Friday, June 8, 2018

A few words about my nurse.

My third day here, a young lady introduced herself as Paola Espinoza, said she was a nurse and wanted to volunteer.  Her 4 year old daughter finished preschool at noon, so she had to leave by then.
Her husband has steady work for the city of Yanzatza 30 minutes by bus from here.  He's one of the lucky ones, the average wage here is US$400 a month, when jobs are available. 
Paola's takes blood pressures and weights, gives IM injections, but her most important function here is interpreter.  She speaks no English, but her Spanish is normal speed and clear; she rephrases things nicely.  But often I hear her saying exactly the words I used to the patient, and they understand.  We all have expectations of others that influence what we hear.


Last week a patient arrived after a 2 ½ hour bus ride with a large lipoma of the back, some 8cm (3 inches) across.  The growth came out nicely.  I had Paola make a few snips with the scissors and put in a skin suture, first time she'd done so.  She said she learned a lot, I wanted her to feel her time was valuable to me, all in all things worked well.  (Understandably, the patient didn't want to look at the specimen).  Pathology's not readily available, which limits what we can safely remove, but this case was clear.  I hope the clinic can hire Paola once more funds become available.

Thursday, June 7, 2018

End of my first week in Ecuador.

Friday 25 May 2018
I found out late Thursday night that yesterday was a national holiday, the battle that won Ecuador its independence from Spain but celebrated today. Our pastor (Padre Jose Berru) asked me yesterday if I had any plans, other than catching up on sleep didn't have any so I stretched the truth and told him no. He was visiting one of the 15 outlying barrios in the parish today, invited me to come along, ¿porque no?

So Jose showed up at noon and we fried plantains, cooked rice, and vegetables without setting the kitchen on fire. Washed it down with a warm yellow herbal tea. Mealtime is always egalitarian, everyone who eats helps clean up, so we washed dishes/pots and pans and were done by 1PM.

At 2:30 I walked the 50 meters to the pastor's house, we started off in his SUV, but he pulled in the next dirt path in the church complex. We got out of the SUV, and he proceeded to feed the chickens, 30 or 40 of them. Soon 35 of them escaped and were wandering around the yard eating bugs. Jose called to a half dozen children sitting in the covered rotunda, and asked them to come help. We broke off small tree branches, started chasing and sweeping them with our branches while saying something in Spanish. Order restored within 10 minutes. Threw slop to the 4 pigs in the next pen (mostly food scraps), and we were off on a 20-minute ride to Guaguayme alto.

That's a barrio of maybe 400 people, there's a central garden and plaza with paving bricks, and what looks like a giant covered picnic pavilion maybe 30 meters wide. The church was in ruins, nothing but the high entrance arch and the sacristy in the back, being rebuilt slowly by the townspeople. There was a small low-ceiling room being used as a chapel, beautifully decorated as are all the churches here. There were enough fresh flowers around the altar to put most US weddings to shame.

The chapel was filled to overflowing, people sitting and standing in the hall.

Today was the feast of Our Lady of Fatima, a beautiful sermon. Padre praised Mary's role as an example of obedience; she's was a missionary to those around her, an example for mothers, At the end, he spoke a couple minutes about the re-opening of the clinic as a Day Hospital, acknowledged my role here for the next year. Mercifully I didn't have to say anything but had to listen to the unavoidable applause. He's getting a lot of justly deserved credit for saving the clinic, more on that in a later blog.

Saturday 26 May 2018
Jose was scheduled to say 4 masses today, starting 10AM in another barrio. Plan was to pick me up at 1130 and drive to Yanzatza, where he con-celebrates with the bishop at noon. An employee drove us to the barrio where another fiesta was in progress. There were 2 picnic tables and 200 people, I sat across from Jose, and next to a woman who it turns out was the deputy director of the region (something like the Lt Governor).



Next, off to the half-built chapel, we had visited 4 days ago, for their first prayer meeting. It had an intact roof, good thing considering it rained cats and dogs; half the walls were finished stucco, the others cinder block.

Mass at 5PM. Halfway thru the sermon, Padre asked me, at how many months would an Xray show a fetus? Answer, 2; took me by surprise, glad I wasn't daydreaming. He was talking about Mary's visit to Elizabeth, how did Liz know Mary was pregnant?

They'd set up a tent covering near the chapel door, so people could stand around in the dirt and mud (instead of puddles) and eat more soup. Padre and I were invited up to the house not 40 meters away. The house held a single bedroom and a kitchen. Jose and I were given the only two seats in the place, a bench on their porch, ate our soup but declined the rice & yucca (still digesting lunch) so it was packaged for us.

What I remember most, though, was a young mother carrying a child on her back, older than usual. He was obviously post-toddler, just looked around. He weighed a good 12kg (25 lbs). We asked the mother about him, he was paralyzed from birth, now 4 years old, she also had 2 other children. Wonder how long she'll continue to carry him around, what will become of him as he gets older.

Busy Week

The week was a jornada or medical group offering primary care to the  town of Paquisha, and 5 of its surrounding rural <barrios> or vi...