Reports from Ecuador

¡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!