Reports from Ecuador

Just another weblog

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

by on July 24, 2009
Filed under: Uncategorized Tags: , , , , , , ,

Atacames

72

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

banos-1551

A typical view of the town

banos-132

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!

330-cable-car

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

banos-104

At the river that leads into the waterfall

banos-095

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!

week-6-054

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!

week-6-069

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!

¡Soy La Tripa Seca, Mijín!

week-4-002

The Best Hot Dog of My Life
After posting up my new blog post on Monday and finishing  some last-minute errands, Maria Alicia, Stacey, and I left the office pretty late. Driving back, our mentor asked if we’d like to stop by somewhere to get a bite to eat. I, official lover of the culinary, happily agreed. She then quickly suggested, “Oh I know! A hot dog!” Now I am generally not a big fan of this classic mystery mix of meat, but I thought I’d give it a shot. We pulled up to a little stand on a street corner, where there were about four businessmen gathered around a kiosk. Lined along the kiosk were tons of different sauces and relishes and toppings for the hot dog! For a little over a buck, I quickly was served a hot dog and loaded it with practically every dressing available. I tried it, and the rapturous blend of tastes was almost too good to be true…it was the best hot dog of my life!!!

 

Arriving in Planchaloma and Getting Started in Cerro Azul
After dreaming of my hot dog, I woke up painfully early to get ready for a head start to Planchaloma. Stacey and I gulped down our eggs and bread and hauled all of the needed suitcases and chompas, or heavy duty jackets, out to Qui Quín’s truck. There we met the two new bioanalysis lab students from the Catholic University of Quito, Paul and Carlos. We took another beautiful drive up to our now familiar ‘home base’ of the health clinic. A little after we finished unloading our belongings, we prepared ourselves to go to our first community for the week, Cerro Azul. The new and improved medical team packed in the van and headed out.

week-4-004

A view outside our window on the way to Cerro Azul – the community lay in the valley bellow.

The drive lasted about two and a half hours, which was a considerable amount of time, considering we were all quite scrunched together and acutely felt every rock we came across. We finally arrived in the community, where families had lined outside the schoolroom in anticipation of our arrival. We set up our clinic in the one-room schoolhouse, where all the desks had been pushed against the wall to provide a bit more room. The lab students used the teacher’s desk as their main workstation and quickly learned how to set up the microscope and centrifuge from the lab-in-a-backpack. As the patients started filling in, Stacey and I again marked the usage of each piece of equipment. We didn’t have any remarkable cases, although we noticed the tendency for all of the family members of patients to stand around to watch while he or she had to be prodded a bit for a blood sample for a hematocrit test. As a result, the classroom filled up quickly as the general noise got louder and louder. The doctors didn’t seem to mind, but I became a bit nervous. I’m generally not comfortable with large amounts of noise in a work setting, so I had to remind myself that I have to learn to be comfortable with other cultural norms. We finished up our record-keeping and the patients started thinning down. We treated a few more last minute patients when it began to rain fairly heavily. Unfortunately, I wasn’t able to teach any of my quick nutrition lessons since all of the children had taken refuge inside another building of the complex. The community members served us fresh trout for lunch, which we were obliged to finish entirely to avoid insulting the chefs. After eating so much food, I looked with dread to the two and a half hour ride back to Planchaloma. If I had a rough time on the mountain roads on an empty stomach, how could I take a return trip immediately after eating? By sheer will power, the whole medical team packed once again into the truck and somehow made it back to Planchaloma without anyone tossing their cookies. By this time, it was pretty late in the afternoon, so we all got to work on making dinner in the laboratory once again. We finished our meal and the great film of The Count of Monte Cristo, and headed off to bed.

A Painfully Slow Day at the Clinic
The next day we were to remain at Planchaloma and run any needed tests on the patients who walked into the clinic. Although we heard that Wednesdays can be relatively busy, we had very few patients walk in. Of those, the doctors only asked us to run basic urine diagnostic tests. After the hustle and bustle of all the patients the day before, the trickling in of patients was quite boring. We ended up cleaning the clinic a bit, which it needed. 

Being a Patient for a Day!
    Although I had developed a sinus infection earlier on in the week, my nasal problems that had been discussed in my last post were coming to an end. However, I knew feeling good couldn’t last for long. Assuming Stacey and I are still both subject to our self-discovered Law of Mutually Exclusive Gringita Wellness, Stacey generally feels awful in the city, and I get sick with something in the countryside.
    After dinner on Wednesday night, my stomach felt a bit strange. I thought nothing of it at first. When I was getting ready for bed, I realized that there was indeed something wrong, and I rushed to the bathroom to toss my cookies. I thought I was all better afterward as I headed back into my top bunk to go to sleep. A couple hours later, I woke up around 1 AM. I rushed down the ladder and barely made it to the designated receptacle. After going to sleep once again, I woke up four hours later to worship the porcelain goddess once more. As much fun as I was having, I realized that this was a little more than a run-of-the-mill case of food poisoning. The next morning, I woke up to find that standing up was a very unpleasant sensation. I felt as if my stomach were on spin cycle, and I felt so weak that I found myself learning against the wall whenever possible. After walking into the kitchen and then running out after smelling the omelets being prepared, I knew that food was out of the question. I was quite nervous, since I knew that we were planning on heading out to our final community for the week that day. I doubted my ability even to take notes of what was going on! I couldn’t ask Stacey to do my job and hers simultaneously!
    In the throes of mental consternation, I lied down on my bed and took a nap. I woke up to hear Dr. Monica and Dr. Lorena knocking on the door to check up on me. They listened as I relayed my heart-wrenching (or stomach-wrenching?) story of the past twelve hours, as well as other general complaints I was having. After using a stethoscope to listen to the groans of my stomach, Dr. Monica informed me that I had contracted a bacterial infection. She very kindly gave me antibiotics and pain medication, as well as orders to rest all day and drink plenty of liquids. She then brought great news – it turns out that the kids of San Francisco were taking exams, and we would have to wait until the next day to head out. YES!! I didn’t have to miss a day at the communities! After taking my medicine, I fell in and out of a stupor for the rest of the day. I woke up around dinnertime to ask how the day had gone – to find that I was the only patient that they had had! Everyone was dying of boredom, so I suppose my body had chosen a good day to get sick. I took it easy for the rest of the day, and even felt good enough to eat some crackers!

A Barrage of Patients at San Francisco
    T.G.I.F.! I woke up feeling considerably better, and glad I had slept the whole night through. I ate a simple breakfast – namely, tea – and got ready to head out to San Francisco! This community was only about a half hour away (thank goodness – I don’t think my body could take being shoved around for two hours again!)
    We arrived in San Francisco and were officially greeted by the leader of the community, a gesture of courtesy that I thought quite pleasant. We set up in a large room within a pasteurization plant (a little ironic, since the doctors had ordered that milk was still a no-no for me). The doctors began seeing patients, and the line to receive diagnostic tests grew longer and longer. The most popular order? Hematocrit tests to check for anemia, with urine tests in second place. The community health worker pack was not as much in demand, so both Stacey and I ended up working together for the lab-in-a-backpack. We needed to write down all of the items being used as well as help the lab students prepare their journal of the results of the patients´ tests to bring to the doctors. It was quite exciting, seeing so many patients in one day!! We had over 65 come in!

week-4-0511

Paul, Stacey, and Carlos huddled over the centrifuge with a long line of patients at San Francisco

I’m a Kid Magnet!
  We took a break for lunch, which was generously prepared for us by a few of the members of the community. I was luckily able to have the chicken soup they served, although I had to refuse their spicy ají sauce with much regret. Once returning from lunch, when we usually don’t have many patients, I realized that I still hadn’t been able to talk to any of the kids. Looking up, I saw a few being shuttled out of the way by their parents. Thinking that Stacey could manage the now  steady stream of patients coming in, I decided to step outside our “clinic” and see if I could run a quick nutrition lesson plan. I ended up making quick friends with a few of the children outside. I tried to start off talking about the importance of eating well-balanced meals, but naturally, that didn’t quite draw a crowd of kids. It wasn’t until I began with my classic Red Food Green Food game (Red Light Green Light using nutritious and unhealthy food names instead) that more and more children appeared. I had updated the game by asking Qui Quín about more specific vegetables that they were familiar with, as well as brand names of junk food commonly sold in the area. This new information improved the quality of the game quite a bit, and I felt that there was enough variety, as well as enough repetition, to get them thinking  if their normal food such as chupetes, or lollipops, should really be something that they have everyday.

    Red Food Green Food worked out quite well for a while, so I decided to move to the Monstrua de Infección game! This game involves chasing the kids around in order to anthropomorphize a cold virus, or some other infectious particle. We continued this game of tag for quite some time, when I realized that I needed a quick swig of water. I excused myself to take a break and encouraged the kids to keep playing. I asked who wanted to be the new infection monster, but all the kids shook their heads. Even when I picked on one, he or she would simply refuse. I felt a little down about this, since I was hoping that some of these games would be sustainable enough that the kids would continue to play them without me.
    I helped with record keeping a little bit before going out to the kids again. They needed to play a game that could be entirely self-sustainable. Thinking on my feet again, I remembered what used to be my perennial favorite of Duck Duck Goose. After coming outside to finding the majority of kids that I had left, I gave them instructions to for “Sano, Sano, Enfermo” or “Healthy, Healthy, Sick.” The rules of Duck Duck Goose applied perfectly, where one kid would walk around the rest of the kids seated in a circle. He would pat each kid on the head and deem him “healthy” until he would yell, “SICK!” for one kid, who would then have to run around the circle and become the new “infectious particle.”  I played with them for a little while, who all really seemed to enjoy it. It was a little funny, though, when I would hear a few whining that they never got picked. So I guess I found a small problem with my design: with this game, kids wanted to be sick!!

week-4-058

sano…sano….sano….¡Enfermo!

  I stayed a few minutes longer, and then I thought I’d quickly say goodbye to the kids so I could slip back to the clinic while they kept playing. My evil plan didn’t work, however, and soon I looked up to see three children standing over me and the usage forms for the lab-in-a-backpack. I realized that I had played with them for too long for them to give me up easily. I asked why they didn’t want to play “Sano, sano, enfermo” anymore, and one child responded shyly that they wanted me to teach them more new games. Relenting, I handed the form back to Stacey, who was well in control of the record-keeping, and went back outside. I realize that the kids had already gotten a bit attached to me. It might be the fact that I´m someone new and different, a gringa – someone who´s willing to pay attention to them and even play among them! It might also be all the crazy, dramatic facial expressions I tend to make, which always tend to draw a laugh from the kids.
    In any case, I decided to try once again the Cubre La Boca / Cover Your Mouth game, this time with a space restriction so they couldn’t run out all around and create complete chaos. I must not have explained myself well, because as soon as I yelled, “GO!” all the kids left the designated square and ran out to the field. Despite this misunderstanding, the game worked out really well! Everyone followed the rules perfectly! A fog had settled on the field, creating a very surreal atmosphere. Running around with all the other kids really made me feel like I was eight years old again!

week-4-062

Playing Cubre La a Boca – take note as one boy reminds the other in red to cover his mouth after he´s tagged!

After that point, the kids taught me some of the games that they commonly play. One of them, I was happy to see, involved listing a series of fruits, where each participant had been named a specific fruit! When it was time to go, I recapped the lesson, and said my goodbyes. What a great day!

Last Day at Planchaloma
On Saturday, we got ready as per normal and set up the lab-in-a-backpack to receive patients at the health clinic. We ran several centrifuge tests, urine tests, as well as tests for the presence of parasites. The most memorable patient was a young, very depressed-looking nineteen-year-old man who walked in. The lab students examined his stool sample to discover that he not only had a very serious bacterial infection, but also that he had several major parasites! They had laid eggs in his refuse, which were clearly visible with the microscope. Poor guy!

Lesson of the day: Parasites are no fun.

week-4-071

Carlos is not a fan of the stool exams

A Short Weekend
We then cleaned up the clinic as best we could. Being perfectly honest, it was a little disgusting. The laboratory – our kitchen – was filled with fruit past their prime and dead insects hidden behind appliances. We scrubbed, mopped, and swept away what we could and packed all of our belongings. Maria Alicia drove us all back, and we stopped at an amazing café in the middle of the countryside to have lunch. After dropping off the lab students and coming back to Maria Alicia´s home, we watched a couple movies on TV. The next day we met up with Marisol’s family once again, where we had some great seafood and (surprise!) watched a movie. Later that day Stacey and I were able to call our fathers for Father’s Day!

Explanation of the Blog´s Title
The bionalaysis students who worked with us this week taught Stacey and me a lot of cool, “hip” phrases that young people say these days in Ecuador. My favorite word, by far, is the equivalent of “dude” – “mijín.” The lab students called each other Mijín for the duration of the trip; they also liked to give us nicknames. One of the ones they gave to me, signifying someone who is particularly skinny, is “tripa seca” – meaning dried tripe!

Coming Soon
For this upcoming week, we were unable to get any bionanalysis students to come up to Planchaloma, so Stacey and I are staying in Quito. We’re going to work on record keeping and present the lab-in-a-back to the Ministry of Health…wish us luck!

Powered by WordPress