This final post is coming a bit late due to my high level of frustration with Iquitos’ Internet (or lack thereof). We continued in our last week finalizing our mosquito larvae experiment (results are still being processed), enjoying two free days for the Peruvian independance celebration, and planning and executing individual student projects.
On our free day on Sunday, we went as a large group to a nearby butterfly farm and animal orphanage. This farm was owned and managed by a very interesting and eccentric woman originally from Austria. While looking at the butterflies and animals in her care, this woman told us that she often gets “rescue” animals from people whom she described as “stupid people” who buy monkeys or other animals in the market, then bring them to her, saying they “rescued” them. She said, with a heightened inflection in her voice, that her response to them is, “No you didn’t [rescue them], you encouraged [the sellers] to kill the mother for the babies.” She continued, in a mocking tone, that these people’s responses are “Why did you say that? My heart told me to do it.” Then she said “I say, think with your brain.” She spent some time during our tour talking about the political nature of her work. She said she can be fined 50 soles (about 20 US dollars) for each animal she releases without permission from the government. She said she once applied to release two boas, never heard back from Lima, so she “took no answer as a positive” and released the snakes. Later, she says, government officials came to see the snakes and fined her for their release.
This experience at the butterfly farm was the first direct experience with human-animal and human-nature relationships in Peru. What was most interesting to me was hearing about the politics and economics of animal releases on this island, and seeing the reactions of others to her presentation about the animals. For example, when she showed us to a cage of small monkeys that she said are known to climb into hummingbird nests and bite the heads off the young, Fred exlaimed, “They’re too cute to do that!” (Personally, I thought they looked completely guilty of such things, since they looked like rats.) I think the emotional connections we have with these animals strongly affects the way we think about these animals and what we consider ethical or unethical to do to them (e.g. Is it appropriate or ethical to genetically modify a mosquito? A rat? Any other animals? Is genetic modification any different from controlled breeding practices?). I was also surprised and interested to hear that she has trouble getting Peruvians interested in butterflies. She said that US Americans have all read The Very Hungry Caterpillar and are more familiar with butterfly ecology than Peruvians. The Peruvian understanding of insect ecology could strongly affect the reception of transgenic mosquitoes!
Getting back to work during the rest of the week, we continued to count larvae and finalize our experiment, and we were also given one day to focus on a project of our own initiative. After visiting the health clinics in week 2, I was interested in looking further into the health system in Iquitos. Gaby (one of the Peruvian students working with us, who also works with Amy Morrison and NAMRU) helped me coordinate my project. We decided to shadow a NAMRU physician, Dr. Isabel, as she visited patient homes who were suspected to have (or were positive for) dengue. These patients were being watched by a NAMRU physician because they were part of Amy Morrison’s current cohort study, where she monitored movement of people and dengue outbreaks in the cohort. We visited three different homes, all within close range of each other, and Gaby graciously served as my translator. In the first home, the dengue patient was not home, but the mother asked Dr. Isabel to look at her son, who she also suspected to have dengue. The mother seemed concerned because so many surrounding homes had dengue. In the second home, a young woman had tested positive for dengue. She explained that her symptoms had gotten so bad a few days earlier that she went to the hospital, where they treated her for a urinary tract infection. I was surprised to hear this error on part of the hospital, because this woman had already tested positive for dengue. Dr. Isabel also seemed surprised at this, and told her patient to not continue treatment for the UT infection, and that this is a common mis-diagnosis with people who have dengue. Dr. Isabel also talked to this young woman’s sister breifly, as her mother was concerned she also had dengue; Dr. Isabel decided this was not likely a case since she had not had a fever. Just before leaving, the mother of these two women asked Dr. Isabel if she had a way of performing a procedure to improve her vision. After this last interaction, I wondered if some of these patients participated in Dr. Morrison’s project in order to receive healthcare. (And understandably so, after visiting the clinics in week 2.)
Later in the evening, Dr. Morrison gave a lecture on issues of consent in minimal risk studies (she considers her movement project to be minimal risk). There was much discussion about giving incentives in these research projects – do people participate just for the incentive? In a place where healthcare can be hard to come by, is the guaruntee of healthcare too much of an incentive? What is the ethical responsibility of scientists in these situations? The issue of the UT infection misdiagnosis brought me back to another issue – is dengue “legitimate” in the Iquitos health system? What happens rhetorically to give malaria a seemingly higher status over dengue?