Riverine project reaffirms U.S. commitment to medical partnership in Peru Published March 26, 2009 By Tech. Sgt. Eric Petosky 12th Air Force (Air Forces Southern) Public Affairs DAVIS-MONTHAN AIR FORCE BASE, Ariz. -- The Alto Amazonas district of Peru teems with steamy jungles and swarms of insects, but for a 15-member Air Force medical team, no obstacle could keep them from providing patient care to locals there alongside their Peruvian medical counterparts as part of the ongoing Riverine Project. The Riverine Project encompasses an isolated area called the Loreto Region in North-Central Peru. During the two-week medical engagement mission March 7-21, the team visited four villages and saw more than 3,600 patients, according to Frank Campuzano, 12th Air Force (Air Forces Southern) Humanitarian Civic Assistance Program senior program analyst. The medical assistance follows a 4-year study by the U.S. Navy to assess the population of the region for medical trends. Then twice a year, for the next three years, a U.S. medical team will adjust the treatment formulary to engage those problems head on. "The goal here is to establish ourselves and show we are committed to these communities," Mr. Campuzano said. "If we send teams to a different place every time, how will we know if we've had an impact? Not only will we continue to adjust our treatment program as the project progresses, but we will also identify the needs of that area to the regional government in a concerted effort to render the appropriate patient care." For this trip, the team brought specialists in the areas of optometry, dermatology, infectious diseases, dentistry, oral surgery, internal medicine, and pediatrics. Aside from the 15-member medical team, four support Airmen with such specialties as communications and force protection also supported the Riverine Project. Since the project is fundamentally a partnership between the United States and Peru to provide care for its secluded citizens, there were more than 50 Peruvian military, Ministry of Health, and civilian practitioners who were instrumental in making the mission a success. In a social climate currently rife with economic turmoil, it's hard to imagine a place so remote that some of the people who live there have no concept of currency. Air conditioning doesn't exist. Amazon River tributaries, like Rio Maranon and Rio Huallaga, double as highways there. Wooden huts are a common sight. There is no electricity except from diesel generators. Everyone keeps an eye out for poisonous snakes or alligators lurking near the shoreline. Master Sgt. Jesse Moreno, 12th AF (AFSOUTH) Surgeon General's NCOIC of Public Health, was the primary liaison between the medical team and the Peruvian Navy who transported the Airmen and their equipment along the rivers to reach their operating locations. He said that regardless of the challenges, the mission was very successful. "It's very remote," he said. "The people there have little in the way of creature comforts as we know them. Life is very different. I spoke to one shopkeeper who proudly showed us an alligator skin. One of our team members commented that alligator tails were tasty. The store owner's wife quickly responded, 'Here, those things eat us.' How is that for perspective? "We slept on the Peruvian Navy boats," he explained. "Quarters were very cramped and besides having to adjust to the constant rumble of the engines, it was hot and extremely humid. Since we were on the river, insects ruled the night. Our showers were cold, and although manually chlorinated, the water had a brown tint because it was being pumped directly from the river. The days were hot, and we sweated almost nonstop." As he explained the austere living and working conditions, he also shared a story about a special patient. "We were unloading the medications and setting up the pharmacy at the local school in Puerto America, where we would be seeing patients the next day," he said. "An elderly gentleman approached me and asked if I could see his daughter. Hastily, I told him we would be seeing patients the next day, and to come back then. He was persistent. 'Please doctor, please help me,' he pleaded." Feeling a sense of empathy as a parent, and sensing the urgency in the man's voice, Sergeant Moreno convinced the doctors to see the man's daughter early. She had been bitten by a snake, and her lower leg was swollen and showing the early signs of necrosis. Untreated, she could lose her leg or die from infection. The team gave her antibiotics and arranged transport via river boat three hours at night to San Lorenzo, where she was treated further. "The physician in San Lorenzo assured me the girl was fine," he said. "She would be keeping her leg and should be out of the hospital in four or five days. He thanked me profusely for the antibiotics and transportation assistance. Her outcome would certainly have been much worse if we had not happened by... I am looking forward to seeing a smiling little girl instead of the frightened, crying one I last saw." Sergeant Moreno also emphasized the partnership between Peru and the United States to the success story. He said that without boats and sailors to pilot them, Marines for security, and the assistance of local and government health officials, the Riverine Project would not have been successful. "On the surface, it appears that the Americans came in and provided a great service for the Peruvian people, but it's important to understand that even from the earliest planning stages, the Peruvian Navy and Ministry of Health were integral to our mission. They were working right alongside us the entire time. "It is very rewarding for me to have been a part of the mission we accomplished," Sergeant Moreno concluded. "Unfortunately, it is but a drop in the bucket. As we prepared to leave each village, we had to turn people away. We could have probably stayed in one village the entire time and still not seen everyone." Another U.S. Air Force medical team will visit the same area in the Peruvian Alto Amazonas District in September. Armed with the lessons learned from this latest mission, they will continue to have an effective and long-lasting impact on the people of Peru.