Reports from Ecuador

Atacames

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

Stephen and Yvette arrive

It´s been over 2 weeks since my last post, and since Andrea went into such great detail about most everything I´m going to keep the summary pretty basic. Going back to 4^th of July: honestly that day was kind of depressing because this was the first time in my life that I was unable to do a single thing to celebrate the 4^th. I know that we couldn´t really expect a big show, considering our location, but it still made us a little homesick. I decided to wake Andrea up with pancakes (not a common breakfast food here) as a small way to remember the US. The following week though was packed with excitement, as Yvette and Stephen arrived on Tuesday to work with us for a week. Yvette is one of the directors of Beyond Traditional Borders and Stephen is what I like to call ´the godfather of the backpacks,´ so we were excited to see some familiar faces from Rice as well as have time to talk (in English!!) about our progress and our experience. Because this was the first year that Rice sent students to Ecuador, it was especially important for them to get the low-down on the entire experience.

We first got to meet up with Yvette and Stephen on Wednesday morning as we were heading out to Tungurahua. We conducted a medical brigade in the community of San Isidro, which served also as an opportunity for Yvette and Stephen to see how the brigades of Fundación Futuro work. Also, this was the very first time that Stephen got to see the backpacks in action, which was cool for him because he spent all year toiling over making dozens of the lab-in-a-backpacks. The brigade/mobile clinic went pretty successfully, as there were plenty of patients who needed all sorts of tests. We also made good use out of the gynecological backpack, as there was one doctor who wanted to spend the whole day doing well-woman exams and Pap smears when possible.

The rest of the week we spent in the office preparing reports and waiting to hear if our planned trip to the Amazon was going to go through. Yvette and Stephen were pretty busy working with Fundación Futuro trying to coordinate the shipment of backpacks that was going to the Ministry of Health, so sadly we didn´t have a lot of time to talk with them. However, by the end of the week we finally confirmed that we were going to the Amazon (or Oriente, as they say here)! Our plan was to spend Sunday traveling, and then Monday tagging along with the ministry during a trip to one of the communities in which they were planning to do a bunch of vaccinations. Andrea and I excitedly packed up our malaria pills, rain boots and ponchos and were ready to go!

Entering the Amazon: view from the airplane

Adventures in the Amazon rainforest…at last!

On Sunday morning we flew out to the Amazon in a small plane accompanied by Enrique Estrella from Fundación Futuro, Yvette, Stephen, and all of our medical backpacks. It was only a half hour flight but it was awesome looking out the window and seeing the immediate change from the mountain highlands to the tropical rainforest. After a 2 hour bus ride we arrived in Coca, a small Amazonian petroleum town. Apparently a lot of oil companies have drilling projects in the Amazon, and therefore many small towns have sprung up around this business. We also saw a lot of ´gringos petroleros,´ who are white American laborers who live and work in these towns that are located close to the drilling sites. It was interesting to say the least to see oil trucks and pipelines snaking through the untouched wilderness of the rainforest – an ironic juxtaposition.

We arrived at our riverside hotel and were greeted by a zoo, literally! Many of the inhabitants of this hotel were uncaged tropical animals that had made the site their home, interacting with hotel guests (and begging for/stealing food, of course). Andrea, Stephen and I spent a while playing with and taking pictures of the Toucans, peacocks, squirrel monkeys, parrots, and tortoises before we all had to head over to the Ministry of Health branch – Orellana to talk about our trip the next day to the community of Cotóna. On our way back to the hotel we bought some bread from a bakery to take with us the next day because we would usually go without food on the days in the communities unless they decided to cook for us. When we got back to the hotel we saw one of the adorable little squirrel monkeys and were ´talking´ with it until suddenly we were surrounded by four more of its buddies, who then decided to jump on us! We were not sure what was going on until we realized what they were really after: the bag full of bread! We were playing tug of war with them as they tried to snatch the bag out of our hands, and finally after passing the bag between us we were able to break free and run into our hotel rooms! Only in the Amazon…however the next day we couldn´t stay upset with the monkeys because they were just too cute, so we made up and decided to be friends – we even gave them a peace offering of some animal crackers. That usually does the trick!

On Monday morning we headed out super early, as usual, to the community of Cotóna, which was nearly a 2 hour drive in total from Coca. We brought all of the backpacks with us, and when we arrived we were prompted to give the people of the community a short presentation about the backpacks. Because this was not a normal Fundación Futuro brigade, we were just using the opportunity to tag along with the Ministry and test out our packs in this environment the best we could. That also meant that the people were going to choose if they wanted to have any tests done (instead of a doctor dictating what they needed), and also they would not have to pay for anything. I was not sure if anyone would want to have a blood test or a Pap smear when given the choice, but after the promotores explained to the people in Quichua what was going on, people lined up to get glucose tests, urine tests, and Pap smears! The Ministry seems to have done a good job with this community with their medical education programs. Also, we did not have a lab technician with us, so this was the first time that we had to man the lab-in-a-backpack completely by ourselves. Luckily Yvette had some prior experience as a lab tech and she took over most of the testing.

Later in the afternoon we were asked if we wanted to go see the ´piedras de Shaman,´ or magical Shaman rocks. We thought that sounded pretty cool so went on a short trek through the jungle to the edge of a creek, where there were 3 rocks that had been carved with mystical symbols. The people had no idea when the rocks had been carved, so they knew that they were very old. Two of the rocks had abstract symbols on them that our guides told us were meant to represent man and woman. We also got to meet the local Shaman, who helped out Andrea by expelling all of her evil spirits!

The rest of the trip was pretty straightforward – hanging out in the pool, playing with our monkey friends, and then making the return trip to Quito on Tuesday. We sadly said goodbye to Stephen, Yvette, and two of the backpacks, all of which were returning to Houston and to Rice. We found out that Ecuador had recently put an embargo on the number of suitcases you could check, and we would be unable to return with the packs ourselves. It was sad to see them go because it also meant the end of our work with the medical brigades! We couldn´t believe that it had come to an end, but we felt like we had gotten some really good feedback on our projects that would help out Rice. It was also nice to know that Fundación Futuro was eager to get more Rice student volunteers next summer because they had enjoyed working with us! We definitely enjoyed working with them too and we feel like a continued relationship between Rice University and Fundación Futuro will be beneficial to both parties. María Alicia and QiQín again threatened not to let us leave, and are still constantly asking us when we´re coming back to visit! We always tell them whenever we have enough money for the trip, because we´re just poor students right now! It´s great knowing too that we have an Ecuadorian family now who will always welcome us if we come back.

Me with my adorable monkey friends! What cute little devils...

Yvette and Stephen hard at work in the community of Cotona

Trekking through the jungle on the way to see the Shaman stones

The last week – a little bit of work, a little bit of fun on the beach

Okay so that´s a lie, the last week was actually full of a lot of bit of work. Andrea and I were frantically writing detailed reports for both Fundación Futuro and for Rice University, essentially translating every document from English to Spanish or Spanish to English so that both sides could have full reports of every part of the experience. It was exhausting to say the least, but we knew since we´re the guinea pigs for the internship in Ecuador, every detail was important. ¡Chuta! I never want to write a 20-page writeup in Spanish ever again! Andrea and I were also determined to spend our last weekend in Ecuador at the beach, because that was the only region of Ecuador that we hadn´t yet visited (except for the Galapagos Islands, which was WAY too expensive for us to even consider). Therefore as soon as we finished our reports for Fundación, we set to organizing our trip to the beach ourselves, doing everything from going to the bus station to buy tickets and calling hotels to make reservations. Because I don´t want to write too much I´ll just summarize our trip to the beach of Atacames in bullet points:

• Playing loud horror films on an overnight bus trip is not conducive to sleep!
• It´s much easier to deal with cold showers when you´re in a hot, humid location.
• Our trip to the beach felt pretty authentic because we were practically the only gringos there! This also brought a lot of (sometimes unwanted) attention, and we´re pretty sure that we got ripped off by the locals. Oh well, what can you do?
• I ate and drank everything that I could that was made of coconut – from squid in coconut sauce to fresh coconut milk to coconut milkshakes to the Coco Loco. My personal heaven!
• Highlight of the trip: whale watching. We took a small boat ride out into the sea and were able to see 6 or 7 humpback whales feeding at the surface – close up, too! One of the most breathtaking experiences imaginable.
  

The beach of Atacames

I'm in coconut heaven!

¡Hola mijines! Sorry for the wait!

Chillaxing

The Saturday of July 4 was pretty low-key. It turned out that both of our hosts had to work that day, and we weren’t sure if we were allowed to leave the house. In the end, we celebrated America’s independence by eating pancakes and rediscovering the world of Youtube. After all, it was the first time we’ve had Internet at home in 7 weeks!The next day was pretty great, since we ate lunch at a wonderful restaurant sitting atop Panecillo, the hill of Quito we had visited right after our arrival in Quito two months ago. We spent time with María Alicia, her mom, and her great-aunt, who’s 96 years old but still maintains a great memory! We also toured the central market of Quito – El Paisaje Artesanal – and shopped around for local handicrafts.

Monday and Tuesday we worked pretty solidly on the official report for Fundación Futuro. It turns out that revising fifteen pages of Spanish is not the easiest thing to do. We then prepared reports for Yvette (BTB director), who was flying in with Stephen (creator of the 25 lab in a backpacks) late on Tuesday night!

Medical Brigade: San Isidro

Early Wednesday morning, we joined up with Stephen and Yvette for a medical brigade! It was absolutely great to see them, since we hadn’t seen anyone from back home in so long! We drove the thee-ish-hours to Yatzaputzán in Tungurahua. I was happy to see that their clinic that had been pretty disorganized last week had greatly improved. After gathering our lab tech, family doctor, and nurse from last week, we met up with a new orthodontist and three community health workers to drive everyone back to San Isidro.

The brigade worked out pretty smoothly! We set up everything on the second floor of a cheese plant. In one large, central room we set up the CHW pack towards the front, and the portable orthodontics kit at the very back next to the lab in a backpack, which was again a hit with a high demand for urine, parasite, and hematocrit tests. Patients first filtered in through the nurse, who used basic diagnostic equipment, and were then referred to the doctor in the other room, where the gyneoclogical backpack had been set up. The community health workers were quite helpful this time around, for they helped the nurse in keeping all her records. I only have a few complaints: there was some confusion over the extra medical supplies we had brought, since they had been placed in separate containers and were not well-organized prior to the brigade. Also, the lab technician, who was by this time quite familiar with how to use the supplies from the LB, wrote down the results in a notebook and headed back home. When we passed the results to the doctor to interpret, however, she couldn’t understand some of the lab tech’s notations! We had no means of communicating with her, and although we figured it out after putting our heads together, it was a bit stressful!

Once the nurse stopped using equipment from the community health worker’s kit, I was able to go through my routine nutrition lessons. The children absolutely LOVED the Comida Buena / Comida Mala game! (similar to Red Light / Green Light). We also went through the coughing freeze tag game, which was great since they all got to run around for quite some time. Towards the end, though, they wanted yet another game. I decided to try and think of a new game on the spot…I remembered how much fun Marco Polo had been as a kid, in which one kid closes his eyes and tries to tag the others. I also remembered a very startling video I had seen in BIOE 260 this past semester, in which I learned how night blindness can be quite common in women and children who do not intake sufficient amounts of Vitamin A. I lectured the kids a bit over this topic, and ended with the recommendation to eat their carrots (high in carotene)! They all played Marco Polo, which they loved. The game turned out more to be an exercise of understanding the difficulties of blindness so as to scare them into eating their vegetables. Sounds like a good tactic to me!

Overall, I would say this experience was a definite improvement over Cunugyacu!

Preparations
Thursday we worked on our formal report (this time, in English) for Rice that summarized all of our medical brigades. We also simplified the user information sheet for the Ministry officials to use with the 24 lab in a backpacks coming in a few months. On Friday Stacey and I began working on our poster presentations for September. Then we made sure that all our paperwork was together for our brigade….TO THE AMAZON!

An Infusion of Culture
That Saturday, Stacey and I decided to take matters into our own hands and take a taxi to explore the city. We had never felt comfortable enough to do this before, but since María Alicia was having car troubles, we knew it was now or never. We decided to travel to the national museum, which is an amazing collection of roughly three thousand years’ worth of art from all over Ecuador! The “ancient” exhibit was definitely my favorite. We saw a beautiful collection of pottery from the Valdivia and Correrra cultures. Perhaps the most memorable item was that of a shrunken head!! We learned that the practice of shrinking heads was quite popular in the Amazon (where we were traveling to the next day!) A warrior would wear the shrunken heads of his defeated enemies around his neck as a sign of strength. The practice was also intended to soothe the victim’s soul and mitigate its desire for vengeance!

We also saw centuries of religious art inspired by the Spanish. The exhibit ended with very striking modern art, featuring pieces by Guayasamín. The plight of the indigenous population of Ecuador was a common theme in many of the paintings of the twentieth century, and I find it interesting that Americans haven’t seemed to reflect that same social conscience with our indigenous population in recent artistic movements.

_________________________AMAZON!_________________________

Arrival

Stephen, Stacey, myself and Yvette fresh off the plane at La Aguardia

Between La Aguardia and Coca

YAY! Finally we were heading out to the Oriente – the Eastern and wild Amazonian part of Ecuador! We woke up early and headed out to the tiny airport. Getting all three backpacks through security was a little bit of a hassle, but it worked out fine in the end! Soon enough, the whole team – Enrique, Yvette, Stephen, Stacey, and myself – loaded into the propeller airplane and took off! The views during the half-hour flight were unbelievable. We could see the peaks of the largest and most well-known volcanoes surrounding Quito, with Cotopaxi as the most impressive. Once we flew over the Andes, we saw huge stretches of pure virgin forest pass beneath us. We had arrived in the jungle! After landing we took a two hour bus trip to Coca, the town we would be based out of.

Our hotel was astonishing! Peacocks, toucans, and squirrel monkeys roamed around freely. That day we settled into the town of Coca by walking around the malecón, or boardwalk. For lunch I ate guanta – lowland paca – that tasted pretty good! It was certainly a first. Then Yvette, Stacey and I worked out at the hotel´s gym. It had been so long since I’ve exercised that I had forgotten all about endorphins!

We also had a meeting with one of the doctors from the Ministry of Public Health clinic near Coca. In Ecuador it is required that medical doctors spend two years working in the indigenous communities. This one doctor found that serving these populations was his calling! He spent twenty years working directly in the jungle, with those who have the most limited access to medical care. He was amazing! Behind his desk were huge fifteen foot spears – gifts from the people of the Guarani tribe, one of the most famous of Ecuador for their refusal to wear clothing of any type. It was quite exciting to the meet a doctor who had been so involved with the indigenous people of this region! He really liked the idea of the three backpacks, though expressed some concerns about the weight. Traveling light, he told us, is of huge importance for medical professionals in the Oriente. To reach the community of the Guaranis from Coca, for example, you need to travel 18 by canoe! In the end, the doctor assured us that we could use our backpacks in a medical brigade for vaccinations the following day.

Perhaps the most important part of that first day in the Oriente was my first real introduction to the squirrel monkeys. While carrying a few pieces of bread down the open-air walkway of the hotel that evening, I had looked up to see a monkey staring down at me from a beam. Before I knew it, two monkeys had jumped on my shoulders! They didn’t bite or scratch or anything of the sort – they just really wanted to get to the brown bag of food that I was carrying! After about ten minutes of the monkeys jumping back and forth between Stacey and me (they were certain that Stacey’s earrings were yummy insects), we were able to escape. What a welcome to the Amazon!

Squirrel Monkey Surprise

Cotóna: LAST Medical Brigade!

Getting to Know the Kids!

Waking up before the sun rose, the five of us hopped into a taxi to travel to the Ministry of Public Health clinic to catch the truck going out to Cotóna. We first introduced the three backpacks to more of the Public Health officials, including the obstetrician and community health worker who would accompany us. We all packed up in the van with the medical supplies, and traveled down a rocky path to reach our destination of the community of Cotóna. During that time we were able to talk with the community health worker, René. He told us some interesting facts about the wildlife, such as the local snakes whose bites are fatal, and of a type of fish that actually gives an electric shock to those who try and eat it!

The conversation was cut short when the truck pulled into an open field with a line of wooden buildings to our left. We had arrived! After dousing ourselves in bug spray (contracting malaria is not high on my to-do list), we walked in to a huge open room in one of the buildings with all of our packs. After starting to set up our packs, I looked up to see more and more members of the community sitting down on the benches that lined along the walls. Soon about seventy people had gathered, all staring at us. The community health worker then explained to us that we were expected to give a speech to the community about the new equipment!! Luckily, Yvette stepped up to bat first and explained the lab in a backpack. Then Stacey spoke about the gynecological pack, and I finished up with a summary of the CHW pack. During this whole time, René was translating our Spanish into Quichua. It´s interesting to note, though – the Quichua spoken in the Amazon is completely different from the Quichua we´re familiar with in the Sierra! After we had finished our talks, René asked them all in a loud voice, ¨What do you think? Are the packs worth it?” A rowdy applause broke out, as several men gave the thumbs-up sign and smiled. We passed!

The brigade was a hit! The obstetrician set up a women´s clinic in a small room across the field, where she saw a series of women throughout the day. In the large room, I remained with the lab in a backpack and CHW pack. It was a little strange in that there was no general practicioner or lab tech, so the community members could just go up to the table and ask for whatever test they wanted. Yvette and Stephen manned the LB, and we ended up doing mostly urine and glucose tests. The CHW pack was not in use, I was sad to see, so I started the nutrition games early. While some of the children were receiving their vaccines, I pulled others to the side and asked them to list the vegetables and fruits they knew. They said a few names that I had never heard of before (obviously, the kids here are familiar with different crops than the kids in the mountainous regions of the Sierra). We were able to play Good Food Bad Food, which they seemed to really enjoy! One of the boys even helped me be a leader in calling out the different types of food, which gives me hope that the kids will continue to play the games even after I’m gone. After running through a somewhat restricted version of the game (they couldn’t run around too much or leave the building in case René called them to receive their vaccine), we still were able to complete most of the games! Afterward, they really enjoyed taking pictures with my camera and poking at a local tortoise that they had found. I had the opportunity to talk to the teacher for the region, who was very kind and had a lot of great ideas for further developing the area.

After we had seen all the patients, we started wrapping up when we were offered to see a ´shaman´s rock.´ We piled up in the truck and then disembarked to walk along a muddy path with trees on either side. We were hiking in the Amazon rainforest!! All of the team arrived at a thatch hut, where we continued walking down a muddy path to the river. It was quite slippery, but I somehow managed to obtain a semblance of balance. When we got there, we saw three huge rocks, about waist high, that had moss growing over them. Through the moss we could see strange, ancient writing. They actually have no idea how old these rocks there, but I´m going to guess that they´re a couple thousand years old. How awesome! After slipping our way back up the path, we were greeted by a shaman! Although we could only stay briefly, we were able to talk for a little while. At one point he shook his wand made of palm branches over my head. I asked him what that meant, and he responded that it was a purification ritual to rid me of my evil spirits. Sweet! That doesn’t happen everyday!

Before heading back to Coca, we stopped once more at Cotóna, where they served us a delicious meal of pasta, rice, and fish. I found out later that pasta is very, very expensive for members of the community, so it was a great honor to receive such a gift! When we got back in the health clinic, we had a long discussion with the lab technician and obstetrician about possible improvements to the packs. In general, we’ve found that they are always requesting more and more complicated tests, but they already complain about the weight of the packs. In any case, it was very helpful to receive their feedback!

Purification Ritual!

Reflections and Basketball
Unfortunately, we couldn’t stay in the Oriente forever! We spent most of Tuesday taking the bus and plane to get back to Quito, and during this time we spent a lot of time reflecting on the experience as a whole. It´s absolutely mind-boggling to think that Stacey and I are coming back home in a week! Every time I even think about heading back home, I almost start tearing up. Ecuador has been my home for the past two months, and I have come to love the country and the people. At the same time, I can’t wait to see my family again! I don’t think I’ve ever gone so long without seeing them, especially in a country so far away. Until the day of departure, I’ve decided to do my best to finish up my work and enjoy Ecuador to the fullest!

After resting a bit on Wednesday, we were on our way to the office with María Alicia when she asked if we´d like to go to a basketball game. It turns out that the South American Women´s Basketball Tournament is occurring in Quito right now! With a sudden change of plans, we visited the Ministry of Public Health for some errands and then were dropped off at the basketball stadium. Stacey and I were able to see three basketball games: Uruguay vs. Peru, Brasil vs. Chile, and Ecuador vs. Argentina. During the first two games, I must admit, it was a little creepy. None of the audience was cheering, or even talking it seemed. As soon as the Ecuadorian team got on the court, however, everyone went wild!! Children were waving banners in the air and everyone was stomping their feet! I suppose the prior silence had been an expression of loyalty to their country. Ecuador ended up royally creaming Argentina!!! It was a great game! Ecuador´s going to play in the finals tomorrow (July 17), so try to catch a bit of it, if you can.

Drowning in Paperwork
Thursday and Friday (today) I have worked on more reports than I have ever had in my life. Stacey and I finished the write-ups in the formal reports of the past few weeks, and included a series of appendices for Fundación Futuro relating helpful information for future interns and for proper use of the lab in a backpack, which will remain with them. Fundación then requested another series of documents, in which we more specifically detailed how to improve the lab in a backpack and wrote more helpful hints for Fundación as a whole. Each document is written in Spanish, and then revised for grammatical errors by María Alicia or Enrique, and as such goes through a series of drafts. We´re also compiling several documents for Rice that chronicle our experience as a whole. It´s all helpful information, but there´s just so much of it!

Thankfully, we´re wrapping up with all the documents. As a reward, Stacey and I are spending a long weekend at one of the famous beaches of Ecuador (we´re told that there are whale tours!)

Next week´s blog post will be my last, dear readers!

Technology is not my friend!! I have the opposite of the magic touch

Death of a Laptop

Tuesday, our first day after getting back from Baños, we went straight to the office of Fundación Futuro to debrief Maria Alicia and Enrique on our successful trip and also get up to speed on the plans for the week. It was kind of sad though, because while we were off having a grand old time, Maria Alicia and QiQin each spent the weekend in bed with gripe (flu)! I was extremely excited to finally receive a Porta wireless internet connection for my computer, because that would mean that Andrea and I wouldn´t always have to borrow computers from others who still need them, and it also would give us wider internet access. However, this was an opportune time for the gods of irony to strike, because as soon as I had internet up and running on my laptop, my computer battery (which was already struggling) decided to completely shut down. My computer now can only stay on for 10-20 minutes at a time (plugged into the wall the whole time) and can barely handle the internet. This is a huge struggle for us because Andrea didn´t bring a computer, therefore we have both been depending on my sad excuse for a laptop, which is now basically out of commission. However, since we only have a handful of weeks left, we’ve decided to stick it out with my laptop in its current condition so I can focus on repair/replacement when I return to the US.

The portable orthodontics setup brought to Cunugyacu by the orthodontist seen here on the left

Brigada en la comunidad Cunugyacu

After freaking out over these last sad breaths of my laptop, we got up to speed on all of the events that Fundación Futuro was coordinating: the incoming arrival of Yvette and Stephen from Rice, the shipment of 24 lab-in-a-backpacks which are going to the Ecuadorian Ministry of Health, and the medical brigade plans for Wednesday. It seems like a lot is going to be happening in these last few weeks! On Wednesday we left crazy early in the morning, as usual, to go for a one day trip to Tungurahua for a medical brigade in the community of Cunugyacu. We stopped through in Ambato to join up with some doctors and nurses who were coming with us. We then passed through the community of Yatzaputzan to meet up with a few community health workers from the health center (Jambina Huasi) there. After we got our whole team together, we were 13 people in total, much more than the usual six we were used to working with! The craziest part was driving the (thankfully, short) distance between Yatzaputzan and Cunugyacu with 9 people in the tiny cabin of our little pickup truck. I´m still not sure how we managed that. The day proceeded from then on in a somewhat disorderly and frustrating fashion, and I´m not entirely sure why. It may have been due to the fact that there were so many of us working together but we didn´t really have a game plan going in, and we were trying to do too many things at the same time. Simultaneously we were running basic checkups, lab diagnostics, orthodontics exams and extractions, and Pap smears. Although we had 13 people working, only 3 of them were doctors so this probably caused part of the holdup.

I was also struggling a bit because some people wanted to do the 3 Pap smears in the same room as the rest of the exams, when it seemed like there were other rooms available that were more private. We ended up using 2 chalkboards as makeshift walls and balancing the metal stirrups on a small bench. It seemed to work out adequately, but it definitely did not appear to be the most comfortable situation for the patients, especially since a few people were needed just to hold up these makeshift walls during the exams to protect the privacy of the patients. The only reason I was frustrated with this setup was because we had better alternatives for Pap smear exam rooms and wider, more comfortable tables for the patients to sit on. In rural settings it´s definitely a ´make it work´ situation, but because I´ve personally invested so much time and effort into the gynecological pack, I want the patients to experience the most comfortable setup available. It reminds me of an example I read in our BTB manuals, explaining that Americans are unique because they tend to associate themselves very personally with their work. I have found that I am a perfect example of this, and I have to remind myself to chill out when people give me critiques or suggestions about the gynecological pack that I may not consider helpful or applicable. I have to remember that everyone is only trying to help out, but I can´t help but get frustrated when it seems like I´m not being understood, which could be due partially to the language barrier as well. Chuta!

Andrea, Stacey, and Maria Alicia demo the (amazing) gynecological pack and community health worker pack to representatives from the Ecuadorian Ministry of Health

Collaboration with the Ecuadorian Ministry of Health

Moving along: on Thursday we spent the whole morning in meetings with the Ecuadorian Ministry of Health, presenting the other two backpacks (gynecological and community health workers) to all of the bigwigs there. Although we made it clear that these were still first-run prototypes just in the testing stages, they seemed pretty interested in the projects and possibly even eager to request a few from Rice University in addition to the diagnostic laboratory packs that they were about to receive! We also spent a while talking with a couple of representatives about the possibility of tagging along with some of the doctors on a trip to the Amazon rainforest – therefore it would be an interesting medical brigade collaboration between Fundación Futuro and the Ministry, who usually do not have the same ideas about public health! It seems pretty likely that next week we´ll be spending a few days in the rainforest testing out all of our packs in a totally different climate and a completely different culture! Andrea and I are also excited to get a chance to go deep into the rainforest before we have to leave and go back to the United States.

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

A typical view of the town

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!

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

At the river that leads into the waterfall

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!

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!

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!

Checking out Alfaro street in beautiful Baños

A week of office work

After a long week working in the office of Fundacion Futuro (we were unable to conduct any mobile medical clinic trips due to lack of lab technicians), and demonstrating the lab-in-a-backpack to the Ecuadorian Ministry of Health – which will shortly be receiving a shipment of 24 packs to distribute throughout the country – Andrea and I were able to get away for the weekend to recharge. QiQin asked us last Thursday if there was any place in particular that we wanted to visit, and I recalled the fact that Dr. Lorena very strongly recommended that we visit Baños. I really had no idea what was there, so only the name came to mind. Soon after mentioning this, QiQin had us online researching places to stay and things to do, because we were going to fly solo for this one! Scary but exciting, because we were ready to venture out on our own while also allowing our gracious hosts a little bit of personal space.

Piscinas de la Virgen - a natural hot spring pool fed partially by waterfalls

The glorious city of Baños

We arrived in Baños on Friday afternoon and realized we’d forgotten to bring our notes with information about our hotel and potential activities. Luckily we were able to remember at least the name of the hotel (well, a hostel actually), and due to the kindness of the locals we were able to eventually find our way there. We also knew that Baños was a very small town, so it wouldn’t be too hard to find our way around. Baños is absolutely spectacular, sitting in the shadow of Tungurahua, the largest active volcano in Ecuador. It erupts every 10-12 years, prompting a city-wide evacuation. The city is also known for its hot springs, waterfalls, and the fact that the edge of the Amazon rainforest is right in its backyard. And the pennypincher in me needs to gloat for a bit about our great find: we stayed in an extremely nice hostel for 3 nights at just $7.50 a night!! Andrea and I even had our own bedroom (none of that 6-bunks-in-one-room business) and our own bathroom, where I experienced the most amazing shower I’ve had in Ecuador (as hot water and water pressure have been generally nonexistent). Awesome awesome awesome.

Bike tour on the avenida de las cascadas

Cuyes asados, or grilled guinea pigs!

Adventure Time!

Saturday, our first full day in Baños, was one of the longest, craziest, most exciting days of my life. Even though I ended the day with a nasty fever (probably just heatstroke or dehydration), I still fell in love with the area. We started early in the morning by renting bicycles so we could ride down the ‘Avenida de las cascadas,’ or ‘Avenue of the waterfalls.’ We stopped at an area where a lot of people were clustered around and saw that people were bridge jumping – my name for what is essentially bungee jumping but with a more rigid cord. I was happy to just watch, but then Andrea asked me if I wanted to do it, because they could do two-person jumps and she said she would only go if I went too. I thought about it and realized I wouldn´t get another chance to do something that insane in South America, so then we literally took the plunge! The drop was about 15 meters of sheer terror before coming to a quick stop and swinging for a few minutes over the rocky Rio Blanco. What a great opportunity to freak out our mothers! Maria Alicia, essentially our Ecuadorian mom, almost had a heart attack when we showed her the video of our jump (kindly taken by a Canadian tourist). More adventures of the day included getting stuck on an open side-open top cable car 100 meters above a raging river in the middle of a monsoon. The rain put our bike tour to a halt and we had to jump on a chiva (tour bus) to get the 20 km back to Banos. Luckily by this point we had run into two other American tourists (med students from Seattle) and their guide, who invited us to come to some hot springs with them afterwards. They also invited us to go eat cuy (guinea pig) with them. I abstained, but was curious to witness the spectacle. Carnivorous Andrea of course loved it and even ate the tiny liver. Ewww. (Side note reminder: Stacey = vegetarian). The rest of the day was spent relaxing in the heat, and after the hot springs we got an appointment at a small local spa to get (cheap, but awesome) massages.

Sunday was also adventure time, as we had signed up for a full day white water rafting trip. We spent several hours on the Rio Pastaza in Class III+ rapids and nearly got thrown off several times, but despite my initial fear it ended up being a lot of fun. Andrea is apparently some sort of rafting champ and therefore she put the pressure on me when I started to waver – after hearing from other tourists that the river was really dangerous, and that two weeks earlier a tourist had drowned while rafting! Nevertheless, we are both still here to tell the tale, and I´m proud to say that I jumped off a bridge and went rafting in treacherous waters in the Amazon! Our rafting guide also spent a while joking – I´m not sure how seriously – about there being anacondas and piranhas in the river. All the better! I think Andrea and I are just a pair of daredevils.

We returned to Quito on Monday ready to get back to work, rejuvenated by our weekend adventures. 3 weeks to go! Here´s hoping we can make the best of it.

The scary cable car that Andrea and I got stuck on

Andrea and Stacey bridge jumping over Rio Blanco