Third-Worldistas

Last Friday, with one of the internal medicine residents, Dr. Christian Guarderas, I slipped out of the hospital for a coffee at a local gas station which happens to be the only place nearby that serves brewed coffee and not the instant variety that is ubiquitous in Guayaquil.  We were waiting too long to pay when one of the store employees came over and asked for help.  Apparently another employee had fallen in the store-room and was lying immobile in the back of the store, surrounded by her coworkers.  Christian examined her quickly and determined that although she was stable and didn’t have significant neurological deficits, she needed to be immobilized properly and transported across the street. 

The employees seemed unsure of what to do, and said that their boss was coming and would make the call.  Christian, a little annoyed at the unnecessary delay, said he understood but that she needed to go to the hospital.  We decided to take our coffee in the store instead of leaving and make sure the girl was transported.  Christian told me he was embarrassed that they were hesitant to call for an ambulance to take her across the street because of the costs involved.  I assured him that similar incidents happened every day in the U.S.



Dr. Christian Guarderas



When not in the hospital I have spent time settling in to my new abode.  I bought a cheap guitar and a Panama hat (a misnomer; they are made in Ecuador), and lots of bottled water.   A large part of the weekend was spent  hanging out with my new friend Christian.  I met his family and we shopped for lunch, ate a terrific meal of specialty seafoods and then took a little siesta before going to play basketball.    After that we attended a belated birthday party thrown for Christian’s wife, Gabby, who is also a physician. 



El Malecon





Las Penas



This week has been spent working with another neurologist recently returned from the U.S., Dr. Mosquera, and spending additional free-time in the emergency ward and the intensive care unit of the hospital.  While leaving the emergency room one afternoon, I overheard an administrator angrily addressing a crowd of family members and friends of the patients.  Because many poor people come to Luis Vernaza hospital from distant corners of Ecuador to receive low-cost, competent care, the waiting rooms, hallways, and areas surrounding the hospital are always full of people who have nowhere else to stay while

they support their loved-ones.  But apparently, this group had worn-out their welcome.  “This is why we are referred to as Third-World” the administrator fairly shouted, gesturing to the people lying benches, empty food containers and other trash on the floor.  The people stared back blankly, not protesting, hardly even raising an eyebrow.