Differences

So here are some things I`ve noticed in the differences of the U.S. and Ecuatorian ways of doing surgery.

I will also say that I haven´t actually witnessed a surgery in the U.S. but here are things that I`ve seen in surgery here which I have a feeling would be different in the U.S.
So theres a lot less of the safety precautions. The patients don`t wear wrist bands and they don`t do a timeout before the procedure just to make sure they have the right pt and the right procedure. At least its not verbal. The doctor asks the patients a few questions...I didn`t hear him ask her name though.

In fact, the patient walks into the surgery room and lays down on the table. The anesthesiologist starts doing her/his thing and the other nurses and what not start setting up the sterile field.
Also, you can just walk in the surgery room, you don`t need to be scrubbed in as long as you dont go near the sterile fields.

The doctors and med students here also always seem to have their phones on them and pick up when called. But the funny thing is the ringtones. Today the anesthesiologists phone went off in surgery and it was like a pop song.  Oh another thing I saw the other day, was the anesthesiologist playing a game on facebook inbetween his monitoring the patient....haha I dont think that would ever go down in the U.S.

Anyway, their sterile procedre and everything else is good.
Today one of the patients vomited during surgery. She wasn`t under general anesthesia, just spinal.
Anyway, that`s all for now.

El Ultima Semana Ecuatoriana

So my roommate Kristen returned to the U.S. last weekend and now it’s just me and my host mom here plus other students. Things have definitely taken a turn for the laidback. There’s not anything particularly exciting happening, but I will tell you about my clinical experiences this week.

The doctor I’m following around is a gynecologist. My first day there he had a surgery and while we waited for his to begin we observed some other surgeries in progress (a total hysterectomy, a surgery for infertility problems, and another for urinary incontinence). Dr. Salazar’s (the one I follow) surgery was to remove a myoma on a woman’s uterus. He was doing it by laproscopy but when he went to sew up the uterus it wasn’t working so he had to make another incision to suture the uterus properly. It was kind of interesting. That was Monday.

On Tuesday, there were consultations. I saw a lot of pap smears and vag. exams, which was actually a lot of what I saw today as well. However, in the morning Dr. Salazar was doing colopscopies, basically to view the cervix and neck of the uterus. That was more interesting than consults in my opinion.

One of the more interesting things that I was able to see on Tuesday was a prolapsed uterus. This old woman (76yr) was saying she had been having this problem of her uterus prolapsing, so the doctor was basically like…yeah we can do a hysterectomy.

So that has been my clinical experience so far this week. As far as things I’ve been doing to hang out…the past two days after clinic I’ve gotten lunch, gone online, and walked over to the Basilica. I discovered the other day that this week they have 24 hr adoration at the chapel connected to the Basilica. The adoration is with special intention of creating holy priests, families, and fight for the right to life. When I was there praying a woman talked to me and asked me where I was from. She gave me a holy card and a rosary that she said (if I understood correctly) was made in a monastery. She told me it was a great protection if worn around my neck. Anyway, it was really nice of her to take a special interest in me. After adoration, I stayed around the Basilica and went to a nearby café to read 1984.

Today I did basically the same thing, I went to pray at the Basilica, read more of 1984, and hung around there until the 6 o’clock Mass. While I was waiting, this woman came up to me—she looked indigenous and she was selling mandarins and grapes. Here’s how it went (roughly):

Por favor mi hijita, quiere mandarinas o uvas? Son muy dulces. Dulces!

No tengo hambre.

Para despues.

Ah no, gracias

Por favor, ayudame. Son muy dulces.

Cuantos cuestan?

Siete por un dolar. (Once I asked the price she started getting out a bag and bagging my mandarins, which I had yet to commit to buying)

Y por uno?

Siete por un dolar. (She wasn’t having me only taking one…and at that point I basically caved)

Solamente tengo un cinco, tiene cambio?

Si.

Ok. (So I got mandarin oranges and she was right they were very sweet and delicious. I even had just a one dollar bill, so I didn’t even need change. I’m glad I bought them. I’ve been missing fresh fruit at all my meals.

At the Mass in the evening, it was the feast of San Pedro y San Paul. The priest gave a great homily. He had a lot of fervor. Also, it was cool to hear the Spanish version of the gospel where Jesus asks Peter three times if he loves him. In Spanish they differentiate between when Jesus says Agape and Philos. Jesus asks Peter, me amas? And Peter replies Te quiero. And then in the end Jesus says me quieres, and Peter says Te quiero. I thought it was cool that it was differentiated unlike in English where we just have the one word.

After communion, a old woman sat next to me in the pew I was in, different from which ever one she was in before. She started talking to me during Mass and was like, De donde eres? Cual Estado? Ah y la capital de Indiana es Indianapolis no? It was nice of her, but I also kind of felt bad because she reeked and I didn’t want to breath through my nose. I suppose she hadn’t bathed in sometime. But at the end of the Mass, the priest was blessing people with holy water and she was like, come on you need to get the water. People are so much more enthusiastic about blessings here. Anyway, that was interesting.

That’s all for now. Tomorrow is a bit of a celebration with all the students and then Friday I’m going to a traditional medicine hospital in Otavallo. It should be interesting as they pass a cuy over the person’s body to detect illnesses. Although, in all actuality I may not post about it seeing as it’s one day before I leave.

Mompiche

So I had two places I really wanted to visit in Ecuador—the Amazon and the Coast. I’m happy to say that I have successfully made it to both! This past weekend I went to Mompiche, a small fishing town right on the coast of Ecuador. The town has about 4 or 5 roads in total and is known for its surf during the fall and winter months (of USA weather that is). I asked my Ecuatorian friend Luis for a good spot on the coast to visit and he suggested Mompiche. That’s how I heard about it. It’s not very touristy and has a beautiful beach—exactly what I was looking for. I couldn’t find anyone else to come with me, so I ended up taking this trip solo. I decided to just go alone the day of, so I bought my first bus ticket and was told there were connecting buses in Atacames (where I was headed). But basically I was just kind of planning as I went. Mompiche is the type of place with no internet and little phone usage, so its not like I could plan much. The bus I took was an overnight to Atacames, and once I got their I sat around waiting for the ticket office to open…only to find out you pick up Mompiche buses on a corner of a street. While I was waiting I ran into a girl from Germany (Constancia was her name) going in the same direction as me. Once I arrived in Mompiche it was Friday around 10:30. Luis (a local—not my friend from Quito) helped me find a hostal (although it turned out I could have gotten one cheaper. it was still good only 8$/night). I set myself up and decided to hit the beach. I was walking along the shore and ran into some guys who I talked with for a bit then went for a beach run and a short swim. (Man the ocean is Salty. I don’t really care much for the salt; I prefer lagoons and lakes.)

I got some almuerzo and read in a hammock at my hostal. There I met Jose who lives there with his brother Enrique. I talked with him off and on during the day. He was telling me how he teaches surfing and works on construction. It was really cool to talk to locals who had lived there for so long. I was so glad to get out of the touristy edge of things and soak myself in Ecuatorian culture at its heart. 

Anyway he gave me some tips on surfing and offered to give me a lesson, but it turned out I ended up doing other things (more of that later). I also took a walk down the coast and I found some tide pools (but not super cool ones with sea anemonies). There were tons of sand crabs everywhere on the beach and in the tide pools. They were so incredibly fast so I didn’t catch any. I built a sand castle and watched the local kids play soccer on the beach. It was incredible how much the tide changes the shore. At mid-morning there’s barely a beach but by late afternoon/night time the beach is huge.

I tried Ecuadorian Ceviche..although it was cold and my plan is to try it one more time and give it a chance to redeem itself because it was not as good as the Peruvian kind I had in NYC. I was hanging out in a hammock in the evening when I met Enrique (brother of Jose). It was something to do so we walked around on the beach and talked—with many attempts to overcome the language barrier. His favorite word, and the word that describes Mompiche is tranquila. He kept telling me tranquila tranquila whenever I was attempting to try and say something in Spanish and couldn’t remember or didn’t know the words. Everything in Mompiche is very relaxed. Even the workers don’t really seem like they are working. On the way back Enrique introduced me to Jefferson and Manuel who were semi running another hostal—which was an excellent hostal (I kind of wish that I was staying there—and I ended up hanging out their more than my own by Saturday). They are both surfers as well. Actually all the guys I met were surfers. Anyway, Enrique said he would take me to another beach the next day and I actually realized on Friday how not as much fun I was doing stuff alone—so I was thankful to meet all these people and hang out with them.

Saturday started after I woke up lazily, got some breakfast and as I was doing so I saw another white person who looked about as out of place as I did. It turned out he was Canadian and there with his brother and friend staying at the DCMA (small town). We talked for a bit (in English—most people in Mompiche don’t know any English) and then I made my way over to begin the day doing whatever it was Enrique had planned. It was much more than I ever realized it was going to be.

I went with Constancia, Gerry(A woman who was retired and done with the U.S. but originally from Alabama), Manuel, Jefferson, and Enrique. So they tell us we are going to a lagoon (not the other beach) and that it was like a 45 minute walk. We start out walking and realize it’s definitely much much longer than 45 minutes, but if you hitchhike it’s not. Hitchhiking in Ecuador is so much more common and somewhat safer than in the US depending if you are inside the car or hanging on to the side of it. Anyway we got a ride to the crossroad and I was literally standing on the steps up to the door of a truck and holding on hoping not to fall off and die. It was a good time. We got another ride in the back of the truck the rest of the way. It turned out we weren’t even going to the lagoon first. We were at a house of a friend of Enrique’s (Roberto). We hung out there for a bit and then Enrique was like you all need to put on these boots (like black rubber rainboots)—because it will be better than wearing flip flops. I really had no idea what we were doing and I think Gerry, Constancia and I were all under the impression we were still on our way to the lagoon. So we started walking and Enrique asks me if I brought my tennis shoes in my backpack and he was like ok those are for Manuel. Apparently we didn’t have enough boots and Enrique told me to wear my tennis shoes…only I come to find out they are for Manuel and he’s about to get them really muddy. And he’s lucky my feet are so big and my shoes are for men. So Manuel wore my running shoes and later cleaned them in the lagoon. They still kind of reek and are a bit damp…lol anyway…so we make our way up this super muddy hill and into the jungle. For the most part we are following paths but I have no idea where we are going. Eventually we get to a river. It reminded me of Turkey Run how the river is the trail and on either side are rock walls. We saw a lizard and came to a cave of bats. It was pretty sweet. We also had to scale some rock walls, another thing they failed to mention was involved. It was great. Total adventure. The entire time I was like man I hope were going to get to this lagoon eventually.

We were walking for like 2 hours maybe 3 and for part of it we weren’t really on any trails. We also went to get some fruit. The cool thing about the jungle is it just has free cacao trees and the seeds are surrounded in a sweet jelly kind of fruit and its really tastey if you suck on them. So we had some fruit on the way and I saw a snake! We also heard howler monkeys. So we were all getting rather tired and finally realized we weren’t even on a walk to the lagoon. The guys were planning on going back to Roberto’s house to rest a bit and then go to the lagoon. It turns out we had passed the lagoon on the way to Roberto’s and it was actually much closer than we thought.

Por Fin, after our jungle treck we got to go swim in the lagoon. The water was very fresh and cool, not salty like the ocean and it was very relaxing. We caught a dump truck back to Mompiche and finally had some time to relax. A siesta in a hammock has become a favorite thing of mine to do and that was exactly what I did. Constancia and I went out to get a bit of food and we ran into Luis again and another gringo (whose name I have forgotten). He told us he was just traveling around South America and couch surfing, which I didn’t know existed until he told me about it. It’s an actual organization where people open their couches up to travelers to stay and you can search for places to stay as well. Sounds pretty cool. He said he had been hitch hiking and hadn’t spent more than 700$ in 2 months on traveling around. He told me he was coming from Colombia where he picked up Spanish. After awhile, Constancia and I decided to make dinner (at the DMCA they have a kitchen for you to cook your own food) so we bought some papas, huevos, platano verde, etc and cooked it up. It was excellent. After dinner, I just chilled at the dcma, talked to the Canadians and Jefferson. He told me about his surfing and showed me videos of professionals. They also made up batidos (a fruit drink with leche and ice). It was actually from fruit that we had picked on our jungle hike. It’s pretty good, but the fruit by itself is only good for monkeys in my opinion.

The party in Mompiche starts around 1130 on Saturday at the only discoteq in town. So we were talking and waiting until it was time to party. The other visitors at the hostal were smoking joints and drinking and talking. Finally it was time to go to the discoteq but once we got there the music was so loud and it was so hot, so I bailed. I ended up going to check out the sky. I walked a ways down the beach away from the lights and it was the BEST view of the stars I’ve had yet. In combination with the sound and breeze of the ocean it was absolutely perfect. I just really loved how I got to hang out with the locals and learn about their life in Mompiche. It was so relaxed there. If I could go back again one day and visit I would.

Right so I had to make my way back on Sunday, back to Quito. Unfortunately I woke up late for the 8 o’clock bus to Atacames. There wasn’t another one until 11 so I decided to ask around and maybe hitchhike there. I ended up getting really lucky. I found small bus that gave me a ride to the crossroad and literally 2 minutes later a bus heading to Atacames came by. On the bus I talked with the guy who sat next to me and he was also going to Atacames. He helped me get off at the right stop and get to the bus station. He was really nice. He even made sure I got a ticket before leaving me. It turned out that I wouldn’t be able to leave until 3:15 pm and it was around 11am at this point. So I had a lot of waiting to do. I was hoping to get back in time on Sunday for Mass in Quito, but I couldn’t with this bus. So I asked around to find the church in Atacames. I found it and Mass had finished but there was like a mass baptism of all these kids going on. There were about 15 of them all being baptized and all dressed in white. It was cool to see. So after that ended I asked the nuns if there was another Mass or anything I could do to find one. Another one was happening in another town but had started 20 minutes ago and not another one in Atacames till late in the evening after I left. They even had to close the church so I couldn’t stay. It’s so different from being in a big city were there are literally like 5 Masses a day and 5 churches. There wasn’t even a church in Mompiche that I could tell. Well so anyway, I hung out, got some almuerzo and read 1984 until my bus came.

Mompiche was a great experience. I loved the atmosphere of it. Living in huts, chilling out in amacas, and just taking it easy. Sure they aren’t college educated but I asked Jefferson if he wanted to stay in Mompiche and he said he did. He said his job of preference was to be a fisherman. It’s so shockingly different from America in a good way. It was also great to just hold entire conversations in Spanish, especially conversations that didn’t have to do with finding directions or how much something costs and logistics. I was glad I went even if it was by myself—because I wasn’t alone for long. I made some friends there, unfortunately who I will probably never see again. Another thing about Ecuador is people are much more likely to help strangers—like give them a lift somewhere or help them find a place. I was even about to lose my phone on the first bus ride but the conductor came back to give it to me when he found it lying on the seat. And that was MOMPICHE. 

Clinica

So it was pointed out to me that by reading my blog, you may get the impression that all I’ve done in Ecuador is party and go on vacation trips. Be assured that I definitely have done those things and they are the most interesting things for me to write about, but I would also like to let everyone know what I’ve been doing in clinic. It’s not as eventful or as entertaining, but here it is….

So for the first week and a half I was taking Spanish classes with the intermediate class. We reviewed grammar and worked on our conversational skills. I would say my speaking skills have definitely increased and gotten better over these past couple of weeks. I’ve learned so much more medical Spanish and just vocabulary in general by listening to the doctors speak and working on it in Spanish classes. I still make lots of mistakes, but I’m definitely learning new things and I’m much more capable of holding a conversation with someone. I’ve finished with my classes by now, but I still practice the language daily and listen to the doctors in the hospital etc.

I’ve also learned a lot about Ecuadorian culture just by traveling around and living here. I’ve definitely talked about that but its interspersed among my other stories.

As far as my clinical rotations go…last week I was at a clinic for kids and maternal health. I was working with Dra. Paredes and for the most part I just observed her talking to the patients and examining the kids. Dra. Definitely did things the nurse would normally do in the states (height, weight, head circumference). I did a couple of the height and weights and listened to some lung and heart sounds but that was about it. I feel like I was unable to demonstrate my knowledge base and skills with the language barrier. I’m not really sure what the nurses did in that clinic other than bring pt. charts into the doctor’s office. For the most part there were lots of kids with colds, UTIs, or the flu. Other kids/infants came in for well child checks. I noticed a trend of Ecuatorian babies generally being within the norm for height and weight, but in the lower percentages of that norm. Dra was always like “I would like it to be higher.” Another thing you notice in Ecuador is the number of young mothers. It’s not uncommon to see a 15 or 16 year old with a kid. In fact, they have a special ward at the maternity hospital dedicated to adolescent mothers. Anyway, Dra.did a lot of pt. education on proper nutrition and development for the parents.

Getting to listen to the medical Spanish was great, but from a medical standpoint it was kind of boring for me, especially because I mostly just observed.

This week I’m at the Hospital Militar. It’s for those in the military and rich people. It’s also a big teaching hospital. There were tons of interns and residents going with us during patient rounds. I know I talked about these things a little but I want to say more.

Today was a good day, but I want to tell you about one case in particular. I’m not sure if this is a doctor vs. nurse thing, or an Ecuador vs U.S. thing… Anyway, we went down to the ICU to see a pt. that they had operated on over the weekend. She was old, morbidly obese and has problems with her colon. The surgery involved taking out part of the colon and creating an ostomy. When I saw her, she was on a ventilator, unconscious, with monitors, drains, a catheter, a fem line and pretty much naked. I’m not sure if we came during the middle of her bath, but she was just laying their naked and the nurses were cleaning her. The doctors gathered around to just talk about the patient while she was just in front of them naked. It’s not even about an aversion to nakedness, its much more about keeping the dignity of the patient. Even though she was unconscious, I feel as though they should have had the parts of her covered up that were not being washed. I mean I wouldn’t like it if I was having my bath and a group of doctors comes in to just stare at me and talk about me in front of me.

The second thing that happened when we were down there was the nurses went to change her diaper and found a lot of blood that soaked through the diaper and through the sheets. They were saying that they though it was a thrombosis from necrosis of the part of the colon going to the rectum which was detached from the rest using the ostomy. They also discovered digestive liquid in the Jackson-Pratt drain. They though it was due to a possible fistula leaking out into the peritoneum. The patient also had systemic inflammatory response syndrome. I’m not sure exactly but I believe that was what resulted in her needing the ventilator. We talked with the Dr. about her case later and this is what he explained to us. He said they would used a blue liquid to see if the fistula had indeed broken and that is what resulted in the digestive juices in the drain. If that was the case, she would begin receiving TPN.  This is what I ascertained from trying to translate everything.

In general, I can get the gist of things in a Spanish conversation, but its much easier for me to understand things when I am in the conversation and I can ask for clarification rather that trying to figure out what topic someone is talking about.

The second interesting case was a man who had appendicitis, had surgery and developed complications. They thought he had internal bleeding because his BP dropped to 90/70 and he looked pale combined with the lower ab pain he had.  Another thing about the doctors here, they don’t seem to really care about patients being in pain. This one doctor was examining his abdomen and he kept pushing on the areas that hurt and asking him 2 or 3 times if it hurt. I feel like he could have done it in a way that wasn’t so painful to the patient. He also didn’t even apologize or really tell him what he was going to do before he did. The bedside manner here just kind of sucks; there were three patients I saw that happen to.

The doctor we shadow is a great teacher though. I got to hear him lecture his students and grill them about things. He’s pretty enthusiastic. In conclusion for today, I have one more day at hospital military, so I will tell you how it goes later.

I’m starting to miss Home.

Cirugìa

Monday at the hospital I saw a cholecystectomy—gallbladder removal. It was pretty cool to see once, but after that I was bored. So now I know surgery is not for me. The gallbladder that was removed was so bloated with fluid and it had about 50 or more gallstones filling it. It was also obstructed and didn’t have any bile in it. It was pretty crazy. We saw two surgeries like this, but nothing as crazy as what I just described. So after clinic, we went to eat lunch and try to figure out how to get back for classes. We ended up having to take two buses because we got turned around, but we eventually made it back.
Today we just did rounds, saw patients, and sat in on a presentation on fluid and electroltye maintenence. It was given by one of the residents. I can understand so much more when its written down. I noticed in Ecuador the doctors don´t have a great bedside manner during rounds, its proably the same in the US. They just talk about the patient in front of the patient and don´t really warn them if they are about to take off their blankets or lift up their shirt. I guess the patients are use to that here.

I´m trying to plan a trip to the coast of Ecuador for this coming weekend. I hope its amazing!

The Lungs of the World--Los Pulmones del Mundo

So let me tell you about my adventures into the Amazon Rainforest. It was absolutely fantastic. Our trip started on Wednesday night. We took an overnight bus 6 hours to Lago Agrio. On the way our bus driver stopped for about 30 minutes to help another bus driver who had stopped. Apparently from what I heard something had fallen off the engine and they were trying to put it back on. Well, in the end I don’t think it worked at all, unfortunately. So we got to Lago Agrio and from the bus station we were supposed to walk to a hotel. The map they gave us was rather useless because none of the streets were marked with names and it was difficult to orient ourselves to the city. After asking a ton of people and taking the long route we finally found the hotel. We ate breakfast there and cleaned off some of the overnight grogginess of sleeping on a bus. Next another bus came to pick us up and take us to the interior of the Amazon. It was another two hours to Cuyabeno.  From there we took a 2 hour canoe/motor boat trip to our lodge area. It’s quite deep into the Amazon. Our accommodations were huts made of wood with the traditional type palm roofing. It was really cool. The entire place had very little electricity. We ate dinner by candlelight and our hut was lit by candlelight as well. We were in the midst of a flooded forest area so all our huts were up on stilts and there was about 4 inches of water all around. The meals were all wonderful. They were all three-course meals with traditional food. Pollo, arroz, sopas, carne, fruta, empanadas, etc with some other ethnic foods mixed in. There was plenty of hot chocolate, coffee, tea, and clean water. Our shower even had about 5 minutes of warm water with each use. Also, I should mention, I went with Kristen and Livingston. So it was the three of us on our adventure. The camp also had an awesome resting hut with tons of amancas in it or hammocks. They were so comfortable. The first night Kristen and I fell asleep together in one of them. (I really want to buy one here in Quito). Originally we planned to stay until Saturday, but by Friday we were in love and really wanted to stay one more day. We cut a deal with the lodge administrator and stayed the extra day for 40$ more.

So the first day we got there in the evening after our canoe ride into Cuyabeno. There was a baby spectacle owl that was found by the side of the road and brought to the reserve by a man and we were able to see it. It is apparently very rare to see these owls, but later in the trip on the last day I also saw an adult spectacle owl. We saw animals from the river—a baby anaconda and squirrel and capuchin monkeys. Also several different kinds of birds-kingfishers, and other ones which I cant remember the names of. The best part was just how green and lush everything was. It was so beautiful. Getting to see all the different trees and plants—especially the trees with the plants growing on their branches and descending roots down into the water. The air was so unbelievably fresh and clean-hence the amazon being called the lungs of the world. So we went the first evening to the lagoon, which is more or less a large lake fed by the river. And we swam in the middle of the lagoon and watched the sunset. I had so much energy to swim. It was amazing. I think it was because I went from Quito-high altitude- down to a lower altitude. I swam nonstop for like 30 minutes. There were also trees just growing in the water with their tops sticking out. I climbed and jumped off of one. Swimming in the lagoon was awesome and watching the sunset was gorgeous. As it began to grow dark we searched around the edges of the lagoon for Caimans (they are like crocodiles). We even saw the fins of some pink river dolphins-but nothing more. The guide ended up spotting an emerald boa, but no caimans that night. The stars were so beautiful and easy to see. There were so many constellations I have never seen before. But because we are so close to the Equator, we can see a bit of both hemispheres. We came back for a wonderful dinner-soup, a main meal and dessert. We were all starving for it.

On Friday we started off after breakfast to go on a hike in the rainforest. Our guide, Jose Miguel/ Condor, showed us many different plants-some with medicinal or practical qualities. He showed us the bark from which quinine-an anti-malaria med is derived. He also showed us cedar trees, tablaroots, ways to collect water and make shelter. He showed us this sap of a tree that literally when burned smells like church incense—the good kind. Unfortunately I really can’t remember all the names of these plants. He showed us a sour cane that’s a good source of water and a special palm that is used for its fibers to weave strong ropes. If you use this type of thread made from these palm fibers it can last like 100 years. It is so strong. It was a great walk—very informative and beautiful.

Next, we paddled back to our camp. It also wasn’t just the three of us and a guide. We were with a group of about 11. Some of them were from the UK, Australia and a couple of Swiss Germans and some Americans. After lunch, we went out again for some pirhana fishing. It was a lot of fun. We had bamboo rods with fishing string attached at the end and a hook. We used raw beef as bait. You have to be very quick when fishing for pirhana because they are so capable of eating all the meat off before you know it. I kind of caught one pirhana. It was a little one. I went to flip it up into the boat, but instead it flew right over and escaped into the water on the other side of the boat. Condor called it a flying pirhana. Other than that, we just got a lot of the beef eaten off the hook—we were definitely getting bites. That night we again went out to watch the sunset, swim and look for caimans. We actually found a black Caiman, but he was difficult to see. There was also a white baby caiman hanging out at our camp, which was cool. We were continually surrounded by wildlife. It was awesome. We came back that night for dinner and relaxation. We played some card games and relaxed in the amancas.

Unfortunately Kristen and I were definitely talked up by Juan, one of the guides. He was kind of creepy and kept hitting on us. He asked me if I wanted to dance and what kind of music I liked. When we were trying to leave to go to bed at the end of the night, he was like, we could go down by the river and watch the moon and practice Spanish. (He was speaking to me in Spanish). Lol I told him I had seen the river a lot already and I needed to sleep for tomorrow. He was like there is no tomorrow there is only now. You don’t need to sleep on vacation. I mean he was trying so hard. I was also talked up by another one of the guides but he was way less creepy. These Ecuatorian men….

 On the third day we went to an indigenous community. Here we were taught how to make yucca bread from start to finish. You begin by harvesting the yuca which is a root. We pulled it up from the ground and then peeled and clean it. Next it has to be shredded. We all took turned shredding it using a homemade shredder. Yuca is very saturated with water so it was very moist and wet after being shredded. The next step is to squeeze all the liquid out and starch comes with it-it’s a very starchy root. Finally it is cooked in a pan and it makes a bread that has the consistency of toast. It’s very delicious with jam. At the indigenous community, we also saw some parrots and a macaw. The kids there were so cute and excellent futbol players. We went from the community further along the river to visit the Shaman. However, he was sick (he’s in his 70’s). We saw his wife instead and she talked with us a bit and explained the types of things she and her husband do. She demonstrated how they use this plant to help treat muscle pain and arthritis. It’s kind of like a poison ivy. The spines of the plant inject a substance into you that at first burns and itches and then heats and relaxes your muscles. Our guide also showed us the plant that cocoa comes from and also a seed that contains a red dye you can paint your face with. Even though we didn’t actually see the shaman it was still a lot of fun.

We came back from the camp and had time to relax before dinner. Also it rained a lot that day—we were in the rain forest and we had a decent downpour. That’s for sure. The rest of the night we just used to relax and talk and enjoy the atmosphere. I loved it there. It was like camping. That was our last day there. We spent Sunday traveling all the way back to Quito. Our last canoe trip back was really cool though. We saw a river otter and a giant anteater swimming across the river. They were really cool to see in the wild. And there were more monkeys-wooly monkeys this time. They were difficult to actually see because they were high up in the trees, but still really cool. On the bus back I conversed with another Ecuatorian man who sat next to me. He is a police officer apparently and he showed me his ID. He didn’t believe me when I told him I didn’t have a boyfriend. I was thinking I should just start telling all these Ecuatorians that I have a boyfriend and then they will stop trying so hard.

So that was my awesome adventure in the Amazon. I know it would be better told with pictures. That will come once I get back to the states.

Amazon!!!

Hola!

So tonight I´m leaving on a midnight bus to go to the Amazon Rainforest for 3 days. I´m going with 2 other friends from the program and it´s going to be absolutely amazing. The travel agency we booked it with was able to arrange it for us pretty cheap and I figured...when am I ever going to have this oppurtunity again? Also, we bascially decided to do it yesterday, so its a little last minute, but its going to be excellent. Look out for about 5 different posts on Monday with  full description of the amazing time I had.

Early Morning Baños

Sunday morning, the rooster alarm clock woke me up for Mass at the basilica. The hostel reception manager told me they have Mass on the hour every hour starting at 5, mentiras! Walking through the streets of Baños early in the morning was very peaceful. It is much quieter than Quito. The weather was a bit misty, but warm enough. I saw a dead dog on the porch of a storefront. There are a lot of cute stray dogs around Ecuador. I imagine this one was about to kick the bucket and found the porch as good as anyplace to die. I later saw the storeowner cleaning off her porch with hot water and soap.

Anyway, so I made it to the basilica only to find out Mass was in progress, the 6am Mass. There was no 7, only 6, 8, 9, 10. I struck out on that one, but it was a nice walk. On my way there I saw a woman at a restaurant roasting whole cuy skewered on sticks. Cuy is something I’ve been wanting to try since I’ve gotten to Ecuador. It’s definitely more commonly found in Baños, so I thought it would be a perfect place to try it (more about this later). But I decided to return to the hostel and come back for a later Mass. When I came back to the hostel, a group of people were headed out to check out the thermal baths. There are more open in the mornings and there are bigger ones available. We got to the baths for our morning soak (only 2$). It was still fairly busy for being 0730, but totally worth it. The locals there truly use the showers there to clean off. They have soap and shampoo and everything. They soak in the thermal pools and clean off in the cool water from the nearby waterfall. We could only spend a short time there, because breakfast was at 0800. We got back to the hostel, ate breakfast, and I went to the Mass at the basilica with 3 other people. The music there is guitar based, with a definite local flair. There aren’t really altar servers, nor a real procession down the aisle to the altar. It definitely wasn’t a high mass for the feast of the Pentecost, but the basilica is quite beautiful. It’s hard to really describe. Unfortunately, I didn’t have my camera on me, so I’ll have to get those pictures from someone else.

After Mass, I did some souvenir shopping and bartering and I went with my group to finally try CUY! So for those of you who are wondering what cuy is, I will now tell you. (I wanted to leave you in some suspense).Cuy is guinea pig. It’s rather exotic here so it’s expensive. We got half a cuyand split it between the four of us for a total of 7$. It was whole, but we got the lower half (no head). We all liked it. It kind of tastes like pollo. (Haha doesn’t everything that’s not pork or cow?) I even bit into the liver! It’s fattier than pollo though, a bit more succulent and rich tasting. It’s quite good though and I was happy to just say that yes I’ve eaten cuy! I also really like saying the name. It’s pronounced Kwee, like the noise a g-pig makes.

We had to leave earlier in the day around 1200 on Sunday, so after a bit more wandering en el Mercado, we returned to our hostel, packed, and returned to Quito. It’s taken me a couple hours to recount this entire weekend. There was just so much to do and it was amazing!!

The Best Day In Ecuador Yet

This is by far the craziest and best day I’ve had yet, full of experiences you only get once in a lifetime. So Baños is a very touristy place and it was originally named for its thermal baths heated by volcanic springs or something to that effect. They are supplied by natural spring water and the locals love them (more about that later). There are also a great number of waterfalls (cascades) and travel agencies offering everything from jumping off bridges and cayoning to renting ATVs and horseback riding. It’s an excellent place to be. So in the morning around 0600 the residential roosters woke us up bright and early. The view from our room that morning was gorgeous. The city is quite small and lies in a valley surrounded by the Andes Mountains. A ver, that morning we ate our free breakfast and schemed on things we wanted to it. A lady came from one of the agencies to tell us about the different things they had to offer. A big group of us decided to go cayoning and then biking along a route with waterfalls. Cayoning essentially involves repelling down waterfalls and needless to say, it was awesome. The agency gave us all our equipment (wetsuits, jackets, helmets, harnesses, shoes), transport to the site, free pictures of us, and guides for only 25$/person. We all climbed up, like mountain goats along small paths to the top of these waterfalls. Then they gave us a brief demo on how to repel down the waterfall and then we just did it. It was pretty amazing. We went down two falls, and walked to another set of three more. One we went down like a waterslide and the last one was about 100 ft tall. It was just a drop down. After you went initially down you were just hanging in the air and lowering yourself down from the top. It was scary at first, but totally worth it. No one got hurt, but my shoes (The shoes they gave us were like converse shoes with very little grip) had two pretty large holes that originally were there and started out small, but were much bigger when I was finished. So we all signed up to go biking after the cayoning. The agency brought us our bikes and bags with our clothes to the spot where we walked to afterwards. We were all quite wet and cold at that point and it had started raining. We decided to trudge onward since we had already paid for the bike rental (5$ for the day, awesome price!). So they gave us our bags and we changed our clothes on the side of the street. That was definitely a new experience, especially because we were in bathing suits and trying to change into dry underwear and clothes. We were definitely roughing it by the time I had to find a bamboo patch to pee in.

So we then continued in the rain along the roadwith the other cars. There wasn’t a separate path for bikes so whenever a car wanted to pass you they would honk at you and speed passed you. Obviously it was a bit dangerous, but nevertheless exciting. Most of the ride was downhill. We got to see several waterfalls and stopped to watch these people jump off the bridge. I mean, they had harnesses and what not, it was a bridge swing. I was tempted to try it out (that and the zipline) but we were all ready to get out of the rain and eat lunch. A lot of the waterfalls also had paths or gondolas that you could take to get closer, but in the interest of filling our bellies and getting out of the rain, we skipped those parts.

At the end of the trail, there was a pickup truck ready to take our bikes and us back. We were all standing in the back of this sketch truck with our bikes and about 15 of us, with no seat belts. The truck driver was taking slick curves at like 50 mph and people were trying to pass us on the road. This dunebuggy (like a go-kart) even bumped up against the side of our truck. No damage done though. It made me think about how in the states I would have had to sign about 3 different waivers to even get myself in that situation. It was great.

A ver, that afternoon we got back dirty and tired and ready for food. We ate at this cool place called Casa Hood. They had a variety of different ethnic dishes. Oh and people have been saying that Chinese food in Ecuador is not the same as Chinese food in the states—but it is. (That’s for you Claire). I had some very delicious fish. And to open the door to leave the restaurant you had to pull on this plastic banana (Haha I thought it was sweet and unique).

After dinner we planned to go to the thermal baths. Unfortunately they were insanely crowded and everyone in our group decided to check out this recommended place with a Jacuzzi up in the mountains, El Café del Cielo. One of the guys in our group is good at speaking Spanish and haggling, so instead of taking a Taxi up there he asked this random truck driver, if he would take us up there. We would again sit in the back of a truck, with no seatbelts, at night, up a mountain, but it was only 5 dollars for all eight of us. That was definitely the cheapest part of our adventure up the mountain. We discovered that the Jacuzzi, did not cost 5$ per person to use, but more like 15$. The original cost was 20$, 15$ was our group discount. The manager was rather bothered by us and since we came all the way up there. We decided to just go with it. The view of Baños at night is pretty cool and we were high enough up in the mountains we were feeling the mist of clouds around us. The jacuzzi was definitely relaxing. It was connected to this 5 star resort place and it was fairly pricey for Ecuador. We ended up getting a taxi ride down the mountain back to our Hostel for the night. All in all it was an excellent day. The best day yet.

Baños Hermosas

Our trip to Baños began around 1500 on Friday and we arrived at our Hostel around 2000. It took us quite awhile to get there, but the way there was fairly scenic. I noticed a lot of buildings that seems half-way constructed either along the side of the road with not much else, or within small towns. I’m not sure why there were so many what looked like abandoned constructions projects, but there were. We also passed a small town, which had about 20 small shops all selling Jeans, all in a row. It was seemingly odd. We weren’t sure how any of them survived with so much competition. As we got closer to Baños, we encountered a lot more mountainous two-lane roads, with plenty of curves. As we were driving in the dark, this line of cars behind us continued to try and pass our bus on the side of a mountain. So one of them would stick out into the opposite lane to see if a car was coming. There were two very close calls, where the cars were almost going to collide head on if they didn’t merge soon enough. So that was the ride there. When we finally arrived in Baños, we found our hostel, which was very nice. Only 9$ a night with free breakfast and our own bathrooms with hot water, towels and toilet paper. It was great.

We went out to find a late night dinner and ended up eating at a slightly pricey touristy restaurant. Compared to spending about $1.50 for an entire plate of food in Quito, it was pricey. After that we decided to check out the nightlife. We stopped at this one bar/discoteq which advertised free flaming shots and 2$ Pilsener. Pilsener is the beer of choice around Ecuador. The bottles are about the size of 2 beers and when not in a touristy place they cost about 1$. You can easily get totally smashed on 10$-so its pretty cheap here and no I didn’t have any flaming shots. I was actually not in the mood to do much having been accosted by menstrual cramps around dinnertime. I was without any analgesics, so I self-medicated with a Pilsener and it totally did the trick—muscle relaxant and analgesic effects all in one. So after fixing that problem, we danced to what the club advertised on their flyer as F***in’ Good Music…a.k.a. American music. It was pretty funny. Also, the policia came in and we were all worried they were going to be like…you’re drinking illegally (to the people in our group who aren’t 21) because as Americans we have that mindset. The funniest part is they came in there and said, “we’re looking for Cubans.” We just cracked up about it. So after an hour or so at this place, we decided to move on to a different club, where our other peeps were.

It had more Ecuatorian music, like Reggaeton and music in Spanish. So I was dancing and was asked by an Ecuatorian if I wanted to dance. So this time I said okay. It was actually a lot of fun, because he knew how to dance Reggaeton and do spins and dips. So that was great, until the music flowed one song to another which made it quite hard to leave. The music switched to more Spanish hip hop and I was finally able to plead that I wanted to go to the bathroom and then dance with my friends, after saying that, “No I don’t want anything to drink.” He was quite respectful though, so it wasn’t that bad. In the end, I had to start ignoring him and dance with my friends. He just didn’t want to give up. In fact, I saw his face when we went to the bar across the street and asked my friends to hide me. Haha. Anyway, no worries I was surrounded by friends and he didn’t try anything. But the point is these Ecuatorianos don´t like to give up.

So like I said, we went to the bar across the street after the second one. At this place, they had Karaoke. This one woman like sang 5 songs in a row. She was loving it—all in Spanish of course.  Then some of my friends picked songs to sing, mostly all American ones. I had originally wanted to return to sleep about an hour earlier, but I had to wait for other people to come back with me, so we got in around 130—not too bad.

Autobús Tour!!

On Friday, 6/10/11 most of us decided to skip clinic and go on a free tour offered by the language school. The bus we were going in sat about 17 people and we fit 19—a bit squished and of course, no seatbelts. The first stop was a beautiful vista of the city of Quito. To get there we were going up all kinds of steep roads and switchbacks. Most of the cars here are stick shift because an automatic would die trying to handle the hills of Quito.  I can only imagine trying to learn how to drive here. On the way there we saw many of the local people in the traditional indigenous garb. In general, they are all around Quito as well. After we stopped for photos, the second stop was El Panesillo, the Virgin Hill. On top of the hill is a giant statue of Mary—the only one in the world, which depicts Mary with wings. The people of Quito are quite proud of it, because it is distinct. We went up inside of the statue, which is Mary standing on top of the world, crushing a snake creature beneath her feet. She has her 12 star crown and wings, of course. It was pretty cool to go up inside of it and then there is a balcony where you can walk around the world. It’s a bit hard to describe—pictures will show it better. I also incidentally paid to use the bathroom for the first time in  my life. The bathrooms there were run by a little lady. I went in to use one—they were quite nice for being public. She handed us a napkin—an extra luxury in a public bathroom. Most of them don’t have toilet paper. So when we were done she expected a donation. All I had was a dollar and the only change she had was 5 dimes! So I ended up paying 50 centavos to use the bathroom. In comparison, she definitely was not happy about my friends 10 centavo donations.

So another cool thing about Ecuador is you get to barter and haggle over goods, taxi prices, and what not. At El Panesillo, there were lots of booths set up with tourist attractions and souvenirs to buy. So I got to experience some of my first bartering. I was able to get a knitted hat for 2.50 and a medium size purse for 4$. It was awesome. You just can’t do that in the states at all. It’s something I’m going to miss.

After the Virgin Hill, we made our way to one more lookout area on the opposite side of Quito. It was in a nice park area, but we were all about ready for lunch and to get ready for traveling to Baños for the weekend. The way back definitely included lots of crazy driving. This group of school-aged kids got really excited when our bus passed theirs. They were all waving and excited to see us.

Another note, Ecuatorians especially like to stare at white blonde girls. I don’t think I’ve ever turned so many heads in my entire life. They also like to make a point of staring. One man stared at me and continued to look backwards even after I had passed him on the street. Ha and I only looked back to see if he was still staring, which he was.

As promised…

I apologize for the typos in my last post. Spanish keyboards are a bit different and I was trying to type out that post quickly to save money ;)

Alright so Plaza Foch is like the center of the party district. Lots of gringos hang out there and there are tons of guys trying to recruit you into their clubs promising such and such this and free entry that or open bar till blah blah. So we decided to go to this bar that promised free entry for girls and certain free drinks till 11 and 5$ cover for guys. So that was cool and we were basically a group of 25 people filling up their whole club—it was pretty empty when we got there. They had discoteq music, flashing lights, and some pretty intense fog machines. After awhile other Ecuatorians started filtering in. We were using our salsa lessons and dancing and this Ecuatorian guy asked Nicole to dance. And she said she wanted to practice her salsa so she was cool with it for awhile. Although, he was like offering her drinks (which don’t worry she didn’t drink). Anyway, long story short I saved her by telling him we were going to the bathroom. This other guy tried asking me to dance and I was like No thank you….leaving now. One our teachers/friends from the Spanish school taught me how to dance Reggaeton, which was a lot of fun. So we finally had enough of the club and it was around 2330, when we decided to leave. Only the guys from the club seemed to be racking up the price to more than it was originally agreed upon. So there was a little bit of a problem getting out of the club, but all in all it was a good night. It was free for me, which was cool, but some people were feeling a bit chuchaqui the next morning J

Loco Dìa

This should be a good post. I hope you all enjoy it. So today was my first clinical day. I traveled with Maya another student to a clinic in the North of Quito up in the hills in los barrios pobrezas. There is hospital-clinic there, Hopsital Volzades. Many of the people come there from the surrounding area. But its really quite small. The first day I did some nurse stuff-took some vital signs and measurements for the patients before they were seen my the doctor. I also observed several visits with the doctor. One was a couple kids with varicella (chickenpox) and then the more exciting\sad case was necrotizing facitis. This 8 yr old had been hiding his infection from his mama. I suppose he was afriaid of going to the doctor. It was a super bad infection though. It looked like a second degree burn and was quite large. Close to the stage of IV antibiotics--whihc they would go straight to in the states. They dressed his wound with a dressing that had antibiotic in it, prescribed him antibiotics and told him to come back tomorrow. Unfortunately that was yesterday and  we did not see him today. I truly hope his mama gets him those antibiotics or he could lose his leg. Anyway, that was the most of my clinical experience. We then returned by taxi. Drivers are crazy here and I´m pretty sure there arent really speed limits here.
After that we had spanish class and we went to a place for some salsa lessons. It was a serious workout, but lots of fun. We got a bit lost following Alejo he said he knew where he was going but we ended up seeing some rich neighborhoods and taking a 30 minute detour.
In the evening we went out to the Plaza Foch where all the bars and discoteqs are. We found a place to dance and drink. It was an all around good time. I must close this post now, because <i don´t want to pay for more internet but I will tell you all more later!

Energìa

I surprisingly had more energy today than I did yesterday! I think my body is better adapted to the altitude than it was a few days ago. Today was another day of classes for 7 hours. We watched this movie from Peru and played Spanish scattegories—those were the highlights. In the evening we had a presentation on the healthcare system of Ecuador. They passed a law several years back that allowed for free maternal health care and free health care for children under 5. They have a pretty high number of teen mothers, and a high maternal mortality rate. A lot of the mothers don’t receive good healthcare during their pregnancy and often if they have a long walk to a clinic or hospital they will stay at home for their labor and birth. So whenever there is a postpartum hemorrhage they usually die. Anyway, that’s just a bit about the healthcare.

Tomorrow is the first day of my clinical rotations. I will be following a doctor who travels around to different clinics, so it will be a good opportunity to practice my medical and conversational Spanish. I’ll tell you all about it tomorrow.

Tonight after dinner I taught Kristen how to play Bezique and she definitely enjoyed it. Oh and this is for you Michael—in our first practice round we played an open hand and I got a double bezique. It was totally awesome. Anyway, Kristen liked the game a lot. I’m sure we’ll play again at some point.

Cultural note of the day—Ecuador include tax in all their prices and its muy excelente. I wish they did that in the U.S.