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| The Public Hospital in Quito |
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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.
| Ocassionally patient arrive by Helecopter |
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| The Emergency Department entrance |
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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.
| The Staff is friendly ! |
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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.
| Teaching Rounds |
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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.
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