Special Feature Video Clips!

Iguana Park, Guayaquil

This is our first try on uploading video footage, so bear with us.  This footage is from the coastal city of Guayaquil on our trip to the coast last month.  Unfortunately, uploading requires compressing the video file, so the resolution is unbearable if you enlarge the image to full screen, but maybe you'll get the general picture.  This city park has hundreds of iguanas, climbing the trees, basking in the sun, begging from people like pigeons.   And the ponds in the park are filled with hundreds of turtles the size placemats!

A Beautiful Young Voice of Azogues

During the annual Independence Day celebration of Azogues there are a variety of street fair activities, food vendors, and processions featuring dance and traditional music groups.  A small radio station that broadcasts from the house across the street from us hosted recording studio performances for a few talented children who sang regional folk songs.  This girl, practicing her number outside of the station, won my heart singing a ballad about the town of Azogues.

Ophthalmology at the Azogues Regional Hospital

Opthalmology is a gadget-intensive specialty, often requiring expensive equipment for diagnosis and treatment of disease.  The local hospital has some of the basice machinery for adequate eye exams, but surgical treatment options are limited.  When patients do require surgery for cataracts or other ailments, they are required to purchase their own suture, gauze, patches, and any other non-reusable supplies.  There is a decent operating microscope at the hospital, but very few surgical instruments.  Despite this, patients are well taken care of by Dr. Diaz, an ophthalmologist from the nearby city of Cuenca.  He has graciously allowed me the opportunity to help him in both the clinic and the OR.

In Montana, a patient might describe a few months to a year of vision decline before seeing an ophthalmologist.  Here, the history often begins with “My vision has been getting worse for the past fifteen years…”

I’m on my own in the Eye Clinic, so have the chance to use and improve my Spanish.  It’s good to be forced to describe medical findings and surgical procedures in another language without terrifying the patients.  Body language helps.   Everyone has been exceedingly gracious.

Cataracts are the most common cause of treatable vision loss.  In a country like Ecuador with few ophthalmologists over all, there are even fewer who perform cataract surgery.   In areas where access to eye surgery is limited, cataract surgery is often provided by volunteer physicians with the support of charitable foundations.   Fundacion Hogar, based in Cuenca, has supported over 6,000 cataract surgeries over the past year.  Dr. Diaz and Dr. Cabrera are excellent surgeons—the surgeries are safe, efficient and effective.   As soon as a bed is vacated, new patients are moved into the operating room.  Here, two patients undergo surgery while a third awaits her turn.

Inca Ruin Site near Azogues

Ingapirca is an Inca temple site that was built between 1400 and 1500 AD.  The Incas only ruled for 150 years (until the Spanish Conquistadores arrived in 1532).   But during their short reign, they controlled a huge region extending from what is now Colombia in the north to Argentina in the south.  Their capital cities were in Cuzco, Peru, and Cuenca, Ecuador.  The Incas enforced the use of a single language, Quechua, in a region that previously was comprised of hundreds of different language and cultural groups.  As you might guess, in order to accomplish this, the Incas had a very well-organized military.  But they also had a successful agricultural system including irrigation, beautiful art with gorgeous textiles and ceramics, and an extensive  road system allowing rapid travel, albiet by foot.  Perhaps most noteworthy, however, was their sophisticated and compelling religious system, centered around the Sun God or Inti and local mountain spirits.  The Inca ruler was considered the son of Inti.

Inca architecture is well-known for its stunning building sites (location/location/location).  The trapezoidal structures were extremely sturdy and the most important structures were built with carved boulders that fit together so tightly that there was no need for mortar.  

Surgical Camp in the Inland Coastal Region

Earlier this month the Cinterandes crew worked for 4 days in the coastal lowland region in the town of Vinces, a 5 hour drive northwest of here.  There are huge banana plantations in the area, also pleasant rolling hills with dry forests and small subsistence farms.  The town of Vinces initially reminded me of a Southeast Asian city because the streets are filled with motorcycles and three-wheeled bicycle taxis.  But salsa music filling the streets until late at night and street soccer games bring one back around to Latin America.

On the day we arrived, we did surgery until midnight.  The following day, we started around 8am, operated until 8pm, then went to a late night dinner party at a local doctor's home on the banks of the large river that runs through town.  I have been honored to work in the OR as first assistant on about half of the surgeries.  The rest of the time, I have been able to roam around taking photos and find people to make small talk with until the next case. In the end, we did 30 surgeries over the 3 days in Vinces:  hernias, phimosis/circumcisions, tubal ligations, gallbladders, and  lipomas.  The Cinterandes crew works very hard, taking advantage of the long trip with lots of equipment to do as many surgeries as possible.  And usually the host city welcoming party makes sure after work is over that everyone plays in the evening just as hard as they worked during the day.

From the team of local volunteers, working as late as everyone else.

The third day was a more mellow schedule of surgery, interspersed with a tour of a cocoa/chocolate factory and a mandatory break to watch the Ecuadorean national soccer team play Peru in a World Cup qualifying match.  And in the evening, we took a short field trip to a nature reserve where we were able to see monkeys and sloths, then had another late night dinner party, this time with salsa dancing past midnight.  I am embarrassed to admit that not only did I shock the crowd with my Gringo style salsa dancing, but I was also forced to sing Hey Jude in a Karaoke performance!  Luckily, there’s no footage of that behavior.