” Igor had been networking like crazy the past week, setting up meeting after meeting, working his way up to get his foot in the door with the Director. I knew how important this meeting was.  We woke up early to discuss what we wanted to accomplish. Our goal was to articulate who we are and explain how we educate community health workers in the rural regions of the Loreto province of Peru. We would do this hoping he would take note of our great work and eventually trust us to operate freely and maybe even one day collaborate to help train community health workers.

After coffee, Igor, one of our mentors Dr. Richard Anstett, and I crammed into the back of a motorcar and headed to the regional governmental office. I knew right when I walked in that I had underdressed. Official looking men and women hustled and bustled exchanging signatures and handshakes. High heels clacked on the hard stone floor, echoing off the walls and then abruptly stopped in front of us. A well-dressed woman with impeccably placed hair greeted us with flawlessly enunciated Spanish. I looked at my blue cloth shoes, and back up at the dapper Peruvian business woman, then at Igor (equally well dressed), then back down at my raggedy shoes.

The last thing I expected to be feeling in Peru was underdressed. I packed for survival mode: high top boots for protection from the snakes, rain poncho for torrential rainforest soakings, Swiss army knife for emergencies. I left my sleek leather dress shoes at home, polished for when I return. My dress shirts freshly pressed, still hang in my closet. “Surely, I won’t need these amenities?” I asked myself as I packed. “No, CUPeru is about teaching rural health workers in the far corners of the Amazon, they will just be dead weight in my pack.”  This CU Peru rookie couldn’t have been more wrong.

After some time we were taken to a room with a table that seemed to be up on a stage. The thick black tablecloth had a very official looking emblem embroidered into it. Dr. Ferruci entered and everyone stood up. I clumsily scooted back my heavy wooden chair and stood as straight as I could to shake his hand. Most of the Peruvians I had shaken hands with had a limp hand shake, but Dr. Ferruci’s was strong and direct. We sat down again. Igor began the meeting explaining who CUPeru is. He reached into his brown leather laptop case and pulled out several manila folders that contained the schedule for the trainings and handed them to all parties present.  He explained how we are graduate students of various medical fields who volunteer our time throughout the year fundraising and preparing the CU Peru curriculum. He talked about our newly formed partnership with a Peruvian group of medical students in Iquitos called Sociemap and how we are planning to collaborate during our upcoming trainings. He showed them our recently made mini-documentary that explains who we are and our unique teaching methods. Dr. Ferruci listened attentively, every so often pulling out one of his countless mobile phones and skillfully texting responses without taking his eyes off of Igor’s presentation.  It was clear that he was enjoying what Igor had to say, he wore a very sincere smile. He seemed especially impressed by the small group teaching model and how interactive the trainings are. Everyone from both parties appeared pleased with how things were going.

Igor concluded and Dr. Ferruci said a few words about how impressed he was. Then he paused. The silence lingered in the air for a long time. Igor and I exchanged glances. Had we both been wrong? Was the Director of Health less impressed with CUPeru then we had presumed?  He began to talk, his tone notably quieter and more serious. “There is an outbreak of malaria” he said gravely, looking downward, breaking eye contact for the first time. “We are afraid it will get worse if we don’t take action in the villages.”

“What is going on?” I thought to myself. This was not the response I expected after explaining our organization. The meeting had taken a turn and I had no idea where it was going.

Dr. Ferruci paused and drew his gaze from the table back to Igor, looking him face to face. His thick eyebrow were furrowed in seriousness “We would like to form a partnership with CU Peru for the training, to help teach community health workers to prevent, diagnose, and begin treatment for Malaria.”

My mind was blown. What he was asking of CU Peru was shocking to me in so many ways.  I had always been under the impression that the role of the community health worker was only prevention and triage, almost never treatment, especially of a disease as serious as Malaria. Secondly, we had left such an impression on him that he wanted to partner with us. We had tried in the past to form partnerships with the ministry of health and had difficulty even getting them to recognize who we were.

Since I joined CU Peru I have had ambitions of being in a leadership position, but at that moment I did not envy our President. He had a very difficult decision to make. An important man, in a high ranking governmental position was asking for his help to complete a critical and difficult task. Normally we have a year to plan our curriculum. We were just a few steps away from solidifying our training dates and he was asking us to add on two more days. It could potentially be a logistical nightmare.

I looked at Dr. Anstett. We were both on the edge of our seats to hear what Igor was going to say. “Sería un honor (it would be an honor)” Igor replied. Dr. Ferruci smiled as the tension in the room subsided and then filled with excitement. I think that both Dr. Anstett and I knew at that moment that Igor had made the right choice. We came to this place with the hopes of helping train community health workers to save lives. We arranged this meeting with ambitions of taking the first steps in a partnership with the regional ministry of health. In that moment, we had a chance for both dreams to come to fruition.

The days since have been a whirlwind of curriculum planning and we’ve had several more meetings that I still felt underdressed for, but I’m starting to get used to it. We took a 4 hour boat ride from the main city to meet the mayor in Llachapa (one of the locations for our trainings) to sign a logistics contract. As we were going over the paperwork he told us that his son and sister were recently diagnosed with Malaria.  It was disheartening to hear, but at the same time it put in perspective why we are working so hard.

-Michael Carpenter, Second Year Pharmacy Student