I have recently settled into my new home of Guayaquil, where I am completing my neurology rotation and learning a bit about the country of Ecuador and its people.  In 2003, I visited the capital Quito and traveled to Esmeraldas, a very poor region in the northwest where the U.S. government was soliciting for wharf repairs on behalf of the Ecuadorian navy.  Esmeraldas borders the portion of Columbia under control of the FARQ rebels, who fund their revolution mostly by promoting the production and distribution of cocaine, much to the chagrin of the U.S. and Columbian governments.  Regardless of one’s politics, it was stunning to witness the poverty and desperation that existed in Esmeraldas, and it was experiences such as this that convinced me that I could do more to help this world as a healthcare provider than as a construction contractor.  



Guayaquil digs



During medical school, while searching for opportunities to return to Latin America, an ER doctor named Neil Waldman who has spent time in the Galapagos volunteering his medical services for a non-profit called ICE - “Immerse, Connect, Evolve” – put me in contact with Emily Pozo, the program’s president.  ICE envisions a Galapagos community in which everybody has access to education and adequate healthcare, improving their ability to promote efforts to protect the fragile ecology of the Galapagos islands.  The idea of helping to educate and care for the local population and in turn contribute to preservation of the unique and inspiring flora and fauna of the Galapagos islands was enticing, and the opportunity to improve my Spanish and learn more about Latin American culture in such a setting cinched the deal.

During this process, I also took the opportunity to extend my time in Ecuador by completing a required neurology rotation at La Junta de Beneficencia’s Luis Vernaza hospital in Guayaquil, Ecuador.  Mrs. Pozo has a contact with La Junta, Senora Isabel Valdez de Escala, who graciously accommodated my request and has been selfless with her time, helping me with accommodations, transportation, and in securing additional medical supplies to donate to ICE.

Mrs. Pozo told me that ICE can manage their diabetic clinic for an entire year with approximately 2,000 glucose testing strips.  Apparently patients have their blood sugar tested about once per week.   In the U.S. we are taught that good diabetes control usually requires 3-4 glucose tests per day!  As is often the case in poorer countries, people simply do without and do not receive what one might consider the standard of care.  Knowing what a devastating disease that diabetes can be, my goal was to bring 2,000 glucose testing strips to donate to ICE.  Thanks largely to a generous donation from Mr. Steve Kemler, who is CEO of Conversion Partners, LLC, that goal should be surpassed, and many other basic necessities will be provided to ICE and the people of the Galapagos, all free of charge or obligation.

Glass Only

But I do not leave for the Galapagos until the 6^th of March, and until then, I would like to share more experiences in Guayaquil.  Working in the Neurology wards, I have seen mostly hemorrhagic strokes caused by uncontrolled hypertension.  Commonly, people don’t feel any symptoms from high blood pressure and decide to spend their money on other basic necessities instead of their prescribed medicines.  The results can be devastating.  We have a 42 year-old woman who had an aneurysm clipped in her brain, presumably stopping a hemorrhage.  The operation was done in another hospital, but when the patient could not afford to pay for the services, she was discharged and ended up at Luis Vernaza, where the poor are often treated at a reduced rate or gratis. 

Her head has been shaved and she has staples holding her scalp together from above her left eye to behind the ear.  Her right side is immobile.  She cannot speak, but she understands, and whenever I try and talk to her she only cries.  Her left hand grips mine tightly, and it is difficult to tear oneself away, physically and emotionally.  I can imagine without benefit of words in any language that she feels the desperation of a castaway. 

People Watching