Assessing a patient with liver failure. The doctor holding the chart loved learning English and walked us around to every patient. The room holds 38 beds. It is hot and smelly. There is one nurse and several doctors (which leave by 12 so they can go to their private practice where they are paid).

The Minor Surgery room. You get to see some pretty gross looking stuff here.

This is the famous room of death... Reanimacion. The feet are of a patient who was in a car accident and lost half of his head (literally), one patient is being resuscitated, and one has a BP of 50/10 and is about to go into cardiac arrest. The beds are packed in there so tight you can't get to some of the patient's heads.

Teaching CPR. This was tons of fun!

May 8, 2008

Schmoozing the security guard. If they like you, you can see any part of the hospital you'd like.

The hospital feeds us lunch everyday.

This is where the families line up to get a prescription for their family members waiting in the hospital.

Working with the friendly doctor to make a diagnosis.

My secret... shhh!

Today was my last day at the Junta hospital. I spent the day in a woman’s sala. I followed a doctor (there are very few nurses here and the doctors do what the nurses do in the states). He expressed his love for the purpose of medicine—service. He reinforced the healing and importance of touch and love for humankind. Truly, I fell in love with the beautiful women here. They are so kind and gentle… born in a culture of submission and classes. It is both heartbreaking and inspiring to see them.

I am enjoying my time here. I often miss home, especially Matt and the food…but, the experience I have here are priceless.

Alright, I gave in… I ate at McDonald’s today. Yes, it was good.

May 7, 2008

Whew! All that delicious food last night did me in. Something I ate along the way made me sick! I was sick all night long into the morning and couldn’t get out of the bathroom to go to clinical. Bad day.

I started feeling better that night and was able to attend the LDS Temple here in Ecuador. It was an amazing experience. What a beautiful sight for these poverty stricken people. It was the last of the big temples built when President Hinckley was alive. The temple is magnificently large and glows among all the trash and shanty homes. A guard protects the tall iron temple gates. I felt the spirit so strongly and was brought to tears as I witnessed the strength of the members here. What a joy to see them love the Lord in His very house.

There is a lot of sadness here. I think I cry every day. But, there is also hope. I have seen the worst deaths and the best miracles. I suppose I am beginning to truly understand the scripture that explains opposition in all things. The Lord loves his people. We are all his people.

May 6, 2008

Buddies.

HUGE, DISGUSTING SHRIMP. Don't worry... I didn't eat it.

All 21 of us...eating the great food.

Happy birthday to me! What a fun day for me… I get to spend my birthday in a foreign country. I was actually dreading spending my birthday in Ecuador away from my hubby, but it has been a great day. The 20 of us here get along really well. I woke up to a “heart attack” on my door from the room two doors down. That night, all 20 of us crammed into a van and drove to a YUMMY Argentine restaurant on the other side of town in celebration of my birthday. I had delicious carne and all sorts of things I have heard Matt talk about. Yes, he is right… Argentine food is delicioso!

Today at the hospital was another difficult day. I spent the day in Reanimación. This is a place in the ER where the most critical patients are brought. It is worse than the UCI (aka ICU). Patients here have been, are being or will be resuscitated. Walking in, I smelled the distinct smell of death and it has haunted me since. There is a severe lack of supplies here in Ecuador. Patients are incubated and should be placed on ventilators, but due to the lack of available machinery and funds, they are hooked up the wall oxygen unit. They don’t sedate their patients, because families can’t afford the medicine. Consequently, the patients choke on the tube down their throat. Patients are so crammed into the small room I could hardly reach their head. A few lie completely motionless (we kept rechecking their pulse because they look so dead), while others are rocking and screaming.

One patient came in for severe renal failure (her kidneys were shot). She hadn’t urinated in three days. Because her toxins were trapped in her body, she was delusional and in terrible pain. The family could not bring in a catheter for three days. Finally, when the catheter arrived, it was placed and the entire bag was filled within seconds!!! These are the things we so quickly take for granted in the US. We might not be able to afford a catheter, but at least we can get one.

Another patient was wheeled out for an ultrasound. Because they don’t have monitoring devices hooked to every patient, his status dropped within minutes. His internal gastrointestinal bleed turned ugly and his blood pressure dropped from low, to jaw-dropping-low: 50/10. He was resuscitated.

I saw nearly all I could handle in the matter of 3 hours here. From strokes to heart attacks. From make-shift sterile procedures to a gentleman who had his face and upper skill torn off in a car accident. My stomach is in knots when I try to go to bed at the end of the night. It is not that we don’t have these types of accidents in the United States that haunts me… it is the lack of resources to treat them here in Ecuador that is disturbing. People die suddenly and tragically from things as simple as a broken bone while health care personnel are unable to do anything… and we call our healthcare system murderous.

WHEELCHAIR STORY:
A group of students went out to the community to help the poorest of the poor here in Ecuador. They went to teach about various health topics. As they were leaving a shanty house, a mother ran out to ask that they see her daughter. The students went in and witnessed a 16 year old girl lying on a bed where she had laid for 6 years. She was paralyzed from years of cruel seizures. The mother of five pleaded for a wheelchair so their daughter could see the sun for the first time in years.

That Tuesday the students went to the Hogar de Cristo to complete paperwork and show the pictures of the small girl in hope of gaining a wheelchair. The director smiled and said, "How lucky! We only have one left." When she returned with the chair she said, "Actually, It is a wheelchair from your church." It had been donated by the LDS Humanitarian Aide effort and was going to be delivered by the BYU students... truly, a miracle.

The director wanted to bring it on Friday since the ambulance was already packed with 12 people. The students refused, knowing the need of this family far outweighed the comfort of a ride. The large wheelchair was tied to the top of the ambulance they traveled in and the students eventually arrived to the community. When the students arrived, the mother was in tears and hugged the students with gratitude. The frail girl was gently placed in the wheelchair where she saw the sun and took her first breath of fresh air in years.

May 5, 2008

Let's be honest, I am scared to death.

The pretty part of the hospital... very deceiving.

Families waiting... and waiting.

Yes, that's right. Stem-cell research. Hooray!

Comida, te amo.

DISCLAIMER: I will post more pictures of the hospital and patients later.

Today was my first day in the hospital. There are different classes of hospitals and we are at what would be equivalent in the US to the County Hospital... in other words, really crappy. It was very hot, smelly, humid and sad. I was in the ICU and burn unit. The nurse in the ICU did not like me at all, and I couldn't understand more than a few words she spoke. She talked really fast and had a bad speech impediment. Luckily, there was a PA from Yale who spoke perfect English. She helped us along.

The burn unit was really sad. A guy caught on fire driving a taxi. He got out to run the fire off and was hit by a car (not really a big surprise). He lost a leg and burned his entire lower body. The OR was completely unsterile and they we taking pictures of his burnt penis being wrapped while he was under anesthesia. When he came to he was shaking terribly (the room was way too cold for a burn victim... they can't regulate their temperature). He couldn't speak but had tears rolling down his face. They don't believe in pain management here. They believe the people will become addicts.

The families have to pay for all the treatment and procedures and materials before the patients can receive them. Consequently, even in the ICU the prescriptions have to be re-written daily. It is heartbreaking seeing patients not receive treatment d/t a lack of accessible funds. There is very little "emergency reserve" so even patients who have a heart attack can't receive treatment without money upfront. The families are responsible for acquiring and bringing the materials and medicines to the hospital. Families camp out around the outside of the hospital all day and night long. It is a very different world.

The ER is so packed you would never believe it! The room is probably 20 x 30 and there are beds so tightly together you can't reach the head of the patient. When someone dies on a gurney it is a puzzle to get them out of the sea of people. The people scream and cry when someone dies but the grieving only lasts about 30 seconds before they remove their bodies and carry them to the morgue. Today a lady came in with a broken tibia and died from a fat embolism that traveled to her lungs. Totally a treatable complication in the US. But here she received no suero (IV) or heparin. It was shocking.

Today I experienced running in the city of Guayaquil. You wouldn’t believe the looks we got. First of all, I don’t run. I am a great walker however. But, I did it to support my buddies.

Tonight we went to David C.'s mom's restaurant and I got Pollo Ama-something. It was like fried chicken and rice. I still don't like the food here. Let's be honest... it is nearly impossible to find something that isn't raw, has worms, contains stomach, marrow or intestines. Thank goodness for the suitcase of food I packed.

Quick Update...

I don't have much access to the internet, so I will post later. Sorry guys! But, I am safe, sound and very dirty.

PS... happy birthday to me. :)

Be careful, they bite! Well, that's what someone said. Anyhow, they are incredibly large and quite grotesque.

Waiting for the long walk to church.

From Utah to Altlanta. From Atlanta to Quito. From Quito to Guayaquil. Here at last!!!

If I look sick, I am. No editing necessary.

The brave souls who ventured out of the hotel!