It was barely 5:00 am when the alarm sounded. I sleepily found some clean shorts, brushed my teeth and slipped my pack onto my shoulders as I headed downstairs. I dropped my bag in a stack of rice, hundreds of eggs and countless five liter bottles of water. After almost an exact year since I first learned about Comunidades Unidas Peru, I was finally headed onto the river for the 4th Community Health Worker (CHW) Training of this young organization. As I stepped onto the motorboat that would take me to Mazan, I felt a pang of nervousness flutter through my stomach. What was I thinking that I, a barely 2nd year Physician Assistant student, could teach them? The thought never occurred to me how much they would end up teaching me instead.
Mazan is just 45 minutes from Iquitos by motorboat, with one small cement “road” piercing into the heart of it. We hopped onto a mototaxi, which is essentially a small motorcycle with a covered carriage rigged to the back of it. As this shirtless Peruvian man drove our taxi down the center of the pavement and swerved to avoid colliding with another, I realized the days of smoothly paved roads with bright yellow lines and traffic laws were behind me. We arrived at the Maloca, a beautiful pavilion made of tree branches carved into posts and a thatched roof, and began setting up for our trainings. Registration took nearly all day before it was completed and as the CHWs began trickling in I saw the excitement and nervousness in their own You don’t want to be competing on the same machine month after month. That will get boring faster than watching paint dry. We finished up the afternoon with a large vital sign review and then took a bucket shower and crawled onto our mats in the single hotel Mazan had, completely exhausted.
The days began to blur together as we moved through our curriculum from how to use the index in Donde No Hay Doctor (Where There is No Doctor) to creating a makeshift splint from whatever materials they could find in their villages. I was so impressed by their skill and knowledge but even more so by their desire and will to learn every ounce of material we were giving them. I had envisioned the lecture on women’s health and obstetrics being a complete failure. When I first read through the curriculum I envisioned us trying to give a lesson on using contraceptives and the average length of a woman’s period to a group of machismo middle aged men, completely uninterested in what these American women were telling them. But somehow this lesson evolved into a discussion in which the CHWs seemed completely enthralled. They wanted to know how late in life a woman could get pregnant, how well contraceptives worked compared to family planning, how to help with a birth in an emergency, and the list went on and on. These men that I had so thoughtlessly assumed would tune out every word of this lecture, were yanking notebooks out of their back pockets to jot down each piece of new information that was being flung at them. I realized how little credit I had given them, some of whom had been the sole provider of healthcare to a community of 250 people for often times longer than I had been alive. They knew the needs of their community far more intimately than I could ever expect to understand.
As the trainings began to wrap up I found myself reflecting on all the information I had gained from the promoters rather than what we had set out to teach them, how much my perception had changed and how intensely I now understand the barriers and challenges each of them face on a daily basis. It reignited a passion I had felt when I joined CUPeru, only this time it was not in the sense of a teacher guiding a student, but as a compañera de salud (partner in health) supporting and learning equally as much from them as they learned from us.
Caroline Freed, 2nd Year PA Student