Orphaned, Neglected, Abused...

No es justo.  It's unfair.

I spent the afternoon with a lovely Cuencan family.  Here, as in most Latin American countries, lunch is the biggest meal of the day.  Breakfast is bread with coffee, and dinner often consists of cereal, fruits, or soup left over from lunch.  Today, I had rez (beef), mashed potatoes, rice, and salad for lunch with a whole baked apple for dessert.  After a tour of their beautiful home, I headed over to the Municipal Home for children (orphanage), where I have spent the most part of the last 2 days. 

The project that I am working on involves children who are unwanted or without homes for one reason or another.  Neglected, thrown out to the streets, abused sexually/ physically/ mentally, or orphaned.  In order to get a better idea of this hidden population in the region, I went with my colleague to this government run home.

About 25 children live here.  Supposedly, they are supposed to stay for a month and return to their homes when situations are more stable. But parents often never return, and most of the children have already long over-stayed their maximum 3 months. 

I've been screening them all for basic health conditions.  Lice, for example.  Every little girl has it.  I didn't know how to look for lice until now. I've never seen so many little eggs.  They're so small, if one does not look carefully, they can be missed.... but once you realize what to look for, they are easy to see.  little shiny glittering speckles near the root of the hair. 

There aren't enough hired "educators" in the home to take adequate care of the children.  Basic needs like brushing their teeth and bathing are not met, not because they don't have tooth brushes, but because there is no one there to oversee that these things have become routine for the children. 

We decided not to leave any vitamins or meds for the children because this home does not have a space that is closed off from children's access.  They come into the office and open all drawers at their convenience.  It doesn't matter that I am examining a little girl.  The educators rarely say anything.  I made several children cry because I spoke to them like my disciplinarian self.  But they pout for 5 minutes, and then come back to me to embrace me.  They're all hungry for attention, attention of any kind- whether it be playing with them or lecturing them.

Yesterday, my colleague obtained the social background of each child, while I examined them clinically.

Today, in order to make things more efficient, I talked to several children about their reasons for being in the home.

A 12 year old girl told me... mi Papi (my father) sexually abused me 7 times... my grandpa 10 times... my uncle 3 times...  Don't know how she continues to manage that precious smile.

An 11 year old girl, whose eyes shone brightly when I allowed her to listen to her heart with my stethoscope told me, "Un hombre asasino..."  what?  I had to ask her 3 times in order to get the facts.  Last October, a man from the streets entered her home in the countryside and killed her father, her mother, and 2 sisters- a 3 year old and a 9 year old.  She survived a blow to the head and showed me her bald spot and a scar on the neck.  She saw the man kill her family, but not all of it because he also tried to kill her.  Her 15 year old brother and 1 year old brother are also at this home.

A 6 year old boy... "My grandpa mistreated me with his belt"... and showed me the scars.

A child with moderate mental retardation was found on the streets... with Ascaris (worms)- both from above and below. 

These children are so resilient... yet how I wish that they could live in a more stable place. 

My heart's heavy... and my head's starting to itch.... I hugged pretty much every child twice before I left that home tonight.  They are so beautiful, and yet it is a sight too sad for much of this world to bear. 

...   

Chanchos!

Chanchos & chicharrones...

Another week has passed, too quickly.  Thursday was a national holiday in Ecuador, not sure why.... except that the President declared el primero de Mayo (the first of May) to be a holiday.  So, we've been enjoying a 4 day weekend over here.

Weather-wise, it's been cloudy in the mornings, with passing rain in the afternoons.  My sneakers smell and I am thankful to have brought my Naturalizer work shoes, which have now become my daily shoes.

This week was a short one, but one that brought clarity and direction to the project that I'm working on here.  On Monday, I worked alongside an ophthalmologist and saw a case of probable retinoblastoma in a 13 year old boy, along with an abundance of cataracts, pterygiums, and a case of left medial visual loss in a boy who suffered head trauma a year ago.  In the afternoon, I met with several people who are involved in this project and received the green light to go forward with our plans.  By Tuesday, we had gone to the Counsel for Children and Adolescents to meet with their coordinators and to receive more information on the existing orphanages/homes for abandoned children in Cuenca and in the places outside of Cuenca.  This place is such a beautiful tourist friendly town- one would never expect there to be such problems (as is with any other place in the world… the poor/needy are well hidden).  On Wednesday, after observing a pterygium surgery (almost fainted…. “vasovagal”ed… and had to step out of the room) , a knee arthroscopy, and a finger amputation (no problem), we took our official letters to the Counsel in order to get official permission to work with the orphanages.

Exciting…

AS for Chanchos, those who are vegetarian should not read beyond here.

I went to Gualacia today, where my host-mom took me to eat in the market place.  To my horror, we walked up a set of stairs and were met by a line of about 10 vendors selling plates of pork with mashed potatoes and mote (a type of corn), each with a WHOLE roasted pig (with the head and tail and everything) set next to the plates on the table.  I squealed and jumped away from the table, only to see that there was a pig (a chancho), everywhere I turned.  One of the vendors immediately stuck her hand out with a piece of roasted pig skin (real chicharon) and some meat.  I hesitated, and then took just the meat at the insistence of my host-mother.  She ordered a plate for each one of us and then showed me how to scrape the grease/fat off of the pig skin.  The meal was actually delicious, but the idea of eating the pig skin continued to bother me throughout the meal.  Half of me enjoyed the meal, while the other half wondered when the nausea would overcome me and interfere with my ability to swallow the food.  The food was fine.  It was the abundance of pig skin on my plate, which bothered me, as well as the huge 5 foot pig lying across the table just a yard away from us.  When I left some pig skin on my plate, my host-mom told me to eat them, saying that they were just like crackers.  “son chicharrones!” she said… and I realized that I had had chicharrones in California before, but had always told myself that they were not REALLY fried pig skin, but that they were potato chips. 

On the way back to Cuenca, we also saw (to both of our horror), two local women killing a chancho.  My host-mom had never seen the process before and we both cringed as we drove past the bloody site.

The night ended with a rich conversation with my host-mom.  These conversations, as well as the project related interactions I have with the people here, make me realize how much I still lack in my Spanish speaking abilities and pressure me to learn more.  I hope to be able to better defend my position/thoughts better in this language, so that I can be a voice for the children here in and around Cuenca.

Zopotes, tunas, pepites, y cuyes

Here in Cuenca, Ecuador, the mountain weather is such that it is sunny in the morning and pouring in the afternoons.  The town is surrounded on all sides by the Andes mountains.  By driving 30 minutes out of Cuenca, we are able to enjoy the beauty of the nature that surrounds us!

This weekend, I went to several different places in the countryside.  It was a nice a change from walking everyday to and from the clinic/hospital in Cuenca, breathing in the black exhaust from the buses with semi-flat tires.

My host-mother took me to Paute, which is a small town an hour away from Cuenca- hidden in the mountains.  There are 3 rivers that go through Cuenca and they ultimately join together and pour into the Atlantic.  At one point in our trip to Paute, we stopped by the river side and crossed a bridge made solely for those on foot or on horses/cows.  It was about a meter in width and had missing wood, through which you can see the roaring river down below.  It was about a 100 meters/yards across, and as my host-mom crossed the bridge, she jumped on it and made it swing side to side.  What a dear woman she is!

As we drove up to her son's friend's house, I saw meat being roasted on the roadside.  Whole pigs, chicken, and then a little animal the size of a hen. 

Cuyes.

What are they?  I shouldn't have asked, since I'll have a hard time eating them next time I'm served cuyes.

Guinea pigs.

Yikes. But apparently, the are absolutamente DE-LI-CI-O-SO. and RICIsimo, as my host-mom puts it.

Today, I went to the foundation and worked in the eye clinic.  I saw a 13 year old with completely clouded pupils, probably retinoblastoma.  Another kid with trauma to the head, who had lost half of the vision of his left eye and could only see out of the lateral side of his eye... probably nerve damage.

It poured on my way home from clinic- and I was drenched by the time I got home.  It took me 40 minutes before to walk to clinic.  Now it only takes me about 23 minutes.  I'm still trying to beat that time.  (the games I play when I'm alone!)

I am also starting to get more direction/vsion in terms of our orphanage project (a home for abandoned children).

I get to participate as a Pediatrician...and I hope to continue this in the years to come.  Each day, I am getting a better idea of why I am out here.  Pretty cool.  (Que chevere!)

Distance is relative

I would have thought that distance was a measurement- something absolute.

But when I walked home from the clinic in downtown Cuenca today, to my host family's house past the bridge, I realized that it's all relative.  To a person (like myself) who gets lost fairly easily, the 2 mile walk back from the clinic in the rain seemed like forever...until I ran into the secretary who works at my homestay site.  Phew!  I was so happy to run into her, after dodging cars and jumping over the rivers that had formed on the sides of the roads, unsuccessfully (I jumped into many puddles, had water in my shoes by the time I got half way home).

Today was our second day of clinic, surgeries, and consults.  I could never tire of seeing children, but it really grieves me to see those like the girl yesterday who was born with a heart condition called Tetralogy of Fallot (medstudents can review the 4 associated anatomical abnormalities), for whom we can do nothing.  Cyanotic, short of breath, and sitting in our clinic, wondering when she will meet death.  There are Ecuadorian surgeons who can perform the surgery, just not the proper equipment.

I'm sitting at my desk and I'm out of breath. It's probably the 2,400 meters in altitude- where Cuenca is situated.

Goodnight.  Life's amazing.  I'm thankful for so many things right now- for having gotten home safely, without getting too lost, for the hot shower after getting home drenched, for life...

There was a home Bible study tonight- of course all in spanish.  No sabia que el libo James se llama "Santiago" en espanol.  I also answered a Bible trivia correctly.  That the other name for the sea of Galilee is.... the sea of Tiberias! 

It's past midnight. I better go to bed.

Not without purpose

I believe that there is a purpose for everything.

When my follow-up trip to Kenya and Sudan had to be cancelled this year because of political instability in the former country, I was bummed.  Not long before this cancellation, I had also been informed by the mission hospital in Ecuador that my visit there from March to April also had fallen through.

My original plan for 2008 was to spend Jan-Mar in Africa, come back for my residency match, and then to go to Ecuador.  Instead, I waited in the States for a green light to go to Kenya.  By the time I received a "go" sign from the NGO there, it was already late February and March had been set aside for other plans. 

Well, to make the long story short, I'm in Cuenca, Ecuador, writing from my own upstairs room in a nice house.  I am staying with a  host family for the next month as I volunteer as a translator for the Global Health Organization (a medical missions arm of the Christian Medical and Dental Association).  There is a team of women docs here for a week to perform elective surgeries.  After this team leaves, I'm working with the local organization to do my favorite thing... immerse myself in the culture and to learn as much as I can about this community and its infrastructure for medical care to the underserved.  This means going to orphanages, working with Ecuadorian physicians, participating in community outreach events, etc etc...!

Cuenca is situated just 4 hours west of Guayaquil, which is the airport I flew into on Saturday (yesterday).  Funny, because I told my S.O. that I'd call him from Panama City, Florida, where I was supposed to have a layover.  About 5 minutes prior to landing, I started to wonder why everyone on the plane (the pilot, the flight attendants, and the passengers) seemed to speak Spanish.  The guy next to me gave me a “No hablo ingles” when I started to ask him a question.  He was going to Columbia.  Hmmmm…  I finally asked, a bit nervously, “Es Panama City en Panama? O en Florida?”  Before I could even finish my question, he replied “Panama.”  Shoooooooooooot.  I looked it up twice on Google!  They said Panama City was in Florida!  No wonder everyone no hablan Ingles.

I guess I could laugh about it now, but so much for saying my “real” goodbyes to my family- I’d told everyone I’d call again once I got to Florida.

Once I got into Guayaquil, I got a cab to the hotel where I was staying overnight.  It was still early in the afternoon so I walked around by myself for a bit.  I felt a bit lonely, and kept asking myself “so, what am I doing this time?”  This place was nothing like Kenya or Sudan, but I had planned for Africa MONTHS in advance.  I had only purchased my Ecuador ticket on Tuesday this past week because there were logistical details that were unclear to the last moments before the trip. 

Thankfully though- I read my Bible last night- where it talks about doing justice, serving the fatherless, and speaking out for the widows, and I felt a bit convicted in a good way.  These are things I’ve always liked doing and I just needed a little push.  This morning, I met a couple who have a very similar vision to mine.  (networking!)  They too have a heart for children in the underserved world.  We only have one life to live!  I can’t waste the opportunities that arise before me!

I was nervous about meeting my host-mom because I had a previous not-so-great host family in Cuernavaca, Mexico (cereal for breakfast, a bean and onion sandwich for lunch, and cereal for dinner), but she has already been beyond amazing.  A widow with 4 grown children (the youngest is in high school), she rents out this room I currently am in, to bring in some income.  She’s also a high school math teacher.  She told me “open all the cabinets and see what’s in there so that you can feel at home.”  She also took me to her bedroom and showed me every room in the house.  “If you want to use my bathroom, you can go ahead. Use anything you want.”  When I commented on how big the house was, she told me how she worried when she was widowed 7 years ago by her husband who had a spinal cord disorder.  Then, in a dream, God showed her to use her patio to construct another room.  The dream was so clear that she knew where to put what and how to instruct her builders.  It’s so nice. What a pity that I can’t describe this place sufficiently.

Tomorrow, we will start the surgical clinic.  Praying that these efforts really help this community- both the patients/families and Ecuadorian docs/nurses we’re working with.

Just until last evening, I doubted whether there was a purpose to my coming to Ecuador... Now, I'm starting to see it!  I'm glad to be here during my last free month prior to residency :)