As I‘m writing this, my third week in Ecuador is almost over. Yet when I stick my head outside the window, everything I see and hear and smell is still new and exciting. There are motorcycles carrying entire families, street vendors shouting for attention, houses without window panes, three yellow taxis passing by in a row, the pumping bass of reggeaton beats and enchanting salsa rhythms, topped off by the mixture of scents of pollo del asado from the restaurant next door and of fresh pan de agua bread from the backery downstairs… Greetings from Naranjal, a small but vivid town south of Guayaquil!
The reason for my stay here is a Public Health Project called Fundación Omar Mosquera. It’s based in Riobamba, where I arrived by bus from Quito and directly travelled on together with a team of around 20 people covering the fields of medicine and dentistry, nursery, laboratory work and physiotherapy. In slightly changing constellations we would work in the county of Naranjal for the next four weeks. Over time, I got to meet many very friendly and open people with whom I not only enjoyed to work but also spend our free time.
On the first day here, the mayor of the town welcomed us during the weekly ceremony in which he thanks volunteers of the county. He anounced that we would be working in different places around the town of Naranjal to provide cost-free public consultas (consultations) for the people that live there. The next day, our bus driver brought us to our first place of action. Local volunteers were already setting up the tents in which we, the team of medicina general, would examine patients. Next door, the dentists prepared their tools to check the dental status while in another tent the physical therapist got ready to aleviate sore, tightened muscles. Soon, the first patients arrived. The nursing staff weighed and measured them, noted down the blood pressure and sorted them according to their needs. When the first patient arrived at my table, I was more than glad to have Júlia from Barcelona by my side. The accent of the people here is different from the castellano Spanish I learned in school, so it took quite some concentrated listening to understand. With the next patient, I was on my own. Hands and feet helped convey the message whenever I didn’t grasp my patients‘ problems or did not yet know the word to bring my point across. Although one woman that day got frustrated with the situation, the other patients were very kind and literally patient with me, explaining their problems again in different ways. The vocabulary (and a lot more!) guide that former German volunteers from Unified For Health had written was a big help, especially during my first days when each memorized phrase notably facilitated the anamnesis and examination. After having collected all the necessary information with the means available, the patients could for example receive immediate treatment by the physical therapist or pick up his free medication from our supply.
Over the course of three weeks, I have by now seen many respiratory infections, dermatological conditions, headaches, urinary tract infections and unspecific pain in the lower abdomen or lower back. Besides that, frequent reasons for the consultation included wishes for vitamines or desparasitación of children that had lost their appetite. Initally, the latter topic probably posed the biggest challenge to me, as my experiences with parasite infections tended towards zero. In general, the majority of our work is made up of checking for red flags to admit certain patients to the hospital, take the time to listen to their problems and give advice on how to dedicate oneself to a healthy life style. The patients‘ confidence in european medicine is very strong, which is why I think that the majority of people take our recommendations seriously, even though they might have expected a different treatment. Sometimes it is hard to explain that medication is not the solution, but that simple things such as drinking water or taking a break from time to time are much more promising with smaller daily aches. At the end of the day, after around 5h of consultas, I’m usually pretty tired, but nevertheless very content.
Since my time in Ecuador is limited to two months, I try to use the weekends as much as possible to get to know the country. Together with friends from the project, I visited Guayaquil, a busy metropolis near the Pacific Ocean. Looking around in the city centre, one could not deny a baffling similarity to big cities in Europe. Well, the iguanas that rest in the trees of Parque Bolívar quickly reminded me again of the fact that I’m very close to the equator. Another special location was Isla Santay, an island in the wide river Guayas. There, only a handful of indigenous people live in their houses on stilts. Visitors can walk parts of the island on a wooden runway, surrounded by mangroves, colourful butterflies and from time to time even vultures or other special birds. The biologist guides working in the small crocodile park of the island are happy to explain the features that make this small ecosystem and its animals so special.
On another occasion, we went to check out Cuenca (= valley), a city in – a valley! Enclosed by the beautiful Andes, this town had a very charming atmosphere to it. Many young people on the streets, supposedly on their way home from university; vegetarian or even vegan restaurants; and a sort of outdoor history and natural science museum named Parque Arqueológico Pumapungo. A little more than a half an hour drive away from the main bus station, we took the chance to get to know the gorgeous National Park Cajas. With a landscape dominated by mountain peaks, rough terrain and plenty of small lakes, this terrific place sometimes reminded me of New Zealand, while a few steps further I thought I might be standing on the moon. We spent the night in a tent near the base of the National Reserve El Refugio at an altitude of around 3500 m. I sure needed the extra time to adjust to the low air pressure and oxygen level! During the night, I sometimes felt like I had trouble breathing, and during the entire time in Cajas, a slight headache accompanied me wherever I went. Nonetheless, I’d repeat this trip exactly the same way. Waking up right in front of the lagoon Toreadora at dawn was wonderful. The hike that we took lead us to altitudes of more than 4200m. The reward for our endurance were an absolute quiet and multifaceted, very impressive views.
The third weekend was set for getting to know the area closeby. Naranjal is known for its waterfalls called siete cascadas, an indigenous community named Comunidad Shuar and the aguas termales in Zhangal where one can bathe in surprisingly hot water basins or cool down in the river. The highlight of our visit to Las termas de Zhangal was a tour through the surrounding forest. Our guide Alex showed us how to crawl through caves with bats, climb giant rocks and – my personal favorite – take swings above a river bed with a liana!
All in all, I’m more than glad to have met so many friendly people already and to have done so many different things. The coming week will be my last here in Naranjal. I’ll spend the following 14 days in and around Riobamba, working in different projects. ¡Hasta luego!