Facts: Quito, formally San Francisco de Quito

• Elevation of 9,350 feet (2,800 meters above sea level (hence the altitude made me throw up upon landing?)
• It is the highest capital city in the WORLD housing the administrative, legislative and judicial functions
• It is located in north-central Ecuador in the Guayllabamba river basin, on the eastern slopes of Pichincha
• Pichincha is an active STRATOvolcano in the Andes mountains [Strato/composite volcanos are volcanos built up of layers/stratas. Unlike shield volcanos, which are made of fluid lava, stratovolcanos have a steep profile. Example of a shield volcanos are the Hawaiin islands. Example of another stratovolcano is the Fuji mountain].
• Population a little over 2 million according to the last census (2001)
• Is the second most populous city in Ecuador, after Guayaquil, and it's the new economic capital city in Ecuador
• In 2008, the city was designated as the headquarters of the Union of South American Nations
• The Historic Center of Quito has one of the largest, least-altered and best-preserved historic centers in the Americas [I love this area!]
• The central square of Quito is located about 25 kilometres (16 mi) south of the equator
• The city itself extends to within about 1 kilometre (0.62 mi) of zero latitude
• A monument and museum marking the GENERAL location of the equator is known locally as la mitad del mundo (the middle of the world), to avoid confusion, as the word ecuador is Spanish for equator [You can see photos in my prior posts of Mitad Del Mundo and also another actual monument that marks the 0'0'0' latitude].

SOURCE: Wikipedia

 La Mitad Del Mundo Monument, Quito, Ecuador (the "fake" middle of the world). There is another area that claims to be the true 0'0'0'.

 

 La Ronda, the oldest street in Quito. Narrow cobblestone street lit by lanterns and lined with historic homes, restaurants, and shops.

I had the BEST soup here called "locro de papas."  

 Churches of Quito at night.

 House on side of a hill, Cayambe, Ecuador.

 Getting a ride on the back of a truck, Cayamba, Ecuador.

 Jefferson and Maribel, children from the indigenous community of Cayambe, Ecuador.

 Running stream through open field, Cayambe, Ecuador.

 Mr. Sebastion. When I met him he introduced himself as "Sebastion, I am the president of this community." 

I laughed at the joke; who would have guess he really was the president.

A down-to-earth and hospitable man, he showed us around the beautiful hills of his indigenous community.

 View of Cayambe mountain finally peaking through the clouds.

 The charming Hacienda Cusin.

Lake on top of a mountain.

On the last day at the hospital, an hour before I was to take my bus, a 40 year old patient came with open blisters on his torso. His lips, tongue, and other body parts were swollen as well. He had a rare, severe allergic reaction to penicillin known as Steven Johnson syndrome, where the epidermis seperates from the dermis It was painful to watch the man as we put a Foley in him; we put inserted the Foley without analgesia, so the patient was grabbing onto the sheets wailing in pain. . A complication is scar tissue formation in the eyes, leading to blindness. His eyes were closed and crusted over with antibiotic cream to hopefully save his eyes. I asked about the patient's background.
"He comes from a very poor family"
"What about his treatment, medications?"
"Fluids with electrolytes and antibiotics. But he has maybe 2 or 3 days worth. Not enough."
"Then what is going to happen to him?"
"I don't know. Just hope he recovers."
[In Ecuador the medical treatment at the public hospitals are free, but the family must purchase the medications. Medication is expensive, and in this case, was equivalent to 2 months income. So despite having free healthcare, poor families often cannot afford treatment at the hospital].
It made me sad to see the man blistered, swollen and in pain, all because he had a horrible reaction to the antibiotics the doctor prescribed, and to know he wasn't going to get the full treatment he needed. I imagined him going blind because he didn't have the $60 for medication. Before I said my last goodbye with hugs and "besitos" to the hospital staff, I gave the secretary money to pay for the patient's medications with hopes that they could save his eyes. I had faith he would make it.
That was a month ago. Then this week I received an email from the charge nurse.
"The man you helped passed away."
With a 95% survival rate, I thought he would surely make it.
"That is the nature of our profession," read the e-mail. Yes it is. It is still hard to accept though.

After volunteering, we took the rest of the day to visit the churches of Quito.

Left to right: Alex from London, Kaya and Molly from Wisconsin, Brigitte from Ecuador, Marie, and Sabine from Ecuador.

Stained glass window of the Basilica church in Quito.

I'm in the ICU today. I helped Roger, the really nice resident who introduced himself as "Roger, like Roger Rabbit,” get an arterial sample being very careful to practice sterile technique. Since we don't use alcohol wipes, I poured Betadine on cotton balls to wipe the area clean. I had to pour 6 inches above the cotton ball, which required aiming. I'm not even good at birdie-drinking, so expecting me to aim and not be nervous didn't happen. The day went by with many patients that came in for sad and shocking reasons:

The first patient was more of a typical case: an older woman, 9 years shy of being considered a centurion, that came in with for pneumonia.

The second patient was a 45 year old man, healthy, who overdosed on prescription medications in an attempt to kill himself. He had an NG tube filled with black charcoal. The stomach lavage saved him. He had trouble breathing the whole day. It made me sad to think what could have brought him to such depths that he would want to kill himself. The doctors that visited him were very direct to ask him, "Fernando, do you still want to die?" His beautiful wife, or maybe girlfriend, was at his bedside. She caressed his hair and said sweet things to him in a shaky voice that sounded like it was holding back tears. I wonder how Fernando is doing today....maybe he has changed his mind about dying now that he has been given a second chance.

The third patient we had was a man who came in with bruises on both eyes. "Raccoon eyes"- I recognized this sign from photos in my Med-Surg class. It was a classic sign of a basilar skull fracture. He had a huge dressing on the back of his head with a Jackson-Pratt drain. He had been accidentally pushed off a moving bus and hit his head hard on the concrete. We tried to keep him in bed by restraining him with twisted and knotted bed sheets, but the man was uncooperative and kept trying to get up. He seemed confused; my job became the alarm to warn others when he was getting out of bed. Each time he tried to get up, I'd hold the 160 lbs man down. The nurses and doctors would immediately come, coaxing the patient back to bed.

The last patient was a child, just 14 years old, weighing maybe 80 lbs. I couldn't get a hold of her chart to find her illness. From observation I could see that she was in shock and had a collapsed lung.

As far as the practice of nursing skills, Yovanda, a really nice nurse, had me draw up dopamine and put it into a saline bag using that extra port; now I know what that extra port on saline bags are for (we use the same type of bag, but we don't use that extra port. Instead, we just use an extra bag called a piggy back for additional medications). I practiced snapping open glass vials also.

You know you're in Ecuador when...

1- Horse is still a common form of transportation

2-Lunch and dinner costs $1.50 and consists of a soup, rice, potatoes, choice of fish, and beef or chicken.

3-Every part of a cow or chicken can be found in the soup- chicken feet are very common

4-The visit to the hospital costs you nothing, but the bill for the medications used in the hospital is over one month's salary.

5-Your friend from the States brags about watching a great movie in the theaters. You tell him you've had the pirated version on DVD for a week.

6-You can go for days without seeing a color other than white, brown or yellow on your plates.

7-Guinea pig is considered a delicacy (it dates back to the time of the Inca's and is referred to as cuy. The Ecuadorians call it cuy because of the sound the guinea pig makes when it is roasted.)

8- You never flush your toilet paper down the toilet. Instead you place it in the trash cans next to the toilet.

[Adopted from an anonymous writer. Modified by Marie]

Tour of Colonial Quito
My group and I went on a nightime guided tour of Quito's old churches from the 16th to 18th century.

The San Francisco church, just a 30 minute bus ride from my house. This church began construction in 1535, a month after the Spanish arrived, and took more than a century to finish! It was built on an Incan temple, so sits on a high hill. I'm not able to go inside because there is a large restoration project of the facade, but from my readings the interior has a mix of Catholic and indian symbols like many of the churches in Quito. It also has the statue of the Virgin with wings. Interestingly, in 1976 this same statue was replicated and blown up to 100s of times it's size by Spanish artist Agustin de la Herran Matorras and shipped over from Spain in 7000 numbered pieces. They put the pieces together and placed on the hill in Quito known as the Panecillo. There is an "olla", or old water tower here where rain water would collect. Pipes running from this tower would flow to a fountain that sits a few feet from the San Francisco church. This fountain would supply water to the town. The same fountain still sits by the church, but is no longer flowing with water.

More to come! On the day I landed back in the States I had to start my summer classes, so it's been quite busy since I've been back. I'll be updating bit by bit, and hopefully get the whole trip on this blog soon. There is so much to describe!

Just back from Ecuador!
At first, I intended to blog daily, but had a hard time finding time and opportunity to blog. I jotted down notes with pencil and paper. This week and next week I will transfer them onto the blog, along with photos, so please check back again at the end of the week :D

The REAL middle of the world. Apparently the "Middle of the World" monument I visited on my first day is just a fancy monument and tourist attraction. A few miles away is what is a humble arrangement of rocks and a metal that truly sits on latitude 0'0'0.'

Reaching Peguche Falls and enjoying the mist.
Balancing across a rickety wooden bride.
-Peguche Falls hike in the northern highlands of Ecuador.

About 50 miles North of Quito is Otavalo, a town famous for its indigenous handcrafts and a community that is still distinctly Native American. We took a 30 minute hike to Peguche Falls, a 60 foot water fall surrounded by lush green flora. Water from this waterfall comes from the San Pablo, which is an impressive high mountain lake 110 feet deep, spanning 2 ½ square miles, and located 8,700 feet above sea level. This is a sacred site for the natives where they perform rituals. Their religion is based on nature. Water, trees, and sun are important elements in their spiritual practice.

It has been since three days since I started my volunteer work at Pablo Arturo Suarez, a fairly modern hospital in Northern Quito. My typical day is as so:

6:15 AM Get up. Get ready. Breakfast with the host family. Walk to bus stop.
7:15 AM Jump on the bus (literally).
8:00 AM Arrive at Pablo Arturo Suarez hospital, sign in, gown up, and assist the doctors and nurses at ¨therapia intensivo¨ (ICU)
10:30 AM Snack break
12:00 PM Lunch break
12:30 PM Continue the day on the floor (or go home if there are no new patients).
4:00 PM Sign out. Chat with Monica, the secretary, about Ecuador. Buy fresh bread from the corner bakery from Henry. Jump on the bus.
5:30 PM Hop off the bus. Enjoy a walk around my town (Plaza Foch), use the internet, talk to local shop keepers.
6:30 PM Participate in the activity from my volunteer organization (salsa class, city tour, cocktail class).
8:30 PM Dinner with the host family.
9:00 PM Free time: get a drink in the plaza, play with host family kids, etc.
11:00 PM Shower, sleep.

They don´t allow photography at the hospital, but I hope at the end of the trip I can ask for one or two shots.

Day 1 at the hospital
My nurse Elizabeth is an amazing teacher! She oriented me on the ICU floor, which is a single room with 6 beds and the nursing station in the center. As she did her morning round she verbalized everything she was doing. Gestures and context helped a lot to fill in the words I did not understand. There are some interesting differences in the hospital:
They chart on large forms and use a huge clipboard (3 times the normal size) to write on. When they file the chart, they just role it up like a scroll.
Instead of using alcohol wipes, they dab betadine with gauze (gaza).
They do percussion and tampotment: Francisco, the certified respiratory therapist and nurse uses a vibrating machine and vibrates the patient´s thorax. He uses his hands to massage the patients' thorax.
They still recap needles in the hospital.
They have the same drapes, except they´re washable and have been sterilized with an alcove.
There are a lots of similarities too!
Elizabeth explained the 5 Rights to me: right patient, medication, route, hour, and dosage.
The pixes is a cabinet with various medications including oral meds (antihypertensives, ) and IV meds (solumedrol, prednisone, electrico ¨K¨).
They do IV pushes. They suction (but usually through an oral trach tube instead of a tracheostomy).
They have the same mechanical ventilator machine and ABG reader.
On the first day I assisted the nurses and doctors insert a central catheter into a patient (the doctor had to fish for the artery with the 2.5 inch needle since they don’t have ultrasound to guide them), insert an oral gastric tube into another patient, and empty a Foley.

I´m so sleepy.

Taking in the sunlight.
-Pomasqui, an old town just North of Quito.

Landing in Quito, I was nausious and jittery. I thought it must have been the free red wine I drank on the plane. The lady at customs saw my pale face and immediately diagnosed me with altitude sickness. After throwing up two times and taking conscious deep breaths I felt better. My first place to visit was Pomasqui, where I had Cherimoya icecream homemade by a small, sweet, smiling nun in a black and white habit. The park is tranquil with two quiet churches sitting on each corner. The weather was similar to Springtime in Seattle, drizzling that turned on and off throughout the day. I later visited El Mitad del Mundo (the Middle of the World) latitude 0´0´0´. At the top was the view of Pinchincha mountain and glittering lights of Quito. At night, a bowl of warm ¨caldo de pollo¨(chicken soup) at La Ronda was the perfect medicine to restore me. La Ronda is a charming area in Northern Quito with corridors and narrow roads lined with tall white walls housing restaurants, bars, galleries, and shops. Orange lanterns light the brick streets. A young couple takes a romantic stroll, a group of middle aged women laugh at the camera, and the restaurant owner stands halfway outside the shop with a ladel and sterofoam cup selling warm canalizo, a sweet alcoholic drink made with, cane sugar, cinnamon, and naranjilla (a fruit of the Andes that tastes like a kiwi but sweeter).

Tocomen Panama Airport. Awaiting for the flight to Quito, Ecuador. In an hour and a half I board the plane. In 3 hours and a half I land at my destination. Feeling both excited and anxious.

To my friends and family who are making this journey possible:
Without each of you, this wouldn’t be possible. Thank you for your support, your love, and your contribution; I am indebted, and humbled.
So now starts the journey....
Marie

Images of Ecuador

I found these amazing photos online.

About Ecuador

Nature: Mountains- http://www.youtube.com/watch?v=SWgxE8Gbp9s This clip is amazing: I like how the native collects ice from the mountain and takes it down to the city. You will see in the end how they use the ice. - http://www.youtube.com/watch?v=hnbdiPC88MY&feature=player_embedded#at=97

Nariz del Diablo (Devil's Nose) Railroad- This railway was built in the 1900s to connect Guayquil to Quito. Engineers had the challege to get past the big wall of rock (Nariz del Diablo mountain), and had a choice to go around, over, or through it. They decided over it, so now we have a thrilling train ride with tight switchbacks zig-zagging up the side of the mountain. I like this video because it also shows the locals in their traditional outfits: http://www.youtube.com/watch?v=eizXXQlRhPo

Reading material:

Ecuador Trains : http://www.ecuadorexplorer.com/html/train.html

PHOTO: a young shepherd in Ecuador

Make a "reel difference: REEL BADGES FUNDRAISER

Handmade Badge Reels for Sale: $20 for each. Each one is one-of-a-kind. All proceeds will go towards this cause. To purchase a reel: Email me vu.marie@gmail.com.

Part I

http://www.youtube.com/watch?v=rBGg04ndC70

Part II

http://www.youtube.com/watch?v=H5L-4Ytvclc

Hello Kitty Fundraiser

April 7th- Inspired to do good, a friend donates over $1,000 to the Japan Relief fund

Video on Fundacion Bolivar Education- Volunteer Program in Ecuador This is the volunteer program I've signed up for. Check out their website at. http://www.ecuadorvolunteers.org/. http://www.youtube.com/watch?v=QPr2ViYqMwA&feature=player_embedded#at=121

TO "FREE HUGS" GIRL

Remember few months ago, when you held that first Care Plan workshop? I saw how much heart you put into that workshop. I was moved when you told us you understand how hard nursing school is and gave us your personal cell number to call you if we "needed any help, any help at all, even if it is just to talk." You made me cry seeing how loving you are! I went up to you and teared up when telling you that since starting the accelerated nursing program I felt I was losing my passion to reach out and do loving work. You reassured me,"You won't." Since deciding to go to S.America, I felt revived. Every moment I've spent on this project has been an excitement for me, because in it I find meaning, and in it, the side of me that never gets tired. I guess we don't lose that deeper side of us that makes us, even in the midst of our pile of "to do's" for nursing school. You were right, that "you won't" is the answer to my fear that a demanding nursing program will have me lose my passions. On the contrary, it has prepared me to do more. In the 8 months at CSULB I have learned many skills I will use to help patients at the hospital in Ecuador. I plan to take many pictures and update my blog so I can share the experience with everyone over here. After telling everyone about my trip to Ecuador at today's meeting, you came up to me and gave me a hug, your tears, and said, "I admire you." I want to let you know, Free Hugs girl, that I admire YOU. You reach out to nursing students like myself, offer your open heart and hugs, and encourage us to reach our goals. In this simple gesture you have made a difference in my life. Thank you. *Big hugs* Marie

CANDY and CHIPS fundraiser

$1 each. Snickers, Twix, Milky Way, Sunchips. Just stop by my desk, house, or email me if you want a snack.

March 29th - $255 raised today

Thank you for those who purchased reel badges, and everyone who gave their encouraging words. Special thanks to ANONYMOUS for sponsoring the purchase of all medical supplies. I am touched by all your support!

Quito. Snow-capped Pichincha volcano.

MASSAGE FUNDRAISER

Support the cause by purchasing a chair massage

May 28-April 1st

To my friend who said "Wish I can help more" ......

You helped out plenty. I really mean it when I say "thank you" because if it's $1 or $10, to me it's the same- you are showing that you support my cause, and I can't ask for more. This fundraising has made me feel overwhelmingly blessed to know the kindness of my friends and family. When I think of how I feel, "indebted" is the word that comes to mind. But not the kind of debt like in business where I can pay back every dollar given to me. Instead it's a debt that can't be repaid in cash. Money given in business carries no emotion, but money given with love is worth more than the currency itself. Thank you so much for supporting me.

VIDEO GAMES

Used video games and systems sale: Nintendo, Xbox, Dreamcast. I didn't have time start this fundraiser. Maybe next time!

April 12, 2011

I received my assigned hospital today: Hospital Pablo Arturo Suárez in the north of the city.
And my homestay will be with 3 other volunteers.