Introduction

¡Hola a todos! As a 4th year medical student , I just got through a long and grueling residency interview season.

In Miami Int. Airport, on my way!

Despite traveling non-stop over the past few months, I am in fact sitting in the Miami airport at this very moment, traveling yet again. I’m on my way Quito, Ecuador to participate in a six-week program with Child Family Health International (CFHI), a nongovernmental organization that specializes in providing medical students and residents with global health education programs. I’ll be participating in their Urban and Rural Comparative Health Program, which for me will involve three weeks of clinical rotations in Quito, Ecuador (the capital and Ecuador’s second largest city) and three weeks in Chone (a more rural village close to the Pacific coast).

I chose to go abroad through CFHI for several reasons, including

First Week and Birthday

February 3, 2013

I just finished my first week here in Quito, Ecuador. I spent my first Sunday here wandering around Quito, exploring a couple parks, walking around Old Town, and getting my first taste of public transport. All the other students were off having a weekend adventure so Rosita, my house mom, gave me a little driving tour of Quito and then dropped me off in El Ejido Park to fend for myself, which resulted in a great, sunny afternoon exploring the city. I had two full days of Spanish lessons on Monday and Tuesday. Since I was the only student taking lessons this past week, it was just me and Mario, my Spanish teacher this week. We spent the mornings going over some medical terminology, reading some articles about Ecuadorian culture and traditions, and chatting. During the afternoons, we went to different places around Quito, all the while practicing Spanish, which involved me asking lots of questions about the places we visited as well as random words I couldn’t remember or didn’t know.

Outside the Clinica de los Adolescentes.

I spent Wednesday, Thursday, and Friday mornings at La Clínica de los Adolescentes with Dra. Carrera. It’s a pediatric clinic for the infants of teenage mothers, ages 12-18, and is part of a complex of clinics and hospitals devoted to maternal health. We spent the first couple hours every in Dra. Carrera’s outpatient clinic and then saw all her newborn patients. I had the opportunity to perform lots of newborn exams and infant blood draws and saw several interesting cases.

Cirujia y Carnaval

February 13, 2013

Mural at La Fiesta de las Frutas y las Flores en Ambato (Festival of Fruits and Flowers), made entirely out of fruit, flowers, and bread!

Just finished up another week here in Quito. This was an interesting week (and a half) because this past Tuesday was the holiday of Carnaval, which falls on the Tuesday before Ash Wednesday, so we had a four-day weekend. Several other CFHI students arrived this Saturday, which was the official start date for this month of the program. We all had orientation together on Sunday, which included some general program guidelines and a tour of our clinical sites in Quito with a mix of walking and Trole (an electric bus that runs through the middle of town and only costs 25 cents!).

Cochapamba y Playa

February 17, 2013

Another week (or 5 days really) has gone by, and I find myself a little sunburned and sand-worn after a weekend at la playa. I spent Wednesday through Friday in Quito with my now familiar routine of clinic in the morning and Spanish class in the afternoon. I was at El Subcentro de Salud de Cochapamba this week, which is a primary care clinic in the northern part of Quito, just a short bus ride away from Rosita’s house.

Outside Cochapamba.

I worked with Dra. Sancho, who is a family care physician. It was really great to see a mix of pediatric and adult patients, as well as the variety of issues that come with primary care. I had a few new experiences this week, such as using a fetal stethoscope to listen to a fetal heart beat, a skill which has been replaced by Doppler-based fetal heart monitors in the US.

Chone y Bahía

Liz, Dra. Díaz and I on the Pediatric Floor.

March 1st, 2013

My time in Chone and on the Coast has definitely been an adventure. Not every experience has been pleasant. In fact, a couple have been down right terrible, but my stay in Chone was definitely a valuable experience. Liz (another CFHI student in the Urban & Rural program) and I rotated in El Hospital Napoleon with Dra. Díaz, an inpatient pediatrician. We rotated mostly with her and the rest of the pediatric team, but also spent time in surgery, neonatology, and the emergency department.

On our first Wednesday, Liz and I went to the OR to observe a cleft lip repair. This turned out to be the worst clinical experience I have had during the entirety of my medical training. Due to multiple medical errors, including an improperly placed endotracheal tube and administration of incorrect fluids, the infant did not wake up following the procedure and eventually passed away. The entire situation was handled rather terribly by the surgery and anesthesiology team, all of whom seemed unconcerned when the infant desaturated during surgery and subsequently did not wake up following the procedure. Watching the poorly managed resuscitation was incredibly frustrating, as Liz and I were in no position to advise or assist the team.

There and Back Again

March 11, 2013

Hello, all. I just got back to St. Louis from Quito this afternoon. I can’t believe it’s already been six weeks.

I spent my last week in Quito at the Maternidad, which is part of the complex of clinics and hospitals where I spent my first week there. I had the opportunity to see numerous births and a couple C-sections. It was very interesting to see how childbirth is managed in Ecuador versus the US.

The biggest difference I noted is that, at least during my medical training, everything is much more private in the US. In Maternidad, there are several rooms in the birthing wing, and patients are divided based on stage of labor and clinical picture. For example, all women waiting to go into active labor are together in “Dilatación.”

I didn’t have Spanish class this week, so my afternoons were free to explore some more of Quito.