Updated... finally!

May 18, 2008
Today was an amazing day! As always, we went to church and enjoyed the strength of the ward. But, afterwards we had a great opportunity to go sing at the Psychiatric Hospital of Guayaquil. It was truly an unforgettable experience. If there is one thing this country does far better than us, it is taking care of the mentally ill. We arrived and met with the nuns and then were split into two groups. Our group was the lucky one... we sang longer than the other group and to the women and the children. The hospital is divided into salas that consist of inside sleeping quarters and an outside, fenced in area where the patients can freely roam. It is very well kept and beautiful. The patients are well taken care of and the staff is kind, gentle and loving... a stark contrast to the majority of psychiatric facilities in the States.

In each sala we were greeted with hugs and kisses from each patient. Many of them were abandoned and were thrilled to have a visitor enter their world. As we sang songs to the patients the Spirit was so strong as we sang to the beautiful patients. They were thrilled to hear about their Lord and a peace overcame them as we sang. One of the salas we visited was specifically children. It was heartbreaking to know most of these children would lose their family along the years. We sang, "I am a Child of God," and "Families Can be Together Forever," and tears welled in my eyes knowing their difficult future ahead. Yet, they were completely happy. Kisses, claps and smiles filled each room. What a beautiful people.

May 19, 2008
What a wonderful day! I was able to visit Sotomayer Hospital again (the Maternity Hospital) where I helped with labor support in the room for high risk patients. It was an amazing experience to see these women give birth in stressful conditions with no pain relief or prior teaching. I was able to teach relaxation techniques, give counterpressure and provide support for the women in the room. I specifically helped with three births.

At first it was very overwhelming. A few of the women were in terrible pain and very afraid. The hospital does not allow anyone in the room while they labor. Women lie naked on the tables filled with patients and labor together and then are wheeled into another room where they have to switch tables as the are crowning to be delivered. There is no pain medication and very little monitoring. Needlesstosay, this is a very different experience than I had at the epidural capital, UVRMC. The high risk room where I was stationed was a little different--much smaller and each woman had an old monitor. In addition, my women did not have to switch beds. However, the added stress of having a high risk delivery (pre-term, stillbirth, pre-eclampsia, etc.) made the experience all the more frightening.

The patients were so grateful for the support we gave. One of the patients was wheeled in later in my shift and saw that I was finishing helping during a delivery. She motioned for me to come over and asked if I would please stay with her. She was very scared. Her baby was going to be delivered quite early (she was 29 weeks along) and she had driven 3 hours to get to the hospital. She was only 19, but this was her second baby (very common for this country). I promised her I would do all I could to help her. Immediately, we bonded. I started her IV and prepared her with some brief relaxation teaching. Then, I turned her on her left side and applied counter pressure to her lower back with each contraction. When she was ready to deliver, I assisted her into the position and helped the doctor dress. I held her hand and reminded her the God would give her strength. With each push she wrapped her arms around my neck and squeezed me with all she had. We breathed together and cried together when her baby was rushed out of the room. I don't know if her baby lived. It was born with a tracheo-esophogeal fistual. Basically its digestive system and breathing system was linked together... incompatible with life if radical medical interventions are not taken. I didn't get a picture with her in all the rush of things, but I will never forget her sweet face as we talked about trusting the will of the Lord.
After the hospital, a few of us rushed over to another CPR class. We taught a group of school teachers and were in the newspaper the next day! It is a neat thought to think that a life might be saved for the teaching I have done.

May 20, 2008
Today I spent another day in the maternity hospital. This time I didn't get to go into the labor room but spent and hour in the nursery and the rest of the time teaching in the salas about umbilical cord care. It was so fun to hold and bathe the little babies. They can't afford wipes here so when I changed the diapers, I had to undress the baby and rinse it off in the basin. It is amazing what we take for granted in the States.

Afterwards, a small group of us went out to the community where we met with the auxiliaries (like CNAs or PCTs) and held a 3 hour class. I was the team leader and helped arrange education on Vital Signs, First Aid, Safety and Security in the Community, and CPR. It was lots of fun and my Spanish is definitely improving with all this teaching I have been doing.
We drove straight from the community to a Stake Center in South Guayaquil (the dangerous part) where we had another Stake Health Fair. (Of course, we made a quick pit stop at a local McDonald's for a five minute dinner). Again, me and two other girls taught about Nutrition and Exercise. I continue to be amazed at how much these people want to learn and are willing to change. They are genuinely concerned about their health.

At each health fair we take the blood pressures of all those who come to the class. As usual, I took the blood pressure of a woman in her late 30's. Although I was shocked at the reading... 210/100. She was literally a walking stroke. I asked one of the girls to double check my reading and I immediately went and got one of my instructors from the other class. After the class was completed, we pulled the woman aside and asked if she had a history of high blood pressure. She explained that she knew her blood pressure was high but she could not afford the medication. She had been having headaches and nosebleeds a lot and knew that she should take the medication, but her family needed to eat. We explained that she should see her bishop for help and meet with a doctor either tonight in the ER or first thing tomorrow morning.

After meeting with her my instructor and I found the Stake President. We explained the situation and made sure we had done the right thing in referring her to her bishop for help. He was so concerned for the woman and wanted to meet with her immediately. I raced out to find her before she left, I hadn't even gotten her name. Luckily, I found as she was walking out the front gate. The President met with us and told her that her medical expenses would be covered, that she needed to be a mother for her two kids. Her eyes filled with tears and the utter relief was clear. She hugged me and told me she would love me forever for the help.

A few moments later another women asked me if I would please take her blood pressure because she was having bad headaches. Sure enough, it was 185/95... another potential stroke patient. The Stake President saw me take the reading and immediately asked if it was dangerous. I gave him the usual schpeal and his eyes welled up with tears... it was his mom. He had no idea that she was in danger of having a stroke. He was so grateful that we were here helping him help in ways he couldn't. The entire trip was worth those moments... lives potentially saved by a simple blood pressure reading. It is amazing how the Lord guides us to bless each other's lives.

May 21, 2008
Today was dreadful. All that McDonald's finally caught up with me... I got food poisoning and was throwing up all last night. I couldn't much get out of bed except to expel what was left in my body.

Haha! Watching Seinfield I couldn't help but get a kick out of this line...
"Who goes to South America? You go there, you come back with things taped to your large intestines!"

I concur.

May 22, 2008
Today I finally got out of bed and headed to clinical at the Gilbert Pediatrics Hospital. I had clinical twice before (once being sick). I banked on a quick recovery and was wrong. After about two hours of clinical... which at Gilbert consists of standing and watching whatever you can see over the herds of staff... I began to feel really nauseated. I walked out into the hall... having no idea what was about to happen. Luckily, I had the sense to sit down... originally to prevent barfing. The next thing I remember I was being shaken by a team of doctors. My ears were ringing and I couldn't hear a thing they were saying but their faces were so close I could lick them. I was so confused until finally I heard... "Do you speaka eSanish?" In my just-out-words, I managed to say, "Si."

I was forced to spend the rest of the clinical day in a wheelchair. Remember... this is a children's hospital. Thus, I was confined to a wheelchair that was tiny toon size. That will teach you not to pass out a clinical! All in all though, it was fun to joke with the little kids who were in the same size wheelchair as me as I passed out another round of presents. And, my hot wheel skills thoroughly improved.

That afternoon, we were scheduled to meet with a local nursing school to discuss the experiences we were having and compare it to the experiences of Nursing School in the States. Of course, we were dropped off at the wrong University. So, we walked for 30 minutes to find the correct University. By the time we got there I was exhausted and feeling sick. I was already dehydrated. Sherri (the main lady) took me to the air conditioned heath center on campus to lie down for a moment.

As soon as I laid down a student was in to take my blood pressure (which was fine). Then, the nurse came in to assess me. She didn't believe me that I wasn't in pain. I repeated explained to her the situation... I had passed out earlier, yesterday I was throwing up a lot, I was just hot and tired and needed to lay down for a few minutes... but, more needed to be done. She raised her finger in the air and exclaimed (all in Spanish of course, but for your sake I will translate this)...
"She needs las gotas (the drops)!"

Worriedly, I asked, "What are las gotas?"

"Las Gotas!" She exclaimed again, this time annoyed.

Confused, I asked, "Well, do las gotas have a name?"

"Yes, Las Gotas!" She was becoming far more irritated with me than I had imagined she would.
I motioned to see the bottle to look at the name. For the first time in my life I was actually hoping for the JACHO mandated label. Of course not, though. It was a plain dropper bottle with the word, "Emergencia" (Emergency) scribble across the side. Oh great, I thought. Las Gotas are going to get the best of me. There was no one else in the room to help me out with this one, so I used the line we hear all the time in nursing school...

"Well, I am actually taking a few other medications, and I don't want this one to negatively interact with them. So, I actually do not want Las Gotas, but, thank you."

That was it! She had had it with me. She inched closer to me and said, "I don't care. Either you open your mouth, or I will open it for you."

Evidently, patient autonomy does not play a role in the heath care of Ecuador. I received three drops of las gotas. Now, I don't know if it is due to the lengthening of time, or las gotas, but I am feeling significantly better.

That night we went to the beautiful temple of Ecuador again. I so enjoyed it. I felt as though I was returning home and was comforted to be inside the house of the Lord.

May 23, 2008
Today was the our last day in Guayaquil. It was filled with packing, a lunch sponsored by the Junta (the charity hospitals we have been working in) and a pool party at David's cousin's house. I am excited to move on the Quito for a little bit of tourism! It has truly been a great experience here. I have learned so much about gratitude. Although I have been rather ill for the majority of the trip (those darn intestinal bugs got me good), I am grateful for this experience and wouldn't trade it for the world. Often, the world is not a happy place... but, the people still live happily.

10 Things I Discovered I am Grateful for:
1. Clean, running water... this is not something we have to think about in the States, but it kills people here.
2. The Medical System in the States... sure it still sinks sometimes... but, at least we can get adequate care. Although we might not be able to afford the ER visit, at least it will probably save our life.
3. Pain Management... I am so glad my mom did not have to suffer in pain while she had the neck problems. Culturally, we accepted she was allowed the opportunity to take whatever pain medication necessary to feel better.
4. A Loving Husband... I am so grateful my husband loves me and is faithful to me. How difficult it was to witness the pain, fear and abuse suffered by so many of these women.
5. The Crappy Economy in the States... hey, at least my home has a floor, roof and windows (even without screens). I have a job that meets my needs. I can get an education at a great university. I can eat a balanced diet. I will not die, because I have been given much.
6. Bug repellent and sun tan lotion... I probably will not get malaria, because I can afford to wear bug repellent each day.
7. Good old American food... Oh my skinny body needs some good food.
8. Enforced Traffic Laws... it is amazing what I have lived to see! Here, the lines painted on the roads are mere suggestions.
9. Contact with the outside world... It is amazing how difficult it is to live without cell phones, computers, internet, etc..
10. The United States of America... people, we have it good. Sure, there are things to change, but do it with gratitude, not whining. We have a country that can change.

10 Things Ecuador Can Teach Us...
1. Resourcefulness... that's right, use that rubber glove as a tourniquet. Go ahead, fill that bucket with water to be used for traction.
2. Happiness is Not Dependent on Money... I saw more smiles here than I see in the States. Sometimes, being poor is a blessing.
3. People Don't Bite... we really ought to say, "Hi," to that person on the elevator. Sit next to someone new at church, smile at a stranger... what is life without friends?
4. Invest Our Time in Learning Another Language... Far more people here speak English than those who speak Spanish in the US. We are an ethnocentric people in the US. Opportunities are becoming global, we need to participate!
5. Love the Land You Live In... Every person I met immediately asked, "So, how do you like my beautiful country!" They are proud of the beauty around them. We need to learn to appreciate our land as they appreciate theirs.

I am happy to be on the tail end of my journey. I am so grateful for my parents in providing this opportunity and for my husband in letting me go! I miss you all so much! Talk to you soon!

May 23, 2008
I finally arrived in Quito for the touristy stuff. I am excited to be here. It is much different than Guayaquil. Much nicer... much more beautiful. I am excited to get home, but will enjoy these last few days. I will post pictures later. Love you all!

The stellar hikers. The view is amazing... no, not us... the greenery around us.

Can you see the top? Me neither!



Can you see me? The tree is huge! You all should be proud. I had to sacrifice myself for this picture... I had to walk off the "beaten path" to where I couldn't see what was surrounding me for the sake of a good picture. Needlesstosay, when the picture was done I RAN back wiggling.

Beware, spiders are everywhere. I faced my fears and walked through the jungle amongst the meanest of them. I am just as afraid as I was before... if not more.

This is before I knew the boat had holes in it. After this picture they handed me a topless milk carton... bail or sink my friend.

Update from the jungle...

One of the few shots I could get. You can't really see the houses. It is too dangerous to bring my camera. I will post more pictures if I can get them.

The Junta honored us and we got to sit at the big, fancy conference center table.

Taking BPs. Tiny picture, not sure why.

Teaching about nutrition at the Stake Health Fair.

May 14, 2008

Today I was out in the community again. It is such a fabulous opportunity to serve and teach. We are dropped off in pairs at various Centros de Salud about an hour from the center of Guayaquil... one Spanish speaker (me) and one non-Spanish speaker. Then, we serve.

When we arrived, no one was waiting at the Centro de Salud for us to teach. So, we went out like missionaries and knocked... or yelled BUENO and recruited 40 women to come. We taught the same basics we always do... water purification and nutrition. It is amazing how simple these topics seem to us in the United States... however, they are landmines for the poverty stricken people of Ecuador. They don't have water... and when auga potable is driven in each day, it is contaminated (yet, chloro costs money and not everyone can afford to use it). Nutrition is a whole new battle. We use the beautiful food pyramid in the US. However, these families do not have the resources to eat like we can... nor do they have many grocery stores to buy from! Rice just went up 10 cents last week and is a great cause for concern for these people. The 55 gallon tanks of water raised from 80 cents to 90 cents, and families are afraid they won't be able to drink. The bare necessities of life are such a challenge here.

After we talked about the necessity, I felt the need to talk some more about sexual abuse of women. We talked about coming together as women... as a community to fight against violence. I saw eyes light up with hope. We passed out violence pamphlets and urged them to spread the word throughout their community. I pray for an end to the domestic abuse here.

This evening, after clinical in the community we went to David's birthday party at his mom's restaurant. To our surprise, his mom had hired a professional mariachi band to play while we danced the night away. So, we danced, and danced, and danced. It was great fun... I learned the art of dancing to Regatone.

May 15, 2008

Today I was in the community once again. However, driving there today was not nearly as conveinent. There was a huge protest over the pay of professors at a local college. So, they appropriately lit tons of tires on fire across the front of our bus literally trapping us inside. I am not quite sure what this served them, but we had to wait for an hour before they would let us go. It was intoxicating breathing in the smoke! We had a man stand at the bus door preventing the protesters from coming in and we shut our windows to attempt to shield the smoke. I was so happy when a peace agreement was made with our bus because we were health personnel.

I love going to the various homes and feel such love for the people. We were asked to visit a "special home" that was about a 25 minute bus ride away. As we were leaving, one of the volunteers pulled me into a room and told me to please empty my pockets at the Centro before leaving because I would for sure be robbed on the bus. He explained the route that we would be on was incredibly dangerous and I needed to be careful. When he explained more about the bus that we would be traveling on I explained that BYU would not be okay with this form of traveling. Instead, I explained that we had walked 20 minutes the day before and we could surely walk 40 to the home. I began heading towards the door when the guia stopped me. They refused to let us walk. They explained that we would be jumped by the gangs... our clothes would be taken and possibly our life. It was decided that we would find another home closer to the Centro.

Although the Centro I am assigned is very dangerous, I don't feel threatened by the people at all. In fact, I am very impressed. We taught a lady who had a very difficult life. Her husband was unfaithful and abusive and she finally left him with her 5 kids. Then, her oldest son was jumped and beaten to death by a gang in a nearby area. She was distraught. Then, she started a business which promptly failed... leaving her without a home. The Hogar de Cristo recently built her a "home" so she can live in a shelter. I figured she was probably uneducated, and would know very little about health. When I began teaching her about the prevention and treatment of diarrhea I was astounded at her incredible knowledge. She could have taught me the lesson. She commented, "Sister, I may be very poor, but I am also very crafty. I learn me lessons well. Don't feel bad for me."

What a lesson we can learn from this beautiful woman! There are many lessons to be learned through our trials... and pity shouldn't be one of them. I am sad for these poverty stricken families. My heart breaks to see their trials. But, they are truly happy. They are resourceful and obedient. They are kind and charitable... they don't need money to do it.

Tonight we sponsored a ward health fair. It was amazing to see the many people show up and participate. I absolutely love teaching! My Spanish is really beginning to improve as I teach and interact with the people here. Me and two other girls are in charge of the Nutrition and Exercise booth. It is truly amazing how much these people love to learn. They are so willing to change and adapt to newer, healthier ideas. We taught them about the food pyramid and healthy eating, how to take a pulse, blood pressure and exercise. Many of them had never felt their own pulse and were so excited to learn. They thought I was such a funny gringa when the the Relief Society President couldn't find her own pulse and I dramatically exclaimed that she must be muerta (dead). I am beginning to fit right in to the lighthearted, Latin humor!

May 16, 2008

Today I spent the morning teaching a group of administrative nurses in the Sotomayor hospital (maternity hospital) about various health topics. I am so pleased to see the great knowledge these nurses have. If only they would implement more of it here. We are working on implementing continuing education for all the nurses and improving communication with the doctors. We have a great responsibility, however, not only to teach but to learn. We get to learn how to be far more resourceful from them and how to love learning. It is a great exchange.

This evening began with an adventure. We had a Stake Health Fair that we were sponsoring. After arriving, a small group of us realized we had been so busy we had yet to eat. We figured there would be a place to get a bite if we walked up the road a bit. We set out to buy an empanada or two and discovered after about 15 minutes of walking that we were not going to have much luck. We were determined to continue and finally found a huge mall in which we discovered an American favorite... Burger King! We were thrilled (until we ate it and discovered it was not quite the same). It was now 10 minutes after the Health Fair was supposed to start (good thing Latins are always late)! We rushed outside only to discover it was raining! Being that we were all wearing thin, white scrub tops and it would be about a 25 minute walk back we decided to hail a taxi. Evidently, gringas are not good at hailing taxis. A good 15 taxis passed us by before we got desperate! We stopped a car and asked if he would be willing to drive us to the LDS church for a dollar. Luckily, money talks. We arrived just on time... like I said, you can always count on Latins to be late (even with their clocks set forward a half hour).

Once again, teaching was tons of fun! I LOVE IT!

May 17, 2008

Today was a delightful day! We traveled to a protected area of Ecuador called Cerro Blanco. It holds 50-60% of the world's diversity in animal and insect species. It is beautifully preserved and is a diamond among all the rough here in Ecuador. We were able to go on a 4 hour hike up the mountain and all around. When we first arrived, we were greeted by the staff in an outside amplitheater. I was so scared of the huge ants... little did I know what was to come. After the hike, the ants seemed like bunny rabbits. I cannot explain the amount of spiders I saw today. These are no ordinary spiders either... they are huge... literally the size of my hand. We saw the world in its purest form and although I sweat like a pig and was probably hot enough to boil an egg off of, it will always be one of my favorite experiences. The trees are huge... literally gigantic. We learned about the history behind each tree and its medicinal purposes. We also heard some pretty scary sounding monkeys, but never could find them. Our guide was so in tune with nature it was incredible... he was our own Steve Irwin. He would pick up the huge spiders and move them out of our way. He could spot anything, including a frog the size of a nickel, 2 tarantulas, birds, etc.. It was absolutely amazing. The hike was quite strenuous and was great exercise, but I was energized by the nature.

Afterwards we went on a "canoe" ride through the Mangrove Forrest. It was beautiful but way too hot. I got very sea sick along with several others. And, well, it wasn't quite a canoe... more like a sinking piece of wood.

Well, for those of you who have emailed and asked... I am starting to feel better. The cipiro is doing its job. I am so blessed to have this opportunity. It is such a wonderful experience. I love the people and I love the beautiful land. I am missing Matt more each day and look forward to seeing him in a week and a half.

Thanks to all of you who post and email... it is so helpful. Sorry I can't write back... I hardly have time to post at all.

Update

Man, it is difficult to get my hands on a computer here! I will update as much as I can before I get kicked off.

May 9, 2008

I am no longer in the Veranza hospital. I spend 2 days in the Gilbert Pediatrics hospital here and was very impressed. Although the poor kids don't get the luxury of private rooms like the rich kids do, they still get fantastic care. The facilities are well equipped and the kids get all the care they need regardless of pay. It is very similar to Primary Children's hospital in SLC. I spent the first day touring the hospital. The nursing program put together little bags of toys and we went to a sala and distributed the toys to some of the kids. I put up a picture of me with one of the girls. The bad of toys had a ring in it so I gave it to her and told she was a princesa. She already had a ring on and took it off and handed it to me. She told me that it was a ring of sickness and the ring I gave her would help her heal. She wanted me to keep the old ring as a token of remembrance of her. SO SWEET! I will keep it always!

Many of the children here are abandoned when they get sick. The Junta will still pay for their care until they are well enough to be taken into government custody. You can "buy" a child for only $300. It is sad to see their dirty little faces line the streets. I have tons of pictures of the sweet children that I will post in a tribute at the end.

That night we went to the ward party in celebration of Mother's Day. It is an odd celebration here. All year long husbands abuse and are unfaithful to their wives, yet on mother's day women are praised. It just doesn't sit right with me. Women cannot afford to take birth control here and their husbands refuse to use condoms. Many women tell me they are beat by their husbands if they even ask. Consequently, by the age of 20 women often have 2 or 3 kids... which in turn are abandoned. It is heartbreaking. The ward party on the other hand was a blast! I so enjoyed serving the ward member and playing with the kids. We taught them the classic American dance moves... you know... the fish, the robot, the sprinkler. It was great.

May 10, 2008

Today we went to Playa Salinas. This is a beautiful beach about 2 hours away. We spend the day be hounded by vendors. We couldn't even see the water from our "hut". They sell the same stuff they do everywhere else in South American and Mexico. So, I didn't buy anything...but, oh man... some of these Gringas went crazy out there! Haha. The town of Salinas looks just like every other Latin beach town... glorious on the coast and poverty inside. But, we had a wonderful lunch at an international hotel where they had SPAGETTI! I can't tell you how grateful I was for that spagetti. I miss American food!

Afterwards, we went on a boat that took us out a ways for 20 minutes and then brought us back. I started to get a little queasy when the driver rocked the boat "for fun" towards the end. Forty minutes on a boat in the ocean is plenty for me, thank you.

Although I slathered myself in 45 sunblock I still managed to fry like a little egg. I didn't show any signs either until about 5 hours later... when I progressively began to bake. There is a reason the country is called Ecuador (equator for those of you who still didn't get it).

May 11, 2008

Church with the ward was great as usual. I attended the Primary which was a huge mistake, and will never be repeated. The 2 kids were so loud I couldn't hear a single thing the teacher was saying. She kept asking me questions and all I could see was her mouth moving. I felt like a true gringa and just pretended like somehow I no longer spoke any Spanish. I spend the rest of the day doing what good Sunday is for... and rested.

May 12, 2008

Well, today was what you call a wasted day. I spend the entire time in the bathroom. Yes, all day. I know it is hard to believe but Montezuma's Revenge was at it's best. I started antibiotics and will probably get to add an antifungal. I spent the day fighting dehydration and counting down the time when the 24 hour antibiotic mark would hit.

May 13, 2008

Today was my first day out in the community. It is a whole different world out there. All the times I mentioned poverty before don't compare to what I saw today. It is tear jerking, life altering stuff out there. We taught a group of 40 women in a Centro de Salud about STD's and that they need to remember it is their body, not their partner's. It is a difficult topic to teach since sex is viewed as a taboo here. We pled for the women to take charge of their bodies and to teach their daughter's... I think they agree but live bound by their culture and fear. Out of the group, at least 5 couldn't read or write. I was a scribe for one and I could tell she was so ashamed to have a gringa write for her. It broke my heart.

The perimetropal has a certain smell I will never forget. There are no bathrooms and few outhouses. Garbage lines the streets and accumulates in piles until the floods come in January and February to sweep it out. The houses are mostly on stilts, the ones on the ground are sinking and partly washed away. Often, houses do not have roofs and are missing pieces of the floor and wall. Furniture is scarce and consists of old frames of couches with cardboard pieces to sit on. Bugs are abundant due to the swampy roads. You have to watch every step so you don't walk in a "sewer" (the stale liquid along the road). Dogs and pigs roam the streets. Water is scare and expensive for the people. There is no running water to families purchase 55 gallon barrels to fill from the tanks that drive through the barrios everyday. The open containers breed mosquitos and thus further the spread of illness. Vendors gather at the entrances of the perimetropal and have pollo, carne y frutas ready to be sold in the terribly hot and humid weather. It is amazing what these people make with the little they have. The are kind and proud of their country. The first thing anyone asks me is how to I like their Ecuador? We drove out to the community on a series of vans, buses and an ambulance (that has only been used eight times for transporting the critically ill). It is a bumpy and hot one hour ride. The roads are completely unmanaged and have pot holes as large as a car. It is a game of chicken on the road... the loser falls in the pot hole.

I am impressed and discouraged as I teach the people in their homes. Although they know so much, they do so little. Merely living is a chore here. The conditions are not sanitary and do not foster a good environment to raise children. It is heartbreaking and seems to me that no one breaks from the walls of this poverty.

I miss home and the comfort of my life. I am so grateful to be a witness of the strength of the people here. I hope to be of encouragement for them and to gain encouragement from them. Truly, it is wonderful and terrible here at the same time.

Premies here can't be saved before 31 weeks, generally. This is me with a 34 weeker. He is tiny. Some of the babies are so tiny their skin barely covers their protruding ribs. It is a sad sight... but there is good care here.

This little girl has lupus. She is in one of the Davita Dialysis rooms. She is waiting for a kidney transplant and has not be picked yet. One of the other students and I were joking together and I grabbed his arm... she immediately made sure I knew that she didn't hit people and in this country they don't believe in abuse. How cute! She will change the world one day.

In front of the Gilbert hospital. The sun is brutal!

This is my sweet ring buddy! Viva!

I hiked to the top of the lighthouse... 444 steps. The view was incredible. The tiny little house span for miles beyond view. It was so hot my entire backpack was drenched in sweat. Afterwards, we went and ate at a hotel... I ordered lasagna... big mistake. Evidently, they don't have tomato sauce here, so it was replaced by oil.

Broken down homes... much nicer than in the community, but heartbreaking nonetheless.

Yes, the famous pose from Titanic. I am king of the world!...and very afraid of heights. There was a straight down drop off the side. On the way up to the lighthouse (during the 444 steps) there is a little village. It was beautiful and full of loud, competing music, of course.

Dancing with the kids... American style. This one is pretty modest... I won't fright you with the ones of me doing the sprinkler.

Houses on stilts. These are some of the "wealthier" ones right outside of Guayaquil proper. They area I am teaching in is dangerous and I am at risk of being robbed if I take out a camera to take pictures. So, this will do.

This seven year old sells on the beach for a living.

This is his younger brother who tags along. I took of picture of him and then he asked if he could get a picture taken of me kissing my cheek... these Latin boys start young!

On the boat. The birds behind us are ugly, but rare. There are only at or right around the Galapagos. I don't remember their name.