Tuesday, June 30, 2009

Update for the last full week!

Hey everybody!

So we're having a good time and getting a lot of work done our last week or so in Guayaquil. Yesterday we went to the Maternity Hospital Orames Gonzales. We all split up and did different things so the other too can explain more about the hospital because i went out into the city of Duran for the day. We were doing a Health Survey of a local area. There were about 5 doctors and myself. I had thought I had seen the poverty of Ecuador before, but it was nothing compared to the area we went into. Our job was to go to each house we could find and do a survery of how many people were living there, and their health situation, and finally we would end by inviting them to go the Orames Gonzales if they ever need anything (FYI it is a free, government run hospital).

These 3 hours in Duran were the most moving of my trip so far. Most of the houses were built of sugar cane or loose pieces of wood. They were up on stilts because in the winter month the land floods up to about 3 to 5 feet of water, yet in the summer it is incredibly dry, and the air is filled with dust. Unfortunately this leaves the ground disheveled, uneven, and hard to stand on. I was amazed at the speed the people living there walked across the ground, as we went very slow for fear of falling down with one wrong step. The houses were open the air in many places, so tended to be full of flies, and did little to keep out the heat. The water was miscolored and stored in barrels out in the open. And the children ran around in clothes that had lost their original colors and all seemed to be the color of dust. At first sight I was deeply saddened by the condition of this area, because this was not some small poor area of a city, this appeared to go on for miles. But the people themselves helped lift my spirits. Many were glad to have visiters, and quickly brought us inside their homes and found us somewhere to sit (often times they would give us their only chair) and would talk to us for as long as they could. They were happy for conversation and excited by the help the doctor I was with offered them. Some notable examples of people I met. 1. A family of 10 in a house that was 1 room, but content and happy. A battered woman with 2 kids whose husband had 2 other girlfriends, this was a tough case and the doctor I was with said it is a very common case in this area. A family with 2 girls, 13 and 15, both married and pregnant. A pair of twins who were studying for school (mathmatics). A house where 2 of the 5 family members didn´t know their birthday. And finally a house (which was just framework with blankets thrown over it to make it whole) with a young man who lost most of the use of his legs (which had all but wasted away). He had been shot in the back, and suffered spinal damage, but didnt have the money to have the bullets removed. He didnt try to exercise or move his legs, so had lost more mobility, and the bullets have migrated forward giving him stomach pain. The doctor arranged to have an ambulance pick him up next week, and surgery to be done in a free hospital.

Overall the experience was very humbling. It was very sad, yet at the same time enlightening. Even though these people had near nothing, they were not sad, nor angry. Most of them seemed cheerful, and helpful, and willing to give up what little they had to make us comfortable.

Today we went back to Padre Damien (I played some more domino´s with the guys), but we also got to talk to a very interesting gentleman. His name was Portanando. He just turned 90 year old (yup, and still in good shape). He told us about his life, his family, and God. He was very happy to have someone to talk to, and wouldn´t stop complementing us and how generous and thoughtful we were, we of course told him how much we enjoyed going there, and how much we enjoyed talking to him, and he just blushed and complemented us more.

Thursday, June 25, 2009

Update from Matt

Hola mis amigos! Como estan. Todo esta bien en Guayaquil. Este Semana estamos trabajando muchisimo! El Miercoles trabajamos en Duran en la casa de Alicia. Hicimos terapias osteopáticas de seis o siete personas. Fue muy bien. Pudimos ver la differencia despues de nuestro tratamientos. En la tarde fuimos al hosptial seguridad social a reunirnos con cynthia. Los otros dos fueron a cirugías y yo trabajé con cynthia en traumatologia. Yo vi una fractura radial distal y mucho otros casos de articulaciones. Hoy fuimos al hospital otra vez y vimos una cirugía de cáncer de pulmón. Y despues fuimos a la casa de Padre Damien y yo jugue dominos con los pacientes. Yo Perdí los primeros tiempos , pero por fin gané cinco veces de hacer campeón. ¡Estamos aprendiendo mucho!

For those of you who cant speak spanish I will sum it up for you again in English (note this is not a direct translation of the above).
We have been working a lot this week at a variety of different places. Yesterday we had the opportunity to practices some osteopathic manipulative medicines. We had a steady stream of patients from when we started until we left! We performed all sorts of techniques including a lot of soft tissue, muscles energy, and pedal pumps to help their respirations. They were very greatful for all of our help, and we noticed a difference in many of them when we finished.

In the afternoon we went to the hospital and met up with our friend Cynthia. She took Jeff and Christine up to watch a few surgeries and I stayed with her in Traumatology. I got to talk to a bunch of patients, and helped check them in and send them off for X rays. I saw a radial distal fracture and watched the doctor set it back into place. I also saw a couple more broken bones, and got to talk to a patient with viral encephalitis who had broken an arm, as well as a woman who fell on a rock and injured his knee. Basically I had a great time, and it really reinforced my opinion on emergency medicine.

Today we went back to the hospital early in the morning to watch another surgery with Cynthia and her fiance Jonas. Ill let Jeff tell you about it as surgery is more his thing than mine, but it was also a great experience. In the afternoon we went to Padre Damien. Christine and I talked to a few of the patients for a while about food and Ecuador. They are some of the friendliest people i have ever meet and love telling stories (even though christine and I struggle to follow them in spanish). After this we went and played dominos with some of the men. I ended up staying for 3 hours playing dominos. I quickly lost the first few rounds, but eventually won 5 which made me the champion! They liked having a challenge and asked me to come back soon and play some more!

Thats it for now! more to come later!

Tuesday, June 23, 2009

Clinic in Duran

While I have this CD and some time on the computer, I realized that I still have yet to upload any pictures of us at the PFH Duran clinic...but that is because it recently began construction and we haven´t been able to work in the actual clinic much since we arrived. I have a bunch of pictures of the construction as it has been coming along, and hope that we get to see the final product before we depart in two weeks!


Jeff and Matt outside the clinic, pre-construction


At the start of the construction - changing the clinic from 2 patient rooms to 3, and making space for a dentist and a gynecologist!


The family med (L) and gynecology (R) rooms

Jeff checking out the family med room
(the hole in the wall is the site of a door in the near future)

Tomorrow will be fun and interesting...we are scheduled to do osteopathic treatments in the PFH clinic, but due to the construction, we will be working on Alecia´s patio with our osteopathic table - she is one of the two amazing women who live right near the clinic and volunteer their time to help gather information and keep the clinic running smoothly. The other wonderful lady, Anita, can be seen in the photo below, checking out the room that will be the check in desk and the dentistry room. Hasta luego!

Getting our hands dirty

This has been a great week so far, and I know it is only Tuesday; however, yesterday and today were packed with learning and seeing medicine in action, and all three of us are definitely excited for what is to come for the rest of our time here. Unfortunately there wasn´t really a good time to take pictures yesterday or today, but I will try to get some later this week and get them on here asap.

Yesterday, we spent the morning at the government clinic in Duran, in an area called Orames Gonzales. It was originally mostly a maternity clinic, but it has now expanded into a huge facility with pediatrics, dentistry, emergency medicine, family medicine, and obstetrics. The three of us split up, and shadowed three different physicians. Matt followed a family med doctor and got to help with physicial examinations for various problems...but he ended up seeing mostly respiratory issues, which are common here due to the dust that is constantly in the air in these impoverished communities. Jeff got to follow a pediatrican and saw everything from babies who were literally only 12 hours old, to school aged children.

I got to follow an obstetrician, and not shockingly, I loved every second of it. To those of my friends who keep telling me they think I will end up as an obgyn, I kind of think you are right. I saw women who were anywhere from 3 months to 9 months pregnant. When I first got to the obstetrics room, there was a young woman who was having terrible labor pains, and when I heard the doctor ask her date of birth, I thought she said something in the 1990s but I assumed 1990, which would have made the girl 19. However, I was wrong...when I asked a few minutes later, I realized she was 13 (!!!!!). It sounds like it is extremely common for girls who are 12 and 13 years old to get pregnant due to the lack of education about birth control methods, as well as for women who are upwards of 40 to get pregnant with their 8th or 9th child. I know that unplanned pregnancies are common in young women in the US, but I have to be honest that the youngest pregnant person I´ve seen was probably 16...for some reason, age 13 came as a real shock! Anyway, it was great to help out with the examinations and I look forward to returning next week.

Today, we got up early and headed out to the hospital where Matt´s host dad works - the government-run social security hospital. He is the chief of intenal medicine so we got to spend some time learning about the 15 or so patients they had in the ICU, and then he took us down to the emergency department and we met a med student from the University of Guayaquil named Cynthia who spent the rest of the day showing us around and introducing us to patients, doctors, and other students. She is currently working with the department of cardiothoracic surgery, so she asked us to come and scrub in on a surgery on Thursday morning! All of us are really excited about it - the doctors are removing a lung from a patient with metastatic lung cancer, and we got to see the xrays and cat scans today to give us an idea of what the cancer looks like right now. Obviously I won´t be getting any pictures but this will be the first surgery I have physicially scrubbed in for and I´m really excited about it.

Tomorrow we have a crazy day planned - from osteopathic treatments in Duran in the morning to spanish lessons in the afternoon to an evening shift at the social security hospital. More to come soon!

Sunday, June 21, 2009

Visit to Cuenca!

Apparently the boys aren´t into blogging right now, but I´ll hassle them to post sometime soon so that this doesn´t become solely my trip blog.

This weekend, we ventured to Cuenca to visit Matt´s family. I don´t want to steal his thunder in case he decides to post about it, but we had a wonderful time - thanks especially to his aunt Fabiola and her friends Veronica and Piti who showed us around the city and kept us constantly entertained!

Below are a few photos from our weekend, and I´m really hoping to upload some pictures to previous posts tonight, so scroll down and check them out!


Myself, Jeff, and Matt at El Chorro, a waterfall on the outskirts of Cuenca



The boys after they ventured under the waterfall


The three of us after a night of some serious dancing to everything from authentic Latin music to the YMCA...

Thursday, June 18, 2009

Thoughts for the day

These are not the most introspective or provocative thoughts but I´m in rare form tonight and so I wanted to reflect on the following.

1. Cumpleaños Feliz, Jeffrey!!!!!

2. When I was little and we used to go to the community pool, my mom always used to say "you are what you eat" when I would ask to get Nerds as a snack. After this first 9 days in Ecuador, I think that concept can be applied to the come up with the conclusion that I am a ball of rice. Not that I´m complaining about the food, my host mom and grandma are fantastic cooks. I just don´t know the last time I had so much rice floating around in my system.

3. Much love to everyone who is helping my gmail inbox fill up each day, please please keep it coming!

Wednesday, June 17, 2009

¿We´ve only been here a week?

I have no idea why, but for some reason I feel like we´ve been in Guayaquil for at least a month. It has been a looooong first week - not in a negative sense - it´s just due to the fact that all three of us have been slow in adjusting to the difference in lifestyle here. I can´t help but feel that if you want to become a physician, then no matter how laidback you seem to be, there is a bit of type A personality hiding in you (or it´s right out there in the open, whichever), and it definitely came out in all three of us when we first got here. We were all a bit restless due to the extremely random schedule during the first few days.

I don´t know what exactly happened, but somehow overnight we all chilled out and have been taking things in much better stride. Today was a great day and I somehow feel that things are going to go a lot more smoothly now that we all let go of the notion that our schedule is never set in stone (not to say we weren´t warned...). We know that no matter how hard he tries, Dr. Aguirre will always get caught up in something, and will be an hour late, ie. when every ATM he stopped at for me was out of order, or when his car wouldn´t start today and the three of us had to get out and push it down a hill while he shifted into gear.

Today we went to a school way out past Duran that was literally in the middle of a billion rice fields as a favor to some women who have helped out at our clinic in Duran in the past. We took the heights and weights of all the children in the classroom and when we head back on Friday, we will be gathering information about their health by surveying their parents. The school is actually a one-room schoolhouse with about 40 children that are in what we would consider grades pre-K to 7th...all in one room...with two teachers. It was a madhouse after we got there, and although Jeff insisted it was due to my extremely white skin (my host grandma just calls me gringa, which means white girl, instead of Christine), Dr. Aguirre assured me that it was because usually when a doctor comes, it means vaccines. So anyway it was fun to see all the kids and I look forward to going back on Friday. This weekend we plan to head to Cuenca, where Matt´s stepmom has family, and that will be a nice change of pace and apparently a little cooler in temperature, as well. Since we will be working in a big clinic next weekend, this is probably our only weekend to travel a decent distance away from Guayaquil.

The one room schoolhouse (sans children, who get to leave at 1230 for the day!)


A typical house in "el campo" aka the countryside, on the outskirts of Duran

After we got back from the school, we headed to Jeff´s house, where we´ve been taking Spanish lessons for a few hours each afternoon. I won´t lie, my head definitely hurts after trying to cram that much information in at one time. I miss my laidback intro teacher from college. Then came what was probably the best part of the day - as I got ready to head home for the day, Jeff´s host mom, Fatima, surprised him with an early birthday cake...and a fiesta! The other students who live above their house came down, and all of his family members were there, plus Matt and me, and we did some serious dancing all around their house. Fatima was easily the best dancer, although I have to say I gave her a little competition with my macarena heh heh. I have some amazing pictures, especially of Matt and Jeff dancing, and since I forgot my camera cord, I´m planning to put them on a CD at a store here one day and then upload them to the blog...sorry in advance, boys.


Jeff´s host family celebrating his 25th birthday!

Fatima forcing Jeff to do some birthday dancing


Matt getting in on the action!



Hasta luego!

Sunday, June 14, 2009

Hola mis amigos!

Hola! Como estan.
Hi everyone. Its Matt. Just a quick update on the first few days in Ecuador. Christine has already talked about the 2 places we have worked in so far, so I will talk a little bit about what our life has been like down here. First we are each staying with a different family. This is both a blessing and a curse. Its a blessing because we are immersed in the culture and language of the people of Guayaquil. While at home trying to speak in a Spanish is a must, and hopefully after the first frustrating week communicating with those we live with will become easier. Already I find I can talk (in spanish) to my family better than anyone else here. Also you get to see how family life is in Ecuador. Everyday some of my host familys kids or grandkids are over at their house. There is a lot of introductions and kisses on the cheeks, and a ton of little kids running around interested in the tall guy who speaks spanish like a 4 year old. The meals are AMAZING, and consist of a BIG lunch with wonderful soups, meat, and lots of rice. Jeff pointed out to me earlier though, you dont see a lot of steamed veggies of plain salads.

Ayer Fuimos a Malecon dos mil. Subimos millóns de escaleras para ver el faro, y también fuimos a un parque con millóns de iguanas.

Yesterday we went to Malecon 2000 (this is kind of like a boardwalk, with tons of shops, and beautiful walkways and monuments). We climbed a million (more like 400) steps to see a lighthouse, and we also went to a park with a million (well....100) Iguanas.

On our first day Christine and I saw the partido (game) of futbol (soccor) between Ecuador and Argentina. This was a biiiggg game because Ecuador needed to win to stay in contention to go to the world cup next year. It was fun, with a lot of energy! I also learned the hardest word for me to remember in spanish is Goal Keeper (arquero...though i had to ask for the 100 time what it was).

Well thats it for now!!! We will update everyone again soon! Que tengan un buen dia!

Friday, June 12, 2009

¡Hola!

As we end our first few days in Ecuador, I thought it might be time to update everyone on the happenings so far. Matt and I arrived on Tuesday evening, several hours later than anticipated thanks to severe thunderstorms and a broken light on the plane from Miami to Ecuador. Luckily our families here are in it for the long haul and were waiting for us when we arrived after midnight (we were scheduled to land at 920). My family is so sweet but we have a pretty big language barrier since I speak un poco espanol and they speak un poco ingles. However, it has been great to get acquainted with them as best as I can and I´m probably going to be a master at charades upon my return to the US since I´m always dancing around and making hand gestures to try to explain myself.

We have been pretty active so far - spending two afternoons at the clinic in Duran, which is a wonderful space to have, and also getting to spend time at la universidad catholica with Dr. Aguirre, who is essentially our host doctor and part time chauffeur. He tried to fake me out the first day and act like he can´t speak English but in reality he has beautiful English and he has been a wonderful guide for us. My other Ecuadorian BFF is Alberto, a fifth year medical student (the system is much different here than in the US) who has been taking us out to meet his friends and get an authentic Guayaquil experience as a twenty-something. Again, he speaks amazing English and has been muy helpful in the transition.

Our other main volunteer experience here is at the Padre Damien House, which we were introduced to yesterday. I can see why people love to work at this foundation - there is a peace while you are there that I just can´t begin to describe. Essentially it is a dormitory of sorts for patients with Hansen´s disease, also known as leprosy. The thing is that when you meet the people, you may see some of their physicial deformities due to the severity of the disease many years ago, but they don´t look sick. They are just a group of older people, hanging out and reading the newspaper and the bible, making hammocks (the men) and jewelry (the women), and then you might run into the occasional rousing game of dominoes. They aren´t forced to live there because they are lepers - they enjoy the camraderie and the access to healthcare, and in some cases, have been outcast by their families, and would rather live at PDH than try to go back to their ¨homes.¨ Leprosy has such a negative connotation, and I think the reason that I really like the idea of PDH is that they accept as many groups as are willing to volunteer, in hopes that these groups will go back to their respective nations or cities and spread awareness that leprosy isn´t the scary contagious disease that we might have grown up learning about. I know that my family and friends all had strong reactions to the word leper...and I imagine most people do. Anyway I look forward to returning there next week and singing some more songs with them - those of you who know me just adore my singing voice and I´m sure you miss it already.

Chao!

Tuesday, June 9, 2009

PFH In The News

Physicians for Humanity is in the news! Check out the link...
http://abclocal.go.com/wpvi/video?id=6855451

Sunday, June 7, 2009

What's this blog for, anyway?

As first year medical students at PCOM, we are offered many amazing service opportunities. However, few compare to the idea of spending a month in Ecuador, where we work in various medical clinics, learn the Spanish language, and have an authentic cultural experience by living with an Ecuadorian family. There are 8 of us heading to Ecuador this summer - the first 3 in June, and the other 5 in July.

As we made our last minute preparations for the trip, the suggestion was made that we find a way to keep in touch with each other and our family and friends while we are actually in Ecuador. Creating a blog seemed like the easiest way to keep in touch with the largest group of people.

We plan to use the blog as a live journal to keep everyone updated on the amazing experiences we are having, the struggles we are facing, and how the trip is helping us to grow to be stronger physicians in the future. Keep your eyes open for posts in the near future - group 1 will be arriving in Guayaquil in 2 short days!