Iquitos, Peru
Global health

DOCARE in Peru: Anatomy of an Amazonian medical mission

DOs treat patients in Iquitos, the world’s largest city that can only be accessed by boat or air.

Deep in the heart of the Peruvian Amazon rainforest lays Iquitos, the world’s largest city that can only be accessed by boat or air. The city perches at the edge of some of the planet’s most lush and beautiful jungles, but its nearly 438,000 residents face limited access to health care along with high prices for goods that can’t be trucked in.

In August, AOA President Mark A. Baker, DO, treated patients in Iquitos during a DOCARE medical mission. Following is an edited interview.

Where were you treating patients? What was the setup like?

We set up a clinic in the military hospital in Iquitos. Our total group was about 100 people, and many of us brought supplies with us in our luggage, including portable ultrasound units. We took over 14 empty rooms and turned them into a clinic in 3.5 hours.

What was the demand for care like?

You could tell right away that there’s a great need for health care in Iquitos. When we finished setting up and were leaving for the day, there was already a two-block line of people waiting to be seen the next day. When we opened the clinic in the morning, we saw 485 people in one day. At the end of that day, there were more people lined up, ready to wait overnight.

Which patients stood out most to you?

Unfortunately, on trips like this you often see maladies that have progressed far beyond what you would normally see in the U.S. Usually it’s because people aren’t able to get care right away or can’t get the appropriate care for their condition.

Dr. Baker (left), examines an X-ray image with a medical student during DOCARE's medical mission to Iquitos. (Photo provided by Dr. Baker)

I took care of a patient who had the largest goiter I had ever seen. Fortunately, it was benign. Another patient had suffered a gunshot wound to the leg three years ago, and his fractures had not been aligned properly. He also had chronic osteomyelitis as a result of the wound. We arranged for his travel to a bigger city so he could get IV antibiotics.

My wife, Rita, is a retired speech pathologist. She spent some time with a little boy who had a cleft palate. He’d had surgery for it, but it didn’t turn out very well. He was unable to speak, but she said he was the smartest little boy.

What are DOCARE’s long-term plans for Iquitos?

Dr. Baker's wife, Rita, connects with a boy during the DOCARE medical mission in Iquitos. (Photo provided by Dr. Baker)

DOCARE has been organizing medical missions in Peru for the past 10 years and in Iquitos for five years. These missions have really strengthened the relationship between DOs and the local and national Peruvian leadership—in fact, DOs now have full practice rights in Peru as a result of these missions.

DOCARE is currently in discussions with Iquitos’ mayor to establish a permanent continuity of care clinic there, similar to the clinics DOCARE has set up in Guatemala and Nicaragua.

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