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Published: September 19th 2012
Something else I've noticed about the food in Ecuador is that we are served fresh-squeezed juice with EVERY meal! It's really good and a lot of it is made with fruit I've never even heard of before. After breakfast, we headed out to our second day of clinic. We did the same physical exams that we did yesterday and found many of the same problems including hypertension, high glucose levels, and dehydration. Many of the patients also complained of arthritic pain and back pain. Unfortunately, we did not recommend medications for them (which is likely what would happen here and it does help) because, again, medications are not always available so we wanted to leave them with something that they could count on. With all the mountains and having to walk a ways to get water to drink, cook, and shower, a good majority of this population suffers from chronic pain. Even the elderly walk miles each day. This is good because they are getting exercise and staying in shape but at some point it becomes too much. We were able to teach them how to incorporate good body mechanics into their everyday life and we also showed them stretches/exercises that
might help depending on what pain they had and where. I had a patient who could not speak or hear. One of her neighbors brought her to the clinic. We were unable to obtain a history from the woman but could tell that she had been this way for a long time. I wondered how she could be managing to live on her own. This brought up a good point and that is that there is no such thing as a nursing home or assisted living in Ecuador. There are very few places for elderly people to stay if they need help. This is the responsibility of the children but if someone does not have children, they have nowhere to go. Again, we were able to do lots of education for the patients abotu how to help control their blood pressure and blood sugar and what they can change in their diet to stay as healthy as possible with the little resources they have. Throughout this trip, I really learned the importance of teaching in the nursing profession. "Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for
a lifetime." We can prescribe medication for a patient to help lower their blood pressure, or we can teach them how to eat healthier, reduce salt in their diet, exercise regularly, and practice stress reduction techniques, and we don't have to worry about the patient not being able to find or afford their medications. This is not to say medications should never be used and in lots of cases they have to be. However, in some circumstances, education is a better alternative and in all cases, education is a necessary compliment to medical care. This is a hard concept, not only for a healthcare profession to grasp, but also for patients. Just like many people go to the ER in the US and expect to leave with a prescription, people in Ecuador come to the Timmy Brigades and expect to leave with "magic gringo pills." Timmy Global Health usually runs brigades with doctors, nurses, and many other health professionals so the locals are used to the doctors prescribing and giving medications. Our brigade was the first brigade that focused on education. I think this is really important and when the next group of students goes to Ecuador with Timmy Global
Health next year, I am excited to see how this is affecting the community. It feels good to leave knowledge rather than a pill bottle that will be gone in a month (or sooner because they will share the magic gringo pills with their family and friends).
After the clinic, we went to Fundacion Guayasamin which is an art museum featuring art from Guayasamin. Many of the paintings were a little disturbing as his goal was to portray human suffering. They were excellent paintings, however and he had some neat interpretations of things.
Before dinner, we took the bus to Basilica del Voto Nacional. It was the most beautiful basilica I have ever seen and the view from the top of it was even more amazing. Quito is so interesting to look at because as you look out at the horizon, you see houses and buildings climbing up the sides of mountains. It seems like you can see so much further because you are constantly at the bottom of an auditorium, looking up at the mountains on all sides. The basilica looks complete, but if you look closely it is missing some pieces. Legend has it, if the
basilica is ever completely built, the world will end.
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