|David and Sally Monahan
began their volunteer medical trips to the Brazilian Amazon
basin in 1979. Currently they spend Thanksgiving there working
at the Medical Clinic, The Diabetes Program, The Child Malnutrition
Treatment Center and the Quilombo Boat Trip.
Dr. Monahan is on the Board of Directors of the Amazon-African
Aid Organization (3AO) a 501(c)(3) nonprofit support organization.
In addition, to donating their time and paying their way the
Monahan's are deeply involved in financially supporting the
Brazilian medical activities. They also work to recruit physicians,
dentists, and surgery teams to serve.
For more information please contact us at:
Quilombo is an African word that means "run away
slave village". The Portuguese enslaved 3.5 million Africans
between the mid 1500's and 1888. That is seven times the number
brought into the United States. Although these African-Brazilians
were spread throughout Brazil, most were in the northeast
area where they labored on the vast sugar plantations.
Of the Quilombo, assemblages of runaway slaves, the most
famous was the Republic of Palmares. A virtual state reviving
African traditions, creating social order and a highly civilized
community. Palmares resisted attacks from colonial authorities
for over 100 years from 1580 to 1694 lead by their great
resistance leader Zumbi. Finally in 1695 the Portuguese
transported large cannons across miles of trackless jungle,
killed Zumbi and destroyed the 20,000 men, women and children
of the settlement.
Last fall, David Monahan, M.D. '62 traveled 24 hours by
boat, deep into the Brazilian rain forest, to bring medical
care to the descendants of runaway slaves living in hidden
villages called Quilombos. There is no way in or out of
the villages except by boat and "there is no health
care in these places at all—zero," said Monahan.
Monahan spends most of his time running a busy, full-time
medical practice in Southern California. But since 1979,
he has traveled frequently to the central Amazon River valley
to volunteer for Fundacao Esperanca, a humanitairan organization
that operates the Quilombos boat.
Once a month, the medical boat makes the journey from the
port city Santarem—itself about 500 miles from the
mouth of the Amazon—to three Quilombos villages. There
are 27 villages, all located in a biological reserve on
an isolated stretch of the Rio Trombetas, a large tributary
of the Amazon. The villages were settled in the 1830's by
slaves escaping from vast rubber and sugar plantations.
At that time, there were 3.5 million African slaves living
in Brazil, more than seven times the number of slaves in
the United States.
"Eight staff members, the volunteer physician and our
captain leave Santarem at 8:00 a.m. Thursday morning. We
cross the Tapajos, continue upstream in the Amazon (40 miles
across at points) and turn north on the Trombetas to arrive
at the village of Moura in time to see patients at 7:00
a.m. Friday. Our 24-hours boat trip certainly pales in comparison
to that of the runaway slaves who founded this village 170
years ago in 1832," said Monahan, describing day one
of a five-day trip.
There is no electricity in the villages, so Monahan and
his colleagues use the boat's generator to provide power
for the equipment they bring in with them. Typically, they
see patients in the village school. The recently built school
is constructed of wood and sits on stilts 10 feet above
ground with a high, thatched roof, woven palm leaf walls
and hard-packed dirt floors to insulate against the oppressive
The medical team immunizes villagers, provides prenatal
care, and treats a wide variety of ailments. They see everything
from parasitic infections and diabetes to malaria, leprosy
and crocodile bites. They also teach nutrition, sanitation,
and preventive care. "We are appreciatively welcomed
as our monthly excursions are their only contact with western
medical care. Before the vaccines we bring were introduced,
50 percent of the children perished before age five,"
The team keeps charts and records on the villagers to provide
for continuing care. Doctors can monitor patient's progress
by communicating with physicians who volunteer on subsequent
river trips. Last year, Dr. Monahan treated a 12-year old
boy suffering from his third attack of malaria. "He
was extremely ill, but somehow our drug regimen saved his
life. I didn't learn of this happy ending until our volunteer
team returned in January."
On his most recent trip, Monahan saw 100 patients in three
days. The nurse who traveled with his crew saw another 100
people. At the end of the long day, the team retires to
the boat to update medical charts and sleep in hammocks
in the intense jungle heat.
Village life revolves around the river. Looking out from
the back of the 100-foot boat, Monahan sees mothers scrubbing
their children, villagers fishing and children cleaning
their catch. "That's where all the crocodile bites
come from," Monahan commented simply. It's a subsistence
living and the local diet consists mainly of fish, rice,
fruit, and manioc roots.
Headquarters for Fundacao Esperanca and the home base for
the Quilombos boat, is a well-equipped primary care clinic
in Santarem, a city of more than 350,000 originally settled
in 1661. Santarem sits on the Rio Tapajos where it flows
into the Amazon. Since the clinic was founded in 1975, it
has grown into a compound that includes a children's center,
women's health program, a diabetes clinic, a dental clinic,
and a general medical clinic with a laboratory and pharmacy.
The clinic employs a full-time Brazilian doctor and staff,
but it depends on volunteer physicians for plastic surgery,
orthopedics, opthalmology and other specialties. The doctors
who volunteer come mainly from the United States. They pay
their own way and stay for three weeks at a time."It's
really edifying for doctors because you treat things here
that you train for but don't often see at home," observed
On their arrival in Santarem, the volunteer doctors work
at the medical clinic, the diabetes center and the children's
center. The highlight is the Quilombos boat trip which takes
place on the third weekend. Monahan recruits and screens
physicians as project volunteers. "The villagers asked
us to come in and that gives you a nice feeling as a physician,"
said Monahan. "You're saving lives."
Monahan, who is self-effacing about his humanitarian work,
is deeply committed to improving the quality of life in
the Quilombos villages. He is a member of the board of the
Amazon-African Aid Organization, and currently is raising
funds and recruiting doctors to bring the boat to the other
Quilombos. Without health care in the villages, he said,
"if you get something you die. It's a fatalistic approach,
but that's the third world."
The boat is partially underwritten by a bauxite mining company
located not far from Moura. "We have worked to keep
our administrative costs at less than six percent of our
cost of providing patient care, and because all donated
funds go directly to medical delivery services, virtually
all of our donations are used to pay for medications and
supplies," said Monahan. "We're filling a gap,
and the advantage we have here is our administration ongoing
set-up in Santarem. The clinic has sustained itself for
30 years and that is very unusual in the third world."
The need for medical care is not the only thing that brings
Monahan to Brazil. He loves the spectacular beauty and tremendous
power of the Amazon. An astonishing 200-foot rain forest
canopy reaches the river's edge near the Quilombos. During
the rainy season, the river rises 40 feet. "The phenomenon
of the Amazon is that because it is so difficult to reach,
there are many species that haven't even been discovered
yet," marveled Monahan. The Amazon provides one-fifth
of the world's water supply, emptying 8 trillion gallons
a day into the sea. Ten Amazon tributary rivers are themselves
twice the size of the Mississippi River.
The Quilombo Project, The Diabetic Clinic, and The Children's
Clinic are three specific areas to which Dr. Monahan dedicates
himself when visiting the Amazon Jungle. Our fundraising
efforts are aimed at individual donors and no gift is unappreciated.