Genetic disorders are far more common in isolated remote communities than in places where there is frequent genetic exchange with outsiders. The vast, sparsely populated Beni region of north and northeast Bolivia, stretching between the Andean mountains and the Amazon basin, is an extreme example of where small towns are separated by days or weeks of arduous travel on foot or on rivers through dense subtropical forest. This story starts in the Beni town of San Joaquin, “discovered” by the outside world because a previously unknown viral disease that became known as Bolivian Hemorrhagic Fever (BHF) Because many inhabitants were dying, and no treatment or means of prevention existed, in 1964 American and Bolivian scientists formed a research team and field laboratory in San Joaquin. The research team, headed by Dr. Karl Johnson, also included Dr. Ronald (Ron) MacKenzie. I had met both medical scientists in Panama a year earlier, and both became lifelong friends. One of our PCV nurses, Rose Navarro, was assigned to San Joaquin hospital to assist in the care of BHF patients.
Dina, pretty and perky like her older and younger sisters, was about 8 years old when Ron MacKenzie met her in her birthplace, San Joaquin, in 1964. Dina differed from her sisters in one undeniable way: she had been born with a genetic disorder known as “club feet” that caused severe deformity of both of her feet. They literally curved backwards, forcing her to walk on the top of her ankles. Disfiguring and disabling, this congenital anomaly doomed Dina to a less enjoyed, less fulfilled life than that of her sisters. Her family had little money and was in no position to seek medical attention. Furthermore, surgical intervention for this condition was relatively new and could be performed only in a few, distant medical centers.
Working in San Joaquin, Ron learned about Dina’s condition and began wondering if anything could be done to help her. I was in La Paz when I learned about Dina in a letter from Ron, and I speculated that sophisticated orthopedic surgery might be able to correct her deformities. Unexpectedly, some weeks later, because of serious road injuries suffered by PCVs in an overturned vehicle, I met a highly respected Bolivian orthopedic surgeon in La Paz. The injured PCVs were taken to a private hospital in La Paz and placed under the care of the orthopedic surgeon. Over the following days, as he cared for the PCVs, I came to know him better, and to acquire confidence and respect for his professional capabilities and his personal qualities.
Some weeks later I was able to meet Dina in person for the first time, in Trinidad, an important central town in the Beni. I was scheduled to fly there for other reasons, and Ron and Rose arranged for Dina to fly there from San Joaquin in a military aircraft and stay with her Trinidad relatives. Thus I was able to see Dina and to take Polaroid photos of her feet (Figures 1,2,3). Later, showing the photographs to Dr. X, I was delighted when, without hesitation, he offered to take on this substantial surgical challenge with no professional fee. More important, he convinced the administrator of the hospital, operated by Catholic nuns, to provide the necessary support free of cost.
The orthopedic surgeon also carefully explained to me that a series of 6-8 operations would be required, but that the greatest challenge would be post-surgical care and rehabilitation. Otherwise, Dina’s feet would likely return to their former orientation. Furthermore, she would be required to remain in La Paz, away from her family, at least several months.
Peace Corps Bolivia responded to the challenge. Russell Tersey, the La Paz-based Associate Director of the Peace Corps in Bolivia, and his wife Ellie, with a young son of their own, offered their home and support during and after the series of operations. Rose Navarro traveled with Dina on a military aircraft to La Paz where the Tersey family lovingly took Dina into their family, providing comfort and attending to her every need. Dina, who had never seen a flush toilet or an indoor bathtub, had to learn about these strange new contraptions and their proper use. She was exceedingly bright, and quickly became a family member and within weeks was communicating in English with ease.
About six months after the final operation, clutching her favorite doll from the La Paz sojourn, Dina returned to her family in Trinidad (Figures 4,5). Her return, and her remarkable transformation, became something of a celebrated event in the Beni region, but her ongoing rehabilitation remained a challenge, requiring special shoes, braces and exercises.
Dina’s strong spirit, combined with the resolve of her support network, resulted in a lasting triumph. In 1972, Ronald MacKenzie returned to San Joaquin for follow-up medical research, and was able to locate Dina. At my request he stopped in Trinidad to see and photograph her. The photo (Figure 6) reveals Dina as an elegant young woman in her mid- 20s, standing straight and tall, smiling radiantly as an example of a life enriched by a collective effort by the Peace Corps in Bolivia.
