MedSpanish Equador

This is a quote from Hamilton Wells, MS4:
"In the emergency room, it is a necessity to be able to ask your patients a large amount of questions and understand their responses at the same time. Before this program I had little organized Spanish educational experience, but the lessons greatly helped me to understand a majority of my patients and convey to them what information I needed. Not only did this benefit me in Ecuador, but I feel that this will help me to better treat the Hispanic population that I will see in the ED in the United States as well.

The following was abstrated from Hamilton Well's write up:
Hospital Experience

The clinical experience in Quito, Ecuador concentrated on emergency medicine and surgery at a public hospital located in the southern part of Quito. It is one of two major trauma centers for the city and receives several referrals in surrounding areas. The patient population at this hospital is uninsured and serves the poorest of the poor and the indigenous population. Most of the patients speak only Spanish; some patients speak their indigenous language and little Spanish, or no Spanish at all. The conditions of the hospital are meager and you will better appreciate the advanced medical system in the Untied States.

The emergency room is divided into a surgical side and a medical side with a separate area for critically ill patients. Patients wait outside the emergency room until they reach the external consult room where a physician or nurse decides whether the patient is sick enough to enter. Challenges facing the hospital encompass a lack of 24-hour specialty coverage and a limited amount of supplies including ventilators, central lines, and many medications.

Medicine is practiced differently because the hospital cannot afford to pay for diagnostic equipment or tests like a CT scanner or MRI. These necessities must be purchased by family members outside the hospital and the results or medications brought back to be used. Patients and families without the means to pay for the medical procedure, imaging, or supplies have to do without. The lack of diagnostic tools has forced clinicians to rely on their clinical skills. Staff in the emergency room is also extremely limited. There are both residents and medical students that rotate in the ED, but unlike EDs in the U.S., it is occasionally run solely by residents on nights and weekends without attendings.

You will have the opportunity to completed several night and weekend shifts, but most will be during the weekday. General rounds occur twice a day at 8 a.m. and 12 p.m. to examine the critical medical and surgical patients. The attending teaches interesting cases during afternoon rounds to residents and students and oversees weekly teaching cases on Thursdays. On Fridays, everyone presents a journal article related to the previous case that was presented. Attendings also take special time to teach visiting students during certain afternoons. Oue MedSpanish Student was able to take both an Advanced Trauma Life Support class as well as an Advanced Life Support in Obstetrics class while on rotation. Clinical opportunities in this rotation include the ED, Surgery, Orthopedics, Plastic Surgery, OBGYN.

The variety of pathology seen is extremely varied. Many of the cases you may have never seen but have only read about. There are, for example, a couple of types of parasitic worms that we found by ultrasound as well as viral diseases including Dengue fever that are normally not seen in the U.S.

Spanish Experience:

Spanish classes aren taught in a small Spanish school which is a short 15 minute walk from the hospital. Lessons were held four to five days a week in the afternoon with a private tutor and usually lasted for 3-4 hours. The Spanish is individualized to be sure that you are taught at your level and so that it willl be appropriate for your future work as a health care provider to Latino Patients.

Living Conditions:

The participants stay at a Bed and Breakfast run by a a couple whose son, Dr. Galo Sanchez, is the coordinator the MedSpanish Program in Ecuador. There are opportunities to work with him in Family Medicine and at other clinical sites in the Quito areas and even in more remote locations.
The Bed and Breakfast is located in a secure neighborhood with security personnel at almost every corner. It sits next to a park with paths for running and beautiful views of the Pichincha Volcano can be seen right outside your window. There is a teleferico (gondola) located a few blocks away from the hostal that allows you to be at the top of the volcano within minutes at an altitude of 4200 meters, and shows off magnificent views of Quito and the surrounding volcanoes.
The Bed and Breakfast itself is very clean and well-run. The rooms are equipped with a private bathroom, hot water, and cable television. Galo serves a standard breakfast of eggs, bread, and natural fruit juice. A full kitchen is available for use if you chose to cook your own meals; otherwise there are a variety of cheap restaurants nearby. Laundry service can be found close as well, and costs around 1.75 per kilo. If you miss the amenities of the states there is a mall within walking distance called Plaza Americas that has free high speed wi-fi, along with a great movie theatre, and several restaurants including McDonalds.

What to do in Quito: Adventures: One can find many guiding companies for anything from mountain climbing to rafting to jungle tours. Be sure that if you climb, there are never more than two people to a guide, and that your guide is ASEGUIM certified. There are also several great hikes that are not technical and are within a day's reach. Volcano Guagua and Volcano Pichincha are adjacent to Quito and are very accessible. Both have an altitude of around 4800 meters. Volcano Pasachoa is south of town and has an altitude of 4700 meters. There are many other activities available!