In the beginning...
In 2006, two friends and co-workers from Los Angeles, Stella Cruz and Anita Soluna, spent 19 glorious days vacationing in Perú. They visited cities (Lima and Cuzco), mountains (the Sacred Valley and Machu Picchu), desert (Nazca), and jungle (Iquitos and the Amazon area). What they discovered about the lack of healthcare for people living in remote areas in the jungle had a profound impact on them. Driven by the desire to “do something,” they contacted members of the Southern California Chapter of PAMS. Although skeptical, since Cruz and Soluna are neither Peruvian nor medical professionals, the PAMS members recognized their sincerity and agreed to serve as mentors for the duo.
Cruz and Soluna returned to the Peruvian Amazon five months later to conduct a two-week needs assessment (what area would benefit most). After visiting several villages on many different rivers, and after extensive discussions with villagers, village leaders, and medical professionals, we selected the Rio Momón (near Iquitos, in the NE quadrant of the country). Accessible only by boat, the people who live along the Rio Momón consider themselves “the forgotten ones.”
Hence, in 2007, Selva in Action (SIA) was founded - based on the belief that access to adequate healthcare is a basic human right. A feasibility study (how best to offer services) was then developed and SIA team members conducted interviews with 125 families in 14 of the villages along the Rio Momón.
As a result of the feasibility study, and after extensive research by Cruz, the initial project was designed using a cooperative model. Villagers would pay a very small monthly “quota” (dues). In return, they could collectively pay for a doctor to visit each month, medicines, and hospital costs. Meetings were held, a Board was elected, the cooperative was formalized, people joined from more than half of the villages, and local SIA staff began the “teach them how to fish” part of the project.
Extensive leadership and financial training was provided for the Board and other interested co-op members. They built their own “clinic” and hired a doctor. SIA local staff held meetings with the co-op twice a month, where they provided guidance and continuing education. Guests were also invited to discuss such topics as agriculture, soil amendments, budgeting, fundraising, nutrition, and more.
SIA took a small medical team yearly to deliver services and medicines to co-op members. Non-members paid a small fee to the co-op for exams and medicines.
Co-op members indicated that the most important thing for them was to have access to an ambulance boat because the river trip from the villages to the nearest hospital in Iquitos could be between 4-8 hours. To that end, SIA worked with Rotary Clubs in the U.S. and Peru to fund the donation of an ambulance boat.
In our enthusiasm to provide the ambulance boat, we neglected to ensure that the infrastructure to sustain the boat was in place. There were no co-op members licensed to drive the boat, co-op dues were insufficient to cover associated costs including gas/oil, maintenance, licensing, and insurance. Additionally, no village was willing to take responsibility for providing a secure dock and guarding the boat.
SIA had to assume the costs for a boat dock and guardian (in Iquitos). The boat was eventually returned to the Rotary Club of Iquitos and has since been donated to another NGO (Water Missions) with the agreement that, if needed, SIA can borrow the boat.
Several years later…
As the years passed, SIA’s medical team grew in size, but the co-op patient base diminished. It became increasingly clear that there were serious issues, and we set out to find them. What we discovered was, that although the co-op model had been proven effective in other places, an evaluation determined that our lack of in-depth knowledge of the local culture was the biggest causal factor in its demise.
- In a culture that is used to “I give you money and you give me a product,” the concept of “pay now and get something later” was truly unknown.
- Wellness was also an unfamiliar concept; people couldn’t understand why they needed to see a doctor if they weren’t sick.
- While we knew that people from Village “A” did not know people from Village “B” prior to the development of the co-op, we didn’t realize that there was an inherent mistrust of anyone from another village. This led to a lot of name-calling, finger-pointing, and false accusations between the co-op members, which, in turn, created a significant lack of cooperation.
- We had been misled in many ways, but mainly, people had told us “yes” when they really meant “no.” The “yesses” were said just to keep us returning in hopes that we would bring or give them things instead of just teaching them how to “do” for themselves.
- People really didn’t want to add one more thing to their plates, and going to co-op meetings and events became cumbersome since the villages are not close together and people had to make an effort to attend…sometimes in the rain.
In 2013, the co-op was officially disbanded. However, SIA did not abandon the Rio Momón, and our group of volunteers from around the world continues to venture up the river every year to provide medical and dental care to the underserved. Beginning in 2014, SIA developed a medical/dental/education mission for the entire population living on the river.
- SIA is now celebrating 10 years since its inception, and 8 years of providing consistent medical services.
- Luis Espinoza (Tropical Medicine/Infectious Diseases) is our Medical Director.
- Sammi Raéz (DDS) is our Dental Director.
- Since the shift in focus, we have gone from serving 250 patients in 2014 to our record high of 540 patients in 2017.
- Our medical/dental teams of volunteers and local staff expanded from 25 in 2016 to 40 in 2017.
- We have added chiropractic and acupuncture to our services.
- We are now providing in-village follow-ups for patients with the most serious needs.
- We have sent patients to Lima for successful pacemaker implant (thank you, Dr. Cesar Aranguri) and plastic surgeries.
- We will be holding our second Pterygium (eye) surgery campaign in 2018 (thanks to former PAMS President, Dr. Miguel Pro)
- We have formed a partnership with the Global Health group from the University of Illinois-Chicago, and are undertaking the battle against anemia.
The mission statement of Selva in Action:
“To improve access to health care, promote wellness and education, and provide economic development linkages for the people who live along the rivers in the Peruvian Amazon jungle.”
SIA welcomes all medical and non-medical volunteers who have a willing heart and helping hands. For more information, call Anita Soluna at 505-705-5700 or email: email@example.com.