Week 6: Chone week 1

On Sunday, Maddie, George, and I took the 8 hour bus ride from Quito to Chone to begin the rural part of our comparative health program. As soon as we stepped off the bus we were hit by the thick humid air and a cloud of dirt... Welcome to Chone! We are spending all three weeks at El Hospital Civil. Chone is very different that Quito. The culture in general is more relaxed and it is a slower pace of life. This is definitely reflected in the attitudes of the doctors at the hospital. They tell us to take pictures of anything we find interesting throughout the day, even encourage it. So, this post does contain some fairly graphic pictures, just a warning before you continue! Dra. Diaz is our supervising doctor for our time in Chone. She is a little wacky, but in the best, most welcoming way. Dra. Diaz is a pediatrician so typically, days spent with her are on rotation in pediatrics and in her external consults, seeing kids with various illnesses. Almost all the patients we see are children with severe diarrhea due to parasites or intestinal infections. Parasites are very common here because of the poverty and dirty water conditions. One of the best indicators of a patient's condition is poop. So its no surprise Dra. Diaz LOVES poop. With nearly every patient we go into in depth discussions about the color, consistency and smell (she smells poopy diapers like they are flowers) of the deposits. Fun stuff. Monday, we met a 13 year old girl who was involved in a random shooting. She was shot in the wrist and leg (x-ray below). Her mother was also wounded and was recovering in another part of the hospital and her cousin was shot and killed. The girl was in a lot of pain and when we were standing over her bed I noticed there was blood soaking through her bandage and pooling onto the bed. When I told the nurse, she just shrugged her shoulders and when we came back 3 hours later it was still the same bloody bandage. Things like this are what remind me that I'm not back in the States! Another interesting case we saw was a little 4 year old boy who was pushed into boiling water (don't know if it was an accident or violence) and received burns all over his back. Although he was screaming and crying, his mother couldn't hold him or give him a hug because of the burns. She just had to watch him lie there in pain. It was heartbreaking. But by Thursday when we saw him again, he was a lot better and the mother was able to hold him in her lap a little. Tuesday was spent in the surgery unit. We saw 3 surgeries throughout the day.The first surgery was a cleaning of a foot wound. The patient was in a motorcycle accident and pretty much destroyed his foot. Motorcycle accidents are ridiculously common here, and if you walk around town for 10 minutes this won't surprise you at all. Every day I see families of 4 or 5 (with the family dog!) all piled onto one bike without helmets or shoes! This was the second, of three surgeries for the patient to try to save what they could of the foot. They flushed it with iodine and cut away the unsaveable skin. I literally couldn't get close enough, it was SO NASTY and I loved it. Here is a picture :) enjoy! Oh, and yes that's the surgeon wearing FLIP FLOPS during the surgery! Nuts!

The second surgery of the day was another motorcycle accident. The man needed stitches for two deep lacerations on his left leg. Usually, we just walk into the surgery say, "Buenos dias" then stand back and watch, but this time as soon as we walked in the head surgeon told George and I to go scrub in. We thought they just wanted to be cautious about infection but when we came back they put a gown and gloves on us and pushed us towards the table to assist. Can you say intimidating?! I held the leg still (even under anesthesia the leg jerks and twitches), pulled on the belly of the muscle together helping the surgeon aligned the stitches, soaked up the blood as he sewed, and cut the excess string of the sutures. As the surgeon sewed he taught us how to suture and we taught him some medical terminology in English. Having the opportunity to not only see, but feel the site of injury was hugely educational. Easily, one of the most fascinating and interesting experiences of my life.

The rest of the week was spent in various parts of the hospital. Wednesday, Maddie and I spent the morning in NICU where we saw a bunch of incredibly tiny babies and two c-sections. The unit also does various surgeries for women's health so we saw an ovarian cyst removal as well. When they cut into the cyst liquid literally squirted across the room! The surgeon in this unit was VERY friendly and we had a nice long talk about drugs, God, Madonna, and Nazi Germany.... all in Spanish. You could say it was a little strange.

Here is a photo from the C-section, the exact moment this life came into the world! See his little hands? Absolutely awesome!

Otherwise we spent the week in External Consult, pediatrics, or Emergency. Emergency was hit or miss, sometimes it would be active and other times nothing. Throughout the week we saw several broken bones, minor stitches and burns. One patient in Emergency was a 15 year old boy who broke his arm in 5 places. When we asked what happened he said he fell off a horse, but we later found out that he actually fell while doing a celebratory dance on the soccer field. He was just embarrassed and wanted to sound macho! This is his X-ray.

So far I love Chone! This doesn't even begin to show or explain everything I have learned here and everyone is incredibly kind. Every day is an adventure and I'm always excited when I wake up about what I will see at the hospital.