After a one-hour motor boat ride to Mazan and then a two-hour slow canoe boat ride to Llachapa we pulled up at an idyllic green hill on the side of the Napo River. Eager children approached us to help carry all of our supplies up to the school where we were staying. One little boy was only 3 years old and carried 2 large sacks of bread up the hill. As we passed by two rows of little wooden houses on stilts with people peeping out, it hit me just how rural this community was. Our whole team was excited and moved by how welcoming and invested Llachapa was in our visit.

We quickly sprang into action getting everything ready for the arrival of the Community Health Workers (CHWs) and the first day of the training.  Our new partner, Teresa Benedez, from the Peruvian Ministry of Health (MINSA) helped us register the CHWs as they trickled in. I was excited to meet all of them and see what they knew and how they practiced in their community. After a year of being on the Education Committee and preparing a curriculum for these trainings, I couldn’t wait to find out what they had retained from past trainings and what new things we would teach them.  After seeing that many of them needed help with taking a pulse and a respiratory rate we immediately began reviewing those skills in small groups and facilitating the more advanced ones to teach their colleagues.

Now it was time for dinner. We brought a ton of food, so much that I couldn’t even carry the 300 eggs that we brought. I had eaten in the jungle before. I knew to expect bones in my food and strange Amazonian fish. However, I couldn’t stomach the fact that I had a cabeza (fish head) staring up at me with its pearly eyes while Lida sitting next to me had the other half of this creature including the tail. I looked around me and saw everyone else happily eating so I offered my cabeza, a delicacy, to one of the other CHWs who appreciatively ate it.

The next morning we taught the CHWs about nutrition. Each small group had topics such as malnutrition, diet and growth charts. After each group had learned their topic, they presented it to the entire group of students. My group made a meticulous example of a growth chart and then taught everyone how to read one. Jaime, one of the older promoters in my group, explained that if a child’s growth crosses 2 or more growth lines then that child is in danger.  Afterward, he explained to me that he was so thankful to know that someone (CU Peru) trusted him enough to teach him and his colleagues how to read a growth chart since he was never entrusted with that capability before and never had felt empowered to even ask to see a child’s chart in his community.

On our third day of the training we taught about malaria. This topic was well received by the CHWs especially during a time of increasing cases. They were engaged and asked questions about the lifecycle of the mosquito. They even asked if malaria could be transmitted by drinking water that contains mosquito eggs (it can’t, in case you’re wondering). During this lesson was one of the many times when our new partnership with Sociemap, a medical student group in Iquitos, came into play. Guillermo a 3^rd year medical student accompanied us and taught the mosquito life cycle and facilitated a discussion among the CHWs on different points at which prevention could be implemented. This new partnership has widened our circle of influence and provided a cultural and regional link between CU Peru and the CHWs.

Things got competitive when we started a game of jeopardy about malaria. The students would run up to us to buzz in on the imaginary “bell,” which was slapping our hand. They were so into the game and almost always knew the right answer, even down to the tiniest details.

At the end of a long day of learning about malaria we started a game of Volleyball with the CHWs and some children from the community. Soon it began to sprinkle, rain, pour and then thunderstorm. We all kept playing despite being drenched, screaming and laughing and jumping in giant puddles. This was when I finally felt a strong connection with everyone involved: the CHWs, the community, the children; everyone was ready and willing to stick things out and work as a team even though it was pouring buckets on all of our heads.

The final day I was filled with excitement to test what we had taught our students. When Rolando, one of my most attentive students, stepped up to take the post test, I felt excited and nervous for his performance. He answered the test questions with such confidence and so quickly that I was taken aback and had to check to make sure that I had heard him correctly. At the end of the test, I looked back and he had gotten nearly every question right! I felt so proud of Rolando when I handed him his certificate and said “Felicitaciones” (congratulations). As I got into our “peke peke” (boat) and waved goodbye to the people of Llachapa, I felt a pang of sadness to leave the community and all of the CHWs. As I waved bye to them, I was fully confident that they were to return to their community with the knowledge and capability to change the lives of their fellow villagers.

Sarah Allexan,
2nd Year Medical Student