Friday, March 4, 2016

Health and Needs Survey: Pictures, Patients, and Parasites!

Health Survey in La Libertad

During the last week in January, 2016, we were grateful to have two volunteers work with us in the village.  Fernanda was from Brazil and Rebecca was from the USA.  They both helped us to collect health, occupation, and needs data.

A pan for toasting yucca to make farina

Fernanda is a fourth-year med student.  Rebecca is a business consultant.  They arrived in Leticia on the same day.  While in Leticia they stayed in the local hostels Alas Excusiones and Residencia Marina, both located less than a five minute walk from the project's office/apartment.

Wagner with the mixing spoon.  Richard in the background with his kids.

We went to each house in the village and spoke with the people.  We asked questions about their illnesses and overall health concerns.  Almost everyone in the village was receptive to speaking with us.  Some people talked much more readily, others answered with only yes/no.

Wagner, the man in the pictures with a white and red striped shirt, is the health promoter for the village.  He has had advanced first aid classes, communicable disease classes, training for snake bites and insect stings, and practice stitching up wounds.  He is responsible for seeing that the people of the village follow healthy practices.

Carmen with her father and little brother

We noticed that the people were not always able to easily express their health conditions to us.  For example, when asked if they had parasites about half the families replied that they did not.  Upon further questioning we asked if they had frequent stomach pain, diarrhea, vomiting, or other gastrointestinal issues, to which they responded, "yes", that they had at least one, and in some case all of these symptoms.  All of these symptoms are frequently caused by parasites.  One house, when asked if they had diarrhea exclaimed, "When do we NOT have diarrhea!".

So how accurate is the self-reporting that we recorded?  It is good that we have collected this information.  It would also be good (for the next volunteers possibly?) to compare the data we collected with the health data that the government's Secretary of Health has, or with their health provider insurance agency.

The villagers do have free, state provided health care.  However, they frequently do not have the money or ability to do into the city (a three hour boat ride) to receive the care.  Even if they do go, they must sometimes wait up to two days before they are seen.  Frequently the treatment given may be sub-standard (one ibuprofen table, one antibiotic tablet, then told to go home).  Given these shortcoming in the medical system, the villagers may wait until their health is so bad that they are dying -before seeking medical care!  During the past four years at least two people in the community have died en-route to the hospital in Leticia.

Carmen with her cousins

Rebecca and Fernanda collected the data over three days, working part-time.  Fernanda then typed the data into a small report, which is found at the end of this post.

Some interesting points are:

  • over half of all houses wanted glasses, dental care, or both
  • all houses had, we believe, water-borne illnesses
  • 50% of the population is under 15 years of age
  • 1.5% of the population is over 65 years of age
  • 3% of the population has tuberculosis
  • an unknown number of villagers have AIDS and/or other sexually transmitted diseases
  • malaria and dengue are frequent and ongoing diseases in the village

Making the fermented drink chicha de chantadura

While some parts of this report may paint a dismal picture of the health conditions in the village, while collecting the data we were able to get a glimpse into the daily life of the villagers.  This showed us the closeness of the families, less-hurried pace of their life, and their connections to nature.

While Fernanda collected health data, Rebecca asked about the villagers' work aspirations.  Planting, harvesting, and processing yucca (cassava) was one of the most common business desires.  Fishing, increased tourism, and planting other crops was also common.  When the idea of growing and processing cacao was brought up, 96% of the houses wanted to go into the chocolate business.
  Basically, everyone wanted to do everything for employment!

Learning jungle skills!

Fernanda and Rebecca also had time to speak with the villagers informally and try their hand at weaving the palm leaves to make a thatched roof.

We are also very thankful to Fernanda and Rebecca for helping the most ill of La Libertad to access health services in Leticia.  After collecting the health data they organized and led a trip to Leticia, spoke with the insurance providers and the clinics in order to help the people receive the services that they desperately needed.

Here is the full health report...

This health data is self-reported. and therefore subject to error.  But this info may be used to give some idea of the villager's health, may be compared to government-collected data, and may help in the design of future health studies in La Libertad.  In other words -a great start and more research is needed!

COLLECTION OF DATA - LA LIBERTAD, January 24 - 26, 2016
"Children" and "girls" are always people <15 years
"Women" and "men" are always people> 15 years
The house numbers described here might not correspond exactly to the village map.
HOUSE 48
- 8 persons: 3 girls, 3 children, 1 woman, 1 man
- Diseases in the past year: flu, parasitic worm infection
- Water: Rain untreated
- Bathroom: no
- Win: glasses
HOUSE 47
- 8 persons: 3 boys, 3 girls, 1 female, 1 male
- Diseases in the past year: parasitic worm infection
  • 3 days ago 1 child has a fever (39.1 C), diarrhea, vomiting - no medication; parents are boiling water
- Water: Rain untreated
- Bathroom: no
- Win: glasses
* Many people have eye complaints. From what I have observed many "pterygium" (medical heat in Portuguese; do not know the word in Spanish)
HOUSE 46
- 8 persons: 3 boys, 2 girls, 2 women, 1 man
- Diseases in the past year: parasitic worm infection, flu
- Water: Rain untreated
- Bathroom: yes
- Win: glasses, dentist (have dental infections)
HOUSE 45
- 7 persons: 3 boys, 2 girls, 1 female, 1 male
- Diseases in the past year: diarrhea, parasitic worm infection, flu
- Water: Rain untreated
- Bathroom: no
- Forward: -
HOUSE 44
- 10 people: 2 boys, 2 girls, 4 women, 4 men
- Diseases in the past year:
  • currently one woman has inflammatory signals in the left eye; 1 child has "bumps" (medical heat in Portuguese é s, not the word é s ENGLISH) on her forehead; 1 women also "Pterygium" (medical heat in Portuguese é s, not the word é s ENGLISH) in both eyes
- Water: Rain untreated
- Bathroom: no
- Win: glasses
HOUSE 43
- 6: 1 child, 3 girls, 1 female, 1 male
- Diseases in the past year: diarrhea
  • now the child is 9 months with diarrhea two weeks ago; It is visibly dehydrated. She was  given re-hydration fluid (1 liter of boiled water + 4 tablespoons sugar + 1 teaspoon of salt), but he needs a doctor
- Water: Rain untreated
- Bathroom: no
- Forward / problems: children have bumps on forehead
HOUSE 42
- 8 people 5 children, 1 girl, 1 female, 1 male
- Diseases in the past year: diarrhea, parasitic worm infection, flu
- Water: Rain untreated
- Bathroom: no
- Wanted: dentist
HOUSE 41
- 11 people: 4 children, 2 girls, 3 women, 2 men
- Diseases in the past year: parasitic worm infection;
  • currently one child has colic pains diffuse type at the abdomen
- Water: Rain untreated
- Bathroom: no
- Win: glasses
HOUSE 40
- 8 persons: 2 boys, 2 girls, 2 women, 2 men
- Diseases in the past year: -
- Water: Rain boiled or chlorinated
- Bathroom: no
- Win: glasses
* Stories: 6 cases of tuberculosis in the community; frequent sexually transmitted diseases, particularly gonorrhea; there are also cases of dengue and malaria
HOUSE 39
- 10 people: 4 boys, 3 girls, 2 women, 1 man
- Diseases in the past year:
  • currently 1 female of 58 years has undiagnosed illness - progressive muscle weakness that box when the prevents walking
- Water: Rain untreated
- Bathroom: no
- Forward: -
HOUSE 38
- 8 persons: 2 children, 4 girls, 1 female, 1 male
- Diseases in the past year: flu
- Water: boiled rainwater
- Bathroom: no
- Forward: -
* To talk to teachers, they complained of problems with your vision; also claim that doctors give away the same drugs for all patients, as amoxicillin, acetaminophen and ibuprofen. I also say that major problems in san school: lack of toilets (without 2 bathrooms for 80 children), lack of books and food.
HOUSE 16
- not present
HOUSE 15
- 6: 1 child, 3 girls, 1 female, 1 male
- Diseases in the past year: diarrhea, parasitic worm infection, flu
- Water: Rain untreated
- Bathroom: no
- Forward / problems would like to have more doctors and medicines; also they told that one of her daughters have eye problems
HOUSE 14
- 5 persons: 2 boys, 2 girls, 1 man
- Diseases in the past year: -
  • man complains of pains in the shoulder blade; Five years ago it was performed surgery to repair fractures in his right shoulder blade and ribs
- Water: boiled rainwater
- Bathroom: no
- Forward: -
HOUSE 13
- 6: 3 children, 1 girl, 1 female, 1 male
- Diseases in the past year: -
- Water: Rain untreated
- Bathroom: no
- Forward: -
Casa 12
- 5 persons: 3 girls, 1 female, 1 male
- Diseases in the past year:
  • currently one baby has diarrhea, vomiting and other
- Water: Rain untreated
- Bathroom: no
- Forward: -
house 11
- 8 persons: 3 boys, 2 girls, 2 women, 1 man
- Diseases in the past year:
  • now a baby has the flu
- Water: Rain untreated
- Bathroom: yes
- Forward / complaints: lack of medical attendance
CASA 10
- 6: 1 child, 2 women, 3 men
- Diseases in the past year: diarrhea, flu
  • a man is quasi-blind; 15 years ago it was made cataract surgery
- Water: Rain untreated
- Bathroom: no
- Forward: -
House 9
- 11 people: 2 children, 4 girls, 2 women, 3 men
- Diseases in the past year: parasitic worm infection
  • 1 week ago a baby presents coughs; he also has "pimples" on his forehead
- Water: Rain untreated
- Bathroom: no
- Forward: -
House 8
- Nobody home
House 7
- 4 people: 1 woman, 3 men
- Diseases in the past year:
  • the woman complains of always being "dizzy" and also says not see well
- Water: Rain untreated
- Bathroom: no
- Forward: -
HOUSE 27
- 8 persons: 2 boys, 2 girls, 2 women, 2 men
- Diseases in the past year:
  • a woman complains of pain in lower abdomen three weeks ago; menstruation is with more color black; 7 years was performed surgery "tubal ligation" (medical heat in Portuguese é s, not the word é s ENGLISH)
- Water: boiled rainwater
- Bathroom: no
- Forward: -
HOUSE 26
- 5 persons: 3 children, 1 woman, 1 man
- Diseases in the past year: flu, diarrhea
- Water: boiled rainwater
- Bathroom: no
- Forward: -
HOUSE 25
- 7 persons: 3 children, 1 girl, 1 female, 2 males
- Diseases in the past year:
  • 3 days ago the woman has a fever, headache, body aches and weakness hair; on the last night she had 2 episodes of vomiting
- Water: Rain untreated
- Bathroom: no
- Forward: -
HOUSE 18
- 8 persons: 4 children, 2 girls, 1 female, 1 male
- Diseases in the past year: diarrhea, flu
- Water: boiled rainwater
- Bathroom: no
- Wanted: dentist
HOUSE 19
- 2 persons: 1 female, 1 male
- Diseases in the past year: flu
  • the woman is blind 1 year; It was also treated tuberculosis two years ago
- Water: boiled rainwater
- Bathroom: no
- Forward: -
HOUSE 2
- 12 people: 3 boys, 3 girls, 3 women, 3 men
- Diseases in the past year: flu
- Water: Rain untreated
- Bathroom: yes
- Forward / problems: "irritation" of the skin
HOUSE 30
- 5 persons: 2 children, 1 woman, 2 men
- Diseases in the past year: diarrhea
- Water: boiled rain
- Bathroom: no
- Forward / problems: glasses
HOUSE 31
- Nobody home
HOUSE 32
- Nobody home








Total c bag with residents                                
30
Total people (so far)
  • Total persons <15 ng os
  • Total persons> 15 ng os
  • Total persons> 65 ng os
190
106
84
3
Diseases (home)
  • flu 12
  • Diarrhea 11
  • INFECTION or n parasitic worm 8




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