So I finally made it to Ecuador! My goodness it was a mission!!

It all began with a lovely early morning flight to Auckland… after the last minute packing mission, resulting in 3 hours sleep. Note to self NEVER a good start to long haul flying. The idea that I would sleep on the plane definitely did not compensate for the following 72 hours. Particularly as 12 hours after my expected arrival time I was headed out on the rural surgical bus!

In transit, I discovered I had a whole day in transit in Santiago, Chile. This was great – I caught a bus into town and some how I was collected by a bunch of tourists and ended up on a walking tour of the city. This was a fantastic way to use my time! Later I bussed back to the airport to sleep, as check in was 3am.

From here to Ecuador quickly became a nightmare. My flight from Santiago to Lima, Chile, was cancelled. After spending 4 hours lined up with everyone else from my flight, I was given another flight to Lima and Lima to Quito, Ecuador. However, as my final flight (Quito to Cuenca) was with a different airline, they would not compensate that flight, even though they had caused me to miss it. After many stilted arguments in Spanish, in three different countries (Chile, Peru and NZ), I conceded, there was no way I would make it to Cuenca in time to catch the surgical bus.

After much stress, I need to thank the man at the restaurant in the Lima airport for allowing me free use of their WIFI (as I had no Peruvian dollars) and Telecom for actually working in Peru (it doesn’t in Ecuador), for helping me get in contact with Carolina (my hospital contact). This wonderful woman, organized some of her poor friends to come and collect me at 1am in Quito, take me to a guesthouse to sleep, AND THEN driving me 3 hours to Pujili (and 3 hours back), where I would meet the bus. Without them I seriously don’t know where I would be right now.

So, for my first day in Ecuador, I slept. A lot. 20 hours or something crazy in fact! That evening, I went down to the local hospital to meet the Cinterandes team, who had driven 8 hours from Cuenca (right about then I was mighty pleased to have missed that bus trip.)

A little information about Cinterandes…

Cinterandes is an Ecuadorian organization, which began in 1990, by Dr Edgar Rodas. It is aimed at providing healthcare to those in the country who need it most. In 1994, he set up a mobile surgical van, which travels to various rural parts of the country to perform operations. In the 18.5 years it has been running, over 7000 operations have been completed.

Making up the Cinterandes team for the week was; Dr Edgar Rodas (coordinator and surgeon), Dr Ana (anaethetist), Dr Blasco (physican), Dr Fernando (paediatric surgeon), Freddy (OT technican), Haydee (scrub nurse), Dr Ivan (general surgeon) and Gonzalo (MSU driver and coordinator). Alongside them was Dr Geelhoed from USA, 2 students he had brought with him and a few students from the local university in Ecuador, who get to go on the bus as placement!

But back to the evening..

Down at the hospital, the clinic was used to prioritise the patients’ operations, which we would complete over the next 2 days. The idea was to use the operating rooms in the hospital as well as the van, to double the number possible. After clinic it was finally dinner time – much to my delight, as so much sleeping meant I had not eaten since leaving Lima, over 24 hours before!

I quickly discovered that my high school level Spanish was somewhat basic, and I could only follow basic instructions and conversations. Thank goodness for the two USA students, who spoke much better than me, and translated as needed – very useful when there were 6 of us in a dorm room!

Over the following two days we completed open tubal ligations, hernia repairs, descended several undescended testes, removed ovarian cysts and completed 2 laparoscopic cholecystectomies. Interestingly, most of these operations, particularly those on adults were done using spinal alone, where as in NZ, every single one would have been done under general.

One major thing I noted was the reuse of equipment and packaging – in NZ everything is disposable. Here, everything, including the sterile packing is carefully collected, taken away, re- sterilised and reused. Right down to the little pieces of cardboard that a non-sterile person can hold to help a scrubbed person gown up!

Assisting in theatre in Spanish was great fun! The surgeons were extremely understanding of my limited Spanish and keen to learn English – so we would word exchange, naming tools and anatomy in each other’s language. The anaesthetists were also extremely friendly and keen to let me help out – to the point where I was being left in charge of patients!! Fortunately once a spinal is in, not much can go wrong!

Over the course of the week my Spanish has improved markedly. On arrival, I could pull off Spanish at a 5 year old level. By Tuesday it was at 8 year old level, and now on Thursday night, it is at 11 year old level. (As judged per conversations with small children.) Hopefully it will continue to improve, as my main translator, Clayton, heads back to the USA on Saturday!

Having completed the list of operations on Wednesday evening (although it did mean we were up operating until midnight on Tuesday), the locals put on a celebratory meal and song / dance session for us. This was a great experience of local culture, clothing and dance – especially as we were all dragged up to have a go! Afterwards I spent time bonding with some of the other students and doctors, although admittedly, as the night wore on my abilities to understand Spanish dropped and bed was called for.

Today (Thursday) we drove 8 hours in the bus back to Cuenca, through some jaw dropping scenery, with many stops for icecream and other goodies.

For the next few weeks I will be based in Cuenca, living with Sonia (my host mother) and Sonita (her 11 year old daughter). It is so nice to have arrived at a destination where I am not living out of a backpack – however I am really looking forward to heading back out on the bus in 3 weeks time!

Tomorrow I am going to see the hospital and decide how I want to spend my next 3 weeks – I’m thinking something surgical. Then Clayton and I are going to the panama hat museum, where they custom make hats – so we feel the need to purchase one – photos pending!
A great start to Ecuador!