Aguaruna (People of the Water)

In January of 2002, CNN reported a massacre in the remote jungle region of Northern Peru. Settlers had been attacked by upwards of 150 Aguaruna Indians. The Aguaruna were in war paint, their faces red and black. They used rifles, bows and arrows, machetes, and shotguns and blowguns (loaded with poison tipped darts) to kill 15 settlers, seven of them children. Scores of others were wounded in the attack.
The roots of the problem date back to 1981 when then-president Fernando Belaunde Terry declared the Cajamarca jungle an economic expansion zone, and launched a campaign to “Peruvianize” the Aguaruna. Belaunde did this for security reasons. He wanted to create a demographic barrier to curtail Ecuador’s attempts to penetrate the area. This involved not only making the Aguaruna identify as Peruvians, but also bringing in settlers from other parts of Peru to help populate the sparsely inhabited region. The colonists flocked to the region- engaging in agriculture, especially the growing of coffee.
The Aguaruna have been struggling against this incursion into their lands since its beginning. They are the most politically organized of Peru’s indigenous groups, and until recently their battles were carried out mostly in the courtroom. This tactic saw much success, especially in the late 1990s, with several different courts finding in favor of the Aguaruna and recognizing as valid the property titles the Aguaruna hold for the land.
The colonist settlers did not recognize the claims of the Aguaruna. They stayed on the land, leaving only briefly in 2000, but returning after the case was appealed and moved into a higher court. The Ministry of Agriculture offered the settlers other land, but the settlers were adamant- they would not leave. When they saw that their final appeal had failed, the colonists formed their own paramilitary force, comprised of peasants and known as the “ronderos.” Several of the settlers armed themselves with rifles, preparing to defend against forcible eviction. The police are not allowed to use their weapons in such situations, so the settlers remained.
On January 12 2002, the eviction was again supposed to take place. The settlers, demonstrating no small amount of media savvy, invited a local television station to witness the proceedings. The Peruvian government, unwilling to risk a public relations disaster, backed down.
Seeing the government as unwilling, or unable to rid their land of the trespassers, the Aguaruna decided that they had to act, and on January 19, they did.

The Aguaruna are known for being fierce defenders of thier culture

The Aguaruna have always been hostile to outsiders. When the Inca Empire covered much of modern Peru, Ecuador, Chile, and Paraguay Aguaruna territory was an impenetrable pocket of resistance. When the conquistadors came from Spain, they easily overturned the Inca Empire, which had been weakened by a civil war over succession to the throne. The Spanish were no more able to conquer the Aguaruna than the Incas.
The Spanish found the Aguaruna territory hostile. It is rugged terrain; much of it covered by dense jungle, with extreme temperatures and unfriendly wildlife. There are tarantulas that emit a powder than blinds for days, as well as flesh eating piranhas, and yellow, white and black cayman (a type of alligator) which can grow to 2-4m. The Aguaruna were even scarier than the wildlife. They were fierce warriors, who would remove the heads of their foes after battle. They then shrunk the heads, using a method that involved curing, boiling and roasting. These shrunken heads, worn around the neck and known as “tsantsa,” were believed to contain the soul of the person killed.
The Aguaruna success in keeping out foreign intruders later led to some problems. The Spanish colonialists created many of the borders that divide the modern states of the region. The border between Ecuador and Peru runs directly through the heart of Aguaruna territory. Before 1941, the Aguaruna were able to move freely between the two states, oblivious to their existence, and unconcerned with political boundaries. Others, namely the governments of Peru and Ecuador, were quite concerned with this border.
The Spanish had never been able to penetrate Aguaruna territory, and hence had been unable to map out a 75-mile area that included where the Peru-Ecuador border would fall. In 1941 a war over this border began, a brutal and ugly conflict fought on Aguaruna land. Later that year, the two sides met in Rio de Janeiro, hoping to settle the dispute. They both signed a treaty known as the Rio Protocols, which was supposed to end the war, but did nothing of the sort. While they were able to agree on 95% of the border, 5% was left in dispute. This 5% was the area of the Cenepa River, the area that ran through the Aguaruna land. This area was to be fought over for more than fifty years, with hostilities flaring up intermittently, most notably in 1981, and 1995. No peace treaty was signed until 1998; it had been the longest running border conflict in the Western Hemisphere.
During the conflict, the border was closed. Aguaruna were unable to visit friends and family who lived across the border. More than 20,000 Aguaruna villagers were displaced by the fighting, and at least 28 were killed by stepping on land mines, between 130,000-150,000 of which were planted by both sides throughout the border region. The war wreaked havoc on the natural resources of the area. Chemicals from exploded and unexploded munitions contaminated rivers. Acres of rainforest were cleared for troop transport and the building of military bases.
The Aguaruna suffered another environmental disaster in the mid 1990s when potential oil reserves were discovered in northern Peru. Oil companies rushed in eagerly, destroying the rainforest by the hundreds of acres, often using TNT, in order to build paths and heliports. This wanton disregard has been very troubling for the Aguaruna. They have been, for centuries, ardent conservationists of their portion of the Amazon. In order to survive in such a remote and apparently inhospitable region they have had to carefully adapt to and respect the unique ecological balance.

Aguaruna...the original biotech industry

The Aguaruna know how to use the plants of the Amazon in a way that is just now being understood by western scientists. They, like other tribes of the Amazon used the bark of the Quina tree as a malarial antidote. The active ingredient, Quinine, was developed and spread around the world as the first preventative treatment of malaria by researchers, becoming one of the most important medicines of the 20th century. Other plants of the forest have been used by the Aguaruna to treat ailments such as gastritis, dysentery, snake bites, skin disease, constipation, and used as birth control. The Aguaruna have long extracted poison from frogs to use on arrows when hunting. This extract is a powerful muscle relaxant, a synthetic of which is used during surgery by major hospitals all over the world. Recently, the Garabato plant (cat’s claw), used by the Aguaruna as an anti-arthritic and anti-inflammatory, was labeled by the World Health Organization as the most important medical discovery to come out of South America since quinine.
Of course, this great resource has again drawn outsiders into the Aguaruna territory. Bio-piracy, or the theft of Aguaruna plants and plant knowledge is the most recent threat to the Aguaruna people. Large corporations want to create new treatments from these plants without reimbursing the tribes. Fortunately, some companies have begun to help them share their medical knowledge in a way that will be mutually beneficial.
Most Aguaruna now realize that in the future they will be unable to remain as isolated as they have been in the past. Many of them are taking steps so that they can take control of their future. They have become politically savvy, organizing with other indigenous groups, and young Aguaruna have placed great importance on education. Their conflicts with outsiders are surely not over, but it is safe to say that they will be able to retain a great deal of cultural integrity for years to come.

Aguaruna Agriculture

Most of the Aguaruna survive through subsistence farming. With an average per capita income of only US $34, they are unable to buy much food, and must grow or catch their meals. 80% of the Aguaruna diet consists of carbohydrates, so malnutrition is common. Hunting and fishing are practiced by men using the traditional methods, and have great cultural significance for the Aguaruna, but they do not provide nearly as much sustenance as agriculture and domesticated animals.
The Aguaruna mainly grow plantain, maize, and yucca. Plantain is the main cash crop, one of the few viable exports of the region, but yucca is what feeds the Aguaruna. Yucca is an essential part of not only the diet, but of the culture as well. It is consumed daily by the Aguaruna, both as a staple food, and as a beverage, masato. Masato is a beer made by fermenting yucca. It is an intoxicating drink, much valued as a social lubricant. It makes parties and festivals lively, relaxing inhibitions. It is common for couples to form after meeting at village socials while under the influence of masato.
Traditionally Aguaruna women are in charge of gardening and farming. A woman’s standing in her household and in the community is related to her horticultural abilities. This is rooted in the Aguaruna mythology of Nuguki, the “earth mother” who is said to reside within the soil. The following story from the book “Tsewa’s Gift” by Michael Brown is about the Aguaruna's first encounter with Nugkui.
Long ago, the ancestors had no cultivated plants or clay pots, and had to live on a diet of mashed balsa wood cooked in their armpits. Then one day a woman saw peeled yucca skins floating down the river, and followed its trail until she saw Nugkui along the riverbank. The woman wanted Nuguki to return home with her to provide food for her hungry family, but Nuguki declined and instead sent her daughter. Once in her new home Nuguki’s daughter continued to provide an abundance of beautiful food and clay cooking pots, until one day some mischievous children made her summon fierce animals for their entertainment. The children however, became frightened of the animals and threw ash into the daughter’s eyes. So abused, she fled and hid inside the stem of a bamboo plant. Later, a woman from the house found the daughter and began to kick her. In an attempt to escape she crawled into the woman’s anus, which is why humans are plagued with intestinal gas today. After the daughter disappeared, the people were forced to go back to their previous depressed state. Nuguki however, took pity on them and appearing in a woman’s dream directed them to a field of infant plants that were then cultivated and used to feed the people.
Masato

Making masato is easy:
Boil yucca over an open flame until soft. Remove from heat and drain excess water. Mash the boiled yucca with a wooden spoon. Chew the mash and spit it into a vat. Mix with water and let sit for two days.
Enjoy!

Taiwan Root on the road to Imaza

The road ends at Imaza. It is a five-hour journey from Bagua along, what according to the Peruvian police is “one of the more dangerous stretches of road in Northern Peru.” Originally built to help make way for an oil pipeline, travelers on the road to Imaza are frequently victims of attacks by rebels and bandits. It is a grueling ride, littered with boulders and blanketed in mud that has washed down from the hillsides. The Peruvian government had assigned two armed guards from its elite police force, ‘Segundo’, to insure the safety of the medical mission. Stationed at the front of the Taiwan Root caravan, the guards keep watch for danger ahead, their pistols and automatic rifles always in plain view and within easy reach. After Imaza, “The Gateway to the Northern Peruvian Amazon,” any further travel into the Amazon must be made by boat. Huampami, the first destination of the TRMPC medical team, is another six-hour journey up river, on open-air boats where there is no protection from the blistering Amazonian sun.
Taiwan Root was not traveling light. Four boats were hired, three small speedboats for the doctors and support staff, and a cargo boat to carry the 2,000lbs of equipment that they had brought from halfway around the world. There were thirty-two crates full of not only medical supplies and personal luggage, but lights and generators, a stove and food, tents and sleeping bags, etc. All of which would have to be unloaded from the boat at each stop they made, and reloaded when it came time to set out for the next destination. Taiwan Root had with them everything that they would need for their three week medical service, as procuring even the most basic items is would be all but impossible once inside the Amazon.

Amazon jungle and yucca beer. 35 patients an hour. 11 hour days. Welcome to Huampami

Taiwan Root was welcomed to Huampami with a meal of boiled yucca and plantain, and a chunk of wild pig. A traditional welcome ceremony of the Aguaruna, the meat of the wild pig is offered to all guests and is considered a specialty. The pig was killed shortly before the doctors’ arrival, and was so fresh that shotgun pellets could still be found in some servings. After the ceremony the Root met with local leaders and then headed back to the village’s giant tool shop to set up what would be their home for the next five days. The ‘kitchen’ was outside and the portable stove that was purchased in Bagua during a brief stopover was immediately fired up. A team of kitchen volunteers set out into town, buying five chickens, some yucca, two dozen eggs, and vegetables. The rest went to check out the local hospital.
A Peruvian doctor and nurse who choose to move from the more developed parts of Peru to the Amazon staffed the “Centro de Salud – Huampami”. They had only the barest of medical supplies and were both trained as general practitioners, specialty care does not exist in Huampami. The Root was going to swamped with patients. After a few days wait the medicine arrived from Lima and the 32, 70lb crates were unloaded and carried through the mud to the “Centro de Salud”. Within a couple hours Taiwan Root created their own makeshift hospital. Triage was near the door. After waiting for their number to be called, patients told the Spanish-Chinese translators their ailments, names, age, sex, marital status, and number of children. Weight, temperature, and blood pressure were then taken and based on their medical needs were taken to different rooms. Dentistry, gynecology, internal medicine, external medicine, and pediatrics were all represented. A fully stocked pharmacy was set up near the window so patients could easily pick up their prescriptions. A two-way radio in the Centro de salud was the only means of communication with world outside of the village. In order for the Root doctors to coordinate the delivery of extra medical supplies from Lima, they first had to use the small short wave radio to contact the authorities down river in Imaza, who then made the call to Lima. Coordination in the Amazon takes a little finesse.

Parasitic infections of the skin, stomach, and intestines are common in the Amazon.

The Root starts work early, cooking breakfast around 6am, and punching in around seven. But so do the patients. The lines began to form before the doctors arrived at the clinic. Young mothers, some only 14 or 15, were the first to show up. Reserved, stoic, and extremely suspicious of outsiders, they spoke as little as possible. Their hands were often stained black from the crushed leaves of the Huito plant that is used to dye their hair. Most of them had a young child feeding off one of their breasts. For the women in their thirties, it wasn’t uncommon for them to already have 6 or 7 children. The men of the village showed up later in the day, and while more willing to talk than their wives do, they still remained extremely suspicious of the doctors. Their bodies are strong from the heavy labor and nighttime hunting expeditions that are a part of their survival. Scars and disfigured bones from injuries that never quite healed right add to their sometimes-somber features.
The older patients, some who were old enough to remember the time when the Aguaruna still practiced headhunting, were the hardest to treat. Their traditional Amazonian facial tattoos as striking as their omnipotent gaze. What little experience they may have had with outsiders was in most cases pretty unpleasant. After a lifetime of working the Amazon jungle, many went to the Root seeking relief from pains, something that doctors cannot cure. Others suffering from illnesses that Aguaruna medicine could not cure visited the clinic unaware that they were suffering from high blood pressure or diabetes brought on by an unbalanced diet, consisting mostly of sugars and carbohydrates. The long-term treatment needed to control these type of illness cannot be provided during the short medical service provided by the Root. The prescriptions given out are extremely useful, but can only last for a limited period of time. However something as simple as dietary and health education provided by a doctor can go a long way to improving the health of a patient.
Living in the harsh environment of the Amazon dealing with parasites is a way of life, and the majority of the patients treated by the Root suffered from some type of parasitic infection. Skin diseases like scabies are the most common, with intestinal bugs coming in a close second. Often, patients don’t even know they are sick until their stomachs or testicles shows signs of swelling. For this reason, the Root took random blood samples from arriving patients in order to get a better understanding of the level of parasitic infection in the community. Under the microscope of the Root parasite expert, Professor Cheung, bugs like Chagis disease and malaria were identified and treated. Others were not so lucky. On one of his scouting trips near the Equador border, Root President, Dr. Liu, came across a sick child in one of the more remote inland villages. As he was only there on a quest to find the next location for the Root doctors he had with him only the barest of supplies, and no medicine. His only companions were his translator Jim and the policeman Felipe. The child was brought to Dr. Liu by her parents who asked if there was anything he could do for her. While his training is in dentistry, Dr. Liu was still able to recognize that the child was suffering from malaria and pleaded with her parents to let him take the child down river to the Root camp for treatment. The parents, adamant in their superstitions, refused. They said they felt that their child would suffer even more if she were taken away from her home. Dr. Liu left a couple hours later. Shortly after, he got word from a contact in the area that the child had died.

Steaming heat, screaming children, and suspicious patients are not the norm in the Taiwan offices of these MDs.

Dentistry was by far the busiest area of the medical service. Most Aguaruan are rarely even within 50 miles of a dentist office. This not only created a heavy workload for the Root dentists, but also made it difficult to work on some of the younger patients, most of which became frightened by the mere sight of the instruments. Screaming children could be heard throughout the day. When the other doctors and nurses returned to the tool shop for lunch, the dentist and his assistant would remain at the hospital. At night they often ate their noodles cold because they had to remain at the hospital while they finished up their work. By the time they got to eat dinner the ‘pulled tooth bowl’ was overflowed with 12 hours worth of decayed teeth.
Medical work can often be intense and stressful. In the Amazon that stress is increased ten fold. Steaming heat. Screaming children. Suspicious natives. The doctors do not only feel this stress. The Root medical team had over 40 volunteers who literally took over a section of a village. They built a makeshift kitchen that cooked over 40 meals three times per day, took walks around the village, and took photos. During working hours they would sometimes see over 400 patients in one burning hot Amazonian day. This, in addition to the completely different cultures and customs of the doctors and patients inevitably led to some tension. Unaware of their past experience with previous groups of outsiders exploiting them with their High-tech cameras, the Root were unaware of the Aguaruna’s aversion to photography. This led to some embarrassment for the doctors when the village chief sent out a warning to the Root team stating that from now on “any pictures taken in the village must first be approved by me first”. Already suspicious of ‘outsiders’ the tension over the misunderstanding about photography caused some of the patients to be much more reserved and withdrawn during the medical service. This makes the doctor patient relationship a lot more difficult, especially when the doctor must ask questions regarding sexual relations or habits. When it came time for the doctors to leave the village of Huampami for another destination in Aguaruna territory it caused one of the more tense moments of the three-week medical service. Unaware that the Root was expected at a different village along a different river, a group of Huampami villagers became upset that the doctors had yet to see patients from some of the surrounding mountain areas. They were adamant. The doctors could not leave until the people from some of the more remote villages were given notice of the service and brought down from the mountains for treatment. The doctors tried to explain that it was impossible for them to treat everyone, but their response was only a warning that they could be prevented from leaving “by force if necessary”. Eventually a compromised was arranged with the wife of the village chief who got the group upset with the doctors to agree to let them go if they left a months supply of medicine for the town with their local doctor. The compromise was agreed to and within the next 3 hours the Root had loaded 32 crates, 40 beds, a portable kitchen, and over 40 backpacks onto their boats and were on their way to their next stop along the Rio Santiago.

Professor Cheung

Professor Cheung feels that he was fated to practice medicine. Diagnosed with cholera at the age of five, he was cured by an Uncle who was also a doctor, and now feels that it is his responsibility to help others in need of healing. At 65 he is the senior member of Taiwan Root, all of the others call him “babysitter.” His first service was 38 years ago at Ming Kwung, back in 1955. Dr. Cheung has traveled all over the world on medical missions, becoming an expert on rare parasites in the process.
Now, when he looks at blood samples through his microscope he can quickly identify what kind of parasite the patient is suffering from. Not only does he know what these bugs look like- he knows how to stop them from killing their hosts. Wherever he goes with Taiwan Root, he is always collecting data about the parasites that he finds there, contributing to what the medical community knows about parasites in different places around the world. He also gives this information to the local government, so that they can have a better understanding of their community’s health needs. Of course, when he goes on a mission he can only treat his patients for what they are currently suffering from, not from what they will get in the future. He acknowledges this as a limitation of an organization like Taiwan Root.
The Root is a group of people who all have families and practices in Taiwan, so it is difficult for them to provide long term care for those that they help. To correct for this it is necessary to engage in what Dr. Cheung calls “seed spreading.” When Dr. Cheung treats patients for parasites during a medical service, he gives them not only medicine but tells them how they can take preventative measures so that they can protect themselves from future parasitic infections. He also imparts his wisdom to any health care providers that he encounters on the missions.
In Huampami, Dr. Cheung found that the woman working at the Centro de Salud lacked even basic knowledge about parasites. He gave her pictures illustrating the most common parasites that he had found in Peru, and taught her how fight them. So, while Dr. Cheung may have come home from Peru, his knowledge is still being put to good use there. This is the most important thing that Taiwan Root does, giving the people in the places that they visit knowledge so that they are capable of better addressing their own health care needs.

Felipe

There is an entry wound in the middle of his front left shoulder. It is small and tidy, at least compared to the massive exit wound on his back, created when the hollow tipped bullet exploded on its way through his body. The steel plate in his head is the result of a terrorist’s bomb. Now in his forties, Felipe has been working for the Peruvian police for most of his life. Although a shaky peace has now been established in Peru, for the past 20 years the country was ravaged by violence. Rebels and terrorist groups controlled large portions of the countryside. Drug traffickers stalked the border areas. For Peruvian law enforcement violence was just a part of life.
Felipe has never been married. He spent much of his youth fighting against various terrorist groups and chasing drug lords. His size and menacing features make people respect and fear him. However, he is much kinder than he looks, and he is dedicated to his work. After suffering numerous wounds in the line of duty, training with the CIA’s counter-terrorism and narcotics agents, and receiving the rank of sergeant he was given a job with elite Segundo branch of the police force. Segundo is Peru’s version of the US secret service. They guard the president on his trips abroad, and are involved in counter intelligence programs throughout Peru. The agency is also responsible for guarding foreign diplomats and envoys that visit Peru. They provided security for Taiwan Root’s journey into the Amazon.
Upon arrival in any new village Felipe and his partner Jaime became the center of attention amongst the populace. The people knew and feared the reputation of Segundo. In a country with a history of violence like Peru’s it is sometimes difficult for the local population to determine who is more dangerous- the drug traffickers and terrorists or the police and the military. In order to calm the villagers Felipe always met with the chief to explain that he was only there to provide security for the doctors, not to cause any problems for the locals.

Inspired by the teachings of Mao Tse Tung, university professor Abimael Guzman founded the Shining Path in the 1960s. Although starting out as a political organization seeking greater power for peasants, by the early1980s the Shining Path had declared war on the government of Peru. Using assassinations and bombings, the 10,000 armed combatants of the Shining Path soon controlled large areas of the central Andes. During the Fujimori administration, the government regained control through brutal and repressive shows of military power. By the late 1990s, the Shining Path had dwindled to only a few hundred members, and violence now flares up only occasionally. More than 30,000 were killed during the 20 years of fighting. The vast majority of the dead were civilians.

Dr. Huang

Dr. Huang has been with Taiwan root since its inception. He participates in almost every medical mission- doing work in Taipei’s mountain regions once or twice a month, and traveling abroad 4-5 times a year. Dr. Huang also volunteers at the HIV dental clinic in Taipei and has a private dental practice in Pan-chiao.

RM: Why do you do this kind of work?
DH: I like the feeling of accomplishment I get from this, and I realize that it is just the natural thing for me to do. Through this work I have learned to see things from outside of my Taiwanese perspective and have taken on a more global view of the world. I guess the most important thing for me is the satisfaction and, well, joy I get when I am able to connect with people who are so different and actually help them when they are in need.

RM: How did you start going on medical missions? Wasn’t it difficult to balance this work with the demands of your dental practice?
DH: Well, I was invited. Some other doctors were already doing it, and they asked us (what became Taiwan Root) to come along. Of course, at the initial stage we were all pretty hesitant about undertaking such an arduous task, but we kept encouraging each other, and eventually got it going. The most important thing for someone interested in doing this is to make sure that when you start you have a stable environment that will support you through the beginning without too many distractions. I suppose the trick for me was to not do too much too fast. When I first became involved with Taiwan Root, I told myself that I needed some type of goal. I decided that I would do this type of volunteer work for at least one year so I could be sure that it was suitable for me. I also needed the time to work out the volunteer work with my work schedule.

RM: How many teeth you have pulled in one day?
DH: Well, when we were in Africa I pulled around 50 or 60 teeth from about 100 different patients in a day of medical service. In Africa, pulling teeth is more difficult than other places. African's teeth generally have roots that grow deep into the jaw, and it can be really hard to extract an entire tooth, especially if the tooth has fused to the jawbone.

RM: What was your impression of the people in the Amazon? How did you feel about their situation?
DH: I guess I could answer this question in a number of different ways. We were able to help them solve some of their medical problems, and in some ways meet their health care needs. I think it is interesting that many people in Taiwan probably would look at the Aguaruna lifestyle and automatically assume that it is an unhappy one. I actually don't think that this is the case at all. For the Aguaruna, closeness with the natural environment, and a community more or less unmolested by "development" is probably the best lifestyle for them. To me, they seemed innocent and optimistic. I saw how joyful and content they were using their traditional methods when hunting or cooking food. While we doctors, or other outsiders, try to help them in a way which we think is beneficial, they might just want to maintain their own culture and lifestyle without being disturbed. At the same time, I feel that politically they are in an inferior position, which may have a lot to do with the way others view their traditional way of living. From what I can tell, the Aguaruna are treated unfairly by the people in power in Peru. In some ways, they are deprived of their human rights. They suffer from such a gross shortage of medical services, while the army has built well-equipped hospitals and bases. We Taiwanese, as well as other people from around the world should become more aware of such things and try to help as much as we can.

RM: What are some of the differences you saw between people in Taiwan and the people in the Amazon?
DH: There was one thing that really surprised me. I noticed that the way that parents treat their children in the Amazon is similar to the American style of parenting in the way that they connect with their children. For example, while we were searching for cavities or extracting teeth the children were so nervous, this was their first visit to a dentist, and they were always crying and making a fuss. The parents weren’t impatient at all; instead, they did their best to comfort their children. They would spend as long as two hours asking the children what they were scared of, patiently explaining that we wanted to help, that they weren't in trouble or being punished. The amount of interaction parents had with their children was quite impressive. I can only imagine how angry Taiwanese parents would be if their children did the same thing at my clinic in Pan-chiao. When you look at this simple interaction between parents and children, it is easy to see the differences in socialization between Taiwan and Peru. Because of these differences we must also take care to recognize that there must be different methods of treatment as well. In the Amazon, children will eventually trust us to an extent, but won't submit to us.

RM: Speaking of different treatment methods, what type of clinical differences between your patients in Taiwan and those in the Amazon? How do treatment methods change when you are practicing "flashlight dentistry"?
DH: It is very comfortable and convenient to treat patients in Taiwan, while it is strenuous and inconvenient to do so in Peru. All of the equipment is so sophisticated and delicate in Taiwan, while all of the equipment in Peru was very crude. As you said, we even had to use flashlights to perform basic check-ups and treatment. Because of this, we generally spend twice as much time treating a patient when we are in developing countries. It can be quite a challenge.
We have found that the structure of people's teeth and oral cavities vary from region to region. Every group of people has its own unique lifestyle and diet. The people in more developed countries generally have more decay because they eat more sugar, while those from the developing world have less decay but a higher rate of periodontal disease. For instance, in the Amazon people's teeth had a lot of wear from grinding- because their food is rougher and they need to chew more. All of them are different from the cavities I treat in Taiwan.

RM: What is the most beneficial part of these medical services? How has your view of these medical missions changed from your first mission until now?
DH: My first overseas medical mission was in refugee camps in Macedonia. Before I left I had no idea what I was going to do, how I was going to practice dentistry, or even if the refugees needed dental care at all (laughing). After we arrived, it turned out that they needed dentists more than most other places. The country is somewhat developed, but the political situation in Macedonia caused the refugees to have to constantly drift around, sometimes without even spare clothes, let alone a toothbrush. During our two week service at the camp, thousands of refugees lined up to see Taiwan Root dentists. It was even a bit of a surprise to the UN and MSF, and we all felt proud that we had this chance to help people in need. We would have never known what the situation in Macedonia was like if we hadn't gone there to see for ourselves.
I feel grateful that I have been able to step out of my own culture and see a totally different world, while at the same time using my skills to help people. I guess the most beneficial part of these medical services is being able to bring medical care to people who are often forgotten by the rest of the world. We also bring the stories and conditions of these people back from the “secret places” we visit. This lets people understand the lives and conditions of people totally different from them.

Children

Like in all cultures, children are an important part of Aguaruna society. In Huampami, to honor the anniversary of their school, children make paper lanterns and march through the town. The march ends in the Town Square where everyone participates in traditional Aguaruna dance and songs.
At home, a daughter sits in her kitchen and admires the basket weaving skills of her father. Outside, boys play along the river, taking refuge in an abandoned boat when the afternoon downpours arrive. Scenes like these take place in cultures all over the world, but in the Amazon, it is especially easy for a child to become sick or be injured, and help is not always close by.

Emergency surgery in the Amazon

Soon after Taiwan Root arrived in Huampami a young girl with a facial wound was brought to be treated. Five days earlier, while playing outside of her family’s house, she had fallen, and a tree branch had punctured her cheek. Her mother attempted to heal the injury using traditional methods, but this proved to be inadequate. The swelling had increased, and an infection had set in.
When the doctors examined the girl, they noted that the entire right side of her face was swollen, and that a large splinter remained implanted in her cheek. The infection had rapidly progressed, and the doctors knew that they had to operate immediately. Unfortunately, the medicine that Taiwan Root had brought from Taipei had been lost by the airline, somewhere between Los Angeles and Lima. The little girl could not wait for the medicine to arrive in Peru.
The doctors had no choice but to go ahead with the operation, using the little anesthetic that was available. The girl’s father helped forcibly restrain her, holding down her small arms, while four doctors removed the splintered branch from her cheek. The girl’s pain caused her to shriek and howl, all the while attempting to break free of her father’s grasp. These unorthodox conditions caused the operation to take much longer than it normally would, as the doctors had to be careful to minimize the girl’s discomfort.
The swelling began to go down almost immediately after the operation, and even with the limited antibiotics available, the infection quickly regressed. The girl’s mother and father stayed by her side while she recuperated in the small hospital. Her mother told the doctors that she “thanked god that they came when they did.” After a hospital stay of only a few days the girl was able to return home with her family.

Leaving the Jungle

During Taiwan Root's medical service in Peru, they traversed the Pacific Ocean, the Equator, the Peruvian Coast, the Andes Mountains, and penetrated deep into the Amazon basin. In three weeks, they gave medical and dental help to over 3,000 Aguarunas. They took over 1,000 blood, stool and urine samples (in order to contribute to the medical world's knowledge of the region), and they left behind not only healthier people, but also practical know-how that will have real effects on Aguaruna health in the future. Dr. Cheung used his microscope to teach the nurse at the Centro de Salud- Huampami how she could, using the limited means she has, diagnose and treat the dangerous parasitic infections that are all too common in Amazon. Dr. Huang provided quick relief from pain, pulling hundreds of decaying teeth, but he also taught his patients about how they, on their own, could take steps that would prevent their teeth from rotting in the future
On August 4, 2002, the day before the Root began their journey, neither they, nor the Aguaruna, knew very much about the other. The smells and sounds of a Taiwanese kitchen had yet to penetrate the air of Huampami. The Taiwanese palate had not yet been introduced to the intoxicating charms of the sour yucca beer called Masato. Three weeks later, these two groups had lived side by side, and came to understand that though they were from opposite sides of the world, they were not so different. They had some disagreements and misunderstandings of course, but they were able to put them aside in order to work together for their mutual benefit. The Aguaruna were now healthier than they had been a few weeks before, and the Taiwanese were now living in a slightly bigger world.