Goodbye Guayaquil, Hello Otovalo!

Our students and the family we helped build a house for

We love visiting the Guayaquil temple

Our Ecuadorian Friends

A plate of typical Ecuadorian food that I got for dinner.  The patacones on the upper right are my favorite!

Myself and some of the students.  The hill behind us with all of the colorful houses has the light house on top

We reached our mid-point Thursday here in Ecuador.  We built a house in the community out of prefabricated wood/bamboo structures.  It is really fun to see a house go up in one day.  There is a Catholic organization here called Hogar de Cristo (House of Christ) that helps provide houses, nutrition and immunizations in the schools for children, health care at little health centers, and micro-credit loans for small business ventures.  The students work with them in the community—the poor areas outside the city center—as well as the maternity hospital, the pediatric hospital, and the medical surgical hospital.  The medical surgical hospital is the oldest hospital in South America, and is considered a historical landmark.  Although they have updated many parts of the hospital it is HUGE, and has only a few elevators—patients have to be carried up and down the stairs on stretchers for transport between floors.  The pediatric hospital is probably about 10 years old and is nice, similar to the niceness of Primary Children’s Medical Center.  The maternity hospital is muy Viejo—very old.   The regular patients labor in one large room; together, have vaginal exams in front of the other patients/staff, and are not allowed to have family members with them (space and privacy don’t allow it).  Our students provide labor support.  They learn a LOT about it, as 28,600 babies were born in that hospital last year.  Patients rarely receive pain medication and labor support is not provided by anyone.  In the labor room, with 20-30 patients in it, there is only one licensed nurse, with two auxiliaries (aides) to help her.  There are probably 6 doctors in the corner that get the H &  P, do exams, yell “parto”!  (delivery) and deliver the babies, but we did not see any labor support.  One doctor did provide a lot of good coaching to a patients, but overall the others just said “No grite; empuje abajo”.  (Don’t scream, push down below).

There are some great doctors at the maternity hospital, though.  One is doing a study to determine neonatal oxygenation in the first 10 minutes of life at sea level, to add to the body of evidence about infant oxygenation.  Another doctor is a champion for skin to skin in the first half hour of life.  On the UNICEF website, it says that there are 15,000 hospitals worldwide that are considered “baby friendly”  (a UNICEF/WHO initiative to promote breastfeeding).  Ecuador is listed as having 141 baby friendly hospitals, while the whole US has only 25 baby friendly hospitals!!  I talked to the doctor about this; she said that the Ecuadorian hospitals had fallen out of compliance since that data was published, so now there is a government initiative to get baby friendly status back—hence her work to facilitate skin to skin.  It was really impressive. 

 They also had a donor who donated $57 million for a new maternity hospital.  They are building it now, right by the pediatric hospital.  Judging by the pediatric hospital, it will be very nice.  It will be interesting to see what happens as far as family involvement during labor if there is more room and privacy that would allow room for a labor support person or persons.
We got left Guayquil this morning, and flew in to Quito, and took a bus north to Otovalo.  Otovalo is a charming town in the Andes.  On Saturdays there is an amazing market with textiles and handicrafts that are sold all over the world, and start here in Otovalo.  I loved the market, and did my part to stimulate the Ecuadorian economy.  It is going to be a good week here in Otovalo!!