Reports from Ecuador

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¡Chao, Ecuador! ¡Fue increíble! / Goodbye, Ecuador! It was amazing!

by on July 24, 2009
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Atacames

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Vacation time! Stacey and I were originally supposed to come back to Houston this past Saturday, but our time was extended so we could enjoy more of Ecuador. We spent a long weekend at Atacames, a pretty nice beach town lined with stores and vendors all along a beautiful beachfront of the Pacific Ocean. The highlight of the trip, by far, was the whale tour! We saw about seven humpback whales – I even saw one come up head-first!!

We also took a gastronomical tour of the coastal region of Ecuador by trying their tropical fruits and all the wonderful fresh seafood that they had to offer!

Stacey and I got to read and tan on the beach for a bit, and unfortunately we now look like lobsters, but it’s all in good fun! Our characteristic pale skin is now a tinge darker, and Enrique has joked that we are no longer Casparinas! (Casparina is the Spanish version of Casper, the friendly ghost)

Saying Goodbye

After wrapping up all of our paperwork, we unfortunately had to prepare to leave all of those at Fundación Futuro.  After our last dinner together of eating typical Ecuadorian food, we said our final goodbyes. They told us that they were very sad to see us go, and they hope that one day we can return to Ecuador, for we’ll have a family waiting for us…

After catching the flight back to Houston in the early morning, I am now safe and sound in the United States.

Final Thoughts

It’s hard to believe that I’ve just completed two months of work here in Ecuador, and I can honestly say that it’s been some of the most memorable couple of months of my life.

I’d like to thank all those in the BTB program, most notably Dr. Richards-Kortum, who encouraged and guided my BIOE 260 team when we were designing the CHW pack this past semester, and Dr. Maria Oden, whose word in the final assessment and design of the pack was unbelievably helpful. Also, many thanks to Yvette Mirabal, who has been our mentor for the pack since the start, and whose insight really helped Stacey and me look out over the past few months and realize how much we’ve accomplished. The lab in a backpack now here in Ecuador would not have been possible without Stephen Wallace´s hard work, and his assistance to get me in the door at Medical Bridges really helped me out at crunch-time!

Also, a most important shout-out to all the doctors, nurses, community health workers, lab technicians, and patients we have seen throughout all of our medical brigades. I would especially like to thank a few by name. To Dra. Lorena and Dra. Monica, you are extremely inspirational people, and you have clearly demonstrated your love for others through your dedication in treating the indigenous populations of the Sierra. To Lucia, Karina, Carlos, and Paúl, you all have been the best lab technicians I’ve ever met! With your fun attitudes, you´ve brightened up our weeks at Planchaloma. Also, many thanks to Nicolas and René, my team and I designed the community health workers´ kit for you, and I welcome your feedback wholeheartedly.

I cannot say enough in gratitude to the people of Fundación Futuro. María Alicia and Enrique have opened their arms to us this summer. Stacey and I came in as two unknown strangers, but they welcomed us in immediately. María Alicia’s generosity has been outstanding, for she’s offered her home for us to stay at these past two months. She has let us into her life, and I can honestly say that I will be extremely sad to leave her and her beautiful family. Enrique has also welcomed us as daughters, and in meeting and spending time with his family, I have seen a glimpse of the life I hope to have one day. Marisol has also been more than generous, not only in helping us refill the supplies of all of our backpacks, but in simply brightening our day with her silly voices and contagious laughter. These people have helped us in the daily struggles in implementing our projects. More importantly, though, I will miss them personally…With their relentless sense of humor, laid-back attitude, and selfless care for others less fortunate than themselves, they have become my Ecuadorian best friends!

This program of Beyond Traditional Borders has provided me with an experience that I could have hardly ever dreamed of! Even though I’ve only finished my freshman year at Rice, I’ve been able to experience first-hand how to efficiently run mobile medical clinics and to see my own project being used by medical professionals in remote regions. Through living here and learning so much from the locals about Ecuador, I’ve come to know and love this tiny South American country. These experiences have also helped me grow personally: I’ve learned to become more patient, more empathetic, and more inclined to sit back, listen, and truly enjoy the company of others.

I´ll admit it – these two months have not been the easiest in my life. I’ve struggled with homesickness, parasites, and language barriers, but I have gained a stronger sense of strength and self-confidence to help carry me through these and future struggles. I hope to carry the lessons I have learned here for the rest of my life. The generosity, kindness, strength, and intelligence of the people with whom we have worked will always represent to me the essence of Ecuador.

Adiós, y gracias por todo.

Con todo mi cariño,

Andrea

Pura Locura

Talking to an Angel
    When we had first joined Fundación Futuro, Maria Alicia and Qui Quín had shared with us plenty of stories of setting up the healthcare system in the indigenous communities, and particularly how key the community health care workers have been. One of the most amazing stories was that of Angel, a community healthcare worker from Tungurahua. When he first joined, he was a very shy young man who talked in a barely audible whisper. After a few months of training and working in the communities, he became one of the most influential leaders in the community. He became not only an effective health care worker but also a stellar speaker in the “capacitation” sessions, in which he’d discuss a health topic of importance to a large group of other community health workers.
    After completing a pretty full day at the office this past Monday, Stacey and I were able to meet him! We had the opportunity to sit down with him one-on-one and have a serious conversation about the problems he’s encountered. He fully believes in “the system,” for Fundación enlists an entire family under healthcare coverage, and is able to give them needed prescription medications on the spot for a discounted price. He also cleared up a question I had harbored for a long time – why does Fundación absolutely insist on a membership fee and fees for each medical service? It turns out that every cent of that money goes into a fund that Fundación watches over while they are with a community. After the organization ensures that there is enough medical staff and that the system is strong enough, the fund turns over to the indigenous organizations to aid in the cost of running the healthcare system on their own.
    We also learned more about the involvement of the government. Recently, they’ve become more involved in providing healthcare, and at no cost. Although many people are now receiving medical care from them, many faithful believes in Fundación Futuro, like Angel, are a little concerned about the sustainability of these programs. They’re hungry to establish and build a healthcare system of their own, without dependence on anyone else.
    Angel, personally, was pretty awesome. He asked Stacey and I if we missed home, which of course we do. He nodded and added that just after one day, he couldn’t stand being away from his family. He had a baby girl about to turn one-year-old at home. He also said some pretty fun expressions, like working at the office all day gave his brain blisters.

Visit to the Ministry of Health: Meeting the Big Wigs
    Tuesday passed by without a glitch, where we continued to do a bit more research. The previous day, Angel had mentioned how important it is to prepare the people of Tungurahua for the tests that the lab-in-a-backpack can do. For example, for most of these people, they’ve never in their lives received a hematocrit test, and perhaps may have never had blood drawn. For most of Tuesday, I drew up a hypothetical question-answer report of why we have to run these tests, including the importance of detecting anemia and tuberculosis.
    Wednesday finally came! The big visit to the Ministry of Public Health in Quito! We were presented the lab-in-a-backpack to several top officials in public health. The meetings went particularly well! They seemed really excited about the practicality of the pack. However, I was slightly concerned how sure they were that any doctor could simply pick it up and run all the needed tests (we’ve found that a lab technician tends to be quite helpful, especially when visiting a community where a doctor could have around fifty patients in one day). In any case, perhaps my favorite part was meeting several health officials who, after being introduced to the pack, were eager to try it on! They all laughed and joked how if the smallest doctor among them could carry it, surely they could!

From Errands to Fiesta: The Beginning of a Break
    The next day Qui Quín, Stacey, and I headed around town gathering price quotes for all the supplies we need to refill for the lab-in-a-backpack. When we were almost done finishing up our errands for the day, Qui Quín noted that we didn’t have much more office work that needed to be done for Fundación that week. He then wondered if we’d like to go somewhere for the weekend, when Stacey piped up that she had heard from the nurse in Planchaloma that a town nearby Quito, called Baños, would be worth a trip. Qui Quín agreed, and suggested that we head out the next day. That night Stacey and I researched tourist attractions for the city and packed for our trip!
    After we finished packing, Qui Quín and his family picked us up for a peña! Peñas can most be likened to small concert venues featuring a series of famous local singers. They had been quite popular in the 70s and 80s, when the dictatorship in Chile and Argentina had been particularly awful, and a series of protest songs sprouted up from grassroots support such as that found in the peñas. We heard a great round of singers (including the famous Ecuadorian duo Los Hermanos Nuñez), and I even learned a little bit of salsa! It was a great window into Ecuadorian culture!

¡Vacación! A Weekend in Baños

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A typical view of the town

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Iglesia de la Virgen del Agua Santo – Church of the Virgin of Holy Water
   

    Stacey and I had the opportunity to spend a long weekend in Baños, a few hours outside of Quito. It was absolutely beautiful – surrounded by about 60 waterfalls and close to the Amazon, the town attracts tourists from all over the world. The day of our arrival, Stacey and I walked around the town for a bit and talked with a few travel agents to finalize our plans for the weekend.
    That Saturday we woke up pretty early in the morning for a bike ride. We had heard that it was quite a common thing to bike ride to Puyo, a neighboring town in the Oriente (the Amazon proper). We rented a bike (only $5), grabbed a few water bottles and headed out. It felt absolutely great being able to ride again! We haven’t been able to get much exercise during our time here, so this was a really welcome change! At one point we came across a bridge over a river – El Río Blanco. We saw that a series of tour buses had stopped and a bunch of people were peering over one side of the bridge. We joined them to see what all the fuss was about – people were bungee jumping!  Well, to be fair, it wasn’t actually bungee jumping: the cord was thicker and the movement was more of a swinging motion than a straight drop. The bridge was about 20 meters above the river, and the adventure guides would strap up the willing participants to a harness, after which they would simply get on the other side of the railing and jump! Stacey and I decided to join in on the fun!!! It was such a thrill, especially the initial half a second when we jumped off the edge of the bridge and felt as if we were free falling! A Canadian tourist we had met there volunteered and took a video of us (we´ll upload it soon to Youtube and post a link to it here).
    We then took a cable car to Manto de la Novia (Bride´s Veil), one of the most famous waterfalls in the area! At that point, though, it started pouring. I’m talking about a full-on, clothes-soaking, typhoon-style rain that seemed as if it wouldn’t let up for hours. We ended up having to hitch a ride back on a bus back to Baños, where we warmed up in some hot springs. I also tried cuy (guinea pig) for the first time in my life! It’s very popular here, and has been rated as one of the most exotic foods of the world! The next day we went rafting along the river Pastazo (class III+ rapids, yo). Our boat was pretty fun – along with our Ecuadorian guide, we were rowing with people from France, Italy, and Belgium! That night, during dinner at a Mediterranean restaurant, a couple sitting nearby us overheard a conversation between Stacey and me. They introduced themselves, and it turns out that they’re also from Houston! The woman had even attended a sister Catholic high school to the one I had gone to!! Later that night I was able to catch Mass at the Iglesia de la Virgen del Agua Santo – one of the best Masses I’ve been able to attend in quite some time. Afterward Stacey and I headed out to a night time tour of the active volcano next to the city – Tungurahua. This past week it’s been spewing some smoke, so we didn’t quite have the best view of the volcano itself, but we were able to take some great pictures of the city at night.
    The next day we headed out to the hot springs located downtown and packed up our bags and left. Baños has been, without a doubt, one of the most amazing places I’ve ever visited!

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Stacey and I on the cable car heading to Manto de la Novia

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At the river that leads into the waterfall

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Manto de la Novia!

Office Space
    After a weekend of altering adventure with rest, Stacey and I were refreshed and ready to put our nose to the grindstone. We essentially spent the rest of the week at the office, once again completing our norm of eleven-hour weekdays. We spent most of our time writing up a report summarizing all of the work we’ve done and the data we’ve collected from the medical brigades. I was also able to add more information to a teaching session we’ll have with the community health workers in Tungurahua. That was actually kind of fun, because I had to research different types of parasites to teach them about the horrors of eating uncooked foods. Good stuff!

Medical Brigade to Cunugyacu 
    This past Wednesday, all of us woke up ungodly early to head out to a medical brigade in Tungurahua. Along with Maria Alicia and Enrique, we drove for about three hours to reach the town of Ambato, where we picked up a doctor and an orthodontist. We kept driving another hour to reach the town of Yatzaputzán (a town I had written about in my second post). It turns out that the health clinic that we had seen just about a month earlier had been taken over by the Ministry! Later we heard how there’s a dramatic political undercurrent in the communities, where some of the leadership is promoting working only with the government for healthcare matters. Quite a few of the indigenous population, however, wants to keep with the current healthcare system, where they’re able to see doctors whenever they need to and receive needed medication. Fundación´s clinic had moved to a community building down the street, where they had hurriedly boxed away and moved all their supplies. It was such a shame to see them kicked out of their own clinic!
    We then picked up a lab technician and another general practitioner, as well as four community health workers, to complete our health worker team. All of us (a total of 13) then drove another hour along a series of twisting mountain roads to reach Cunugyacu, a small, insulated community. After carrying in all our equipment, soon the room was flooded with children and parents. With such a huge medical team, things got a little unorganized pretty quickly. It was also a little stressful since it turns out that we have several headstrong people on the medical team, each of whom feels very entitled to their opinions. Everything was settled in the end, and the packs were set up alright. The basic diagnostic equipment from the CHW kit was again a favorite, and the nurse was particularly excited about the thermometer covers (they’re single-use and really cut down the time that the nurse would have to sterilize the thermometer after each patient).
    I also walked around a bit and was able to talk to the some of the kids. They were particularly shy, and didn’t quite feel like running around or playing any sort of game. I then opted for the ´sit down and lecture´ style, and I hope their wide eyes and silent nodding indicated that they picked something about the importance of hygiene and nutrition! In any case, we were quite productive in this little pocket of the world, but it turned out to be the most stressful medical brigade yet!

A Morning of Meetings –> Amazon Trekking?
    The next day we presented our other two backpacks, the gynecological pack and community health workers´ kit, to the Ministry of Public Health here in Quito. One of our audience members was a doctor who coordinates medical brigades to the Amazon. It’s super exciting, because after talking to several of the officials, they agreed that it would be worthwhile to try out the backpacks in some of the more remote communities in the Oriente. I´M SO EXCITED! The naturalist in me has wanted to go hiking ever since we arrived in Ecuador, and this just might be our experience of “roughing it” with our packs! SWEET! Dear reader, you’ll be sure to hear a bunch about that trip next week!

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I´m the one with the jazz hands on the far left, explaining the CHW pack. Public health officials to the right.

Some Tidbits about Ecuadorian Culture, Pt. 2
Manners: People here definitely interact differently than in the United States. For example, I can’t even count how many times I’ve passed a fellow Rice Owl in a hallway, or even along a walkway at Wiess, without acknowledging them. If you don’t know them, why would you say anything? They’re probably busy, anyway, thinking about life, or work, or whatever. In Ecuador, when you walk into a room, even if you don’t know them, you great everyone around you. Good morning, good afternoon (sometimes my sense of time is off and I get confused) are all proper greetings. There’s one morning greeting that’s commonly used among the older folk, in which one says in one breath, ¨!Buenos dias!¨¿Cómo le ha pasado? ¿Cómo ha amenecido?¨” / “Good morning! How are things going? Did you start your day alright?” Also, if you walk by someone else who’s eating, you politely nod to them and say “Buen provecho!” – basically, “Enjoy your meal!” If you’ve met someone previously, then when you greet them you also kiss them on the cheek. That’s led to lots of fun awkward moments. All of these customs are a little friendlier than I’m used to, but it’s pretty interesting!

On the Road Again: Traffic in Quito is pretty awful. As Maria Alicia explained to us, rush hour runs from about 6 to 8 in the morning, then from 11 to 2 in the afternoon, and finally from 4 PM until about 9 PM. Needless to say, rush hour is a pretty familiar state to us. To pass the time waiting in traffic, we often play a game. The goal: be the first one to see and call out a “Pichirilo” – basically, any model of a Volkswagen Beatle. You have to call out PICHIRILO, its color and then, if you´re fancy, the time of day that they´re situated (at 6:00). The latter’s pretty hard since cars tend to be moving, so you end up saying something like, “2:00! Okay now more like 5!” Anyway, it’s a pretty fun way to pass the time. Another thing you can do is denounce the hated abuseros. The term is actually a play on words and refers to bus drivers – buseros – who tend to drive horrendously and just generally abuse the traffic laws. The term abuser – abusero – is then used. If you´re ever in Quito and can´t quite think of a conversation topic with a local, just mention the term abusero and you´ll be sure to hear quite an earful.

Another Look at Family:  So I know I´ve mentioned it previously, but it´s worth noting again. Making sure that there’s enough family time is always a top priority. It´s also a little weird, since Stacey and I are of marriageable age, at least in their eyes. Never in my life have I been asked so often if I’m in a relationship, or what I think about marriage. It’s pretty funny, actually, since at the age of eighteen, marriage is just about the farthest thing from my mind. It’s write up there with “research retirement homes.”

Everyday Expressions: As you’ve probably figured out, the term “gringa” is used to describe any foreigner but is most commonly applied to Americans. Stacey and I have been affectionately called gringita for the duration of our time here, and I feel like it’s a legitimate nickname now. Another term that I hear and say many, many times a day is the term for “wow” – “chuta.” I’ve gotten so used to saying “Chuta!” whenever I hear something surprising, that I’ve even started saying it during my phone calls to my parents! A common greeting that’s used, particularly by Qui Quín, is the question, “¿Qué dices?” Literally, it translates to “What are you saying?” So whenever I silently walked into the room, and was asked that, I would reply with a confused expression “Nothing…?” It took me a ridiculously long time to figure out that Que Dices really translates to “How are you?”

Ecuadorian Painter – Guayasamín: Walking around Quito, I´ve seen countless striking paintings of a very distinctive style. I was really drawn to them, and saw that they were by the same painter – Oswaldo Guayasamín. I did a bit of research and found that he was born of an indigenous father here in Ecuador. Throughout his life, he has taken to heart the oppression of the indigenous populations throughout South America, and most of his paintings reflect the struggle against injustice. If you´re interested, I´d recommend checking out his work. Be warned, though! He´s pretty intense, so don´t expect watercolors of sunsets and butterflies!

Food: The food here is absolutely amazing. I’ve mentioned the guinea pig that’s quite popular here, and it tastes great! (A little like turkey, actually) Their seafood is also of course very fresh. The grilled oysters here are the best I’ve ever had, and are seasoned perfectly. Although I do miss Mexican jalapeños, Ecuadorian food satisfies my spicy tooth with a famous sauce – ají. It tends to vary by region, but it always has a kick to it and typically includes a mixture of onions and peppers. This week I was able to stop by one of the parks, where vendors set up their grills and tons of locals gather around to get a bite to eat of typical Ecuadorian food. I was able to try a bit of tripe (my namesake, haha), as well as try an empanada of cheese, or known commonly as a “wind empanada,” for its fluffiness. All in all, the food here´s pretty wonderful, and I´m trying to learn how I can prepare some so I can enjoy it back in the U.S., too!

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Local cooks prepare tripe…mmmm!!!

Coming Up Next Time
AMAZON!!!! Also, Stephen and Yvette, both staff from Rice’s Beyond Traditional Borders program, are coming to visit. YAY!! MORE GRINGOS!

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