Good Times

We've had a very busy summer so far, and it has been packed with progress, growth, and lots of joy. Humor me while I share what's been going on through different literary media.

Women's Exercise:

• Martha completed her month-long internship and is now certified as a Manna Fitness Instructor
• Rosario AND Susana have completed 100 classes!!
• We bought a plaque for the "Exercise Club", where all the women who have attended 100 classes will have their names engraved
• We are assembling a bungee cord cage to house the exercise balls
• We made new signs and had them laminated to protect them against wear and tear
• We are almost done translating the "Women's Exercise Manual" for future training of fitness instructors

Celebration/Despedida:

We had a fiesta
To celebrate the year
A way to say "bye"
Without shedding a tear

Food galore
And basketball too
Laughter with friends
And all of the crew

Host families attended
There were dogs and children
Doctors and students
Husbands of women

Once strangers, now friends
We gathered to be
Together as a family
Before we leave

Alinambi Kids:

The students in our class started coming to the library a few weeks ago to complete projects for their open house for parents. Since then, they have come almost everyday to color, read, interact with new friends they met, and do many many puzzles. It's been a pleasure to hang out with them outside of the classroom setting. They are great kids, and I hope they continue to use the library and its resources.

Great Experiences with Dr. E:

Diabetes
Respect for patients

Enfermera (Nursing!)
Surgery Prep
Cronic Diseases
OBGYN
Bailoterapia (Exercise Dance Class for The Diabetes Club)
Amistad (Friendship)
Rounds

Thanks for indulging me and letting me fail in my attempt to be creative.

All Kinds of Busy

Here's an update of the last couple of weeks:

We've had summer volunteers here for about 3 weeks now. They've been helping with programs and have done some projects of their own. One exciting contribution is that we now have a reading club at the library. When kids read a book and do a mini book report, they earn a "piece" of an ice cream sundae. They put a construction paper banana or scoop of ice cream on the wall, and once they complete the sundae (8 pieces), they earn an ice cream. It's encouraged kids to read and take books home at the end of the day. They've also worked to improve our programs and have lesson planned for different classes.

On the weekends, the volunteers have done some traveling in this gorgeous country. Two weekends ago, I helped lead their trip to Banos. Banos is what we call a "transitional forest" (on the border between the rain forest and the cloud forest). There we mountain biked, rappelled through water falls, had massages, took a swim in thermal baths, and went 4-wheeling. It was an adventurous weekend, and I'm glad we got to make it to Banos before Tungarahua started erupting (Banos is at the base of a volcano that started erupting 2 days after we left).

Dr. Escobar, the doctor who I shadow on Tuesdays, has asked Krysta and I to attend a couple of the Diabetes Club meetings throughout the year. He has a club of a couple hundred diabetes patients that meets on Friday mornings to discuss different relavent topics, to get their glucose levels checked, and to meet as a support group. We just attended the (belated) Mother's Day Celebration. Dr. Escobar talked with me about the possibility of offering exercise classes for the club, and we are now in the process of setting that up. I think this is an awesome opportunity and I hope that these classes will be up and running before I leave.

Diabetes Club

Last Friday, our 6th graders at Alinambi gave interviews to local tiendas to ask about the nutritional value of what they sell and how that affects the health of the community. Some of them were shy, but for the most part, I was really impressed with their journalism skills.

They look thrilled, don't they

Adventures with Dr. E

The Spring Break group from Tulane is here this week, but I managed to slip away this morning to go shadow at the hospital. When I arrived at the nursing station this morning, there wasn't much to do, so I was sent to the Emergency Room to help out. On my way there, I ran into Dr. Escobar (a doctor who is a prominant figure in the hospital and the community of Sangolqui). We all met Dr. Escobar back last fall, and he is a friend of Manna. He greeted me and asked why I wouldn't be working with the nurses this morning. After explaining that there weren't many vaccinations to give this morning, he suggested I follow him around for the morning. I gladly accepted his offer and accompanied him to his office. Dr. Escobar specializes in internal medicine, tuberculosis patients, and diabetes/hypertension patients.

As Dr. E's nurse this morning, I got to record each of the visits in a patient log (I learned to do this in the rural clinic in Jatumpungo) and I took a LOT of blood pressure measurements. I had the privaledge of seeing several cases that made me happy to have a strong stomach. This includes, but is not limited to, a perirectal abscess, a case of vaginosis, a recovering case of TB, and a woman with vomiting reaction to a new medicine. YUM!

The "perirectal abscess" was on an 18-year-old boy whose mother works at the hospital. Along with the pain, the poor boy was suffering from embarassment. It was all I could do to keep from telling him about when I had to sit on a doctor's table butt-up last year. That probably wouldn't have been professional, but my empathy and general inclination to care for people and make them as comfortable as possible leads me to believe that I'm fit to be a nurse one day.

Also, we treated several hypertension patients. This was especially interesting, since many of the women in our communities or involved in the Women's Exercise program struggle with hypertension. It was yet another great morning of shadowing.

Waaaaaaaaaah!!

That's the sound I heard from 8:00am-12:30pm today... the cries of infants as they got their vaccines.

Since my doctor left the subcentro clinic in Jatumpungo in December, I've been trying to find a way to continue shadowing. I've really grown to love healthcare and my experiences here in Ecuador have just confirmed my desire to become a nurse. Therefore, I sought out the head nurse in the Sangolqui hospital to see if I could shadow some of nurses. She was delighted, and asked that I return the following Thursday to help her.

I showed up this morning to the head nurse welcoming me with open arms and a huge grin. The hospital is implementing a vaccination program where people can come in on certain days to receive specific vaccines. Today was vaccinations for children under 1 year of age. That meant that I gave about 60 babies their vacunas this morning. We administered the following vaccinations:

Newborns (around 2 weeks old): one shot in the shoulder for TB
Infants (2, 4, and 6 months old): one shot in the leg for 5 diseases/infections, 1 administered orally for Polio, and 1 administered orally for diarrhea

Now that's a lot of vacunas! I thoroughly enjoy learning about the Ecuadorian health system and the possibilities of nursing.

That's NURSE Haley, to you

I'm a nurse! A couple of weeks ago I started shadowing a doctor at clinic. In Ecuador, after finishing medical school, new doctors are required to spend 1 year at a rural site. My doctor, Andres (or affectionately Andresito, since he's only 25), was the only one at his rural clinic (or subcentro, as we call them), so when several us expressed interest in shaddowing at the hospital, I was assigned to be the nurse at the subcentro in Jatumpungo, because Andres needed help. Excuse me? Jatum-what?

After explaining no less that 12 times that I am in fact NOT a nurse (university is much more specialized here, so they don't understand how the US degree system works), I made my first trip to Jatumpungo and fell in love. I'm working alongside Andres every Wednesday to help see patients and make house visits in the rural community. I do a lot of administrative work with paperwork and all, but I've learned how to do a lot of physical examinations of patients as well. Ecuador has a motto of "hear one, see one, do one", so Andres has taught me about and allowed me to do tasks I wouldn't be allowed to do until after finishing nursing school in the states. I've taken vitals, checked breathing patterns with a stethascope, written prescriptions, etc. My favorites were giving charlas (mini-lectures) to elementary school kids in the area about Tuberculosis and giving Hepatitis B shots to middle schoolers. I was so nervous giving shots, but the histerical kids forced me to keep my calm. It was so exciting to have hands-on experience like that.

At one of the schools, I was referred to as "Doctora Haley" by one of the teachers. Not yet, Se
ñora Suntaxi... but nurse just may be appropriate.