During the first two weeks of August, I had the incredible experience of travelling to the Peruvian Amazon with DOCARE and Michigan State University for a medical mission. To begin, I want to give a recap of our trip. We first landed in Lima, Peru and met up with the rest of our group who had flown in from all over the United States as well as Mexico and Spain. Our group consisted of high school translators from Barcelona, non-medical volunteers, nurses, medical students from Michigan State University, emergency medicine residents (including myself and my co-resident Codey Pedersen), pediatric residents, and attending physicians in multiple specialties, including emergency medicine, pediatrics, geriatrics, neurology, urology, radiology, and osteopathic medicine. In the afternoon, our group all boarded a plane to Iquitos, Peru, a city of roughly a half million people situated on the Amazon River in the rainforest. This would be our primary location for our medical work. After settling into our hotel that afternoon, we had an introductory dinner and orientation before going to bed early for our first day of clinic in the morning. 

For the next four days, we held all day clinics lasting ten to twelve hours set up in a local catholic parish and community center. Patients were lined up outside from early in the morning waiting to be seen. We split up the various specialties of medicine into different areas and patients were sent to each area based on their chief complaints. For our emergency medicine section, they attempted to shuffle any urgent care or ED visits towards our station. Many visits were also general medical visits that would fit more in family medicine category, as that was where most of the need was for the patients. We used translators when needed and had medical students assigned to our stations allowing them to rotate and see the various specialties. We saw a variety of pathology over the four primary clinic days. Notable and interesting cases that I saw would include tuberculosis, diabetic ketoacidosis, gastrointestinal parasites, and acute decompensated heart failure. There were also many visits reviewing chronic conditions with the patients and making sure that the local doctors were handling their conditions optimally. We had little diagnostic testing available, however a few POC lab tests could be performed, and formal ultrasound studies were available thanks to our radiology colleagues.  I found the patients to be incredibly grateful and gracious. It’s particularly enjoyable to provide care to patients that are so thankful to be seeing you because of their limited access to care. We did have several local physicians who joined us and were able to coordinate follow-up for patients, so we were not leaving them without resources after departing. 

During the second week of our trip, we had planned to host several half day clinics throughout the week at various smaller towns upriver on the Amazon with the more remote tribes who have even less access to healthcare. Unfortunately, we had several trip members become symptomatic and test positive for COVID-19 during our first week. Given that these more remote tribes are mostly unvaccinated with limited resources, the decision was made to cancel these clinic days to protect them from getting infected. This was, of course, a large disappointment as we all had looked forward to this part of the trip. However, we were still able to spend that week upriver experiencing the remarkable beauty and biodiversity of the Amazon rainforest. We also used our extra time to hold lectures and other teaching opportunities for the medical students. I particularly enjoyed holding a Q & A about residency to share my advice about making the transition and answering questions from the medical students. 

Overall, the trip was excellent. I have long desired to make international and remote medicine a part of my career. This was a fantastic opportunity to take a few weeks away from residency to get a taste of what that can look like. I hope this is the first of many similar future trips. I’m particularly thankful to DOCARE and Terra One Health who provided scholarships to make it financially more manageable to join this trip as a resident. I don’t doubt that the experiences I had during the trip have better equipped me for my career in emergency medicine and future international medicine endeavors.