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Peru By Diana Wolfe (Class of 2004)
I also worked at a clinic in Belen, a poor community. Most of the inhabitants are from villages in the Amazon. I saw patients on my own, provided contraceptive counseling, vaginal exams, and pregnancy check-ups. Adolescent pregnancy is prevalent in this community. I participated in a week-long boat trip with a group of doctors, dentists, and nurses on a clinic boat up the Nanay River. The boat was named "Amazon Hope." On the fifth day, I worked with the family medicine doctor. We started out with the surgical removal of a basal cell carcinoma tumor, appended to the back of a man's ear lobe. I sutured. I saw a 9-months pregnant patient who was having labor pain. I told her that we would be happy to help her deliver her baby if she would like and told her to come back if she has blood, water, or more severe and frequent labor pains. About an hour later, I am examining another patient when the family medicine doctor interrupts me and says, "Diana, I will take this patient. Go quickly and find the pregnant patient, we are going to have a baby and this is going to be YOUR BABY, go and if possible, bring her to the boat." I run with gloves in my back pocket and bring the woman back to the boat. She was 100% effaced and dilated, frequent contractions, about 3 minutes apart, lasting 40 seconds. At 12:10pm, I delivered a baby boy on the "Amazon Hope!" Thankfully, no complications, normal delivery. I was proud of my bloodstained clothes and shoes.
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I worked at "Hospital Apoyo," in Iquitos, Peru. I saw patients with various tropical diseases including malaria, dengue fever, and leptospirosis. My first week I learned how to perform "the tourniquet test," a physical exam used to diagnose dengue fever. You hold a blood pressure cuff at the number equal to the average of the patient's systolic and diastolic measures for 3-5 minutes. You then remove the cuff and look for petechiae (small red-purple points on the skin, an indication of microvascular bleeding). If there are 5 or more within a square centimeter or 20 or more within a space equal to the size of your thumb, this is a positive finding for dengue fever. 