Lets talk Chone. The name says it all. Chone is Quechua for "Inferno" and yes, its VERY hot. My host family tells me that this is actually the colder time of the year. The rainy season from January to April-ish is much hotter. Its plenty hot for me. Just doing rounds in the morning and walking home after clinics I am dripping with sweat. There's no such thing as hot showers, and it would seem relatively pointless anyway. My family in Chone is great. Mariana and Pepe are "mom and dad" and their son Javier has a small family practice that he runs out of the house. Mariana's son-in-law, also named Javier lives "junto" to their house, so pretty much the same house. Mariana is a great cook and very helpful.
Since this is an urban/rural comparison program, lets compare. So far I have seen only two hospitals in Quito. La maternidad is not what I would consider an advanced hospital, but i've heard good things about other private hospitals that are pretty nice. Axis, which i've only been in non-clinical, is very nice and it looks brand new inside. The public hospital in Chone is not the fanciest hospital in the world. Its probably the tallest building in the town, the concrete is cracking, and they're undersupplied. One of the best things i've noticed about comparing the two cities is regardless of what the hospital looks like, the personnel are extremely smart and caring. The doctor who leads the Chone part of my program, Dr. Díaz, is a pediatrician and is one of the best doctors I have shadowed. She is incredibly smart, caring, and somehow makes every one of her patients and their parents smile, laugh, and love her. She is a great teacher and takes time to make sure we understand everything. One of my favorite things about working in Chone is not a single patient, doctor, nurse, or intern speaks english. At some times it seems like they're speaking two foreign medicines (spanish and medicine).
We start every morning with Pediatric rounds, which are very interesting watch. Tuesday and thursday we had surgery. Yesterday (thursday) was a great day for surgery. The first patient had been attacked with a machete, and used his left forearm to block the blade. It cut most of his extensor muscles. The docs first tried to block his whole left arm with lidocaine, but he could still feel it, so they had to knock him out. It was really cool to see them checking with muscles went where because they could pull on a tendon and his fingers would move. They made a pretty large incision in his arm and sutured the tendons and muscles back together, and the surgery was a success!!
The next one we saw was pretty gruesome. A man had fractured his his Tibia and had a plate put in. The plate became infected and they had to remove it. A very large incision was used to open it up. Upon removing the plate the docs discovered that two of the screws had broken inside the bone. They spent a fair amount of time removing them. The poor guy was concious the entire time, they just blocked him with lidocaine from the waist down. It must have been pretty tough for him to listen to the scraping, drilling, and cutting of infected bone. It was pretty crazy to watch the block being put in his spine... lesson: Don't break your leg!!!!!
Internet is expensive and charged by the hour here and i'm being cut off.... thats all for now, i'll post some pics tomorrow.
Adios!!
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