This will be my last post from within the borders of Ecuador. Tonight I leave at midnight but need to leave my hostal 5 hours ahead of time to allow for traffic and gliches at the brand new airport. Yep, in classic ecuadorian style they have been building a new airport for several years and it has been completed but unusable until Feb 20th, 2013 because they didn´t quite get the timing of building the road right. Hmm, who builds an airport without a road that can access it? Silly Ecuadorians.
We spent the last week in the rainforest along the Napo river in the Amazon. There are many things I adored about the rainforest. After about 5 hours on the bus we stopped at a waterfall along the side of the road. As the bus pulled in we were greeted by dense humidity, the sound of a waterfall in the distance and butterflies. Walking down the hill the beautiful watefall (did you all know I´m a huge sucker for watefalls, absolutely love them) more butterflies materialized, there were literally hundredes of them of several different varieties flying to and fro. If I´d been standing next to that waterfall petting a horse and eating a bar of chocolate I would have thought I´d died and gone to heaven. Alas I would never have a heaven without horses and chocolate so despite the waterfall and butterflies I knew I was still among the living.
After this amazing experience I was even more excited about our journey into the rainforest. When we arrived a couple hours later at the edge of the napo river we unloaded and looked forward to our next leg of the journey, a 10 minute motorized canoe ride down the river. Yep, there are no roads where we went. After disembarking from the canoe we ventured into the jungle on the 15 minute walk towards the high school or colegio where we would be staying. Sweating profusely from the 99.9% humidity and swatting away bugs we arrived at our barracks. I was instantly reminded of summer camp or outdoor school. The rooms had screens with holes large enough for birds to fly through and no screens between the walls and the roof so we would be sleeping in open air bunk beds. There was no internet and no electricity expcept when they turned on the generator for 4 hours in the evenings. It was perfect. After settling our things and putting on less oppressive clothing our fantastic guide Robert took us on a tour of the jungle. The man had super human senses and caught various bugs and frogs to demonstrate the local wildlife as we walked to an extraordinary view point where we watched the sun set over the Amazon rainforest and the Napo river. One of the frogs was poisonous enough to kill a human if you dared lick it, but honestly who would voluntarily lick a frog? The viewpoint was a scene very few have the priviledge to see and it was incredible.
The next three days took us on journeys to various communities surrounding the napo. Now, I know at OHSU we have a ´rural´ medicine rotation but this experience changed my view of rural forever. Picture this- 7-9 hour bus ride from Quito, 20 minute motorized canoe ride and 1 hour walk through the jungle, now that my friends is rural. With our bags of medicine and supplies we ventured to communities where once again the biggest problems is parasites from drinking non-boiled water, headaches from squinting constantly and nutritional deficiencies from lack of vitamins. We tried to complete as much patient education as possible but this is difficult when 11 year olds show up at your school desk without parents. Trust me an 11 year old has no idea if his mom boils the water and forget asking about how long. To make matters slightly more challenging on our second day we had a torential downpour in the middle of our brigade and rain on a tin roof makes it extremely difficult to hear your patients, let alone listen to hearts and lungs. I witnessed children drinking out of the river and running around barefoot in a an area endemic with hook worms. Sigh, you can´t fix everything. Interestingly in this community we also saw a lot of pterygium, for non-meddie folks that is where an extra layer of tissue grows towards the center of your eye. We saw several patiens who had not had medical care for so long that this relatively easy to fix growth had left them blind by growing over their pupil. Although we referred them to the nearest clinic it´s a little uncertain as to whether or not they will actually get the attention they need, tragic.
These health brigades were some of the most satisfying. In the afternoons we had various other activities such as practicing our blow dart skills - I didn´t win but hell at least I got close to the target! I´ll add that to my talent list in case I need to apply to residency again, haha. We hiked another day and went back to the old Yachana lodge where we were originally scheduled to stay. However, it was sold to the canadian organization Free the Children and they took over operations in January. The lodge has a gorgeous deck overlooking the Napo and we gazed at the scenery and chatted with one of the team members. It´s a cool organization, more information here - http://www.freethechildren.com/.
Our 17 year old chef prepared all the meals we eagerly consumed while in the rainforest and they were amazing. The colegio teaches all the students spanish and english and gives them opportunities to learn trades such as tourism or cooking, it´s a fantastic place with a wonderful mission run by a nice gentleman originally from Kentucky who has been in Ecuador since 1992. The kids had dinner with us each night and practiced their english while we practiced our spanish. Each year they also try to send one or two kids to the US for a year at a private high school. Fernando, who accompanied us on two of our health brigades will be heading to Austin, TX this summer. We tried to tell him how great Austin is while also preparing him for the culture shock of the US especially since he grew up in the jungle and took a canoe to school. He´s a good kid and it will be a great opportunity for him.
Overall, the rainforest was one of the most intriguing places I´ve ever been. The plant life, the beautiful birds, the exotic animals and all the delicous tropical fruit you could possibly want. I´ll admit I did miss having warm showers, cool air and no humidity. My least favorite part of the rainforest? The bugs! They have bugs as big as small birds and the thing about insects is that unlike their flying bird friends they have no respect for human space. When a grasshopper hops it´s way onto your shirt in the middle of dinner or during a patient enounter and you swat it away frantically you risk looking loco and let me tell you I did some crazy swatting more than once, floundering around like a chicken with its head cut off. Oh well, I miss the rainforest but definitely not the bugs.
Well, that´s all from Ecuador. I didn´t write much but hopefully enough to give anyone interested at least a superficial picture of life here. I expect in the future I will refer to these notes and be glad I have them to supplement my many hundreds of photos and burn this awesome experience into my memory forever. Home will be a welcome place but I´m going to miss traveling, the new experiences, the language and the richness of growing in a new culture. Who wants to have cookies and big glass of red wine waiting for me?
Ciao!
Saturday, March 2, 2013
Thursday, February 21, 2013
Quito
We have spent this week in Quito. The sun is shining and after being in clinic all morning I have ants in my pants so this may be quicker. If you are bored while reading imagine me dancing around like I have ants in my pants, jig jig jig. Beautiful picture I know. Ok, moving on.
So we have had Spanish class in the mornings and afternoons this week except yesterday when we went to the medical museum. Be prepared, here comes a rant. I am so sick of the machismo crap in this culture. We walked up to the building and split into two groups. My group had 5 girls and 2 guys and of course the male tour guide looked at the two men and asked if they were going to be doctors and then at the women and asked if we were going to be nurses. No! I´m in MEDICAL SCHOOL, not nursing school!! I am a woman and I´m going to be a damned DOCTOR! Ugh, what is wrong with people? Nursing is a fantastic job but just becuase I am a woman does not mean I can´t be a doctor and a surgeon.
Ok, stepping off soap box, or at least onto a different one. As the 8 of us crowded into a tiny elevator to begin our tour the guide stood at the door approximately 4 inches from my face and asked everyone´s names. Seems normal right? Wrong. The doors had already opened on the floor we were going to get off at and he just stood there talking as though we were going to have the entire tour in the tiny elevator. Haha, awkward moment. We then asked him to speak in short sentances so we could translate for the less advanced speakers and he told us this was not possible, ok, that makes no sense. We then spent 30 minutes 60 minute tour talking about one painting and not even about the medical relevance of the painting.
The tour was terrible but makes for good stories. Just imagine a slightly creepy man with his face 4 inches from mine, elevator door open, him blocking it and everyone wondering why we are still standing there. Haha, it does make me laugh now. The rest of the museum was actually really fascintating. There was a table that is 170 years old and contains many bottles of meds from original hospital. The first EKG in Ecuador was also in the museum. Amazingly, speculums have not changed at all. Torturing women´s lady parts for 200 years.
I went to clinic this morning and it was an interesting experience. Mostly, they gave every woman antifungals or metro for vaginal infections. The worst was watchign a woman have cauteization of her cervice for dysplastic changes, she was crying but at least her partner was there with her holding her hand as she endured the pain. It was actually quite wonderful to see how supportive he was. Ever heard of penoscopy? Yeah, me neither. It´s like a colposcopy but on a penis. Hmm, maybe if more men in the US had to endure the same torture as women it would motivate them to get vaccinated againsta HPV. Just a thought. Anyway, we have our last private spanish lesson this afternoon and then this weekend we have some time off. Then on Sunday we are heading to the rainforest and I won´t have internet access until the following Friday and then home Sunday. I can´t believe my trip is almost over.
Ciao!
So we have had Spanish class in the mornings and afternoons this week except yesterday when we went to the medical museum. Be prepared, here comes a rant. I am so sick of the machismo crap in this culture. We walked up to the building and split into two groups. My group had 5 girls and 2 guys and of course the male tour guide looked at the two men and asked if they were going to be doctors and then at the women and asked if we were going to be nurses. No! I´m in MEDICAL SCHOOL, not nursing school!! I am a woman and I´m going to be a damned DOCTOR! Ugh, what is wrong with people? Nursing is a fantastic job but just becuase I am a woman does not mean I can´t be a doctor and a surgeon.
Ok, stepping off soap box, or at least onto a different one. As the 8 of us crowded into a tiny elevator to begin our tour the guide stood at the door approximately 4 inches from my face and asked everyone´s names. Seems normal right? Wrong. The doors had already opened on the floor we were going to get off at and he just stood there talking as though we were going to have the entire tour in the tiny elevator. Haha, awkward moment. We then asked him to speak in short sentances so we could translate for the less advanced speakers and he told us this was not possible, ok, that makes no sense. We then spent 30 minutes 60 minute tour talking about one painting and not even about the medical relevance of the painting.
The tour was terrible but makes for good stories. Just imagine a slightly creepy man with his face 4 inches from mine, elevator door open, him blocking it and everyone wondering why we are still standing there. Haha, it does make me laugh now. The rest of the museum was actually really fascintating. There was a table that is 170 years old and contains many bottles of meds from original hospital. The first EKG in Ecuador was also in the museum. Amazingly, speculums have not changed at all. Torturing women´s lady parts for 200 years.
I went to clinic this morning and it was an interesting experience. Mostly, they gave every woman antifungals or metro for vaginal infections. The worst was watchign a woman have cauteization of her cervice for dysplastic changes, she was crying but at least her partner was there with her holding her hand as she endured the pain. It was actually quite wonderful to see how supportive he was. Ever heard of penoscopy? Yeah, me neither. It´s like a colposcopy but on a penis. Hmm, maybe if more men in the US had to endure the same torture as women it would motivate them to get vaccinated againsta HPV. Just a thought. Anyway, we have our last private spanish lesson this afternoon and then this weekend we have some time off. Then on Sunday we are heading to the rainforest and I won´t have internet access until the following Friday and then home Sunday. I can´t believe my trip is almost over.
Ciao!
Tuesday, February 19, 2013
¡Baños!
¡Hola Amigos!
Friday all 15 of us took advantage of our one free weekend and ventured to Baños, an amazing city tucked away in the mountains about 3-5 hours from Quito. Seems like a big range of time right? All the buses claim to be direct but direct is not a word Ecuadorians understand so instead of hoppping on the highway and making our way to Baños we enjoyed a number of meandering detours through the countryside, once again traversing paths no bus in the US would dare go. So, the time it takes to get to Baños depends mostly on how circumlocuitous your route becomes and on the aggresiveness of the driver. Take for example our ride back where in our huge bus the driver was hauling past little sports cars around turns like they were standing still. I´m fairly certain our bus was driving on two wheels for a greater duration of our return trip than we would have preferred. In fact I quite appreciate it when cars and buses keep all four wheels firmly churning against the pavement at all times but hey beggars can´t be choosers right?
When we arrived in Baños Linds, Anne, Trissa and I set off with the boys in search of Princessa Maria, the hostel we hoped to call our home for the next two nights. Seeing as how the boys already had a reservation for themselves and we only had tentative email contact, the girls weren´t sure if we would successfully secure a bed to sleep in. After some meandering and many rounds of questioning random people about the location of this hostal we successfully reached a charming blue building with decoratinos that can only be described as slighty ecclectic but fitting. Princessa Maria is run by a father and son who are two of the nicest people we have run into in Ecuador and so we each put in our $7/night and settled our gear before venturing out to quench our growing hunger.
Saturday was dedicated as adventure day extraordinaire. A large group of us set up a canyoning experience. What´s that you say? You have no idea what canyoning is but it sounds awesome! Yep, it is. Basically you don a wetsuite, harness, helmet and knee pads and head for las cascadas or waterfalls. If you´ve top-roped you know the satisfaction of the journey back down the wall. Now imagine climbing down a waterfall surrounded by the Andes and tropical plants and you have the epic experience of canyoning. The tallest waterfall was about 45 meters of awesomeness. Having huge fears of drowing and heights this was a serious face-your-fears situation for me and well worth the internal pep talk. I had a blast. We have pics that I will try to add when I get them uploaded onto my laptop. Our guides were two hilarious Ecuadorian men who loved to shout woohooo everytime someone repelled. By the end our adrenaline was exhausted and the shivering set in. On the way back into town we stopped for hot tea that Linds astutely noted tasted just like fruit loops, yumm. So, we sat rewarming in the tiki hut before piling 12 people into a very small pickup. No, that wasn´t a typo, 6 in the cab, 6 in the truck bed. Good thing we didn´t hit any big bumps.
After venturing back into town Linds, Anne and I pulled on our hiking shoes and ventured into the surrounding mountains up the Bella Vista to a gorgeous overlook of the entire town. It´s too bad it was a bit of cloudy day but we were still able to appreciate the beauty. We then continued up higher in search of a resort called Runtun. The trail was not so much a trail as a mini gorge that certainly becomes home to a stream with enough rain. Towards the top of the mountain we wandered down a road and made a new friend named Christian. I think he was about 6 and when we asked him where Runtun was he looked at us like we were crazy and said aqui! Oh, oops we found the town of Runtun not the resort, still a good hike. That night we ventured to the hot springs in town that sit right next to the biggest waterfall. It was very relaxing and comfortable except for the whole getting stared at by every single other person there You would think they had never seen a white girl in a swimsuit before, oy vey. The other not-awesome part of the hot springs - getting my butt pinched by one of the creepiest men ever. After sequestering the girls into a corner and giving him the look of death for a while he finally left. However, he was spooky enough that we kept an eye out for him on our way back to our hostel, no sightings thankfully.
Sunday Linds and I woke up early to head to the big cemetary in town. I know what you are thinking, why would you go to a cemetary? We are lucky we share the same slightly off-beat fascination with cemetaries. Just think about all the stories in the stones, it´s amazing. My fascination with cemetaries started in elementary school when my class ventured to the local graveyard to complete rubbings of different headstones and learn about how some people lived and died. I´ve loved them ever since because while death is sad it is more interesting to think about someone´s life. Also, when you find really old graves the history is fascinating. Cemetaries are a good reminder that our time is limited so we should enjoy it. In fact I think we will try to find a few more while here in Quito.
We then went to meet up with other friends to go on another hike but our plans changed. One of the members of our group had spent the moring in mass and as she leaned over to give the sign of peace to her neighbor some jackass stole her bag. Yes, you read that correctly he stole it in the middle of church during the sign of peace. I´m not even religious and I find that incredibly offensive. One thing is for sure, he has collected some seriously bad karma. The biggest loss was her camera. Thankfully most of her money and her passport were left securely in our hostal and she has trip insurance so she will get reimbursed for the camera. The real devestatation is loss of the pictographic eveidence of awesome memories and the extreme violation of trust in a place of solidarity and spirituality.. We spent the morning talking with the police and wandering around town hoping the perpetrator would be stupid enough to have the bag in plain sight. If he was, we weren´t lucky enough to spot him.
On our way to the bus station we loaded up on chocolate-banana empañadas, so delicious. Then it was onto the bus driven by our wannabe race car driver and back to mami Gloria´s where delcious dinner was awaiting our arrival.
More about our trip to old town, spanish classes, clinic, the medical museum and adventures in Quito in a day or two.
Hakunah matata! (hey, that´s not spanish! nope, but with match coming up it is my new moto!
Friday all 15 of us took advantage of our one free weekend and ventured to Baños, an amazing city tucked away in the mountains about 3-5 hours from Quito. Seems like a big range of time right? All the buses claim to be direct but direct is not a word Ecuadorians understand so instead of hoppping on the highway and making our way to Baños we enjoyed a number of meandering detours through the countryside, once again traversing paths no bus in the US would dare go. So, the time it takes to get to Baños depends mostly on how circumlocuitous your route becomes and on the aggresiveness of the driver. Take for example our ride back where in our huge bus the driver was hauling past little sports cars around turns like they were standing still. I´m fairly certain our bus was driving on two wheels for a greater duration of our return trip than we would have preferred. In fact I quite appreciate it when cars and buses keep all four wheels firmly churning against the pavement at all times but hey beggars can´t be choosers right?
When we arrived in Baños Linds, Anne, Trissa and I set off with the boys in search of Princessa Maria, the hostel we hoped to call our home for the next two nights. Seeing as how the boys already had a reservation for themselves and we only had tentative email contact, the girls weren´t sure if we would successfully secure a bed to sleep in. After some meandering and many rounds of questioning random people about the location of this hostal we successfully reached a charming blue building with decoratinos that can only be described as slighty ecclectic but fitting. Princessa Maria is run by a father and son who are two of the nicest people we have run into in Ecuador and so we each put in our $7/night and settled our gear before venturing out to quench our growing hunger.
Saturday was dedicated as adventure day extraordinaire. A large group of us set up a canyoning experience. What´s that you say? You have no idea what canyoning is but it sounds awesome! Yep, it is. Basically you don a wetsuite, harness, helmet and knee pads and head for las cascadas or waterfalls. If you´ve top-roped you know the satisfaction of the journey back down the wall. Now imagine climbing down a waterfall surrounded by the Andes and tropical plants and you have the epic experience of canyoning. The tallest waterfall was about 45 meters of awesomeness. Having huge fears of drowing and heights this was a serious face-your-fears situation for me and well worth the internal pep talk. I had a blast. We have pics that I will try to add when I get them uploaded onto my laptop. Our guides were two hilarious Ecuadorian men who loved to shout woohooo everytime someone repelled. By the end our adrenaline was exhausted and the shivering set in. On the way back into town we stopped for hot tea that Linds astutely noted tasted just like fruit loops, yumm. So, we sat rewarming in the tiki hut before piling 12 people into a very small pickup. No, that wasn´t a typo, 6 in the cab, 6 in the truck bed. Good thing we didn´t hit any big bumps.
After venturing back into town Linds, Anne and I pulled on our hiking shoes and ventured into the surrounding mountains up the Bella Vista to a gorgeous overlook of the entire town. It´s too bad it was a bit of cloudy day but we were still able to appreciate the beauty. We then continued up higher in search of a resort called Runtun. The trail was not so much a trail as a mini gorge that certainly becomes home to a stream with enough rain. Towards the top of the mountain we wandered down a road and made a new friend named Christian. I think he was about 6 and when we asked him where Runtun was he looked at us like we were crazy and said aqui! Oh, oops we found the town of Runtun not the resort, still a good hike. That night we ventured to the hot springs in town that sit right next to the biggest waterfall. It was very relaxing and comfortable except for the whole getting stared at by every single other person there You would think they had never seen a white girl in a swimsuit before, oy vey. The other not-awesome part of the hot springs - getting my butt pinched by one of the creepiest men ever. After sequestering the girls into a corner and giving him the look of death for a while he finally left. However, he was spooky enough that we kept an eye out for him on our way back to our hostel, no sightings thankfully.
Sunday Linds and I woke up early to head to the big cemetary in town. I know what you are thinking, why would you go to a cemetary? We are lucky we share the same slightly off-beat fascination with cemetaries. Just think about all the stories in the stones, it´s amazing. My fascination with cemetaries started in elementary school when my class ventured to the local graveyard to complete rubbings of different headstones and learn about how some people lived and died. I´ve loved them ever since because while death is sad it is more interesting to think about someone´s life. Also, when you find really old graves the history is fascinating. Cemetaries are a good reminder that our time is limited so we should enjoy it. In fact I think we will try to find a few more while here in Quito.
We then went to meet up with other friends to go on another hike but our plans changed. One of the members of our group had spent the moring in mass and as she leaned over to give the sign of peace to her neighbor some jackass stole her bag. Yes, you read that correctly he stole it in the middle of church during the sign of peace. I´m not even religious and I find that incredibly offensive. One thing is for sure, he has collected some seriously bad karma. The biggest loss was her camera. Thankfully most of her money and her passport were left securely in our hostal and she has trip insurance so she will get reimbursed for the camera. The real devestatation is loss of the pictographic eveidence of awesome memories and the extreme violation of trust in a place of solidarity and spirituality.. We spent the morning talking with the police and wandering around town hoping the perpetrator would be stupid enough to have the bag in plain sight. If he was, we weren´t lucky enough to spot him.
On our way to the bus station we loaded up on chocolate-banana empañadas, so delicious. Then it was onto the bus driven by our wannabe race car driver and back to mami Gloria´s where delcious dinner was awaiting our arrival.
More about our trip to old town, spanish classes, clinic, the medical museum and adventures in Quito in a day or two.
Hakunah matata! (hey, that´s not spanish! nope, but with match coming up it is my new moto!
Monday, February 18, 2013
CENIT
I haven´t written in a few days so I´m going to try to write two posts today. I think they need to be separated because the experiences were so vastly different it feels like as disservice to put everything in one very long, drawn out post. A few days ago I started re-reading some of my posts and have noticed a significant deterioration in my ability to write above the level of 6th grader. This is probably occurring because when I try to form sentances in Spanish my level of sophistication is approximately that of 12 year old. Seems like maybe I can´t talk in either language anymore but I will try smarten it up a bit, haha.
So onto CENIT. CENIT is a fantastic organization in Quito that was initially started by the Sisters of the Good Shepard in 1991. The mission of the organization was conceptualized to provide schooling to working children in Quito who lived in such extreme poverty that they were required to go to work at a young age to help their families earn enough money to eat. Being an incredibly masoginistic culture the men were always treated better than the woman and allowed to remain in school so it is the young girls who suffer the most. Observing this problem the Sisters started a school for young girls where they were educated in the traditional manner and also in trade skills, allowing them to obtain a better job upon gradution. They have a deal with the families which states the entire family will be provided with meals as long as they children continue to attend school on a regular basis. It is really an amazing cause and today the elementary school is also open to the brothers of girls who attend school at CENIT.
Now you might be wondering what our role was in this whole situation. We spent Thursday and Friday of last week holding clinics where we saw every teenage girl who attends school there and also some of their parents. One of the most difficult parts of these clinics was talking with these young girls about very difficult subjects such as violence in the home, if they had enough to eat and sexual activity in a room full of people. We did our very best to make sure conversations were kept as private as possible but I can´t help but think many of these girls were not as honest as they would have been if their friends weren´t sitting 20 feet from them observing their clinic visits. Another huge challenge is attempting to listen to heart sounds in a very noisy room. Sheesh, I have enough trouble hearing murmurs in dead silence.
However, because CENIT is a great organization full of very conscientious volunteers I think these girls have a much greater chance of receiving the medical care we intend them to have than other groups we have seen. On the second day Leah and I made the decision to function completely on our own since one of the preceptors was a 4th year Ecuadorian med student and the other was a an RN who was nice but thought Albendazol and Lansoprazol were in the same class of drugs. Yep, after a few interactions we made the choice to function on our own which was great since it made our interactions much more efficient and we asked for input if something was really complicated.
Anyway, se la vie. I think we did some good for these girls. This week we have a lot of spanish class in the afternoon and clinic in the mornings with a visit the the medical museum and medical school on Wednesday. Should be interesting!
Ciao!
So onto CENIT. CENIT is a fantastic organization in Quito that was initially started by the Sisters of the Good Shepard in 1991. The mission of the organization was conceptualized to provide schooling to working children in Quito who lived in such extreme poverty that they were required to go to work at a young age to help their families earn enough money to eat. Being an incredibly masoginistic culture the men were always treated better than the woman and allowed to remain in school so it is the young girls who suffer the most. Observing this problem the Sisters started a school for young girls where they were educated in the traditional manner and also in trade skills, allowing them to obtain a better job upon gradution. They have a deal with the families which states the entire family will be provided with meals as long as they children continue to attend school on a regular basis. It is really an amazing cause and today the elementary school is also open to the brothers of girls who attend school at CENIT.
Now you might be wondering what our role was in this whole situation. We spent Thursday and Friday of last week holding clinics where we saw every teenage girl who attends school there and also some of their parents. One of the most difficult parts of these clinics was talking with these young girls about very difficult subjects such as violence in the home, if they had enough to eat and sexual activity in a room full of people. We did our very best to make sure conversations were kept as private as possible but I can´t help but think many of these girls were not as honest as they would have been if their friends weren´t sitting 20 feet from them observing their clinic visits. Another huge challenge is attempting to listen to heart sounds in a very noisy room. Sheesh, I have enough trouble hearing murmurs in dead silence.
However, because CENIT is a great organization full of very conscientious volunteers I think these girls have a much greater chance of receiving the medical care we intend them to have than other groups we have seen. On the second day Leah and I made the decision to function completely on our own since one of the preceptors was a 4th year Ecuadorian med student and the other was a an RN who was nice but thought Albendazol and Lansoprazol were in the same class of drugs. Yep, after a few interactions we made the choice to function on our own which was great since it made our interactions much more efficient and we asked for input if something was really complicated.
Anyway, se la vie. I think we did some good for these girls. This week we have a lot of spanish class in the afternoon and clinic in the mornings with a visit the the medical museum and medical school on Wednesday. Should be interesting!
Ciao!
Wednesday, February 13, 2013
Temescal
Well we are back in Quito. This week will be dedicated to more health brigades and lots of Spanish class. I think the brigades will be going a little more smoothly from here on out, now that we have figured out a little about what our roles are when we get to the communities. The more populated brigades should be an interesting change from the ones in rural communities and I´m lookign forward to observing the differences.
For our last night in Peguche we all participated in Temescal. In temescal there is a dome with a pit in the middle. Everyone piles in and sits in two circles surrounding the central pit. In the pit they put hot stones in and then close the door so it is dark. There are four rounds, water, wind, fire and eartth. Steam and incencse fill the dome and it gets very very hot. Most of the time I put my head on the floor even while we were singing since heat rises. It was a lot easier to breath with my head down low. The point of Temescal is a cleansing and spiritual journey. I´m glad I participated but I´m not sure if I would do it again, perhaps if the opportuinity presented itself since it really was a fascintating experience.
The worst round was the third round or Fire. This was the worst because the woman in charge poured water over the steaming hot stones in the middle and a rush of extremely thick, hot air filled the dome. My eyes were burning. I was a bit overwhelmed but breathing through it until others panicked and started crushing me in an attempt to get away from the heat, that was not so fun. Overall, our entire group was able to make it through all four rounds and I was proud of everyone for sticking with it.
Afterwards we prepared a very traditional dinner of many veggies and chicken that is cooked in a hole in the ground. We put very hot stones in a hole and then put the food down in layers with layuers of cabbage separating some of the bigger and smaller types of food. When the hole was filled the entire thing was covered with two blankets, dirt and traditional decorations and left to cook for about an hour. When we removed everything it was extremely delicious and we were able to eat with our hands which was awesome. Overall, it was a great experience and one I am grateful to have had since I don´t think too many people really get to immerse themselves in another culture the way our group was able to experience this traditional ecuadorian meal and cleansing.
Anyway, that´s all for now. I´ll try to write again in a couple days!
For our last night in Peguche we all participated in Temescal. In temescal there is a dome with a pit in the middle. Everyone piles in and sits in two circles surrounding the central pit. In the pit they put hot stones in and then close the door so it is dark. There are four rounds, water, wind, fire and eartth. Steam and incencse fill the dome and it gets very very hot. Most of the time I put my head on the floor even while we were singing since heat rises. It was a lot easier to breath with my head down low. The point of Temescal is a cleansing and spiritual journey. I´m glad I participated but I´m not sure if I would do it again, perhaps if the opportuinity presented itself since it really was a fascintating experience.
The worst round was the third round or Fire. This was the worst because the woman in charge poured water over the steaming hot stones in the middle and a rush of extremely thick, hot air filled the dome. My eyes were burning. I was a bit overwhelmed but breathing through it until others panicked and started crushing me in an attempt to get away from the heat, that was not so fun. Overall, our entire group was able to make it through all four rounds and I was proud of everyone for sticking with it.
Afterwards we prepared a very traditional dinner of many veggies and chicken that is cooked in a hole in the ground. We put very hot stones in a hole and then put the food down in layers with layuers of cabbage separating some of the bigger and smaller types of food. When the hole was filled the entire thing was covered with two blankets, dirt and traditional decorations and left to cook for about an hour. When we removed everything it was extremely delicious and we were able to eat with our hands which was awesome. Overall, it was a great experience and one I am grateful to have had since I don´t think too many people really get to immerse themselves in another culture the way our group was able to experience this traditional ecuadorian meal and cleansing.
Anyway, that´s all for now. I´ll try to write again in a couple days!
Tuesday, February 12, 2013
Espuma, Big Buses and Small Roads
Today our group fully embraced Carnival. Now since that is a great story and out of order from yesterday's frightening bus ride I'll continue in proper sequence and add some photos today.
Oh and a brief update on the mystery of the sudden onset illness that plagued the group. The culprit: phytohaemagglutinin, a toxin found on uncooked beans. While we were out picking corn there were also beans growing in the field and Slav (UMDNJ), John (UMDNJ), Amy (New Mexico) and Trissa (Medical College of Wisconsin) decided to partake in feasting but rest easy they have all recovered completely. Ok, now onward and upward - literally up into the mountains and above the clouds. Sounds amazing right? Well, the photo ops were amazing but the very big bus on the very small road on the very steep cliff was terrifying. I'm talking dirt road and very tight corners. At one point the back wheel slid a bit and well we definitely strategized to jump to the other side of the bus to put all the weight on the side opposite the huge cliff. But hey we lived to tell about it. So maybe you are wondering what the heck a bunch of Americans were doing on a bus up in the middle of nowhere. The community where we went was Padre Chupa which only has about 50 people.
As we neared the school up in the mountains that we used for our clinic there was a family on the side of the road who were all showering together outside. I'm not sure who was more surprised us to see them or the family to see a huge bus full of gringos in their rural community. The one room schoolhouse became our new clinic and people poured out of the woodwork for a few hours as we saw patients at our miniature tables and chairs more appropriately sized for those 3-10 years old. This clinic was less chaotic now that we have the routine down and I can now understand almost all of what someone says to me - now speaking that is a different story. My brain and tongue can't seem to keep pace with each other.
After our journey back down the mountain we went back to the El Mercado into Otovalo. I bought a gorgeous piece of artwork made out of corn that will look beautiful in my living room, wherever that living room may be be over the next 5 years. On the way home we spent the journey dodging children with water, espuma and corn starch died all variety of colors. I was super annoyed by this situation considering I was still in clinic clothes and carrying a new piece of artwork that wouldn't agree with water. Anne and I made it back only getting espuma'd once - I think my look of death helped fend off most of the little devils.
In the evening we went to see Nanda Manachi, a farely well known band from Ecuador who lives here in Peguche. We watched the lead member make one of his small instruments out of reeds in about 5 minutes and it was amazing. Afterwards he demonstrated all the instruments and let us play with them. Let's just say I'm not musically gifted and the only thing I could get to work was a whistle and that was even a bit of a struggle. I guess I'm not as full of hot air as some people claim, eh hem, family, you know who you are :). Needless to say it was awesome except for the street fight we were in the middle of on the way there - hmm, sometimes espuma goes wrong when there are too many teenage boys with their high testosterone and unmyelinated frontal lobes running wild on the streets.
It's literally like a war zone here with children running rampid along the streets. Today we decided to give up and partake in the festivities. So armed with espuma, bombas and corn starch we hit the streets. The pack of gringos held our own. Since John gave me some of his powder and starch I was able to fight back when I got espuma'd in the face many a time. It was actually a blast. One teenage punk espuma'd all of us as he was driving by so I sailed a bomba right through his open car window, muahaha - he wasn't expecting us to fight back. As we returned we were all covered in mud, very colorful powder and espuma juice. We have some awesome photos, stay tuned.
We are getting ready to leave for Temescal now which is basically a three hour sweat followed by cookign traditional food in a stone pit. More on that excitement tomorrow.
Now I'm going to look carefully out the window before bolting back to my room in an attempt to avoid the packs of children running through the streets with their "weapons". Carnival was a blast while we were willing particpants but now we are back in avoidance mode.
Hasta luego amigos!
P.S. If you are dying for more reading Linds writes a lot more often than I do: portlandiatoecuador.blogspot.com
Sunday, February 10, 2013
Markets and medicine and cui ... oh my
Hola!
I think our first true health brigade was a success but I struggle with the idea that I'm not actually doing a lot to help the people of this country. We traveled to an area further in the mountains where there is a small school. The people from the community lined up in the cement courtyard between our "eye clinic" and "regular clinic" in our makeshift waiting room. Our clinic consisted of one room with 6 small school tables where we had our conversations with our patients, a table for check in and a table for our mobile pharmacy. There is no privacy. One young girl needed an abdominal exam so Misha (Indiana) and I had to take her outside in the courtyard and have her lay down on the cement steps. We put our coats down so she wouldn't get dirty and others watched as we listened, pushed and tapped on her abdomen. It's a very strange thing to have what in the US we consider very private conversations in a room full of people.
Misha and I successfully treated several patients but our last two patients didn't speak Spanish so we had a three way translation: Kichwa to Spanish to English - now there is a chance to have important information lost in translation. Of course these were also our two most complicated patients of the day with alarming symptoms such as spontaneous, intermittent complete vision loss. Sigh, it truly is sad. However I was also struck by the parallels between the poor here and the poor in the US. They have bad diets, stop taking their medications because they run out and don't seek medical care because it's too expensive. The differences? In the US many of the poorest patients with the worst health problems have severe substance abuse problems. In Ecuador the poorest people don't have food or warm places to sleep and they are poor becuase they are indiginous or marginalized, not because they did anything to bring it upon themselves. However, I was also struck by the number of things that are actually available to the people here. Many services and medications are free. There are even basic surgical procedures such as appendectomies, tubal ligations, some joint replacements and others that are completely free of charge. The free services shocked me. If a country that is economically unstable can offer free necessary surgery to its citizens why can't we? Of course I know there are many difficult political and cultural reasons for our poor health care system but it makes me think and makes me a bit more frusturated with our own system. The day was mentally and emotionally exhausting.
We haven't had much in the way of down time since we have been here. In fact I've had hardly any time to just sit and reflect on our trip so this is a healthy time right now. Today we had several interesting adventures. In the morning we went Agato where we met up with some traditional Ecuadorian healers. First we walked around in the mountains learning about various plants and their different medicinal uses. I'm going to attempt cataloguing them soon with the help of my fellow travelers. After looking at different plants we ventured into one of the many corn fields. They can compete with the midwest for the cornfield density prize. They have a tree here called the lechero tree that they plant around the corn fields. Legends tell the indiginous people these trees are protectors and all connected to the mother tree which is up on the side of one of the mountains surrounding the valley where Otovalo and Peguche rest. Lechero are planted around the corn fields as protectors for the corn and they are said to never die. The leaves also contain a milk-like substance that when applied to the skin gets rid of warts. It certainly seems to be as good as anything I've seen used in the U.S.
Today we sat in a large circle ouside with the mountain sun on our shoulders. In the center was a small fire with a red rug and many herbs next to it. As we watched several students participated in healing and diagnostic ceremonies. Emma was the first to participate. As she stood on the small red rug one of the indiginous healers chanted, perfumed her with burning sage and other herbs and literally swatted her with the leaves of a small plant. Her ceremony was diagnostic. The end result? She is stressed and tired - hmm, considering we are all medical students that isn't too surprising. Next the healers asked for a volunteer who had been through recent emotional turmoil. Well, I was generously volunteered. After quietly removing my shoes and walking to the rug a small elderly indiginous woman chanted and gently brushed my body with beads. During her ceremony she beckoned to the mountains and the water and the trees to give their positive energy to a cup of horchata and an egg. I then drank the horchata and slurped the not quite-completely-cooked egg. I admit I've never been much of a believer in these sorts of things but for the first time in a while I feel energetic and at peace. Hmm, maybe there was something to it. The last ceremony was one with a cui (guine pig). This was the most disturbing because the guinea pig starts alive and then the cut it open at the end of the ceremony. The purpose of cutting it open is to diagnose internal problems for the person in the ceremony. This is an important part of the culture here and so I am grateful for the experience but I'll admit it isn't one I want to have again.
In the afternoon a small group of us set off into the hills to adventure to parque condor. As we walked briskly along the road we had to dodge carnival foam, bombas and buckets of water everytime a car drove by. I think it's cheating if you spray someone or dump water on them from a moving vehicle - we were so defenseless! As we ventured up the mountainside through small villages and past run-down houses I said hello to all the pigs and cows who graze casually along the road. We even had one pig who escaped off his tie and snorted and ran in front of us, trying to evade capture. Haha, pigs aren't that fast but I commend him for trying. We wandered off in the wrong direction and ended up lost so we climbed up a steep hill between corn fields to the road above us and then there was success - we made it to the Condor Park!! It was worth the walk. All over the park there was beautiful landscaping, beautiful views and amazing birds of prey. Eagles, hawks and owls galore - up close and personal.
The big downside of today was that about half our group ended up really sick including sending one of our girls to the hospital with horrible nausea, vomiting and barely able to walk. Fortunately some very wonderful locals helped her out of the parque condor and into a cab to the hospital with two other students. Currently she's still at the hospital and since we don't have great communication abilities here I don't know her status but the rest of the students are sending good thoughts her way.
Now, even though a trip to the hospital is the most recent happening here in Otovalo I needed to end this entry on a more upbeat note. Anne, Linds and I spent a lot of time bargaining in the market. There are beautiful blankets, jewlery and bags and well I made my appropriate contribution to the Ecuadorian economy. My spanish is getting much better as are my bargaining skills and I'm proud to state I've scored some awesome deals and there will be plenty of gifts when I return - I know you are excited!
Ciao!
I think our first true health brigade was a success but I struggle with the idea that I'm not actually doing a lot to help the people of this country. We traveled to an area further in the mountains where there is a small school. The people from the community lined up in the cement courtyard between our "eye clinic" and "regular clinic" in our makeshift waiting room. Our clinic consisted of one room with 6 small school tables where we had our conversations with our patients, a table for check in and a table for our mobile pharmacy. There is no privacy. One young girl needed an abdominal exam so Misha (Indiana) and I had to take her outside in the courtyard and have her lay down on the cement steps. We put our coats down so she wouldn't get dirty and others watched as we listened, pushed and tapped on her abdomen. It's a very strange thing to have what in the US we consider very private conversations in a room full of people.
Misha and I successfully treated several patients but our last two patients didn't speak Spanish so we had a three way translation: Kichwa to Spanish to English - now there is a chance to have important information lost in translation. Of course these were also our two most complicated patients of the day with alarming symptoms such as spontaneous, intermittent complete vision loss. Sigh, it truly is sad. However I was also struck by the parallels between the poor here and the poor in the US. They have bad diets, stop taking their medications because they run out and don't seek medical care because it's too expensive. The differences? In the US many of the poorest patients with the worst health problems have severe substance abuse problems. In Ecuador the poorest people don't have food or warm places to sleep and they are poor becuase they are indiginous or marginalized, not because they did anything to bring it upon themselves. However, I was also struck by the number of things that are actually available to the people here. Many services and medications are free. There are even basic surgical procedures such as appendectomies, tubal ligations, some joint replacements and others that are completely free of charge. The free services shocked me. If a country that is economically unstable can offer free necessary surgery to its citizens why can't we? Of course I know there are many difficult political and cultural reasons for our poor health care system but it makes me think and makes me a bit more frusturated with our own system. The day was mentally and emotionally exhausting.
We haven't had much in the way of down time since we have been here. In fact I've had hardly any time to just sit and reflect on our trip so this is a healthy time right now. Today we had several interesting adventures. In the morning we went Agato where we met up with some traditional Ecuadorian healers. First we walked around in the mountains learning about various plants and their different medicinal uses. I'm going to attempt cataloguing them soon with the help of my fellow travelers. After looking at different plants we ventured into one of the many corn fields. They can compete with the midwest for the cornfield density prize. They have a tree here called the lechero tree that they plant around the corn fields. Legends tell the indiginous people these trees are protectors and all connected to the mother tree which is up on the side of one of the mountains surrounding the valley where Otovalo and Peguche rest. Lechero are planted around the corn fields as protectors for the corn and they are said to never die. The leaves also contain a milk-like substance that when applied to the skin gets rid of warts. It certainly seems to be as good as anything I've seen used in the U.S.
Today we sat in a large circle ouside with the mountain sun on our shoulders. In the center was a small fire with a red rug and many herbs next to it. As we watched several students participated in healing and diagnostic ceremonies. Emma was the first to participate. As she stood on the small red rug one of the indiginous healers chanted, perfumed her with burning sage and other herbs and literally swatted her with the leaves of a small plant. Her ceremony was diagnostic. The end result? She is stressed and tired - hmm, considering we are all medical students that isn't too surprising. Next the healers asked for a volunteer who had been through recent emotional turmoil. Well, I was generously volunteered. After quietly removing my shoes and walking to the rug a small elderly indiginous woman chanted and gently brushed my body with beads. During her ceremony she beckoned to the mountains and the water and the trees to give their positive energy to a cup of horchata and an egg. I then drank the horchata and slurped the not quite-completely-cooked egg. I admit I've never been much of a believer in these sorts of things but for the first time in a while I feel energetic and at peace. Hmm, maybe there was something to it. The last ceremony was one with a cui (guine pig). This was the most disturbing because the guinea pig starts alive and then the cut it open at the end of the ceremony. The purpose of cutting it open is to diagnose internal problems for the person in the ceremony. This is an important part of the culture here and so I am grateful for the experience but I'll admit it isn't one I want to have again.
In the afternoon a small group of us set off into the hills to adventure to parque condor. As we walked briskly along the road we had to dodge carnival foam, bombas and buckets of water everytime a car drove by. I think it's cheating if you spray someone or dump water on them from a moving vehicle - we were so defenseless! As we ventured up the mountainside through small villages and past run-down houses I said hello to all the pigs and cows who graze casually along the road. We even had one pig who escaped off his tie and snorted and ran in front of us, trying to evade capture. Haha, pigs aren't that fast but I commend him for trying. We wandered off in the wrong direction and ended up lost so we climbed up a steep hill between corn fields to the road above us and then there was success - we made it to the Condor Park!! It was worth the walk. All over the park there was beautiful landscaping, beautiful views and amazing birds of prey. Eagles, hawks and owls galore - up close and personal.
The big downside of today was that about half our group ended up really sick including sending one of our girls to the hospital with horrible nausea, vomiting and barely able to walk. Fortunately some very wonderful locals helped her out of the parque condor and into a cab to the hospital with two other students. Currently she's still at the hospital and since we don't have great communication abilities here I don't know her status but the rest of the students are sending good thoughts her way.
Now, even though a trip to the hospital is the most recent happening here in Otovalo I needed to end this entry on a more upbeat note. Anne, Linds and I spent a lot of time bargaining in the market. There are beautiful blankets, jewlery and bags and well I made my appropriate contribution to the Ecuadorian economy. My spanish is getting much better as are my bargaining skills and I'm proud to state I've scored some awesome deals and there will be plenty of gifts when I return - I know you are excited!
Ciao!
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