Landys In Ecuador: Today's adventure

Today (Sunday) we had a scheduled outing to a town called Paquisha, about an hour away from Guadalupe. The local priest, who is apparently a very dynamic guy, had reportedly done lots of local advertising for our services today. Lots of people come from the surrounding area to go to mass in Paquisha on Sunday, so it tends to be a busy day in town.

We had a "taxista" (taxi driver) from Guadalupe drive all of us in his pickup truck. By all of us, I mean our family of four, and three of the clinic staff -- envision the driver, 2 people in the front passenger seat, 4 people squeezed in the back, and 1 person sitting in the bed of the truck with the boxes of medicine and eye glasses to sell at deep discount. The mountain roads are very curvy and winding, some stretches are paved and some are dirt roads. It was all going along fine at first, and then the pickup started to sputter and stall. The driver was concerned that the gasoline may have been either dirty / contaminated or diluted -- he got the truck to putter along for a little while, and then it stalled out entirely in the middle of the street in a town called Zumbi (about halfway to our destination).

We managed to hail another similar taxi, we transferred all the boxes over to the new pickup, and we were on our way again. We made it (albeit a bit late) to Paquisha and set ourselves up in the side room of the local church. John and Emmett helped set up the glasses, and John has learned how to do simple eye exams and help figure out what strength of glasses someone needs.

Meanwhile, we set up the medical side of things while patients waited at the door.

Over the course of about 4 hours, I ended up seeing 30 patients. These field trips are an extremely simple form of practicing medicine -- with no records, no charting, no history, no medication lists, etc. I would estimate that about 80% of the people I saw had some combination of the following complaints: headache, watering eyes, gastritis (stomach inflammation), and/or knee pain. I had a list of medications that we brought with us, and basically dispensed a lot of Tylenol, antacids, and artificial tears eye drops. I had essentially no diagnostics available to me, and I didn't have an actual exam room so the physical exam I could do in a room full of people was very limited -- so I was going solely on clinical experience. I punted the patients with what seemed like more complicated medical issues back to the local health center, where they are usually seen. (There seems to be a very real lack of primary care continuity, which is a shame, as everyone can benefit from that.) Everyone seemed thankful for my time and attention, and there isn't this sense of being entitled to live a pain-free life like there is in the U.S.

After we finished, our taxista drove us up to see a pretty waterfall about 20 minutes away. After sitting with patients all morning, I was really happy to stretch my legs. At first we thought this was it...