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.
Although it was not a positive case, it was a valuable learning experience regarding medical errors. Before coming, I thought that I would experience good medicine practiced with poor resources, which I believed included technology, equipment, and other nonhuman elements. This case made me realize that one of the resources which rural medical facilities often lack is properly trained medical staff in addition to medical equipment.
Other than this experience my medical rotation in Chone was very positive. I had many more opportunities to practice hands-on medicine than I did in Quito and saw many interesting clinical cases, such as dengue fever.
Liz hiking in the tropical dry forest (after the dog bites!) with Bahía in the background.
The weekend in between our first and second week, Liz and I went to Bahía de Caráquez, a coastal town where the Chone River empties into the sea. We went hiking in tropical dry forests, canoeing through a mangrove island, and enjoyed some more time on the beach (without getting sunburned!).
Liz underwent another mishap when we visited the tropical dry forest where she was bitten by the reserve’s guard dogs. It was scary at the time, but everything turned out just fine. She received 3 very superficial bites, and I had an opportunity to practice some wilderness/creative medicine. I made a pressure wash by drilling a hole in my water bottle, and we ensured the dogs were vaccinated for rabies (I also called 10 days later to make sure that they were still okay to rule out that risk). The trip was still a great experience, although imperfect, and we were very glad we went. Like I said to my host family, our trip was definitely “una aventura,” full of adventure.
Healthcare Disparities & Exploration in Ecuador 