We interviewed Brother José Mª Viadero, director of Juan Ciudad NGO, upon his return from the San Juan de Dios Clinic (SJD) in Iquitos, where he spent a month supporting social and healthcare work in the heart of the Peruvian Amazon rainforest.
How long have you been in Iquitos?
I spent almost a month at the SJD Clinic in Iquitos, from mid-July to mid-August, spending a few days in Lima, where the Hospitaller Order has another clinic and a shelter for the temporary accommodation of needy families who need to come to the capital for treatment or surgery.
Have you already been to the centers of Peru?
Yes, I've been there several times. This is my sixth trip to Iquitos, though usually for a short time, to discuss a project and participate in a meeting.
That's why, last year and this year, I decided to go for a longer period, which allows me to better understand the needs, how people live, and see things that wouldn't be possible on another type of trip.
What was the purpose of your stay in Iquitos?
Juan Ciudad NGO has collaborated with the SJD Clinic in Iquitos since its inception, managing the cooperation project that enabled the construction of this new center, which opened in March 2011, although the Brothers began their mission in Iquitos in 2000.
Since then, we have continued to support them through humanitarian aid, volunteering, and projects that address specific needs, such as the Messengers of Health campaigns.
Therefore, my trip is part of this collaboration, with the goal of continuing to support the clinic's activities and Brother Américo, its director.
This center is very young, and between the exuberance and the scarcity of the site, we can say it's very vulnerable. It has great potential yet to be developed, and there is a huge demand for the services it provides from the population, primarily Indigenous, so it needs significant support and resources.
Since the SJD Clinic is located in the Peruvian jungle in the city of Iquitos, surrounded by several rivers—including the Amazon—access is difficult, with access only available by air or river, which makes any work more complicated.
"There is a great demand for services
provided by the SJD Clinic to the population,
mainly indigenous.
What work does the SJD Clinic in Iquitos do?
The clinic serves children and adults with health problems and is dedicated to physical and trauma rehabilitation, with a special focus on disability.
The population of the area served belongs to the department of Loreto and lives in a vulnerable situation, mainly due to a lack of resources and access to services available in other parts of the country, such as health, education, and administrative services.
As a result, the majority of the population suffers from high poverty rates, and many people even lack documentation, as they are not registered in any registry, which in turn prevents them from accessing the SIS (Comprehensive Health System).
This is partly due to the population's lack of awareness of their rights and the resources available to them. Therefore, one of the clinic's most important tasks is to advise families on these issues and facilitate transportation, including accommodation and food, when they have to travel and remain in Iquitos or Lima to undergo tests at another center that cannot be performed at the SJD Clinic.
What is life like in Iquitos?
The city is relatively large, with a lot of activity on the streets, street vendors, and bustling markets. It's quite hot most of the time, and life is marked by river flooding at different times of the year, which temporarily floods the banks and disrupts river communications, even flooding the city streets.
On the other hand, the constant arrival of people who previously lived in the jungle or along the riverbanks and are seeking work and new opportunities in Iquitos is leading to rapid, uncontrolled growth in the city. This poses serious health problems.
Is the clinic taking any measures in this regard?
Yes. As I've explained before, the center's work goes beyond healthcare, trying to help people improve their living conditions.
During my stay I was able to see in situ an action of the Preventive Health Care Capacity Strengthening Program launched by the SJD Clinic in four human settlements on the outskirts of Iquitos.
Between 200 and 300 people live in each settlement, and although they can remain permanently on the land within 48 hours of arriving and begin to build their homes, which have electricity, they lack sanitation systems, sources of drinking water, and waste management services, resulting in many health problems.
For this reason, the clinic has launched this program, which promotes the training of community health workers within the settlements. It also offers workshops on a wide range of topics, including community first-aid kit management, medication management, wastewater management to prevent infections caused by contaminated water used for human consumption, first aid, healthy lifestyles, breastfeeding, hygiene, sexual and reproductive health, and domestic violence.
This initiative is funded by the Italian Episcopal Conference and would not be possible without the involvement of the SJD Clinic staff.
Preventive Health Care Capacity Building Program launched by the SJD Clinic.
Does the SJD Clinic maintain any collaboration with Peruvian government services?
On the one hand, some programs are developed jointly, such as the Preventive Children's Oral Health Program, which is being implemented year-round and is expected to benefit a total of 9,000 children. This program offers free care, and the SJD Clinic picks up children from school using its dedicated bus. They are treated in the dental department, and then taken back to school.
In addition, the clinic refers cases that cannot be treated at our center due to their complexity to the Iquitos Regional Hospital. We provide them with advice and follow-up throughout the entire medical process, as well as food and financial assistance to cover travel and lodging costs when the families do not live in the city and lack the resources to do so.
Can you tell us about a specific case?
Many families come to the center in need of assistance, and others come into contact with the center's services through the Health Messengers campaigns, in which a multidisciplinary health team travels by boat along the rivers and provides free care to populations living far away on the banks.
These campaigns can serve up to 300 people in a single day, and they also serve to identify cases of children with disabilities or orthopedic problems that can be treated at the SJD Clinic.
Last year, while accompanying the team on one of their Messengers of Health campaigns in San Salvador de Omaguas, I saw a mother walking along a path with a child in her arms, and I approached her to inquire about him, as I thought he might have some health problem or disability.
The mother explained to me that her child was "special," that he couldn't walk or talk, and when I asked if she'd ever taken him to the doctor, she said no. That's how I met Pedrito, the name of this now five-year-old boy, and his family.
From there, we began studying his case, and he was treated at the SJD Clinic, where he was diagnosed with cerebral palsy and a hernia that required surgery.
Since no family member had identification documents, they were helped to complete the necessary procedures to regularize their situation and access SIS services. Pedrito was able to undergo hernia surgery at the Iquitos Regional Hospital in August.
He is now waiting to recover from his surgery before beginning to attend the SJD Clinic for the rehabilitation he needs due to his disability.
that were performed at the Regional Hospital of Iquitos.
It must be very satisfying to see how help materializes for people who need it so much.
It is very gratifying, as it is the result of the work carried out by the Hospitaller Order with vulnerable people, and thanks to the efforts of the Brothers of St. John of God and their collaborators, as well as all the people in Spain who have donated in solidarity.
When do you plan to return?
I don't know at the moment, but through Juan Ciudad NGO, we continue to support this clinic, which does such important work in the Peruvian jungle, so I am grateful for all the help we receive.
Interview conducted by Adriana Castro, Head of Communications at Juan Ciudad NGO.
Photos taken by José Mª Viadero. Copy: Juan Ciudad NGO
