Fruity Goodness

Verse of the day: “The Lord gives me strength and makes me sing; he has saved me. He is my God and I will praise him.” Exodus 15:2

Loving the donated gifts!!

Another busy day at the clinic--same place as yesterday since it is a larger village.  The pastor was running a little late to open the church for us, but he had a great excuse—“I slept better last night because of the PT I got yesterday” ;-)  I continue to have a strong orthopedic patient population steady all day and I just barely got to see everyone before the bus came.  Despite limited time, a language barrier, and mostly chronic pain situations, thankfully everyone left in less pain!  I have only been able to spend about 20-30 minutes with each person in order to see everyone, but they are loving their exercises (hint, hint to any of my patients reading this ;-).  Once I looked up and the pastor was in the middle of the floor practicing his bird-dog, haha!  And since it is a very open area with literally no privacy, I can look around and see others trying the exercises as I am teaching.  For a special mid-morning snack we had traditional morocho.  It is a warmed milk with white corn, cinnamon, raisins, and a little sugar mixed in—perfect timing to a morning that had turned a little chilly and windy!

Registration

Morocho

We had a special treat after the clinic today.  Paul and Sarah made friends with a local farmer playing soccer on Sunday and he invited us to see his avocado farm.  So we walked about a mile to his house up and down a few steep hills, past a castle, past “El Alamo”, and eventually to his beautiful farm.  Except it was not just avocados that he grew; he also grows tree tomatoes, lemons, tea, coffee beans, passion fruit, estavia, grapes, cucumbers, tomatoes, etc.  We went home with a plethora of things to try and of course fresh avocado for dinner! Fun fact about avocados:  it takes about 4 years for a tree to start producing fruit.  Once it does the first crop is only about 50 avocados, but the next crop is about 200!  They sell for about US$0.50 here.

Avacados

Coffee Beans

Tree Tomatoes

Limes

The foundation festival in town is finally over and the town has a renewed peacefulness to it.  No music or fireworks to fall asleep to tonight, just dogs, dogs, and more dogs ;-)

Dirt Tunnels

Dirt Tunnel

Verse of the day: “God can give you more blessings that you need.  Then you will always have plenty of everything—enough to give to every good work.” 2 Corinthians 9:8

Today we went up and down over many cobblestone mountain roads in a taxi-bus with minimal shocks until we eventually got to San Agustin.  However one mountain we went straight through via a dirt tunnel.  This tunnel also had a couple extra walking paths cut through the mountain which we didn’t get to explore, but I would have loved to if we had the time!  Today was my busiest day yet with many patients. I unfortunately did not get to see them all which was frustrating to me however this village is a little bigger so we will be there 2 days.  Those I didn’t get to see agreed to come back tomorrow.

Teaching English

This was the first day we had a translator but he was only one man and those who didn’t speak Spanish were 5, so we had to share his gift!  He is Pastor Nestor who led church for us the first Sunday I was here.  He is a man of many talents as he has not only learned English, but now also has a small 1 room school house out back of his house where he teaches English.  He is also a police officer, a tour guide, and a pastor! He is very kindhearted and energetic fellow who was a pleasure to have with us today! After lunch he invited us to see his home—a few large hills, a puppy eating a cow head, a 1 month old donkey, and a crossing a crick later, we made it.  But the view from his home was worth it and he was very excited to show us!  You can see Ruminahui well, which is a mountain in the shape of a local indigenous face (I think it looks like Abe Lincoln, haha).

1 month old donkey

Puppy Chow!!

View of Ruminahui from Pastor Nestor's house
L-->R: me, Susana, Nestor, Mary Louise, Jim, Sarah, & Paul

Let me introduce you to the new team members. They are a family of 4—a mother and father and their son and daughter-in-law.  In this small world that we live in, they are from very close to my hometown in PA and work with my aunt and uncle!  It’s nice to have some farmer friends around J There is 1 nurse and the rest are general helpers.  This was a huge help as Susana is now the only doctor since Bert and Sameer were only here the first week. So they were able to cover vitals, the pharmacy, and help with health education and praying with people.  Paul was able to lead a short devotional a couple of times while people were waiting. They are also excellent at entertaining the kids after they were treated or while their parents were being cared for!

Paul leading devotion while patients are waiting

lil dance party

And the party goes on!! Town wide dancing, fireworks, candy covered apples, and chickens on sticks ready for roasting!  There was a small separate parade that we followed home to the neighborhood just behind our camp tonight—perfect timing!

Chicken. It's what's for dinner!

Pigs & Cowboys

Verse of the day:  ”We all have different gifts, each of which came because of the grace God gave us.” Romans 12:6

This little piggy's at the market!

Pastor Hector's Church

We have been getting to know Hector, a local pastor here, as he has been driving us places in his second job as a taxi driver. This morning we went to his church. We could have walked, but being the kindhearted man that he is, he came to pick us up just before church started.  Even with the language barrier, it is evident that he is genuine and sincere in caring for both his church and the people of La Merced.  It was a beautiful thing to be surrounded by fellow believers who care deeply about serving the people in their town.  Today’s sermon was fittingly on the different gifts God has provided us—serving, teaching, encouraging, giving, showing mercy, leading, etc.  None is better than another and is only provided by the grace of God as we work together in a common purpose of love.

The festivities continue to grow in La Merced as it builds towards its grand finale tomorrow! The live music and fireworks went on past midnight last night and fireworks resumed around 5 or 6 am!  There was a parade this morning continuing with both musical and neighborhood traditions except with all new groups of people, young to old representing the culture and history of their neighborhoods.  This was all prior to a large outdoor catholic mass which was then followed by live music and fireworks continuing well into the night again.  Our camp is well positioned on a hill just above town so we can hear everything loud and clear as if it was in our backyard.

Today was a quiet day of rest overall though as we prepare for another week travelling to different villages. Hasta maῆana!

Snow, Trout, & Parades

Verse of the day: “Enjoy serving the Lord and he will give you what you want. Depend on the Lord; trust him and he will take care of you.” Psalm 37:4-5

Snowing at Antisana!

Of course it would snow while hiking in only capri’s and a long sleeve t-shirt.  Today we went to the Antisana ecological preserve which is a mountain between Antisana and La Mica where you can hike up and see good views of both on either side—assuming it’s not raining, sleeting, or snowing, haha!  Antisana is a volcano that violently erupted many years ago and erupted so strongly that there are valleys for miles around that were filled with lava that is now volcanic rock.  These valleys have now become huge stone quarries for various things like paving roads.  La Mica is a large lake that supplies water to the capital of Quito as well as the Chillos valley where we have been staying.  We hiked for about 3 miles including up, along the ridge, then back down.  At the summit of 15,000 feet, it was very windy and rainy and unfortunately could not see much of the volcano, but the lake was uniquely surrounded with clouds.  Once we got to the other end it suddenly got very cold and started sleeting and snowing so we quickly grabbed a couple of pics and rapidly made our way off the mountain and found a side trail that wasn’t as cold and it eventually stopped precipitating—but by that point we were soaked! All in a good days adventure though! ;-) 

Fishing for Trout

We had the pleasure of eating lunch at a small family owned trout restaurant.  Their 2 children welcomed us from the road, clothed in aprons, and quickly handed us fishing poles and bait to fish for trout while ours were being served up for lunch.  If we caught an extra, we got to keep it.  Only our driver Hector was so successful.  Lunch was deliciously fresh and included fresh squeezed strawberry juice.

Heading off to elect their Queen

Backing up a little, we encountered over 100 horses on the streets of Pintag on the way to Antisana today.  All of their riders were traditionally dressed and ranged from young to old.  They were gearing up for a customary ride into the mountains to elect a new queen of their indigenous group, Chagra.  We passed through just in time to see them all before they took off!

Parade in La Merced

The celebration of its foundation in the local town of La Merced keeps getting bigger!  Tonight there was more food and craft vendors as well as more and more people coming out of the woodwork to the town square.  A main event of tonight was a traditional parade.  It started out how we would think of traditional with a marching band but it quickly became Ecuadorian.  There were many groups of people all donned in cowboy hats with cheeks painted black and carrying swords and tree branches.  Each group represented a neighborhood. There would be 1-2 leaders in the center of a circle with musical instruments leading others that danced in circles around them.  Eventually all the tree branches ended up in 1 large pile which I assume will later burned.  Others carried a large wooden structure through the parade as well and it was then placed upright in the center of the town square, which I assume will also be burned.

And thus closes my first week here!  Thanks for tuning into my Ecuadorian adventures! The next 4 members of the team arrive tonight for week dos! J

Sunset from my room!

Home on the Range

Verse of the day: “In all the work you are doing, work the best you can.  Work as if you are doing it for the Lord, not for people.” Colossians 3:23

Feeling at home herding cattle :-)

Today we headed out of the small towns and into real rural land--the land of cows and rolling hills! Once we were set up, it was a little bit before the patients started arriving so we were privy to watching a large local farm herd their cattle into the barn and sort out the milking cows for milking. I couldn't have felt more at home in there helping them herd and sort! :)  I even went back later to check out their milking parlor, which is not normal here, but they have one because it is such a large farm.  

Volcanic Stone Mine

Also near this area is a large volcanic stone mine (used to be a volcano—now it is a pile of rocks) where many people are doing the work by hand with sledge hammers and lifting heavy rocks in addition to what the machines are doing. There were several people that came to the clinic with back pain from there and we decided to hold a back school for them to train in lifting mechanics to protect their backs.  We had a great time with lots of laughter as they worked on getting the right form and several others that were around also joined in learning!

Teaching squatting mechanics

I have still mostly been seeing orthopedic injuries, which is right up my alley, but I am also getting to see a variety.  There was one adorable older woman who was so old she could not remember her age.  When she shook my hand she held on for a while as she tried to warm me up, haha. She later told us she used donkey butter on her back to help with her back pain!  Another young girl that I saw today was born with spina bifida and came to me in a wheelchair.  Her knees were contracted and she had braces at one time but has outgrown them.  She has never used a pediatric walker or other device for walking.  In testing her she had nerve input to enough muscles in her legs that with proper care she should be able to walk some with assistance—but will be challenging to achieve with limited medical care.  I was able to provide her with some exercises and educate the family on how to stretch her legs and assist her in standing for further strengthening.  

Llapingacho

Clowning Around

Today was the last clinic day for Bert and Sameer as they were only here 1 week so we did a little photo shoot on the way to today’s village.  Susana and I will be joined by 4 others tomorrow night for the 2nd week.  There continue to be celebrations going on in town all week so we walked over for yet another hurrah.  We saw an audience-participation-is-mandatory play involving 2 detective clowns and considering we made up more than half the audience, we all had to participate, haha.  We finished with second dinner via various street vendors and of course the local bakery!

Volcanic Hot Springs

Verse of the day: “Let us lay aside every weight that may so easily slow us down and let us eagerly do the work that is set before us. …The most important thing is that I complete my mission, the work the Lord Jesus gave me—to tell people the Good News about God’s grace.”  Hebrews 12:1 & Acts 20:24

(Sorry for the delay in posting, the internet has been down.) 

Our setup at Santa Ines

As I mentioned yesterday, today is the start of a large protest in Ecuador’s nearby capital of Quito.  We had to cancel the original village we were going to go to because the roads were closed so we instead went back to the same village as yesterday to try and see more folks.  We saw patients there for half the morning and then were able to visit a local school there and provide fluoride treatments and dental education to 60 kids.  The kids were initially apprehensive about anything “dentist” but then came around and were appreciating all the attention they were getting—and getting out of class ;-)

Susana

Providing flouride treatment

There are many reasons for the protest but overall it is the people against the government and are requesting changes to the constitution.  It involves a wide variety of Ecuadorians from the cities to the rural and indigenous villages.  The current president has been in office for nearly 8 years and has made a lot of changes in his 2 terms.  He is seeking yet another term that would start next year and the people are looking to prevent that and reverse a lot of the changes he has made. Some examples that are most pertinent to the villages we are serving is the closing of smaller schools and a steep increase in taxes.  The families can’t afford transportation to other schools and a steep increase in taxes particularly affects those who are already poor.  The doctors are also protesting because the president has greatly encouraged people to sue for malpractice.  There was even no water today and it is thought that it has something to do with the protest. 

Volcanic Hot Springs

Since not many people were coming today due to the protest, we ended up coming home early and enjoyed a nice afternoon around the town of La Merced.  We started at the volcanic hot springs which weren’t all that hot even though a volcano is spewing but a nice pool temperature at least.  Then we took a long walk up around the upper side of the town looking down into the valley and watching a huge storm come though.  And try as we might, we failed at getting a picture of all the lightening over the valley :/

Storm coming in over the valley

In the evening, Susana’s daughter brought us medicines using money that was donated and while she was here she took us all to the mall.  It was a very different experience than we have been used too and surprisingly better than any mall I’ve been to in the US.  I quickly found a favorite store ;-)

Chicken Soup--El Naturál

Verse of the day: “I was hungry, and you gave me food. I was thirsty, and you gave me something to drink.  I was alone and away from home, and you invited me into your house.  I was without clothes, and you gave me something to wear.  I was sick, and you cared for me.  … Anything you did even for the least of my people here, you also did for me.”  Matthew 26:34-5,40

Today we were set up in the village of Santa Ines.  It is a smaller village than where we were the last 2 days.  The beginning of the day was very busy and we saw a greater variety of diagnoses.  One of the most touching patients I saw this morning was a young man born with a genetic disorder that includes clubbed feet.  He had never been treated before so never had surgery when he was young nor has he ever been casted for braces that he would greatly benefit from.  He only had 1 pair of socks they were very wet and this had a great effect on his hygiene.  All of his toes were macerated and developing wounds secondary to his primary diagnosis.  Since I am not equipped to provide the casting or orthotic bracing he needs, I spent most of my time cleaning his wounds and educating on proper foot hygiene to avoid need for amputation.   I was also able to provide some generalized leg strengthening exercises to at least reduce the loads he is placing through his feet when walking.

Susana performing an eye exam

We had an odd lull in the middle of the day and then got very busy after lunch to the point where I almost didn’t get to see all my patients because our transport was waiting.  One of the main reasons for the lull was due to a large protest that is about to happen tomorrow and each community was in meetings preparing. But more on that tomorrow.  I was able to download and copy Spanish exercises thanks to Medbridge!  This saves a lot of time and also saves my patients from having to endure my stick figure art and broken Spanish instructions ;-)

Slurping up a chicken foot!

Buck, Buck

I needed an extra ;-)

For lunch it was chicken soup el naturál--head, neck, feet, and all!! I will try anything once and I must say, it wasn’t as bad as it sounds!  On the sweeter side of trying new things was espumilla.  It looks like ice cream, but it is whipped egg whites mixed with fruit and served on an ice cream cone!

Espumilla