ABSTRACT
The experience of traveling in West Africa in 1961 and learning of the broad connections between public health, community health and individual disease in different cultures stimulated the author to find ways to work as a physician-in-training in settings where he could participate in patient care and learn more about these issues. Through earlier connections from the West Africa trip, the author found an opportunity to work in a small hospital in a remote part of the Peruvian Amazon where he could apply his new clinical skills directly for people who needed them. In this setting, he began to see the problems of health and illness in the context of environmental issues, high fertility, population growth, and the negative consequences of uncontrolled fertility both for the health of individuals and impact on the local environment.
