Leonardo is a tall and ponderous medical student at the University of Amazonas Medical School, in the bustling and rich metropolis of Manaus, the capital city of the state of Amazonas, Brazil.

He is telling me how he ended up in a small jungle town named Envira during his stitch at the rural internship program. It is so distant from Manaus, that a trip by river takes 18 days to travel the 2,000 miles of its lazy meandering curves. And all this without even leaving the state!

There are only three physicians in the village of 35,000 souls, and health care is mostly provided by nuns of a missionary order, with little medical training. The village is very poor, with 90% of its inhabitants getting monthly wages of US$ 100 or less. No wonder why: more than 80% are illiterate or have studied less than eight years. Most are Indians or descend from them.

"You cannot open your mouth for long in this part of the jungle", he says to me, smiling. "It becomes chockful with disgusting black, small blood-sucking flies, who fill the air around you in thick clouds, all the time". Fierce carnivore fire-ants crawl around everything and the temperature is almost 100 degrees F all year round, with 95% humidity. "Its like a sauna", says Leonardo, "and in some regions of the forest you have to cover your exposed skin with motor oil, which is the only thing that will deter these flies from sucking you dry".

He is certain that the dense, dark, dripping rain forest around the town is unfit for human living; but nonetheless, human beings live there. And paradoxically, he is thinking about returning to Envira when he graduates.

"I liked the experience in Envira. You become emotionally attached to their kind and hospitable people and you suffer with their woes. I and my partner were all by ourselves there, and the things we had to do has prepared us a lot for the profession we have chosen and love".

Like his other 60 colleagues in the medical course, he was part of a 10-year old, highly successful program implemented by the Medical School to teach their last-year students how to work in a rural setting in this peculiar part of Brazil. Eleven back-of-the-wood counties receive two medical students each, for a two months stitch. Seven of them have almost untouched Indian villages nearby.

Transportation and stay are paid by the county government, and the students are required to visit isolated rural communities, observe and understand their way of living and their health care problems, record the incidence of diseases for epidemiological purposes and help to promote simple prevention measures, such as immunization, hygiene, prenatal and infant care, etc. They also teach many things to the villagers, such as the prevention of tooth cavities, breast nursing, how to avoid worm infections and how to handle garbage disposal and water supplies. For this, many times they use the waves of the simple radio station operated in Envira.

The region's inhabitants are exposed to many exotic and dangerous infectious diseases: disentheria and malaria are rampant, and the incidence of dengue fever, tuberculosis, leprosy and leishmaniosis are among the highest in the world. Indians have little natural immunity against many common diseases, including the flu. Lethal fevers that you probably have never heard about, such as ouropoche, and a few others, caused by jungle viruses as dangerous as Ebola, loom in the steaming jungle and can attack their victims any time.

Seriously ill people who require specialized treatment, must be removed to the capital city or to the nearest hospital, which means a two to five days ride in a paddleboat from their riverside homes, plus grueling travel in small planes (when there is money for that) over the hostile and forbidding jungle, or, sometimes death, when there is no money.

In dozens of small towns and villages like Envira, technology is only a dream, and many people in the rural areas live very much like their forebears, Indians with a Neolithic culture.

In Dire Straits

But what to do? Leonardo was able to find a book he brought with him to study for his medical residence entrance examination and also to place a telephone call to one of his teachers in Manaus (yes, at least Envira has public telephone, connected via satellite). Mentoring Paulo by phone during the whole procedure, and with the help of the other medical student and two nurses, the teacher was able to pull of a complete surgery and dressing of the wound! The rural worker was saved.

In another town, the medical students were able to save a 15-year old Indian mother and her baby, by performing for the first time in their lives a cesarean section. They liked it so much that they repeated the feat five times more, becoming famous and beloved "doctors" in the village.

Hair-raising, would you say? Stories like this are in no way uncommon in the rural internship program.

Sometimes they need help from the big city, but it is so far away... Technology is one of the solutions to be used to their rescue.

Please read on...