martes - tuesday
We went to a ICU hospital in Guayaquil where we saw patients with lupus, TB (from a distance), an abscess infected with Klebsiella, and CT scans of a patient with HIV and toxoplasmosis and - or lymphoma. The hospital has been the biggest culture shock so far - docs rarely if ever use gloves and nobody washes their hands. The ER was packed full of random people and there is no triage system - it seems to be based on when you get there. Also there is a shortage of paper which is weird. Patients´ files are written on the backs of old EKG,s etc.
miercoles - wednesday
In the morning we watched a histology lecture given to dental students by Dr. A. Students learned by hand-written notes from microscope slides, light boxes with pictures of tissue preps (which they took pics of with their camera phones), and drawings from the white board. There were no laptops present.
Later in the day we went to Duran to see the clinic - Derecheros de los Pobres. I`ll never forget the drive in - on dirt rodes while stray dogs and children ran by, passing houses made of reeds and corrugated metal and pools of stagnate water, listening to Frank Sinatraçs `Ive got you under my skinÇ. What a culture shock. We did two OMM treatments in the clinic - muy impressivo.
Later still we visited Padre Damien house - a live-in clinic for Hansen´s disease (leprosy). It´s run by an incredible nun, Sister Ann, who is a firecracker from Brooklyn. She stressed the humanism of patients - esp those shunned by society. The patients were incredible - so friendly and welcoming. The men make hammocks and play dominoes. Sister Ann described how the clinic was when it was gov`t run - full of rats with unpredictable plumbing and disgusting food. The facilities now are brightly painted with murals, everyone has their own bed with clean sheets and the patients seem happy. She also purchased a plot of land in the cemetery to bury patients when they pass and holds masses for them - this was very important to them. Her major objective is restoring dignity.
jueves - thursday
we took a trip to the infectious disease hospital in Guayaquil and saw a patient with an infected necrotic snakebite, three AIDS pts. one with toxoplasmosis, one with TB, and one with histoplasmosis, and a man with dengue. The AIDS pts. were in induced comas for treatment. The hospital conditions, as previously described to us by Sister Ann, were pretty awful. The patients were naked in bed under thin blankets with holes. We followed a class of medical students who swarmed a poor old confused woman with pneumonia (and probably some dementia) in order to learn EKGs while leaning over top of her. Patient rights do not seem to be considered here - esp. in the infectious disease hospital which is free for the poor.
sorry again for the terrible grammer as my english is failing me.
