Week 2 with IGERT in Peru – Iquitos, Peru

Editor’s note: We’ve been following first year CRDM student Molly Storment’s experiences in Peru. Please also see her original post here: http://molly.celevorne.net/node/28

This has been an interesting first week in Iquitos. We have begun working in collaboration with Dr. Amy Morrison (UC Davis) who has been in Iquitos studying dengue and Aedes aegypti for 14 years. We were joined in Iquitos by four Peruvian students, three from Lima or surrounding areas, one from Iquitos. There has been some very interesting bilingual communication happening in our activities. I’m very glad their English is much better than my Spanish! I learned some very important differences between “muerta de hambre” and “muerta de hombre,” as well as “café pasado” and “café pescado.” Use Google translate for some nice humor.

Friday, Fred honored me with the “award” (an IOU for a pisco sour) of most improved mosquito larvae counter! But there’s lots of room for improvement when the starting point is pitiful; little do my colleagues know that was my strategy all along. 😉 We have begun an experiment involving breeding mosquitos in six different local homes. Amy’s team placed buckets in these homes 6, 5, 4, 3, 2, and 1 week before we arrived, and we placed differing amounts of aegypti larvae in each of these buckets on Wednesday (7/25). Very simply put, our question is how much detritus is needed to maximize aegypti larvae growth, and what amount of larvae is needed to maximize growth? (The idea is that they will not reach adulthood before the experiments ends, so there is no risk of infecting these homes with aegypti. We have kept netting over the buckets to keep the level of detritus under control, and to keep any potential adults from getting out.) The participant homes have been very generous in letting us in their homes every other day for about 1 hour at a time to count larvae. In our evening discussions, Amy has told us that many people in Iquitos are more than generous in allowing her team in their homes in an effort to control dengue (but not all, as I witnessed myself!).

Between larvae counts, we made visits to two health clinics, one urban clinic in Iquitos, the other on a nearby island in the small community of Padre Coche. I was surprised to see that the bigger concerns in both of these clinics seem to be pregnancies, and in the case of the urban clinic, deliveries. In Padre Coche, the doctors we spoke with said that they do not have a problem with dengue fever, but rather malaria. It was a humbling experience to see that each of these clinics only owned one microsope, and the rural clinic had been out of electricity since December. The doctors in the rural clinic also described to us their intense efforts to keep malaria under control in their community, sometimes involving up to three hours of walking in an outbreak.

In Iquitos, our evenings have been spent listening to lectures on topics like mosqito ecology and dengue epidemiology, but often these lectures spin out into interesting conversations on the social factors related to the disease transmission and the nature of research in Iquitos. Dr. Amy Morrison along with Dr. Tom Scott (UC Davis) is doing some very interesting research on the movement of people in Iquitos and its influence on the transmission of the dengue virus. This work raises questions of how occupation, lifestyle, and possibly gender roles affect dengue transmission. Some of Amy’s work has also shown that most aegypti are born and die in the same home. (Disclaimer: I am not certain how conclusive she is on this research.) This, however, also raises questions of what is a “home.” Based on my very un-empirical observations, residents of Iquitos have a more communal lifestyle than US Americans, where one families’ “home” could extend past the confines of one structure (and even “structure” is loosely defined here). We have also had intense discussion on how to characterize diseases like dengue and malaria – are they diseases of the “poor,” a “rural” (in the case of malaria) or “urban” disease? I have observed in some of my colleagues some frustration in the difficulty in choosing words to characterize disease and the populations they affect; this was an interesting cross-disciplinary learning experience for me, as I was never shaken by these conversations, but rather felt they were very productive. But the problem that bothered the others still remains – do we settle for language that is “good enough,” or is it possible to find a truely productive and effective means of communicating about this disease to each other and to the affected publics? I think we could certainly improve the situation in Iquitos and with the World Health Organization – Amy hopes to use her research to improve health policy decisions in organizations like the WHO, where, as she told me, they promote strategies to control mosquitoes that they know don’t work (for example, some forms of insecticide spraying), but “it keeps the media off the WHO’s back.”

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