Week 2

So the past week has really flown by. After a Monday spent in meetings that basically set forth the foundations for the rest of my time here at the medical clinic, I spent the rest of the week getting into a rhythm of observing, being astonished, and trying to rest whenever I could find a spare second or two.

On Monday, with the guidance of Paola and Dr. Andrade, I finalized the preparatory stages of setting up both: my investigation over utilizing the new WHO child growth standards; and the support group for hypertensions. Regarding the growth standards (although I still need to make up the final proposal for this research to the clinic- “this week’s assignment”…), my project would begin with attending the final, closing ceremonies of the pre-schools that are run in conjecture with the clinic. Five in total, these schools provide basically free schooling to about 250 children aged 3-5 in the Cumbayá- Tumbaco, “northern valley,” area outside of Quito; with the only cost of attendance being a $5 monthly charge used to pay for food and the chef that cooks it.

From Tuesday to Thursday, I woke up early to meet Evelyn outside of our conjunto (pic below), so that we could make it to the pre-schools in time for the beginning of the ceremonies. At each school, we arrived with a number of other Club Rotario representatives, usually consisting of the wives of Rotarians that serve as the madrina for the children from year to year, the Falck’s, and Jennyfer, who customarily presented a thank-you speech to the parents, the students, and the professors.


Although at each school the agenda varied in its own unique way, for the most part, everything began with the masses of children dressed in their navy blue and gold, donated Club Rotario uniforms, suddenly stopping their squirmishness so that they could stand before their country’s flag and sing the national anthem of Ecuador. From this, the audience was graced with a presentation of the years learning; which, often included picking the correct vowels out of a collection of letters, demonstrating their ability to determine which set of apples contained three and not two or four, and even reciting a few English words they had learned from previous volunteers. In all, as I sat amongst the parents in awe, I immediately understood how important it was for these children to have the opportunity that these pre-school provided- not only because of the lessons they had learned over the past 9 or so months, but because how drastically different they appeared in contrast to the children who would occasionally wander past the rickety fences surrounding the compound, peer in to see what the commotion was about, only to then scurry off to continue to kick whatever rusty can, or stray dog that accompanied them on the lonely streets they called home.

From school to school we went, and at each establishment I found a new set of smiling faces accompanied by a couple of professors and a handful of parents that tried to catalyze the change necessary in these children’s lives. Tuesday it was muñequitos de chocolate, Wednesday, mis primeras letras, and Thursday, los amigos de Noruega; in total, the 3 schools and some 150 students I was able to meet dramatically altered my perspective concerning my project, putting an entire collection of dirt smudged, but innocent faces with the set of medical records that I would begin to analyze over the next two months. At the end of the day Thursday, I left the final school with an overwhelming sadness- a feeling of regret if I had to classify it- that my brief exposure to these children had only consisted of watching versions of “head, shoulders, knees and toes” or “Snow White” in Spanish, sitting down in wooden chairs that came up to the middle of my shin to eat plates of chicken and papas, and playing soccer with the recent “graduates.” But at the same time, after I left each school and drove the winding, often extremely bumpy, roads back to the medical clinic, I had a new found optimism to help these children in whatever way I could- and for now, that meant determining what sort of help is needed most.

Following the mornings that were spent at the pre-schools, each afternoon I came back to the clinic to a rag-tag set of chores and tasks that often included translating e-mails from donors and other Rotarians around the world into Spanish for the director, running errands for the infirmary, and preparing for the implementation of what I figure may allow the most successful continuation of the hypertension support group: a “blood-pressure awareness month.”
After meeting with Dr. Andrade, I was better able to understand exactly what has gone into the group, where the problem of hypertension stands within the community, and what sort of options we as a medical clinic have at our disposal. In hopes of ameliorating some of the issues that were brought to my attention (low attendance, very minimal understanding of the problem, and a static utilization of resources/ information), I realized that, above all, I need to reach out to the community in an approachable, compassionate manner in hopes that they in return will do the same. Thus, after a couple of nights spent researching a health topic I still feel I know minimal about, jotting down ideas for what our next group topic may be, and trying to conceptualize the thoughts careening through my head, I knew exactly what I needed to do: start from square one; the general population. Prior to this point, in the hypertension treatment agenda pursued by the medical clinic the majority of forces have been concentrated at targeting those who have shown signs of high to extremely high B.P. While this plan is by no means flawed, somewhere between reviewing my scribbled notes, and waking up from brief siestas with a plethora of books on my lap, I realized that if we truly wanted to attack the problem at its source, we needed to focus our efforts in a more broad spectrum of patients, teaching, increasing the understanding of, and supplying the resources to avoid the health problem that is high blood-pressure. And, in a nut-shell, this is where my idea for “blood-pressure awareness month” came from. In addition to hoping to gain the trust of the community I will be working in for the next ten weeks, this month will hopefully provide all of those possible with the resources, knowledge, and motivation to change their lives in whatever way possible- most importantly, so that in the coming years, instead of solely having a group devoted to reducing the risk in those most susceptible to deadly complications, we are able to curb to incidence and morbidity of this chronic disease within the population, improving the health of the entire community in the process. Right now, as I write this, I’m sort of procrastinating on deciding on what the entire month will consist of, but for pre-view purposes (since July is just around the corner…), I will most likely be spending the mornings at the clinic from 8-1 providing free blood pressure screening to those who come to the clinic day in and day out. Additionally, I am in the process of creating a small pamphlet to hand out to those brave souls who decide to let me take their blood pressure, and will once again be contacting, by phone, each and every person on the register of “high blood pressure patients.” The entire effort, and the month for that matter, will culminate into a support group meeting which will be held on July 22nd.