Reports from Ecuador

On Thursday, Melody and I finally got to visit the Planchaloma clinic, where we will be spending most of our time here in Ecuador.  Planchaloma is a small community located in the mountains about 2 hours from Quito, and the clinic there is the largest we have seen yet.  It offers dental, OB-GYN and general medical services, and even has its own ambulance!  It was great to meet the staff and talk with them about our plans for while we are there, and also see Amanda and Lila’s projects from last year still going strong!

During our time in Planchaloma, we will be working on some community education programs focusing specifically on TB and the importance of recycling.  This will include going to schools where we’ll give talks and lead activities to teach children about these topics, as well as hanging posters in the clinic so that patients can learn about these topics while they wait.  As I mentioned earlier, we’ve been working on our TB posters and have tried to make them as pictoral as possible so that even patients who are illiterate will be able to understand the signs of TB.  Fundación is hoping that by increasing community awareness about tuberculosis, they will finally be able to control the disease as they have been able to do in the other areas they have clinics in.

Along with preparing for the projects for Planchaloma, we’ve also been busy getting the technologies ready to demonstrate!  This has included practicing using them as well as translating the user manuals into Spanish.  It’s certainly good that we started while we still have pretty readily available internet access, because much of the vocabulary we need is not what we learned in our typical college-level spanish class (or maybe I just missed the lesson describing how to read hematocrit levels!).

We also had a chance on Saturday to visit the famous market in the town of Otavalo, thanks to the wonderful Maria Alicia!  We spent the morning and part of the afternoon perusing the booths and picking up souveniers, and then visited some towns nearby as well.  It’s hard to believe we’ve been here for 2 weeks already, and I’m very anxious to get out to Planchaloma and start helping in the clinic and getting to know the community there.  We should be moving out there later this week, so chau for now so we can get back to our preparations!

Melody and I spent our weekend seeing the sights of Quito with our wonderful guide Maria Alicia.   We started with a delicious breakfast of hornado in the valley community of Sangolquí, visited La Mitad del Mundo and the famous Virgin of Quito, wandered through the historic region of La Ronda and even happened upon a ceremony to celebrate the summer solstice!  Plus, along the way we were able to find a shop that sold the dropper bottles we need for the TB and Malaria staining kit.

But now that it’s Monday, and we’re back to work!  We’ve just started our newest project, designing a community education program about tuberculosis for the Planchaloma clinic, where Melody and I will be working for about 6 weeks.  Although Fundación has been able to decrease the presence of TB in its Guayaquil and Yatzaputzán clinics, it remains a significant problem in Planchaloma. Because we will have to travel to the next town over to get internet access while we’re staying there, we’re trying to get as much done as possible while still in Quito.

We’re still in the early stages of research at this point: looking at other TB education campaigns, finding out more specifics about the community in Planchaloma and making some rough drafts of posters and brochures.  We’ll also be starting on an education project about the importance of recycling to support the recycling program that Amanda set up last year.  We have a visit to Planchaloma scheduled for Thursday, and it would be great to get feedback on our progress while we’re there, so back to work!

Buenos días from Ecuador!  Melody and I have only been here for 3 days and yet have experienced so much.  Yesterday we took a day trip to Guayaquil, Ecuador’s largest city at just under 3 million people, to visit the two clinics that Fundación Futuro runs there.  One was in the southern neighborhood of Isla Trinitaria, while the other was in the more central neighborhood of Plan Piloto.  The poverty in these parts of Guayaquil was striking, particularly in contrast to the flourishing city we had seen only a short car ride away.

In addition to getting to experience Fundación clinics for the first time, an especially important message I took away from today was something that Rocio, who showed us around all of the clinics, mentioned while waiting for our flight back to Quito.  She emphasized that the reason these clinics are able to help the communities they serve as much as they do is because of the people that work there. Again and again when I asked why people chose to pay a small fee to receive care at the Fundación clinics rather than visit the free government clinics, I heard that the Fundación doctors take time to really talk to their patients and the care is much more personalized than at the busy government clinics.  In settings where money is so scarce, the fact that patients are willing to pay even a small amount truly speaks to the quality of care provided.

Even during our short visit yesterday we saw and heard about many examples of workers going beyond their job expectations to help patients.  In Isla Trinitaria, the outreach worker knows everyone in the area and is able to use these connections to make the clinic an integral part of its surroundings.  The nurse is from the same neighborhood the clinic is in, and has an intimate knowledge of how the community functions.  In Plan Piloto, patients visit the doctor with physical ailments, but also when they simply need someone to turn to.  One of the women in the waiting room while we were there came to see the doctor because her sister had recently passed away and she was feeling sad.  Another of the workers, who had been there the longest, had recently taken action when the grandmother of a family passed away, leaving her grandchildren in the care of their alcoholic father.

While I find these stories of workers who truly make their clinic impactful inspiring, and admire the ability of these clinics to have such a close relationship with their communities, I also worry about other clinics.  Having such connected nurses, doctors and outreach workers is never a given, but they can factor heavily in the level of impact a clinic on a community.  Is there any way to ensure that clinics form the sort of connection with their surroundings that we saw in the Guayaquil?

I certainly don’t have an answer to this, but I do think that technology can play an important role here.  The less time a nurse or a doctor has to worry about the equipment they’re using, the more they can spend focusing on the patient.  It may be hard to ensure that clinics become an integral part of their community, but BTB technologies can help give them the opportunity to do so by providing devices that work in their setting and allow them to provide the best care possible.

We’re scheduled to visit another Fundación clinic tomorrow, in the more rural setting of Yatzaputzan.  I’m excited to see more of the work Fundación has done, and explore just how the BTB technologies can fit into their work.