We find out where a point-of-care diagnostic will work best in the rural villages along the Cayapas river in Northern Ecuador.

There are 3 ways to deal with being trapped in a remote mosquito infested village:
(1) Pass out ASAP - Susie
(2) Imbrace it by befriending locals - Tanner
(3) Pretend you are somewhere else.  You can withstand any amount of pain for 48 hours - Nick.

A lab tech performing a blood typing test. Notice the lack of gloves.

After a good night’s sleep we woke at 7:30 and searched for breakfast. Since the only thing we could find was fried meat and intestines we settled on coffee. Our meetings with the director and tour of the hospital were very successful. We stayed there until 11 am doing interviews when we had to run to catch our boat to the next village. The boat ride to Zapallo Grande was long, 4 ½ hours in a canoe did not do much for bodies.  We didn’t exactly know where we were going to sleep that night, but it was clear we couldn’t return the same day as it was 4pm when we got there.This town has no electricity and no road to it and so few visitors come here, therefore there is no hotel. The dr. in that village offered to let us sleep in their house, which was more like a dormitory for the hospital. We didn’t exactly have sheets or bed nets with us and so it was we had beds, but that was it.When we finally arrived we were fortunate enough to meet with 6 drs and technicians in this small remote village whom we were able to talk to and interview. The room in the hospital where we did the interviews was scorching hot. We all looked pretty wilted by that time.

Barbie travels with us all the way to Zapallo Grande, taking the place of Anat to fill out the team.

After we were done with the interviews Susie said she was going to go for a swim meaning in the river and then Nick had his most brilliant comment yet “there is a pool  here?!” Surveying our surroundings in a town that had no electricity except solar panels there was hardly any hope of a pool. Susie got a pretty good laugh out of that probably also because she was slightly delirious.

The lab at the hospital in Zapallo Grande. A microscope and a few reagents filled out their inventory. The only diagnosis done here is blood smears to look for malaria.

It was very peaceful there. It started to rain and from where we were staying you could look out from the porch and watch the river go by and the rain fall.Next hurdle was to find food. We went to the store in the town and all they had was eggs, rice and beer. We discovered there are 5 refrigerators in the village. Two are used for vaccines and three for beer. So of course we capitalized on the use of the three fridges and got some cold ones.

Sunburned and greasy with deet, the team is giddy with how well the trip has gone so far.

Nick offered to cook dinner and so Susie and Tanner sat on the porch talking to a 25 year old dr (Santiago) who was there fulfilling his rural medicine requirement, which all drs in Ecuador have to do. Santiago went inside to see what Nick was doing. He asked “why isn’t Susie cooking?” Nick explained that he had offered to and we shared responsibilities and Susie didn’t like cooking that much. He asked, “is that why she is not married?”  We all got a pretty good laugh out of that. We ate dinner (eggs and rice) on the porch and had beers…all in all not bad for a village in the middle of nowhere in Ecuador.

-Susie

We had some very interesting conversations with the local doctors.  The natives here first go to the local shaman with their ailments.  If they are unsatisfied with the results, they will then go to one of the rural clinics.  Going to theses clinics can be difficult, as the only way to travel is via dugout canoes.  The clinic in Zapallo Grande serves a region of roughly 2000 people.  Zapallo Grande itself houses about 250 people. 

The Ecuadorian government allows the Indians (seems un PC, but that is what everyone calls the natives) to practice their own form of justice.  When someone is caught committing a crime, they are publicy whipped.  The village chief decides how many lashings the culprit deserves.  However, in the case where a husband is caught cheating on his wife, the wife gets to decide how many lashings are used.

The locale brew is a drink called Chachi (I think that's right).  The women partially chew up a mixture and spit it into containers for fermentation.  It is supposed to be pretty strong, but luckily we did not get a chance to test this theory.

-Tanner