Annual Report 2025

March 2026

Greetings to all our Amazon Medical Project/Clinica Yanamono friends and family –

Once again, an entire year has passed, which means it is time to bring you up to date on what we have been doing. 

In 2025, we saw a total of 2,521 patients, the most we’ve had in one year since the pandemic.  Of these, 579 were seen on the village visits that we have been making in the last couple of years.  I have always had reservations about trying to take medical care to villages along the river.  It is tempting, because there are many people in remote villages who have little access to medical care.  On the other hand, going around looking for sick people is an inherently low-yield proposition, and there is never a good place to do an adequate exam, and you have to take a very large variety of medicines in order to be prepared for whatever you might encounter.  And if someone is really sick, you’re probably not going to be able to treat them on the spot, anyway. 

But we limit ourselves to offering well child care (worm medicine, for the intestinal parasites that are still common, vitamins, dental fluoride varnish to prevent tooth decay, and a toothbrush); pulling rotten teeth; vaccinating; and checking for anemia and high blood sugar, both of which are simple tests that can be performed with hand-held equipment.  Anemia, which in our area is almost always caused by iron deficiency, is not only debilitating in all ages, but also impairs the ability of children to learn.  And it is easy to treat, with iron pills and B vitamins, both notably absent from diets along the river and both easy to purchase in Iquitos.  If someone has a high blood sugar, we ask them to come to the clinic for better evaluation. 

And we have found rates of anemia as high as 40% among the villagers we have seen, so I think this program is worth doing. 

Other preventive medicine measures include birth control and vaccines, which to my mind are probably the two most important services we provide.  And they’re working.  Nowadays, seldom do we see eighteen-year-old women with three children; and rarely do women have to see their babies die of preventable illnesses.  These are large changes, since my early years here. 

We continue to see folks with diarrhea – some people continue to drink water straight from the river – but not nearly as frequently as we did years ago.  Also, it is now unusual to have people die of it.  Thanks to many different organizations and projects, most villages now have access to clean drinking water, which makes a tremendous difference.  Pneumonia has also ceased to be a common cause of death among babies (or older folks).  Those vaccines do make a positive difference. 

It took nearly a year of submitting one document after another, but we finally managed to get an agreement with the government which allows us to again receive vaccines from them.  So, after having been pretty much out of the vaccine business in 2024, we are now vaccinating our patients again, and reached 172 patients with this service in 2025.  Hopefully, in 2026, we’ll do even better. 

We saw 78 patients on an emergency basis, and evacuated four of them to a higher level of care.  Some of the emergencies would not have been real emergencies had they come in during regular clinic hours; these are maladies such as headache, diarrhea, etc.  Others were trauma — there are always people who slip and fall while carrying their machetes (including, of course, children, who use these tools on a daily basis), resulting in lacerations of various extremities.  One of these patients was a twenty-four-year-old woman, eight months pregnant, who was cutting branches (for firewood) while seated in her dugout canoe.  Her machete slipped and caused a nasty gash on her leg, though fortunately she healed without complication. 

Then there are the daily afternoon futbol (soccer) games, which cause contusions, falls, and collisions among the players (and occasionally, among spectators).  We always see a few burns, such as the three-year-old who lit a plastic bag afire in order to light a candle, then dropped the burning bag on her foot.  (There are fewer burns than there used to be, though, as kerosene lanterns are no longer in use, and a few families now even have gas stoves using bottled gas from Iquitos, rather than cooking over open fires.) 

A couple of local men got bashed in the head when the house they were working on fell in on them, but neither had serious or lasting damage.  And there has been a large construction project underway since mid-2025.  The government is building an enormous school complex in Las Palmeras, which has long had a high school to which students come from many neighboring villages.  This is being modernized and enlarged, to include not only a high school but kindergarten and grade schools.  We have therefore seen accidents related to this work, such as the man who slipped while hauling heavy materials up the muddy river bank, and fell onto a piece of old metal buried in the stream bed, causing a laceration which required sixteen stitches. 

A thirteen-year-old fainted while holding the flag in the tropical sun during the Independence Day celebrations, scraping her face rather badly.  She healed, but it must have been pretty painful for a while.  We saw only one gunshot injury, sustained when a man tripped the gun trap he had set himself.  He was lucky and had only superficial injuries, but I curse these traps routinely.   And there was a thirty-year-old man who was at a fiesta, had been imbibing liberally of the local sugarcane rum, and did not realize that the streamers hanging from the ceiling were not something on which he could get a good grip when he stumbled.  He pulled some of them down with him as he fell, and scraped his face rather dramatically, necessitating a dozen sutures in several wounds. 

Our first emergency of the year came on a Sunday afternoon at the end of the year-end holidays, just before we were scheduled to officially re-open.  This was a twenty-six-year-old woman (whom I have known since she was in her mother’s uterus) who came to the clinic in labor.  Fortunately, her labor and delivery were normal, and her new daughter dropped easily into my hands. 

Our first transport of the year was for an eight-year-old girl in January who came in with what was probably appendicitis.  We gave her antibiotics, which in some cases is all that is needed, but we took her to Indiana for better evaluation, and I believe they sent her on to Iquitos (we do not always receive follow-up on our patients, which is a shame but is just how it is). 

The next transport was in March; this was a thirty-seven-year-old mother who already had seven children (including a daughter who was eight months pregnant), but wanted another baby herself.  She was about five months along, and was bleeding, so we took her to Indiana, where she lost the fetus (which actually seemed to me like a blessing – as Edemita observed, how was she going to help with her new grandbaby, if she had a baby of her own in her arms?). 

Then in July, a thirty-two-year-old woman came to the clinic with slurred speech, rapid breathing, and reported inability to walk for two days.  We took her to Indiana, and they sent her to Iquitos, where she vanished.  I was in the city not long afterward and went to look for her, but there was no record of her at the Regional Hospital.  She may have had some weird illness, but I suspect she was more of a shaman patient than a modern medicine patient (and Dr. Hamlet noted that although her legs were supposedly paralyzed, she was moving them when she was on the exam table at our clinic). 

Our last transport in the year occurred in November, when we took a 26-year-old who was miscarrying a pregnancy of about three months duration to the medical post at Indiana, where they did a D and C. 

We had only two poisonous snakebites in 2025.  The first was a seventy-one-year-old man working in his crop field, who was nailed on the leg.  When he arrived at the clinic, there was blood in his urine, and it took eighteen minutes for his blood to clot, normal being less than two minutes.  But with a couple of vials of anti-venin, he improved and was able to return home the next day.  The second bite was to a twenty-nine-year-old woman, also working in her field.  She also recovered, but she must have been nervous in the interim, as her father had suffered a poisonous snakebite years earlier, and had died of it. 

There were also a couple of stings by scorpions, a monkey bite (tourists sometimes go to Monkey Island, a reserve for monkeys, but I consider these primates to be mildly hazardous – they do not usually cause serious injuries, but people do not realize that they are wild animals, not pets), and a couple of people were stabbed by spines on various catfish, usually as they were removing the fish from a fishing net.  An eight-year-old was stung by a stingray.  This wound appeared relatively minor at first, but the river rays have a venom which simply dissolves soft tissues, and he was back a week later with an infection in the area.  He did heal eventually. 

We see assorted skin problems each year.  A warm, moist climate is the perfect environment for fungi, and people come in with ringworm, athlete’s foot, jock itch, diaper rash, and vaginal candidiasis.  There are also occasional patients with herpes infections around their mouths (“cold sores”), or with herpes zoster (“shingles”), a painful sequela to chickenpox infections suffered years before, and a few kids with impetigo, a bacterial infection usually involving the face.  There are allergic reactions to foods or jewelry, and we have one patient who has lived with psoriasis for many years.  There are also people with scabies, or with itchy reactions to insect bites.  For the latter, we give sympathy and antihistamines; for scabies, we prescribe washing of all clothes and bedding, and treatment for all members of the family. 

Juvencio continues to perform extractions of rotten teeth (of which there are many, since no one is yet putting fluoride into the Amazon River), and he went on a number of the community visits this year, performing multiple extractions on each visit.  In total, he alleviated suffering in this way for one hundred twenty-one patients.  In addition, he provided fillings for thirty patients with teeth that were decayed but salvageable.  These are services which are not available along the river, outside of the Clinica Yanamono, and the patients are generally very grateful not to have to travel to Iquitos for this care.  

Then, there are patients who don’t fall into any real category.  A fifty-two-year-old neighbor came in as an emergency after he passed out in his hammock after lunch.  He had not been drinking, nor engaging in any unusual exertion, but Elmer and Edgardo reported that his jaws were tightly clenched and he appeared to be unconscious for fifteen or twenty minutes, which is a long time.  I’m not sure what exactly ailed him, and we recommended a neurological evaluation, but I don’t think he ever went for that, and has had no recurrences, so I suspect he had what used to be called a “nervous disorder.” 

And in mid-July, Dr. Lenin Hidalgo and nurse-midwife Karina, who work at one of the government clinics in Iquitos, came to the clinic and provided treatment for five of our female patients who had tested positive for the bad strains of HPV.  I have been talking about this in the clinic letters, and will have more to say in 2026, but at least we have gotten started on treatment that is designed to catch cervical cancer before it really gets a start.  For an area with tremendously high rates of cervical cancer, and sadly high mortality rates for those women who do get it, this program is a near-miracle in the making. 

Now, on to 2026.