... back again

i arrived safe and sound in Iquitos on the night of March 25th. the 14 days on Amazon Hope were perhaps one of the most amazing times of my life. seeing, feeling, experiencing, doing things that few people in the world will ever see. we attended to over 2500 patients (medical, dental, immunizations and obstetric visits).
the days that followed were full of last times seeing people, goodbyes, my camera being stolen, getting ready to leave, and much, much travel. i arrived in the USA on March 29th, exhausted, with a sinus infection and intestinal problems where i was met by Caron (with annabelle and violet), Julie, Renae, Joie and Brook. Thank you so much for welcoming me back!
i now have no pictures to post of the boat experience until i track down the people from Scotland who were with us for the first 10 days of our 14 day journey. the rest of the time will only live in my memory and heart. i'll be posting some stories in the days to come. i'm sleeping a lot this week.

As for residency...
i will be joining the staff of the University of Illinois St. Francis Medical Center in Peoria, Illinois starting June 21st! This was somewhat of a surprise, but it is at the Hand of my Sovereign, All-Powerful Heavenly Father whose purposes stand firm forever, who does everything in faithfulness and love for His children. and so it is. my anticipation is growing and i am eager to see what is in store for me there. and to start working as a doctor. finally. the program is well established, primary care focused, family-oriented, involved in the serving the community (especially the underserved because it is a Catholic Hospital), sees a great diversity of people, are interested in preparing me for what i want to do in the future. and as an extra bonus, the financial benefits are amazing. i am thankful that this is where i will be for the next 4 years.

Graduation is May 5-6, 2006. come if you can!
and from thence forth, i'll get to sign my name with an "M.D."

I will cry out to God Most High,
to God who accomplishes all things for me,
to God, who fulfills His purpose for me.
Psalm 57:2

Amazon Hope

tomorrow i leave for 2 weeks on the boat, Amazon Hope. it will hold a crew of 4-5 Peruvians, 8 Scottish medical personnel, 5 peruvian medical personnel, and me, the lone americana who will also be translator for part of the time. and many, many patients. we´ll see patients in the "hull" (if i remember boat anatomy) where there is a "consult room" which will have curtains making it into 3 and a dental room. we are going on the Rio Ucayali to the communities live on its banks. http://en.wikipedia.org/wiki/Ucayali
so i´ll be gone for these 2 weeks without email access or phone so please don´t worry if you don´t see anything on my blog or hear from me for that long.
just pray. pray for safety and health, for strength to see so, so many patients all day, for skill and growing ability in Spanish as i will be translator for the first 8 days (none of the team from scotland speak spanish), and then continued skill as i join Ronald in seeing the 100 patients a day after the group from Scotland leaves. for the people we´ll be serving, pray that they would not only be helped and blessed by the health care, but also know why we do it - because Jesus Christ loves them and we are His hands and feet on earth to show them that.
the boat is quite nice - though old. i´ll have an air conditioned room for sleeping and i´ve been told, very good food all these days. we´ll have the chance to get off and walk around in the communities where we stop, so i won´t be entirely ship-bound for 13 days.
another item is that i won´t be finding out about where i´ll be doing my residency until i return on the night of March 25th. pray for this time of waiting for me.

thank you, thank you.
off to the jungle i go...

if you´d like to help...

i´ve been thinking about how to respond to the comments i´ve received and emails saying... "i wish i could send medicines or supplies..." or "what can i do to help".
today i came upon a way:
we are out of vitamins for kids (who all have anemia)
we are out of cough syrup for kids (and all of them have some viral upper respiratory infection that makes them cough all night and not sleep)
we are out of reading glasses (the kind you buy at the grocery store for $1.75)

SO... to start with, if you are willing, email me at katvenable2006@yahoo.com and let me know if you would like to contribute money, how much and what i should buy "for you" here. you can reimburse me when i return. it is very difficult to send supplies in the mail because of customs issues here. they rarely reach the intended party, unfortunately. so while i´m here, i can at least purchase some of these things for anyone who would like to help. and remember that even a little of our US currency goes a long way here.

thank you.

El Día de la Mujer

today i was greeted with a rose and wishes for "happy day"... the day of the women.
i had no idea this was a holiday. i received many wishes for a happy day. and a little gift. and lots of kisses on the cheek - which is a typical greeting hello and goodbye. but more today than usual. all the women at the clinic recieved a flower and a gift.
a lovely tradition i think we should observe in the USA.
here i am with nimia and melissa who both work at the clinic. they are lovely and sweet and a blessing to work with.

Amy

this is my patient Amy. she´s very sweet and about 6 months old. her mother brought her in because she has had fever for several days, as well as cough and is not well. She is like the other 30 or 40 kids under the age of 2 i´ve seen in 2 days with the same symptoms. it´s an epidemic of some upper respiratory infection running rampant among these people who live so close together in such poor conditions.
Amy, however, i´m pretty sure has pneumonia. i´m only pretty sure because i don´t trust the accuracy of my physical exam skills... because that´s all i have here. in our lab we can´t check to see if her blood shows signs of infection. we can´t do a chest X-Ray. so only my hands, ears, eyes, mind and her mother´s description told me that she has pneumonia.
hopefully, it will be responsive to high doses of Amoxicillin. not the best choice for pneumonia, but again... all we have. i try not to think of the 2 babies i admitted to the hospital in Ecuador with pneumonia who had been treated with Amoxicillin at a different hospital for 7 days before... and had gotten worse. just pray that the LORD will make up for all we lack and bring healing to her little body.

Belén

Some more thoughts and commentary on where i work every day.
Belén means "Bethlehem" and yesterday as i was appalled by the filth and trash and smells and sights, i kept thinking about how a place like this could be called Bethlehem... Bethlehem, that lovely place we think of where Jesus was born, a quaint little town with full inns and a cozy stable with a rustic, straw-filled manger where our Savior, the King of Heaven, was born... where noble wise men-kings and humble shepherds visited, where angels sang and a bright star shone overhead...
How is it that someone named this place Bethlehem?, i kept thinking.
however, as i´ve continued to reflect, Belén is the perfect name for this place, because Bethlehem, beyond our Christmas card images (which are more likely a product of Hallmark than reality), is the place all humanity associates with the miracle of Jesus´birth into this world. and that miracle, at it´s core is that Jesus, King of King and Lord of Lords, humbled Himself to become human so He could sympathize with our weaknesses, save us from our sinful, hopeless life and demonstrate His love for us in that while we were yet sinners, He died for us. and He lived among us - in all our filth and sin and poverty, both spiritual and physical.
"For you know the grace of our LORD Jesus Christ, that though He was rich, yet for your sake He became poor, so that you through His poverty might become rich." (II Corinthians 8:9)

(my taxi driver, Luis)

Hogar de Belén

that´s the name of the clinic where i´ll spend much of the next month. it means "Home of Belen". you can´t imagine (i´ll try to post pictures soon) how true this is. it is distinctly different than all the other buildings there. it is cement, white, clean, solid amidst (literally) a sea of filth, wooden shacks that float, despair and little that is sure or solid.
to get to work today i was picked up (they use one of my favorite verbs for this action - coger - which can mean to catch, to take, to get) by the doctor, Ronald. on his motorcycle. i climbed on behind him - i think that was the first time in my life to have ridden on a motorcycle. it was pretty fun, actually. and an adventure amidst the crazy traffic of mototaxi´s here. we made our way to the "top" of Belén ... where he left his motorcycle in a locked garage of sorts. then we descended the stairs to where the water begins. if you can call this water - it´s filth. sewage. grey and thick-looking. all manner of stuff floating in it. and scores of people everywhere. walking in it, canoeing around it in, living in shacks that float on it. and the ´water´is supposed to rise more this month. this same water is part of the Mighty Amazon.
our taxi to the clinic was a low-riding, wooden canoe. i got in trusting that it would hold all 3 of us - me, Ronald and our "driver" who was a boy of maybe 11 yrs. it did. and he rowed us through the water streets to the steps of the clinic, partly submerged. we pulled up, disembarked, and walked up the dry, solid steps.
a waiting room filled with people, a pharmacy/lab (which can do urine analysis and malaria blood tests, nada más = nothing more), 2 consultation rooms, a dining room where the children´s programs are held including lunch. there are a second and third floor which are being finished.
i saw close to 20 patients today. mostly on my own, consulting with Dr. Ronald when i wasn´t sure what to do or how to diagnose and treat without my usual tools of lab, X-ray, etc. the majority need more than medicine can offer them. so i gave a lot of vitamins, ibuprofen/tylenol, anti-parasite drugs and prayed. prayed for wisdom and understanding in spanish and of their lives. and prayed for food for them. for a day when they have a toilet in their house and clean water. for a day when they don´t have to live in filth. for them to at least be blessed by spending some time in the "Hogar de Belén", hoping they were able to find hope and light and peace there.
after afternoon devotions with the staff, we left. in a canoe, to the water´s edge, and then in a mototaxi to my clean, lovely hostal. the contrast is almost palpable.
i get to go back tomorrow. i can´t believe that this is actually my life. and i can´t believe Belén is actually theirs. i covet your prayers - for them, for me.

Iquitos

i arrived on March 1 at 7am. yes, that´s when i arrived. and praise the LORD, i was met by a lovely woman from Scripture Union named Rosi, the wife of an administrator with the organization named Carlos. i spent yesterday resting and meeting several other people and trying to sort out (have yet to figure out how to say that very useful phrase in spanish) my housing situation. we´re trying to find a family for me to live with. currently i´m staying in a room on the 4th floor of a clean, lovely hostel that looks out over the Amazon River. and costs about $7.50 a night.

To give you a word picture of Iquitos... (photos to come)

• people come here by boat or by plane.
• it´s a city of about 1 million people.
• the primary mode of transportation is in a mototaxi (half motorcycle with a seat behind for passengers and a little roof overhead)
• it´s ON the Amazon River
• there are "CyberCafe´s", lots of stores (all kinds - clothes, shoes, electronics, motorcycles, bread/food items/the usual junkfood selection and drinks shops) , major banks and government offices, a government hospital, a dozen hotels-hostals, some restaurants (including a 60´s style burger joint that appeals to the foriegners called Ari´s Burger) several squares, lots of churches, lots of people, lots of noise, lots of mototaxis, lots of heat. today, for about an hour, lots of rain.
  
• the top 3 reasons foreigners come here are... 1. Tourismo de la selva (jungle tours) 2. Tourismo sexual (no translation needed) 3. Tourismo de brujeria(tourism of witch craft)

So that´s where i´m working. More specifically, in an area of the city that i wrote about the last time i came here (Peru trip June 2004 with Zion Church) called Belén. I´ve recently learned in my study of spanish that Belén means Bethlehem. I´m still trying to sort out the spiritual implications of that.
I´m working in a new clinic in Bélen which wasn´t there in 2004. only the foundations. if you´d like to check out the website for Scripture Union Peru, it´s http://www.unionbiblicadelperu.com
search around a little to the Medical tab and if you can switch it to English, or if you can understand enough in Spanish, you can read about the clinic and the work going on here. The medical work is fairly new, as largely this organization helps children who have been abandoned by their parents or whose parents cannot afford to feed them or care for them. hard to imagine, i know.