Hola! What a weekend we have had!! Saturday morning we went on a tour of "Hospital Iquitos Cesar Garayar Garcia", the small community hospital in central Iquitos.I'm not sure how to begin to explain this hospital to my American friends. It is nothing like the hospitals that we are familiar with. The IV pumps, cardiac monitors, self turning beds, and readily available medications that help me do my job and that I obviously take for granted were nowhere to be found.The beds were simple metal frames, gathered ward style in large rooms.I saw a man lying on a stretcher in the hallway who had visible head trauma and labored breathing. The ICU nurse in me felt an urgent sense to do something.However I quickly realized that all the things I wanted to do and am trained to do (start a few IV's, draw some stat labs, call in specialists, set up monitoring, get ready for CT scanning) were all 100% impossible in this hospital.I would not even know how to be a nurse here.Being so useless next to that suffering man was painful. The Internal Medicine Doctor present told us a bit about the hospital and the city. There are 35 Doctors on staff but only 17 nurses. This is not because there is a shortage of nurses it is because the hospital cannot afford to employ them.Often nurses trained in Peru need to go to neighboring Brazil or Columbia to find work.The Doctor also told us that the primary patient population is birthing mothers. In the small 150 bed hospital they do over 6,000 deliveries a year, 1/3 of which are caesarian deliveries.This high number of C-sections, he said, is due the young age of the women giving birth (14-25). We asked him to describe the major health problems facing the city and he said: Tuberculosis, motor car injuries, diarrhea (secondary to poor water sanitation), and HIV (due to people coming to Peru seeking homeopathic treatment but spreading the virus).BUT, on the bright side there is NO swine flu in Peru!!!Next we met a rather jolly general Surgeon who explained that "general" translates to "everything"!He does 8 scheduled surgeries a day in addition to 4-5 emergent cases with the number one case being cholecystectomys(not surprising, the average diet is high in fats and carbohydrates as fruits and vegetables are too expensive). Next we went to a "posta" (community clinic) and saw the same situation of limited resources. The Doctor present shared the difficulty he has writing prescriptions for people knowing that they will not be able to get them filled. This is not just because they cannot afford them but also because medications are not always available to be sold. "The government allows people to get free health insurance when in need but does not provide the clinics with the needed medications and does not fully reimburse the Physicians".This led to a few of us getting into it about the possibility of universal healthcare in the U. S., one of the Pharmacy students felt that it would cause us to be in the same situation we were seeing here. We left the clinic and our bus would not start again! The boys had to push it to get it to run, it was hilarious!!! We went back to the compound for lunch then went to the zoo!! It was so much fun! We saw tons of monkeys, a pink belly dolphin, and rainbow colored parrots that looked like they came right off of an ad for a tropical vacation getaway! Sunday was a day for relaxing and fun. Some went to a soccer game during the morning (I had to stay and do homework…bleh…) then we went out to dinner at a unique wood-clad pizzeria in the plaza, and in the evening played a few games of volleyball. I'm excited for clinic today (Monday morning) and our upcoming teaching project. Oh! And Will an extra nice Pharmacy student lent me his extra camera so that I can start taking pictures again!! Yay!!!