1/3 of the way down

So this week, in light of the need to finish my med school personal statement (that, now that my baby/ best writer I know has looked over, has a bit of correcting to do before I even begin to feel that its ready to show anyone else) I figure I´ll let some pictures do the talking.

Tuesday through Friday, I came down with an intestinal infection. Stereotypical, I know, but luckily my friends/ doctors at the medical clinic were able to run all sorts of exams, ultimately giving me some antibiotics that have since gotten me out of bed. As a result, I was able to visit Otavalo this Saturday with Evelyn Falck, her friend, Lucha, and my new room mate Ajay.



Which, by the way, this past Tuesday we received a new addition to our family; Ajay Premkumar, a recent graduate of Emory University who will be working at the clinic for the rest of July and into August. We´ve already formed a friendship from the start, and it seems like I´m gonna have a pretty good time here with someone to travel with, or at least someone to deflect the dogs.

Otavalo is a small pueblo an hour or so outside of Quito devoted to selling artisan crafts and local foods above other things.


(spices)


(Ajay getting swindled)


(comida)


Basically, it was a pretty amazing place.


After the market we headed to a town that I will not even subject to my poor spelling skills, but it started with a "C." Here we ran into some friends of Ajay´s (really, a family that´s children were having their education provided by Ajay´s favorite professor back in the states- the same one that recommended the program to him)



In all, it was a pretty exciting weekend full of amazing scenery, great food while watching the Final at Elsa and Jorge´s friends house, and transitioning back into not being horribly sick.



(scenery)



(lake in a volcano crater)


(sangria and snacks- viva españa!)

I´ll keep you up to date in the coming weeks, but hope that the U.S. is treating you all very well

hasta pronto

drew

mixed feelings

As I sit in the living room, listening to what appears to be some mixture of love songs and Spanish-Jazz playing over the sounds of Elsa cooking, I’m hesitant to say that I feel like I’m at home, but although it’s nothing like the life I’ve left, or the houses I’ve been in before, in all honesty, it’s gotten to the point that this “casita” has become my home. For the past three weeks I’ve woken up to the same scenes, the same smells, the same food. I’ve gone to work, I’ve gotten to the point where I’ve seen and eaten the same lunches over again, and I’ve even grown accustomed to the some-what lumpy bed that barely contains my stature. In all, good or bad, this is my home for now, and over the past week I’ve been dealing with the realization that this is going to be what I call my home for another two months.

Don’t get me wrong, things are still going really well- the past week I began to get into a rhythm with my schedule, prepared what I feel like is everything I will need for the upcoming month of “blood pressure awareness,” and put the final touches on my proposal for my growth standards investigation; yet, as the novelty of living in a new place began to fade, and stresses from Medical school applications, constant translations, and a bit of sleep deprivation began to build, I guess you could say, I just began to miss home. I began to miss the comfort of having milk and cereal for breakfast opposed to “huevos and pan;” I started to miss being able to just relax- sit on my front porch and people watch, and not necessarily take everything in for the first time; and honestly, I really started to miss those closest to me: my family, my friends, and most of all, my best friend; my fiancé, and the person I feel incomplete without, Caity. This past fall (in addition to the past 4 and a half years), being together and studying abroad in Spain opened my eyes to a level of happiness, and excitement, and love for every second of life that has since been something I’ve brought to everything I try and do; but here, without her, I’ve begin to realize how much I never want to take her presence in my life for granted- and how much I can’t wait to change the world with her at my side! Along those lines, this time away has given me a chance to reflect on all of the people around me who have supported me up to this point- and more than anything, it’s made me realize how lucky I truly am. For this, although it doesn’t even begin to do justice, I want to say thanks.

There’s really no way to describe how lost you can feel when you’re surrounded by people who you can only express your feelings to in limited terms. Salutations, small talk, and discussing the world cup matches are great- but at some point, the basal level forms of expression only scratches the surface of how you really feel, which over time, becomes increasingly frustrated or, as I have found, just exhausted at times. In the end, being on my own has significantly reassured all of the feelings, and excitement, and determination I had before I got the plane a few weeks ago, and for this, I cannot even express my gratitude, but with 60 or so days left on my journey, I guess it’s good that I’m starting to feel “at home” in one way or another; becasue right now, I'm missing mi propia casa a bit.

To sort of change gears, things this past week at the clinic have been going smoothly. Monday I traveled with Paola to two of the pre-schools to conduct inventory of ALL the things the schools currently have. From chalk boards, to chairs, to broken pencils; we counted, separated, judged, and recorded any and everything that was of even the most miniscule value. Interestingly, one means of categorizing the materials was based on who donated them to the school. Often times, the teachers weren’t exactly sure if it were the parents of the children, the Rotary Club Foundation, or other non-profits that had helped in the past that were responsible for the majority of the necessities, but I was caught off guard by the donations deemed to be from el ministerio de la educación. Sadly, these "gifts"/ obligations usually consisted of things of very minimal worth, including: plastic chairs with rickety legs (some of which were only 75% in tact), stuffed animals that were “new,” as to say newly donated, (which appeared to have been left over from foster homes or garage sales), and some old books with numerous pages missing and/or covers tattered past the point of recognition. In all, it was an eye-opening experience that changed my perspective on what resources were truly at hand here in Ecuador, and at the same time, made me grateful for the public education I was able to access throughout my youth, in spite of whatever negative connotations might be associated with it back in the states.

Tuesday to Friday, my life involved a handful of translations varying from: donor letters, certificates of appreciation for other volunteers that were leaving, yearly updates on children in the schools, and even having to translate a list of 100+ pieces of dental equipment that a group of American dentists will be bringing in late August (needed for some sort of customs formality I think). By the end of the week, these tasks, along with the finalization of my proposals for the upcoming months, left my head spinning, aching, and- thanks to the homesickness I mentioned- a bit out of sync.

The best way to relax, I found, was in keeping myself distracted. And even though it isn’t the first thing that comes to my mind when I think of “relaxation,” this past week marked the start of my summer rugby training program, and the start of any sort of formal exercise for the first time since I landed. Given that my body has more or less adjusted to the altitude here, and any worry of passing out or having a heart attack had subsided after last week’s rugby practice, going on a jog every other day and doing some push-ups actually felt pretty good towards the end of the week. Not to mention that it gave me something productive to occupy my time during the somewhat lonely nights, in between coming home from work and waiting to eat dinner and drink coffee with the family. In fact, I even got to know the neighborhood in ways my parents hadn’t even explored; which, Friday night, came back to bite in more ways than one.

As I had started every day before, my jog around the barrio involved a quick stretch, talking to the front gate guard Jaime, and then heading up hill; other than being a little unusually over-cast and a bit windy, this Friday seemed to be nothing out of the ordinary. My customary route involves trotting through the main street that our conjunto is on, dodging the empty bottles and loose rocks that line the gutters and making my way between cars and school buses as they head to their destinations. For the most part, the first ten minutes or so of the jog is fairly easy, with a slight incline and some decent scenery ranging from a water treatment plant to a campo with cows and wild grass. Then, abruptly, at the end of the road there is a fork that splits into two paths: one, being what looks like a drive way (and thus I’ve yet to find out what it really is); and the other, a steep inclined road that traces the profile of the mountain separating the valleys on either side of Quito. Immediately when I arrived at the foot of this “hill” the first time I knew I had a goal- make it to the top, and since, have tried to climb a little by little, to at least a height further than I had the days before. On this Friday evening, when I arrived at the base of the road my legs were a bit shot after a week of doing this customary run, but after painstakingly convincing them to carry me past the bus stop, past the street vendor, and past the old abuielita I say hola to every time I crawl up the precipice, I made it to a point where the incline subsides and I felt satisfied with my progress. Amidst catching my breath and trying not to roll down the hill, I distinctly recall the red-ish orange sunset that greeted me as I looked down into the valley, peered onto Tumbaco, and stood (actually hunched over) in the presence of the most amazing view of Quito I’d seen yet; represented by the gleaming edifices of ten story buildings nestled between two protruding peaks of densely vegetated mountains on either side. After catching my breath and taking a mental picture, it was time to carry on.

Down the hill I jogged, passing the people I’d seen struggling to walk up it along the way, and reaching the road in probably 1/16th of the time it took me to ascend. With all the momentum from hill, it was almost (but not entirely) easy to make my way through the rest of my customary jog, as I followed along the path that brought me to the hill and then made a left down the street I suppose is known as, calle cinco, due to the scribbled graffiti on the brick wall that lines the corner. Down 5th street, the scenery is a bit more rural, with sprawling fields to the left, and the road being composed of individually placed river rock that has since formed an uneven, but charming, pathway to lead the few people that call this area home to their front steps. I made my way down this route as I had the Wednesday and Monday before, focusing on my footing as not to fall, and taking the streets back south to my home where I could eventually rest. Today though, as I approached the first turn in my path, I saw an oddly cute puppy, wearing an orange sweater and sniffing around in the tall grass alongside the road. As I passed it, it ran in front of me, sprinting down the path and away from my sight; that is, until out of the silence, I heard a quick bark, that transitioned into a chorus of furious yelps and growls that barreled down on me from behind a set of bushes to my right. Within seconds -or however long it took me to turn my head and see what was the matter- a pack of four dogs, one that used to be white before living on the streets, a black-matted lab, and two fierce looking canines that if I had to guess were probably boxers, were sprinting the 5 or so meters that separated us towards me. Before I could even react, two of the dogs had already latched onto the side of my leg and back of my knee, only lessening their grips following a few kicks and yells. They retreated to where-ever it was that they came from, as I sprinted off in a direction towards home, hoping that I wouldn’t accidently set off again whatever animal instinct caused this reaction in the first place.

Once out of sight, I slowed down and assessed the damage to my leg, quickly realizing that, although pretty bloody, there had been no significantly life threatening damage. Relieved, I headed home, only stopping to pick up a stick in case I ran into any other trouble along the way. For the rest of the evening, I got to experience the Ecuadorian health care system from the patient’s perspective; first coming home to clean the cut with hydrogen peroxide and whatever Jorge could find me, and then heading to the emergency clinic at the Universidad San Francisco de Quito. There, I was able to take all precautionary steps (a.k.a get a shot and a schedule of the next 4 shots I’ll need over the course of this month) to make sure I don’t transform into some rabies-crazed zombie while here.

For all the mothers or fathers or future wife that may be reading this, since this some-what hectic evening, everything has been fine, my leg looks to be healing, and other than the hospital bills and new-found desire I have to throw rocks at every dog that barks at me the wrong way, it wasn’t that bad of an experience. And as I sit here now, looking at the teeth marks that’ll probably stay scarred with me for the rest of my life, I realize it could’ve been a lot worse, and if it’s any consolation, at least this way I’m covered in case any other animals decide they want to see what gringo tastes like.

I hope all back home is going well and that everyone reading this (and even those that aren’t) is having a happy Fourth of July, and more importantly, a happy blood pressure awareness month!

Sinceramente
drew

fri, sat, sun...ish

Friday morning I had the pleasure to attend the end of year Club Rotario Quito Valle Interoceánico breakfast, during which, my good old amigo Miguel was going to be passing the reigns to the new President for the coming year. As I followed the directions Mr. Falck gave the day before at the school closing, I ended up approaching an impressive hotel known as the “Swissotel,” but immediately grew hesitant; thinking the hundreds of police outside, the riot guards, and secret service looking personnel must not be there to welcome me as their guest. Oddly, as I walked up the front side-walk and towards the marble steps I managed to avoid any questioning (as I’ve learned so far in my travels, if you act like you know what you’re doing, you can usually steer clear of most suspicion), and easily find my way to the concierge who pointed on towards the breakfast/ ball-room. There, I learned from discussing with a number of white-haired Rotarians that, even though we deserved the attention that was forming outside, the unusual security and attention was being provided for the leaders of ALBA that were staying at the hotel, and soon would be leaving the country to continue on official business; just in case you haven’t heard of this organization, that would include Rafael Correa (the president of Ecuador), Hugo Chávez, and Evo Morales, to name a few.

The breakfast included some of the freshest fruit I’d tasted in my life, fried plantains, and other wonderfully decadent comida that my stomach could hardly bear as I started to get sick the night before (I know I shouldn’t have taken up the school cook on the second plate of potatoes with the questionable salsa…) and still didn’t have much of an appetite. After eating, the podium was graced by directors, treasurers, secretaries, and finally Miguel, who gave the best speech of the day- summing up the year, his time as President, and the desire he has to continue to see this organization make a difference in whatever means possible. In the end, I spent the rest of the day reflecting on his inspirational words (which was sort of easy since my stomach only got worse after eating, and I spent the afternoon and night in bed…) and pondered the possibility of maybe coming back Ecuador after graduating to fulfill my newfound desire of continuing the genuine tradition these people have begun.



The two week-iversary of being in Tumbaco that I celebrated this weekend, again took me to the capital of Quito. After peeling myself out of bed, I called a friend of mine from DU who has been doing community development work on the Southern side of the city to meet up before rugby practice. About two hours, four buses (which should have only been three had the guard at the bus station told me he wasn’t sure what bus to take instead of guessing) and a bit of a walk later, I met up with my team-mate from back in the states, Eric, and a 12 year-old kid he has mentored over the past 12 months. With quick greetings and introductions, we hopped in a cab and headed to the most beautiful field I’ve ever played on. The grass was rough, pot-holes littered every five meters or so, and we had to share the campo with two middle school soccer teams, but situated atop the second tallest hill in Quito, the view from this field- including the vast stretches of urbanized houses and apartments from the Airport at the most northern point to el Panecillo in the south- was breathtaking (not only because of the combination of running and the extra altitude). As I have almost always found with the people I meet through rugby, the players on this team were welcoming from the start. With a few 7s games and a tournament on the horizon, I look forward to building the friendships that started as we scrimmaged in the rain, sun, and then later rain again, over the next couple of months.

Looking at my clock now, I should probably get back to my work that’s due tomorrow, but to sum up the rest of the weekend: I was able to experience my first black-out while in the sketchiest part of Quito, eat the first red meat I’ve come across since being here (in the form of a double bacon cheese burger- I know, typical, but if I was gonna have a burger, I figured I’d make it worth it!), go shopping for some sunscreen that my shoulders sorely need, test out the swimming pool that we have in our housing complex, and relax a little while getting over the U.S.’ loss yesterday with some distracting one-sided soccer games today.

I miss you all, and hasta pronto

drew

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.

fin de semana

After the excitement of the support group, nothing extremely note-worthy occurred over the next few days except for some well needed relaxation and a couple of nights spent talking to mi padre Jorge about life, Ecuador, and the numerous topics that can arise when you throw Latin American politics into the equation. Over a few cups of coffee, we stayed up until almost midnight chatting in Spanish, as I made up for my lack of formal classes, while Jorge puffed away at his favorite tobacco pipe, advised me on the correct way to conjugate verbs tenses I don’t even think we have in the English language. Even more than what I learned that night in terms of specific lessons or teachings, I realized that I have been extremely lucky to find the house I’ll be calling my home for the next few months.

The first Saturday in Ecuador I spent with my dear, first, and probably best friends in the area: the Falck’s. That previous Tuesday, I attended the “mandatory health and safety” meeting with Evelyn and Miguel, where I learned any and everything that a gringo should know in a foreign country (don’t flash your wallet around, make sure the taxi drivers are actual taxi drivers, and that it probably isn’t the best idea to drink the water here…); however, among these lessons, Miguel and Evelyn began to divulge the secrets of the country they’d been born in, and even offered to take me on a tour of what they called “historic” Quito; as well as a quick trip to the equator. Without hesitation, I took them up on this offer and have thrown in some of the many pictures I took on this slightly rainy, but extremely fun exploration.



*Hanging out in both hemispheres


*A vista of the traffic, rain, and "el Panecillo" in Quito


*Los Falck's and the Southern part of la ciudad


*El Panecillo close up

Sunday, after going to church for the first time in a little over a while, I celebrated día de los padres with the Duran’s and an extensive group of people that can only be described justly by the word “family.” All three hijos, two of their wives, four of their children, Elsa’s sister and her son, and even the in-laws of Cristina, Marco’s wife, ended up coming over for an almuerzo that started promptly after mass and lasted through cena, into the late hours of the night until the children and conversation topics had exhausted themselves.

Somewhere between seeing the way the family got along, and heading to bed as Jorge stayed up and played spider solitaire, I guess I began to miss my own Dad a bit, my own family, and everything that I cherish about home. As I fell asleep that night, I realized two and a half months might be a little longer than I projected at first, but in spite of any new-found woes, I also slept well, knowing that in a way I had found a temporary, new home, a new family, and a new part of the world to show all of those I meet the lessons and dreams everyone I miss has taught me I can accomplish.

reunión y fotos

Words can’t even begin to explain the fulfillment of being able to, for the first time since stepping foot in Ecuador, help those at the medical clinic hands on. Therefore, I’ve decided to include some pictures to give you a better idea of how everything went.



Although I hadn’t learned officially how to take blood pressure until the morning of the support group meeting, by the time 5 pm came around, I was pro- having spent the entire day practicing on almost any arm I could find. Fifteen minutes before the meeting, it started to rain for the first time I’d been to Ecuador (ok, not honestly the first time, but prior to, and in comparison to this, it was hard to consider any of the light sprinkles “rain”), but regardless, nothing could deter my enthusiasm and motivation to help the people that already began to join in the Sala Odd Hanssen (our meeting room named after the esteemed entity behind the entire Fundación Valle Interoceánico). In all, 13 people journeyed through the pouring rain to make it to this, the 3rd meeting of the support group for hypertension.




After getting in front of everyone and trying to express my gratitude for coming in the few Spanish phrases that I know at this point, the way that the group welcomed me with warm smiles and an incomparable round of applause made me certain that I had made the right choice to continue working on this project.

For about an hour Dr. Andrade (the head doc at the clinic) and Paola shared the main stage as I observed their well designed presentation to describe the basics of arterial pressure, and the psychological stresses of living with the disease. Following this, I began to personally meet the members of the group in a more intimate manner, taking their blood pressure, advising them on how to fill out a personal record of pressures that should be brought to every meeting, and ensuring them that their excessively high pressures are something that we can work at lowering together. I spent the rest of the night cleaning up the meeting room, and saying good bye to the handful of people that I hope to see in a month or so; my grammar errors and lame-jokes must not have made them think any less of me, as every person that came went out of their way to introduce themselves, shake my hand, and tell me things ranging from “hasta la próxima reunión” to “muchísimas gracias.”



From that point on, I immediately began to think of how I could strengthen the group, build the camaraderie I later found it was lacking (only 2 persons who attended the meeting had been to any of the previous two…), and continue the momentum and desire to change that I felt while looking into the eyes of each and every person I had the pleasure to meet.

the first couple of dias

As dramatic as the last entry was- meeting the Duran’s was painless, relieving, and exciting at the same time. Although the volunteer coordinator had described them to me as “a middle aged couple,” Elsa and Jorge, well, to put it nicely, were a middle aged couple. In spite of the age mix up (Jorge has since told me about how he’s excited to celebrate his 70th birthday this year) the couple immediately won me over with warm greetings, kind smiles, and some of the strongest coffee I’d ever had.

We spent the first night in Tumbaco talking with the Falck’s, resting, drinking, and discussing the logistical functioning of my volunteer work at the clinic- in addition to all the details about where I'm from, what I'm studying, etc, etc. The Duran’s were very welcoming from the start, and immediately began to divulge the dynamic of their lives from the moment I sat down in the plush couch that called their well decorated living room home: Elsa was currently dabbling in cheese making, specifically “queso de hoja,”- a type of cheese that involves flattening queso fresco into thin sheets; Jorge, on the other hand, runs a jardinero business, where he spends the days ensuring all of his contracts are fulfilled, and his workers content. The couple has three hijos; Marco, Juan Fernando, and Maria Elsa- all of which live within a drivable a radius, and all of which I would soon meet this father’s day. As it got later and later we continued to exchange details of our lives until the effects of our café began to wear off and yawns became more frequent than discourse. At this point, the Falck’s headed for the door and the Duran’s showed me too my room. Although looking looking back, everything seems to meld together into one procession that led to me passing out in my new bed, between the tour and my head hitting the pillow I quickly unpacked, oriented myself with my new closet and dresser, and somehow let my family know I was safe. Even with yells coming from the street, incessant barking of stray dogs, and the occasional flashing or car headlights, I slept extremely sound this first night.

Waking up; however, was a much more difficult experience. As I threw off the floral sheets and tried to remember where I was I immediately received a call on the cell phone the president of the Club Rotario supplied me with the night before.

Paola, the director of the 5 pre-schools that are run in tandem with the medical clinic, was on her way to pick me up. In this new found urgency I ran to the bathroom, turned on the hot water and quickly jumped into the shower as it transitioned from freezing, to cold, to luke warm. With a quick dry-off, choice of clothes, and pair of tennis shoes I trotted down the stairs to find my new madre making coffee and setting the table with a basket of small rolls of pan, traditional silverware, and a couple of napkins. Elsa continued to tailor to my needs, making up some quick huevos revueltos, squeezing me fresh orange juice, ensuring that I slept well and that if there were anything I needed to let her know. From this point on I began to feel like I was part of the family.

My first work day at the clinic began when I met Paula outside the front door of the Duran’s and we hopped into her Volkswagen, sped off towards Quito, and began to discuss my responsibilities and motivations for coming to work at the clinic. Before we reached the city we turned off the main road to head towards Cumbayá, passing everything from broken down shops and littered sidewalks , to a centro comercial with a KFC. We continued to climb the inclined streets until on my right I saw a sign with the characteristic Rotary wheel, and below, an arrow pointing to the West- the clinic was on the horizon. At first glance, it appeared to be the nicest establishment in the neighborhood. Surrounded by a silver painted chain link fence and with a mini play ground out front, the clinic stood adorned with signs advertising medical services for under $5.00 and once again, the golden wheel of the Rotarians. It was obvious that hundreds of hours had gone into the building, sustaining its upkeep, and establishing its presence in the community; as I followed Paula through the glass doors, it became even more obvious that the population of Cumbayá put just as much time into utilizing the services offered here.

Directly within the front door of the clinic I encountered a waiting room full of plastic lawn chairs that were reminiscent of my childhood- currently occupied by some 10-15 persons that were waiting to see the doctor. Paula wasted no time in dragging me past the group of future patients and began a tour of the clinic and all that it offered. From the infirmary, to the offices of the accountants and the doctor, I quickly met the staff I’d work with for the next couple of months, also learning the location of the laboratory, as well as the pediatrician and emergency rooms (both of which were currently empty due to a lack of physicians in the area).

Overwhelmed but extremely excited, we continued the tour to the upstairs of the clinic, meeting numerous people whose names I’d quickly forget and have to ask for once again in the coming days.

To make a long story shorter, the remainder of the day was spent meeting with Jennyfer Soto, the directora of the clinic, observing how the infirmary serviced the patients that were waiting in the front, and undergoing a brief introduction into the work that I would be responsible for until September. For the most part I would have a pretty set schedule: beginning at 8am, I was to spend the mornings working in the infirmary or the laboratory, either recording patient vitals or running lab tests depending on where I was. From there, at around 1pm we break for lunch; I had a couple of options, (either eat at the few establishments around the clinic that ranged from interesting to probably dangerous; run to the KFC down the street; or bring my lunch) and although this first day I enjoyed eating with Paula and Jennyfer at a restaurant up the hill, I promptly knew that bringing my almuerzo would be the best choice for my conversation skills and in all practicality, my ability to relax for an hour. Following lunch, the work day continued from 2-5pm, during which I would begin to work on whatever special project was deemed most pertinent for the week.

This first day, I began, or should I say was sort of thrown into, the position of organizing an information session over hypertension. Little did I know, but for seven months before I arrived, a previous volunteer dedicated his time in Ecuador to investigate the morbidity of hypertension within the suburb of Quito, culminating his studies into the formation of a support group, of which now I would have the honor of continuing. And from the very start it truly was an honor.

By “continuing” I soon learned that I was to make phone calls to those patients who had shown un-naturally high blood pressure levels previously at the clinic- which, in total, summed to be some 300 persons- all of which would have to hear my rusty, broken Spanish explain to them the details of the information session

For the first three days, I spent the mornings learning and observing the years of experience Maria, the head nurse, carried on her shoulders. From organizing medical records, to learning how to take basic vitals, to imputing appointment information into the computer, I was swept into the workings of the enfermería from the moment my feet entered the room. Lunch, consisting of learning Ecuadorian dishes that i must try while I'm here, was the only moment I had a real chance to relax, as I got to better know my colleagues while I gladly devoured my customary: locra (potato soup), rice, vegetable salad, and miscellaneous meat for the day. The afternoons I spent with my ear glued to a phone that worked sporadically, chipping away at the mountain of names and numbers of those patients with high blood pressure in the past year. At first, this task was a bit daunting, but somewhere in between my 30th and final phone call I found a rhythm that was ameliorated by the genuine responses of those I called, and their obvious excitement to attend a free information session dedicated to improving a health problem they knew very little about.

As I continued down the list, I still vividly remember calling and speaking with the daughter of a woman who passed away from a heart attack within the past month. Sensing her pain gave me an overwhelming motivation and desire to, in the very least, provide the other 299 persons with the ability to find out more about their life threatening condition.

By Thursday, my anticipation was inexplicable, and by lunch time, we were just hours away from the reunion.