Archive for July, 2011

Site Visit

Fair warning: this post is super long because it was a very eventful week. The dates listed below are excerpts from my journal, and at the bottom are my general impressions about the week.

Based on first impressions, I really really like my site. I feel like I got the best of both worlds. The community I will live in has about 500 houses. But, there are other smaller communities around me, and I am only a 40 minute bus ride from the province capital, Portoviejo. My work will be county-wide, so I could be traveling as far as two hours in a pickup truck to get to some communities. The organization I have been assigned to work with is “The Committee of Health Volunteers of 24 De Mayo” (24 de Mayo is the name of the county). They don’t have any funds of their own, and they don’t even really have an office. They work a lot with the doctors in the health center, and they receive some assistance from the municipality and PLAN international. Basically, the volunteers act as health promoters in the different communities. They focus quite a bit on nutrition for kids under 5 because there is a high prevalence of malnutrition in the county, especially for kids. Some of the activities include giving charlas on nutrition, weighing and measuring kids to see if they are malnourished, helping the doctors with health brigades like vaccines or dental checks, and more. It sounds like I will have a lot to do! I got to meet the current volunteer there- Jen. She will leave like 2 days before I arrive. I can tell she is really looking out for me, trying to fill me in on as much as possible. I really like the people here too. And although I am sure there will be disadvantages later, right now being the 3rd volunteer seem like an advantage in many ways. Everyone has an idea of what a volunteer is, and they are all really proud to have a volunteer living in their community, and they all want to talk to me and get to know me. In fact, there are already 3 families that want me to live with them! 2 families were approved by my program manager and I was assigned one of them, but the other family was still asking about it and even showed me the room. The 3rd family wants to rent me the current volunteer’s house after the 3 month requirement of living with my family ends. I will have a lot of options as to where I want to live after those 3 months, and it will be a delicate job of breaking the news to the families I choose not to rent from. Last, everyone was awaiting my arrival. People kept calling my counterpart and the current volunteer to see where I was. I met the 3 families that wanted me to live with them, and they are all very large extended families. I ate two dinners! In the family I’m assigned to live with, there are the parents, who are the people I actually live with. They are grandparents. Their kids and their spouses/families live in the houses immediately surrounding us, and we basically all share a yard, along with a few cows and a bunch of chickens. I guess the best way to describe it is a family compound. Everyone was there when I arrived, probably at least 15 people, and I kissed everyone on the cheek as is the custom. Then they ushered be into the living room along with the current volunteer and for the most part just stared at me. The funniest moment was probably when they were trying to pronounce my full name. Katrina is not super difficult for them, although they have a tendency to say “Katreen”. Lynn wasn’t too too hard either, but Organ was a bit difficult for them to say. Basically, it turned into a chorus of my name, with person after person repeating it and practicing it. I don’t think I have ever heard my name said that many times in a 10 minute period. It was pretty surreal.


Today I went into Portoviejo with Jen. She had to meet with a doctor briefly, and then she showed me where the post office, bank, internet café, and market were. Then we went to the mall, which will be pretty nice because there is a decent food court and a movie theater… the perfect place to decompress. This afternoon I also had a meeting with some of the main contacts I will be working with. There were two doctors who work at the health center, 2 health promoters with my committee, the president of Los TIllales, and one of the other volunteers in the organization who is very active and who also lives across the street from me. Basically it was to get to know each other a bit and they were discussing various projects as well. I also ended up going to an outdoor mass in the nearby town of Sucre. It was really pretty and the music was nice. It was to celebrate St. Carmen I think.

Today was on the slower side. It was not a work day so I spent a lot of time in my host family’s house. I hung out with the kids a lot… they are great people to practice Spanish with because they have more patience with you and use simpler vocabulary. I also did some of the community assessment tools we had to complete over the week, like asking people about their daily schedules or having them draw community maps. The neighbor who lives across the street tool me for a walk to see where one of two tiendas were in the town. Write now as I sit writing this there are 5 people just watching me write. It is a strange feeling to be perceived as so fascinating. Everyone is just SO interested in EVERYTHING that I do, from what utensil I eat to what time I shower to how I wear my hair. That night we also had a party for what would be my “sister-in-law”. A lot of people came over and my family killed a few chickens for the event. There was also a mariachi singer (who is a pastor during the day). I ate the really good food and danced a little bit with the kids. They also have a practice of giving speeches about the birthday person, and they asked me to say something! Again, the status and privilege I have blows my mind. The only other people who spoke were her parents and husband. One funny thing that I’ve noticed is whenever I say I don’t know how to do something, they just say “you will learn here”. I don’t know how to dance- “you will learn here”. I don’t know how to play soccer= “you will learn here”. I don’t know how to make that- “you will learn here”. And you know what? I probably will (wish me luck on the soccer thing, you all know I will need it).

Sunday. After breakfast (which consisted of beef soup, rice, plantains, and cheese) Jenny took me to the open air market in Sucre, about 20 minutes away. There is a Sunday market for material things like clothes and CDs, and there is also a food market (fish, meat, vegetables) that is open every day but things tend to be fresher on Sundays. The main mode of transportation besides the bus that runs to Portoviejo is pickup trucks. People drive up and down the road, and you pay like 20 cents to ride in the back of the truck. We walked around for quite awhile, and then went back to my family’s house for lunch. After lunch we went to the “grand opening” of a horse track. We sat on the truck in the parking lot instead of paying the entrance fee, which is what many people did. We were there for about two and a half hours and saw ONE race. That’s Ecuador for you I guess!

Today I went to the Centro De Salud (health center) in Sucre. There were tons of young moms with babies there… I wonder if there is a program there somewhere that I can develop? I also met the director and some of the staff as well as a health educator. The health educator made me laugh because he did something that I have seen people in the U.S. do as well. When he was told that I am new at Spanish, he talked really loud in simple words, like nearly yelling at me will somehow make me understand him better. How many times have you heard of someone in the U.S. doing this to person they perceive as not understanding English (whether they understand or not)? After the Centro, I had a meeting in the Volunteer Committee’s “office” which is really just a garage. The meeting was supposed to be to help me fill out my work plan for the first 3 months (which I have to turn into PC), but it turned into a bit of a debate. They talked about the effectiveness of past programs, the effectiveness and capacity of the volunteers on the committee, what my work priorities should be, etc. They mentioned something about whether I should be working in the colegio (high school) or not.

Jenny also had to remind them, quite strongly, of two important things: 1) That I should not be responsible for any major organizing/coordinating/managing of charlas or projects in my first 3 months in site. According to Peace Corps those first 3 months are meant to get to know the community and improve our language skills. We of course can do small projects if we want to, say community gardening or something, but I really shouldn’t be planning and giving charlas on say, family planning, when I do not have the contacts yet to call the necessary people for planning this or the Spanish skills to present it effectively. 2) I am allowed to have secondary projects that are not associated with the committee of volunteers, such as gardening, cooking classes, working with schools, whatever. Even though the committee members said that they understood these things, one part of the culture here is that people say yes even if they don’t completely mean yes. Therefore, I have my doubts as to whether both of these things will hold true.

There is something else very interesting I have noticed about the people I will be working with. Perhaps it is partially because I am the 3rd volunteer, part personality, part culture, part small town… I don’t know. But there seems to be a lot of politics (for lack of a better word) involving the status of having a volunteer. It seems that a great many people want ownership in working with the gringita. The committee appears a bit possessive. One example is their resistance to me having outside projects. This also goes back to the debate over where I should live. My counterpart wanted me in the other house because it was near her home, in the upper part of Los Tillales where many of the “power players” live. I live in the center part of Los Tillales. There are also the houses on the other side of the river, which in general are slightly poorer than where I live. Another example: Jenny started a children’s library for the community. Once a week she reads to them in Spanish, and they are allowed to borrow books. She asked me if I wanted her to move the books to my house when she leaves, and of course I said yes. Reading will improve my Spanish it is also a great way for me to get to know the kids where I live. This is a project that was entirely orchestrated and managed by Jenny; the committee had nothing to do with it. However, at the committee meeting, they were trying to convince Jenny that the books should stay in their neighborhood and they really did not want them moving to where I live, in the center of Los Tillales. All of this “regionalism” is extremely strange and kind of funny to me for one main reason: my house is maybe a 10 minute walk from my counterpart’s house in the other “neighborhood”.
I can see that these power dynamics will be a challenge for me in more ways than one. I am going to work very hard to get to know the entire community, including the houses on the other side of the river, and to work with as many people as possible. With that being said, it is a balancing act because I am assigned to work with my counterpart and organization. I am here to help empower them, and I don’t want to isolate them. So basically, I have to find a way to empower the organization while trying not to bolster the dynamics of privilege that are so obviously at play. It will be quite the balancing act, but I think I am up to the challenge.


This morning, Jenny picked me up and we went to the colegio in Sucre to give a charla on anemia. (Jenny was giving the charla, I was just there to introduce myself and observe). Jenny has been working with this particular group of high school students to educate them on the “Growing Strong and Healthy” program. The hope is that once they are trained in the program, they will be able to replicate the charlas in their own communities. It not only educates them on issues of nutrition and hygiene, but it also increases their self-esteem and public speaking skills while creating another channel of information for the communities to utilize. The kids were super friendly and asked me lots of questions. One girl even asked me if my eye color was natural or if I was wearing contacts (green/blue eyes are extremely rare here). I was slightly disappointed when my counterpart, Nelly did not show up like she said she would. The day before the charla, she said she would help Jenny out, but then she missed the whole charla and just met us after. When we asked why she missed it, she gave really vague answers like “If you only knew” then she said she forgot. Jenny said that basically, if Nelly doesn’t want to do something, she just won’t. This is another challenge I see in my future, but again is something I am willing to work with.

After the charla, we drove 45 minutes outside of the town to do a census for the Ministry of Public Health. This area is much more rural and isolated than where I live. We practically had to drive house to house, because there would be a cluster of 2-3 homes, then nothing, then another cluster way down the dirt road. All of this travel of course is in the back of a pickup truck, so when it started to downpour we had to stop and find shelter until it passed. The level of nutrition and hygiene is much lower than where I live. One family sticks out in my mind. The mom was 40 years old and was expecting her ninth child. Her husband currently does not have a job, but he is sometimes able to find work on a farm temporarily. Even though she should be getting pre-natal checkups, which are free, she has only seen a doctor 3 times in the 8 months of her pregnancy, and has not received all of the exams she is entitled to. She was quite skinny and did not look very well nourished. Her children were also pretty skinny, and had worn clothes and were not wearing shoes. These are mostly the kinds of families I will be working with, and I am really looking forward to getting to know them.

Today I head back to Tumbaco. The bus ride is about 9 hours to Quito. I am really looking forward to what everyone else has to say about their sites. My host family was adorable, saying that they would miss me a lot and they can’t wait for me to come back.

General Impressions
Overall, I love my site and I can’t wait to move there in about a month. I feel extremely blessed to be in the situation I am in. When I got back to training, I learned that one of the other health volunteers went home because she was unhappy with her site. There are other people who absolutely love their site, but not everyone. The vast majority are still in the middle, unsure. Excited, but not thrilled. Like I said, I feel really lucky.

There are, however, definitely things that are way different from my experiences in Tumbaco thus far and I wanted to share a couple with you. I can’t pinpoint why these difference exist; it could be the difference between rural and urban, coast and sierra, poor versus middle class, or a million other things.

One striking difference is the amount of attention I got as a white/American female. They warned us that this would happen, but besides a few whistles I hadn’t really experienced much. Perhaps it’s because in Tumbaco I am usually in a group of people, I don’t know. It can be a bit unnerving, but I’ve found the best coping mechanism is to just laugh it off. I’ll give you some examples. One young man that was in the group I was with asked me if I had a boyfriend in the United States. I said no. He said “men in the United States must be blind!” Another guy said he could get lost in my eyes for years. Of course there is the “you are so beautiful”. Yet another one offered to take me to Peru. This is my personal favorite: one guy said that if we got married we would have beautiful white children and that I should just live here forever and he could take me around on his motorcycle and I would be very happy. This is all especially hilarious to me because all I can think is I am sweaty, tired, not wearing any makeup, and have my hair bunched under a baseball cap. What the hell makes you interested in THAT.

Time is another difference. Again, they warned us about it but it hadn’t really affected me in Tumbaco. In my site, it seems like I can pretty much count on people being 30 minutes late. It just is not that important to be on time.

Language. People on the coast talk a lot faster, and the common phrases and words they use are different from the ones I have been learning in the Sierra. They also sometimes drop the letters at the end of words. All of this makes it harder to understand people in my site, but luckily if I ask them to slow down, they will and then I can usually figure out what they are saying.

Food. They eat a lot more meat than in the Sierra. Like, with every meal. I had beef with breakfast almost every morning. It is difficult for me, but once I move out in a few months I can cook for myself. They also eat more fish, which I am enjoying.

Creatures. I saw a lot of them, including spiders, a snake, bats, an iguana, rats, and of course tons of flying insects. As long as I don’t get bitten by anything, I think I will be ok!

Status/Privilege. My host family in Tumbaco has had volunteers before, and they treat me as a regular member of the family… I don’t feel special or privileged. However, in my site, as I touched on earlier, I feel like I am being given a lot of status. I feel very catered to, and it is extremely difficult for me because I know that my host family is just trying to make me happy. For example, during the week it was obvious that they were cooking special meals and eating around my schedule. My host mom also took my dirty clothes out of my room and washed them for me. This is something that I will have to work on when I get back; finding a balance of doing more things for myself and being treated like an actual member of the family without special privileges while managing not to offend or upset my host family, especially my host mom.

Visibility. I definitely feel the fishbowl effect here. I have had people watch me eat, watch me write, watch me watch TV, etc. When I walk down the street, everyone wants to talk to me because they know I am the new volunteer. I feel that this will definitely work to my advantage, but I also sense that it will get on my nerves at times.

Overall, I am pretty damn happy and this visit made me absolutely sure that I am supposed to be here. =)


A Funky Week

This week has been… interesting.

It started out great. I had an absolutely wonderful time at our 4th of July picnic/field day. The PC staff put together a field day that involved each of the programs (Health, English Teachers, and Youth and Families) competing against each other in volleyball, basketball, and soccer. They even had a kind of beauty queen competition. Even though I am not, well, athletically gifted, I still had a blast cheering my teammates on. The spirit of the day was just fun. Each group bought team jerseys, and a bunch of us even painted our faces. We also had a potluck, which meant a ton of yummy food for everyone. It was a nice relaxing day, just walking around chatting, cheering people on, snacking on brownies, etc.

On Tuesday, we had a workshop on HIV and AIDS (VIH/SIDA). It was one of my favorite days of training so far. We were fortunate enough to have our PC staff member from Guayaquil, some current volunteers working in HIV/AIDS, and an Ecuadorian activist who is currently living with HIV. It was a dynamic and interesting day filled with all kinds of learning. We learned the basic science about how HIV and AIDS can affect the body, and how it is transmitted. We participated in different activities that we could use in the field. We learned how to give condom demonstrations in Spanish. We also discussed the Ecuadorian social context of HIV/AIDS. We learned about the feminization of HIV due to gender dynamics here. We heard about the lack of condom use. Let me elaborate.

Because Ecuador has a heavy Catholic population/influence, sex education here has been fairly conservative. We’ve heard from some current volunteers that even with sex ed as part of the school curriculum, the teachers can be uncomfortable discussing it, making for a sex ed class that could be lacking. The importance of using condoms to prevent HIV may not be as emphasized as it should be. Proper use of condoms may also not be explained… our staff members told us that men or teenage boys have actually admitted to reusing a condom, or they use two at the same time because they think two is better than one. Obviously both of these uses are incorrect and can make the condom less effective or completely ineffective in preventing STIs or unwanted pregnancy. Another issue surrounding sexual health, HIV prevention, and condom use is embarrassment or fear of gossip. Even though condoms are technically free through the Ministry of Public Health, issues arise. Ecuadorians (most often but not limited to teenagers) are afraid to be seen receiving condoms from their health clinic. This is most prominent in smaller towns where everyone knows everyone and the woman working at the front desk of the clinic could be your Aunt’s neighbor. Since they are embarrassed to receive them, they don’t have any, and they don’t use them. Another issue is that sometimes the health clinics do not receive a supply of condoms on a regular basis, so they could run out.

Another issue surrounding sexual health and HIV is the gender dynamics here in Ecuador. Machismo describes the culture of male superiority and lack of empowerment of women in Ecuador as well as other South or Central American countries. The culture of machismo creates several norms that have led to the feminization of HIV and a rising number of new cases in married couples. According to our staff, about 10 years ago, the rate of new HIV cases was about 17 men to 1 woman. Now, that statistic is 2 men for every one woman. The cycle of poverty is part of the issue. Girls often become pregnant at a young age- anywhere from 12 years old onward. By the time they are 18 many girls will have anywhere between 1 and 3 children. The fathers of these children are typically older, between the ages of 20 and 40. Having children at an early age causes the girls to drop out of school, which then leads to their financial dependence on men. Here comes the power dynamic: these girls rely on the men for financial support, have a minimal education, are younger, and due to marriage are often socially isolated from peers or other forms of social support. If these girls stay in a marriage, there is a high rate of infidelity. A spouse will have unprotected sex outside of their marriage, contract HIV, and then pass it to their partner. Interrelationship rape (without the use of a condom) is also a possibility. Some men here feel they have the right to have sex with their wives, whether their wife wants to or not. Staying with the fathers is not always the case though. And, if these girls are left without a man for financial support, they may become sex workers, once again increasing their risk of HIV.

Speaking of the sex industry in Ecuador…the power dynamics of this industry also leads to the feminization of HIV. Brothels are legal here. Sex workers must receive a health card to work. In order to maintain the card they must come in for health exams and are also provided with contraceptives. A certain attitude is cultivated in men from an early age. It is common for pre-teen or teenage boys as young as 11 or 12 to be taken to a brothel by an older male in their family as a rite of passage. Staff members have also heard stories of men paying substantially more in order to bribe the women into skipping the condom.

Now, what is life like for an Ecuadorian citizen living with HIV? First, let’s talk stigma. There are still huge HUGE myths floating around HIV in Ecuador. This can make transmission more possible (due to lack of education) and also make life difficult for people living with HIV. Some things commonly heard here about HIV: it is contagious (like the flu or something), it is spread through mosquitoes, you can tell by looking at someone if they have HIV (people with HIV always look sick), and many, many more. A great indicator: even though it is illegal, many, many, companies require candidates to receive HIV tests and show them the negative result. With the attitude about people living with HIV, it is no wonder that many people keep it a secret, even from their family and closest friends. With this in mind, let me tell you about medication. In the U.S. it is typical for a person diagnosed with HIV to start medication right away. However, here in Ecuador, a person may not receive medication until their CD4 count is below 250. In addition, this medication is distributed from a hospital in Guayaquil. This means that if you live 10 hours away, you have to take a 10 hour bus ride once a month to get your medication. Now imagine coming up with excuses to make that 10 hour bus ride if your family, friends, and coworkers do not know that you are being treated for HIV. In addition, throw in the complication of a serious shortage of medication, which means you might make that bus ride only to find out that there is no medication for you and you have to return in a few days to see if they have received a shipment for you. You can see why people living with HIV become discouraged and may even stop taking their medication, resulting in drug resistance if they wish to start a regimen again.

As you can see, we learned A LOT in just one day, and I am sure there is much more to learn. Regardless of whatever primary project I am assigned, all volunteers, especially health volunteers, are strongly encouraged to incorporate HIV/AIDS education and awareness into their service. I fully intend on doing so, thanks to everyone who helped run our workshop on Tuesday.

After Tuesday, things start to get weird. I have not really been sleeping well. I have been hit with a bit of homesickness recently. Nothing too, too major. I miss people; I miss the ease of communicating with and seeing friends and family. I miss Panera and Chipotle. I miss hanging out in the SGA office (ok I guess I would miss that regardless of where I was living, with that whole graduating thing). It kind of snuck up on me… I am not really sure what brought it on. In addition to this, I have growing anxiety/excitement/many miscellaneous feelings about my site placement, which I will receive on Wednesday and visit on Thursday. I am so excited to meet my community, to know where I will be living, what kind of work I will be doing, etc. Even though I logically understand the importance of extensive training, I have been itching to find out my site. Now that its approaching though, I am quite nervous. Many fears run through my mind. Logical Katrina knows that these are normal and will fade with time and adjustment. Emotional Katrina fears that my language will not be good enough, that I will not jive with my counterpart or host family, that if there was a previous volunteer there, the community will like him/her better, that I will not know what to do when I get there, etc. Like I said, all pretty normal, but I just can’t seem to shake them.

Yesterday especially I felt overly sensitive to every joke or language correction from my family, and I just didn’t know why. It seemed that I couldn’t do anything right, and I didn’t feel great physically either. It was not fun.

Luckily though, things change quickly around here. Today I hung out with my host mom while doing some laundry, which was nice and calming. Then, in a concentrated effort to remove myself from this strange mood, I obviously blasted middle school hits and 80s ballads while cleaning my room. In the afternoon, my host mom and I made some Russian Tea Cookies, a Christmas-time treat in the Organ/Pencek family. Baking with my host mom was hilarious. She is usually so confident in the kitchen, but she couldn’t quite figure out how I was making cookies without milk or water in the dough. She kept making jokes and we had a great time. This evening, my host mom got a chance to talk with my actual mom via skype (with a little help from my translating skills). This too was a really cool experience.

So, it seems thanks to patience, baking, and a little O-Town, the funk has passed just in time for my site visit this week. Thank goodness.

Tech Trip #1

We left Tumbaco at 6am. Of course we then took several buses to get to the first location, Pedro Vicente. We arrived in the center of town and were greeted by the current volunteer stationed there, Joy Love (yes, that is her real name). All of our sites for this trip are in the transition region between the sierra and the coast, which means that it is very warm and humid, and we could definitely feel the difference. Joy walked us to our hotel so we could drop our stuff off. We then had about 25 minutes to prepare for our first charla of the day. All week long, we would be giving charlas with the same people- in my case 2 other volunteers. After quickly reviewing our lesson plan, we walked to the elementary school in town where we would have about 40 minutes to discuss hand washing and proper nutrition. My group was assigned a class of 6-7 year olds. The classroom was extremely warm, and even though I had presented my first charla the previous Friday I was a little nervous. We started by introducing ourselves as “health teachers” from the United States and explaining that our Spanish is not very good, so they should raise their hands if they couldn’t understand what we were saying. We talked about why it is important to eat healthy food, and then we hung up a blank food pyramid and had them tape food where they thought it belonged. Once everyone had taped their food up, we rearranged the food to reflect a healthy diet, and talked a little bit about vitamins, protein, and other nutrients. This would be the format that we’d follow for all of our nutrition charlas during the week. Our plan was to simply adapt the depth of the discussion based on our audience. Once we finished discussing nutrition, we moved on to hand washing. We sang the same song we used for our first charla (stick with what works, right?), using the “alternate” version that emphasizes hand washing with soap and water. Then we were done… 40 minutes flew by. The kids were great, and were really wonderful about participating. I still wish my Spanish was better though! We left the elementary school and grabbed lunch in a local restaurant, then it was time for charla number two! This time we walked to the local high school so that we could present to some of the professors there about nutrition and healthy eating. This was definitely one of my favorite charlas so far. It was really funny to see them argue about what foods were healthy and what foods were not, and it was great to see them thinking about food that they eat so often, like white rice, and what its nutritional value really is. They were also very attentive during the charla and supportive of our attempts at Spanish. After that charla ended, we walked to Joy’s apartment. She told us about her day to day life as a PCV and it was really nice to hear some of the projects she has been working on. After talking with Joy, we walked down to the river. Some of the other trainees actually went swimming, but I just kind of waded around and took a lot of pictures. Even though it was raining, it was a beautiful place and we had a blast. It was one of those moments that already feels like a memory. I felt safe, happy, and grateful to be in that place at that time. We then walked back to the hotel to change and have dinner. After dinner, we went to Joy’ aerobics class, which she holds Monday through Thursday at 8pm. It was intense but super fun. She also said it was a great way to integrate into your community and a solid health program to initiate as a volunteer. We got back to the hotel around 9:30, sweaty and exhausted.

Our first activity of the day was to give another charla. This one was hygiene for 3-5 year olds. A little bit challenging to say the list. Luckily, the teacher was pretty helpful. This time, in addition to singing the hand washing song, we used glitter to show how germs can spread from person to person. Once that charla was done, we did a few surveys in the neighborhood. We had to create and conduct a survey in order to gain a better picture of health and hygiene habits in the communities. Later this week, we will have to present to PC staff members on issues in the community and propose a hypothetical project to address them based on the results of those surveys. After speaking to a few people, we had the opportunity to meet the Mayor of Pedro Vicente. He seemed like he is really interested in advancing his community, but I wish I could have understood a little more of what he was saying. After the meeting, we briefly visited a daycare and then toured the local hospital. It was very different from a U.S. hospital-much much smaller for one thing-and there aren’t really specialists working there. For many reasons, including a limited budget, only general physicians work there, in addition to one surgeon. However, those general physicians are trained in many specialties so that they can treat their patients rather than referring them to specialists, like how it works in the U.S. We were able to hear from one of the founders of the hospital, an American man in his mid-forties. He was extremely engaging and had a lot of great things to say. One thing that really struck me was when he said that people (most often women giving birth) had died in the back of trucks looking for a hospital in Quito to treat them. This can occur because the hospitals are understaffed and will stop accepting patients when they reach a certain capacity, which often happens by mid-morning. After the hospital visit, we went to the market and had lunch. Then we said goodbye to Joy and got on a bus to Puerto Quito. It was a pretty short drive. Our next site was actually outside of Puerto Quito, at a farm. It was tranquil and gorgeous.

The first thing we did on Wednesday was walk to the local school to give a hand washing charla. This was not as uneventful as it may seem. We had to cross two footbridges. The first was pretty sturdy; 4 people could stand on it at one time. The second one… not so much. It was essentially 4 bamboo trees nailed together and laid across the river bank. I am not scared of heights or anything, but I was pretty anxious crossing it. After all, we all know my balance is not the greatest in the world. How lucky many of are in the U.S., that getting to school is so easy. The school we visited was our most rural visit to date. It was one room and one teacher for all of the approximately 20 students, who were of mixed ages and grades. The bathroom was a few minutes’ walk from the class, with one all purpose water faucet that had no soap. We had only 3 kids in our group, one of who was in a wheelchair and had different mental capabilities from the other students. The kids were shy but adorable and they open up a little after a few minutes. When we were done presenting the teacher talked to us about the challenges she faces running her school. It was so different from the town schools we had previously visited. We came back to the farm and “helped”. We fed the chickens, quails, ducks, pigs, and rabbits, worked in the gardens and collected some fruit. After we ate lunch we hiked into the woods (which felt more like a jungle). We tasted cocoa, fruits, and other plants right from the path. The coolest thing about this hike was that after 20 minutes we were so far in that there was no sign of human presence anywhere. There were giant dragonflies, poison frogs… so neat. After the hike, we received a presentation on medicinal plants. A local staff member at the farm also showed us how to cleanse bad energy using plants. The same woman also explained the practice of using cuy (guinea pig) to diagnose what is wrong with someone. In a ritual they rub the live cuy all over the person’s body. Then, whatever is wrong with the cuy is what is wrong with the person. One of our staff members told us that a very skeptical volunteer tried it a few years ago to prove it wrong and it actually worked! Pretty interesting stuff. After that presentation ended, we all went for a swim in the river, and this time I actually swam. It was very relaxing. The other group arrived in the afternoon. Wednesday was the only day that our trips overlapped.

Thursday we left the farm in the morning and after about an hour and a half on the bus, we arrived in Santo Domingo, which is quite a large city. After we checked into the hotel and had lunch at a yummy vegetarian restaurant, we hopped on a bus to give a nutrition charla in a high school outside of the city. Although I had lost most of my nerves by now, seeing this school made me a little nervous again. The kids sounded very rowdy… and they were our first group of high schoolers. Until now, we had only presented to adults or children. My group walked into our assigned classroom and saw 61 12-15 year olds staring back at us. We did our thing and I have to say they were better than I expected. They were enthusiastic and participated a lot. They weren’t “too cool” for us as I suspected they would be. At the end of our session we asked them a few questions to see if they actually learned anything. To my great satisfaction, they answered everything correctly. We then walked to the community health clinic and got a tour from one of the doctors there. After that it was back to the city for a few surveys, dinner, and some relaxing T.V. time in the hotel room.

After walking to a bakery for some fresh breakfast rolls, we headed back to the town from the day before. This time, we were giving a hand washing charla to grade school kids. This charla was another one of my favorites. They really liked playing with the glitter! After the charla, we toured a nutritional rehab center for moms and toddlers. It was really interesting because so much of it is based on behavior change, like cooking differently or eating different kinds of food. I had lunch at the vegetarian place again, and then we headed back to Tumbaco.

Overall it was a great trip; a wonderful balance of relaxing fun and professional practice!