Tuesday, April 27, 2010

Parasite Infection Investigation in Tarapoto

When Eric Wetzel told me that URKU, the non-profit environmental organization in Tarapoto, Peru, was a place worth visiting, I could have signed up right then. You see, Eric, a biology professor at Wabash College, who has taught such esteemed individuals as…me, is someone I have a lot of confidence in. If he told me jumping from one of Crawfordsville, Indiana’s (the home of Wabash College) high-in-the-sky bridges, I would, at the least, have to go take a look and deliberate. With Eric’s recommendation and emails exchanged with the folks at URKU, I took the figurative leap and bought my 28-hour ticket to go north and east from Lima to Tarapoto.

Awaiting me and my two weeks in Tarapoto, a city of 80,000 inhabitants on the fringe of the Amazonian river basin and the foothills of the Andes, was work. My primary project started with a notebook over an inch thick that contains summaries of all patient visits for 2009. I would highlight all patient visits mentioning parasite infection. The doctor’s staff, then, would retrieve each highlighted patient history, and I would organize an Excel spreadsheet, entering relevant patient data. But, other than keeping me busy and away from cheap ice cream and treats, the point of all this?

Eric Wetzel and I in Lima. He went to Lima to work on creating a Global Health Program for Wabash College during his sabbatical. For three months he and his family lived in the Miraflores district. Juleen and I met up with him and his fam while we were volunteering at the Centro Ann Sullivan de Peru.

Dra Rosa, whose clinic had accumulated the patient data, and Eric are interested in generating a map of parasite infection levels in communities in and around Tarapoto. They’re hopeful that, through the study, they’ll be able to identify segments of the population that are particularly vulnerable to parasite infection. With both the map and infection prevalence data in hand, Dra Rosa and Eric will attempt to identify practices that are leading to high infection rates in certain populations, then wage a public health war against those practices. (More or less, isn’t that the plan?)

Say, for example, that Dra Rosa and Eric take a closer look at the infection of Necator or Ancylostoma parasites. These hookworms are impressive. Though they enter the body via the skin, often using the foot as a port of entry, they end up in the body’s small intestine. At one point on its road trip through the body, the hookworm induces the human host to cough, allowing it to covertly slip into the host’s esophagus. After getting itself swallowed, the hookworm will descend to its comfy and replete residence in your small intestine where it “leeches” blood and nutrients. The danger: anemia, especially probable and dangerous in the undernourished.

Flipping through patient histories, different records stapled one on top of another, struggling to make out the Spanish scribbles (apparently Peruvian med schools, like their American counterparts, teach their doctor candidates to write in chicken scratch), I had a feeling of greater purpose to push me through. And, even if I hadn’t, I knew this was something that Professor Wetzel might be able to use—no more motivation needed.

I came nowhere close to finishing all of 2009’s patient data. In fact, I only made it through January. Understandably, with their regular full load of work, the patient histories didn’t pour out of Dra Rosa’s staff. Still, a slow, steady, trickling really, stream came. The ball on this parasite infection investigation is rolling.

Luckily, in between entering data about patients infected with parasites, there was other work to be done. In addition to the parasite infection project, URKU had translating work and a radio debut for me. My biggest project, in fact, did not end up being the parasite data after all. Instead, the majority of my time was spent preparing for a visit I made to two indigenous communities midway through my second week. There, in a variety of very different sessions, I spoke to various groups about climate change and tried to incite the communities into political activism. More to come on that soon.

Here's a link to Professor Eric Wetzel's Wabash College blog (we're the subject of his last entry).

And here's a link to URKU's website.


  1. I now feel more educated on the subject of hookworms, should they ever come up in conversation with friends. I have to admit, though, that I don't think they ever have been a topic of discussion in my clan. Nonetheless, fascinating project. I hope to hear more about the results at some point. Have a safe trip home!

  2. So that's what you've been up to these past couple weeks, huh?

    I, like my mother, am more versed in hookworms. Thanks for the hookworm 101. I unfortunately, unlike my mother, can imagine that hookworms will come up in conversation, especially if I keep hanging out with you.

  3. If you're so lucky! I think you will be, Juleen.

    I had initially written the piece explaining how a certain demographic might become disproportionately infected with hookworms. At the last second, though, I removed that paragraph, which leaves the piece as is with that unnecessary hookworm lesson. Luckily, parasites are always interesting in and of themselves.

    Necator americanus, as its name suggests, is a hookworm found in the US. Couldn't find infection rates on Wikipedia, unfortunately. Still, I think YOU are empowered to bring it up in conversation at this point.