Francisco

The Pediatric wing is divided into four rooms, each with a large label above the door. One is for infants, one room is for crawlers, one for toddlers, one for school aged children.

The baby I'm here to see is in the infant room, although he is three years old. His name is Francisco, and that's my blood hanging in the bag above his bed, dripping into a line in his foot. We're both O positive.

The room is big, with fading paint, a peeling ceiling, and cracked glass windows. About 12 patients and their mothers and a few fathers share the room; there are no curtains, no privacy. Francisco doesn't seem to mind his screaming neighbors or the nurses in their turquoise pantsuits, hustling around. He doesn't seem to notice anything.

When I first saw Francisco I thought, "That baby is going to die." His arms and legs were like pick up sticks. His head looked like a bare little skull with skin pulled over it. I could, and still can count every rib in a protruding row down to his sunken stomach.

His diagnosis by the hospital is marasmus with pellagra. Both of these are a result of poor nutrition over a long period of time. At three years old, his muscles are severly atrophied. He has never walked or even crawled. His symptoms include skin discoloration, nerve dysfunction, mental symptoms, thinness, poor muscle development, and chronic diarrhea.

When I look at Francisco, it hurts my heart. And it makes me upset. There is enough food in the world, I think. It's not fair. No baby should have to be so hungry for so long. No baby should have to suffer like this.

Franciso has been so long without adequate nutrition that his body rejects whatever formula his family or the nurses try to dribble in his mouth.

We met him at our last clinic. We met his mother, eight siblings, cardboard house, lack of paternal presence, and total lack of financial support or food sources. Francisco, as the baby, was the worst off.

Jenni and I launched into action, getting to know the family, providing emotional support for the mom, organizing frequent home visits, bringing small donations of food specifically for the baby, and little by little, trying to monitor the situation. But Francisco got worse.

His limbs started swelling, and he began to vomit uncontrollably, and he was hospitalized. Some insurance is available for children like him, and although medicines and supplies aren't provided, he can stay for free.

And now I stand at his little bedside, looking down at him. I am afraid to touch him, afraid that his discolored and peeling dry skin will melt away in my fingers. I watch the blood drip in. Will it help? Will he make it?

I look at his face and it is hard to have hope, hard to know if anything good will come of this. But I want to believe that this little guy is going to make it. I want to believe it so badly.

These pictures were taken two weeks later. I went on my weekly visit to see Francisco and was thrilled to see him sitting up with support, and not only eating, but feeding himself. His cheeks were a great deal rounder than before. When his sister wiped his face, he squawked at her. Victory! This was the first time I had seen him display any emotion. He still has a long road to travel, but I praise God that he is doing better, little by little.

Last week

Chasing waterfalls

Goodbyes

It's Monday morning. I'm still in my pajamas, but I wandered out on a noisy Pucallpa street to get a little internet before Jenni comes back from running errands. We're going to head to Yarina Cocha so I can donate blood for a baby who is sick at a hospital there (we're a perfect type match), then pick up the generator at the mechanic, and take a taxi to Km 38 to get started on another week of work.

I'm sad. Last night I took my brother Alban and our friend Aaron to the airport here in Pucallpa, and this morning they are well on their way home to the States. I miss them. I don't like goodbyes.

Alban and Aaron were visiting for their Spring Breaks, Alban from Walla Walla College and Aaron from Loma Linda University. They cheerfully embraced the Peruvian culture and the life that I have come to love.

They endured hours of bumpy bus rides through the jungle mountains, bravely tried chicha morada and papas huancaina, took bucket baths with us at the land, played with our pets, met our neighbors, and corrected our Spanish. We found time to explore ancient ruins in the desert, hike through cloud forest to a very big waterfall, sing lots of hymns, and play many rounds of Rook, Scum, and Spades.

I'm so glad that they came.

Love the brother

Love the market

Teamwork

The A.M.O.R. Projects team. Front row: Jenni, Karen, Ansley, Anthony, Ryan, and Doctor Richard. Back row: John, Jackson, Alex.

Gracie

Gracie came to clinic with a fever of 104.1, a thin eight year old with narrow eyes long tangled hair. Doctor prescribed an injection to combat the fever and infection in her lungs, and wrote a note for her to return in six hours for a reevaluation.

But she wouldn't let me give her a shot. She lay on the bench in the pharmacy, yelling and screaming, refusing to turn on her tummy so we could inject her backside. I sat with her and talked to her for awhile. "The shot will hurt a little, but it will help you feel much better. It is a very fast thing, and then you'll be able to rest and sleep." She pushed me and refused to turn, even when I tried to gently help her.

The mother tried to assist in the situation, to no avail. Gracie cried even more, and that started her toddler brother on a sobbing spree as well.

I was beginning to get frustrated. I didn't want to pin her down and just proceed; I didn't want her to be traumatized and despise gringos from this day forward. But there were other people waiting for their medicines, and this little girl had to have that shot.

I called for the Doctor. He came in, moments later. "What's going on?" he asked.

He didn't need to inquire. He could see the situation immediately. "Are you ready?" he asked me.

I took the alcohol swab in my hand. Doctor scooped Gracie up in his arms, turned her over, and managed to hold her still enough that the injection could be adminstered, although she was screaming hysterically the entire time.

She couldn't walk home. She was too weak, too exhausted. Her mother had the toddler to carry, so I volunteered to carry Gracie.

We walked up and down rough muddy streets with little rivers of sewer water running down their middles. Trash covered the landscape. Neighbors eyed us from their crooked doorways. Gracie borrowed into my arms, her head heavy on my shoulder. She cried a little. I was soaked with sweat from the sun, but her skin was dry and taut.

We arrived at their house a while later, a thing of cardboard with a scrap wood roof, built up on stilts. They had one room up above a murky marsh of water below. There was one small bed on the floor. I laid Gracie on it, softly, and her eyes closed as she rolled over.

I touched her head, pushing back her hair with my fingers. "Take care, little one," I said, "We'll see you soon."

When I made it back to clinic the team had stopped for lunch. I sat down on a bench, trying to find the appetite to eat. How could I eat?

What an unfair world, I thought. I was numb. I could still feel her in my arms, burning with fever.

Surgery by flashlight

Our operating room is made of tarp walls and the dirt floor and tin roof of a small house or church building. It is a challenge to keep the chickens and dogs and curious children out. The patient lays down on a kitchen table borrowed from a neighbor or a church pew or one of our dental chairs. Several student missionaries or Bible workers hold flashlights to illuminate the surgical site while Doctor Richard operates.

We repair hernias, remove cysts and tumors, remove bullets and keloids, and last week we did three circumcisions. Mostly we remove tumors. From foreheads and legs and necks and backs and behind ears.

To prepare for surgery I pull supplies when there is a quiet moment in clinic. I put the instruments we'll need to soak in iodine, then grab sterile gloves, lidocaine, needles and syringes, gauze, alcohol, scalpel blades, sutures, tegaderms, and clean gloves on a tray.

(As I'm sitting here writing this I'm struggling to remember the words for some of these things in English. I've grown so accustomed to calling a scapel a "bisturi," and a needle an "aguja").

Jenni and I take turns scrubbing in with the Doctor and being the circulation nurse. By scrubbing in we put on sterile gloves and assist with cutting and dabbing and holding instruments. There usually is no water for a scrub before the surgery.

When we do surgeries it is usually at night when clinic is finished and we are tired. But I enjoy it, I enjoy talking to the patients during the operation and being aware of sterile field and learning how to anticipate what the doctor wants next.

Many of the patients have been bothered by these tumors and cysts and hernias for some time, because they have no way to afford the simple operations to remove or repair them. I'm thankful that we can provide free and good quality care to them.

March 10

Accept, O Lord, my entire liberty, my memory, my understanding, and my will.

All that I am and have thou hast given to me; and I give all back to thee to be disposed of according to thy good pleasure.

Give me only the comfort of thy presence and the joy of thy love; with thee I shall be more than rich and shall desire nothing more.

St. Ignatius of Loyola

Give to receive

We, the A.M.O.R. projects team, have been developing the land at Km 38 under a legal agreement with the Seventh-day Adventist church for a year, preparing to start building the clinic and trade school in cooperation with mission trip teams from the States this spring and summer. The land, all 247 acres of it, is now available for us to purchase, and we're working together to raise $30,000 to buy it, by the end of March. The following is a letter written by one of our team, in order to shed light on some of our needs and future goals.

TOP TEN REASONS TO SPONSOR A CLINIC AND TRADE SCHOOL IN PERU:

1. It won't have chickens running through the hospital or monkeys in the operating room.

2. No killer bees lurking in the bushes.

3. Real restrooms and not just maggot-filled holes in the ground.

4. Jungle property at bargain prices! (247 acres of land in the Amazon basin for a mere $30,000.)

5. They'll be able to sweep the dirt off the clinic floor instead of sweeping the….dirt….floor.

6. You like earning more than $1 a day. (Poverty plays a huge role in health problems. Our trade school seeks to combat poverty through education to increase students' ability to earn income.)

7. You like eating. (Well, so do Peruvians. However, they often go hungry because they have no money. To address this, the trade school will include a fish farm, chicken farm, bee hives, and orchard to support the clinic and teach people skills that will enable them to afford better nourishment.)

8. When you run out of money, the hospital won't be required to "run out of treatment."

9. If you get appendicitis while in Peru, you can get surgery instead of dying because you can't afford the operation.

10. Because you care, and because we care. It really will make a difference. Give as if you were in our shoes asking for help.

The challenges that face a large majority of Peruvians are many and extreme. Little education. No work. Not enough food for the table. No money to obtain needed health or dental care. No hope to better their situation.

Touch of Love is a grassroots project started by a Peruvian doctor who saw these needs and sought not only to address the immediate health problems but also the poverty that sometimes causes and almost always complicates them.

ABOUT "TOUCH OF LOVE" AND A.M.O.R. PROJECTS

Ambassador Medical Outreach and Relief (A.M.O.R.) Projects is a nonprofit organization based in Loma Linda, CA. A.M.O.R. was founded to run medical outreach clinics for people in the poorest rural and jungle areas near Pucallpa, Peru. We realized that we need to build a clinic to better serve advanced medical and surgical needs in a centralized location; and a trade school to address the issues of poverty and unemployment. Thus, "Touch of Love" clinic/trade school project was born.

For the price of a restaurant meal, a ticket to a football game, or a short vacation, you can enable us to heal and relieve suffering for some of the poorest people in Peru – and ultimately, seek solutions to the intertwined problems of disease and poverty through education and easy access to quality medical care.

Every little bit helps. For example, $0.50 can buy a baby chick for the trade school's egg farm; $0.67 will buy one child anti-parasitic medication; $1.23 will cover the cost of treating one general medical patient; $17 can purchase a calf for the dairy; and $162 will purchase an acre of the land. Your help in any amount will enable us to move forward with the project in a very tangible way.

If you would like to donate, you can send a check payable to A.M.O.R. Projects to this address:

A.M.O.R. Projects
P.O. Box 212
Loma Linda, CA 92354

All donations are tax-deductible. Thank you for your support.

Escort

She is of the kind whose Spanish is the hardest to understand. I will call it Gummy Spanish, because she speaks through a toothless mouth, a rapid speech that has had 77 years to practice its gossip. She tells me she is nearly blind, but she hops out of the moto with a surprising bounce and marches along the street, holding my arm for balance.

I strain to understand her words for a little while and add a comment when I can, but she is way ahead of me.

Before we enter the small but plush city clinic for her x ray, I try (in vain), to smooth down my fluffy hair. It's been a typical day, my scrubs are splattered with stains and my sandals and ankles are caked with mud. I pull my lip gloss out of my pocket. She looks at me.

"Hey!" she says, "I need some lips, too!"

I share my lip gloss with her.

Her name is Amalia. She is a little thing with wide feet and salt and pepper hair, puffed up behind a head band. She came to us this morning, to our tiny and chronically muddy mobile clinic set up, wondering if we could operate on her mangled pointer finger. Doctor couldn't operate without seeing a better picture of the finger, so I was nominated to escort her into town to this air conditioned place with sparkling clean tile floors. I don't think I've ever been able to describe anything as "sparkling clean" in Perú.

A young doctor with big glasses and a bad haircut shows me into a consult room for a brief conference before the x ray. Amalia waits in the waiting room, watching Peruvian soaps on TV.

I explain our work and mission and ask him to lower the price of the x ray. He in turn asks me many questions. He tells me he will lower the price by 50%, and I tell him that we are very grateful. The x ray and visit will cost about $8, instead of $16.

"Why do you do what you do?" he said.

Good question. I thought for a minute.

"For the love of God," I tell him, "and because I want to learn how to serve others."

The trip is over in less than two hours, a miracle by Peruvian schedules.

"Wasn't that easy?" I ask Amalia on our way back to her neighborhood.

"Everything is easy when there is money," she says, "how hard it is to be poor."

I didn't say anything. I just sat there with her, thinking about it.