Monday, April 13, 2009

Support Primary Care

ABC News

We need more primary care physicians. The only way likely to do this is to change the current payment system to foster primary care over consultant care. Support the patient centered medical home.

Sunday, March 29, 2009

Our friends the LLamas


Last Tuesday, Mary and I took a very long bus ride to get to the Black Sheep Inn. The bus ride was long because it was 4 hours on a bus up and down winding bumpy mountain roads. On the way we passed many farms built right into the mountain. The notable thing is that the animals had plenty of room and were feeding on grass. (Not like many American livestock places where they feed grains and are locked up in small areas.)

We got to our ecolodge and found that they had many animals too, including a dog, chickens, pigs, bunnies, and our favorite: Llama's! Here is a pic of them on the volleyball court. The next morning we found one right outside our door (see other pic). They talked to us a lot, but were very calm and fun to have around.
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We made it to the "real" equator. At this site they did a little trick. They filled a sick with water, then drained it. When they did it on the equator, there was no swirl. When they did it to either side of the equator, there was a swirl, but it opposite directions. My book says this is a gimmick. Is it? What's the trick?
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Ecuador Loves America (and New York)


this is the first in a series of blogs about our travelling last week in Ecuador:

Last week Mary and I had a wonderful breakfast at Cafe Mosaico, overlooking the city of Quito. We had a very great American breakfast of french toast and pancakes. While there we saw a little boy running around with a New York Yankees hat on. I'm not sure where he was from, and he didn't even seem to know who the Yankees were. But as we travelled around I saw many people in the cities and small towns wearing that famous NY logo on their hats. (I will admit we did sit next to one guy wearing a Boston Red Sox Hat.) I feel the hat signifies the city of New York, which for many of the people here is a sign of America's greatness. I would agree. (Although Boston is more fun to live in.)

This fondness of America seems to have re-ignited with the election of Obama. People all around Ecuador talked about Obama and my language school had the newspaper signifying his election hanging in the hall. We spoke with a rural truck driver in the mountains who was so excited about Obama. He seemed inspired that a man with colored skin could be elected to the most powerful position in the world.

One more observation that America can learn from: Breastfeeding here is the norm. You hardly see a bottle in any kids mouth. (and there are tons of kids). Women breast feed on the bus, while walking, while carrying things, while make a sale from their store. It's amazing. We even saw a boy, approximately 20 months, pull down his mom's shirt for a snack on the bus. It's good for health, and I wish America would follow Ecuador in this sense.
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Monday, March 23, 2009

El Centro and El Centro

Mary is here and we are having a great time around Quito.

Yesterday we started out with a giant fruit bowl at our hotel. We then climbed up lots of stairs to a park overlooking the city, and had banana pancakes at a cafe there.  Then we went to El Centro (the old town), where we walked around, saw old buildings, and churches.  Had a plaintain and cheese empanada for a snack.  After some resting, we went to dinner in the New Town at a Mediterranean place.

Today we took a trip to the monument where the measurements were made to show where the Equator is.  Took lots of pictures on the "Equator Line".  Then we walked down the block a few hundred meters, to the site where current techonolical measurements put the REAL equator.  Took a nice tour of that site and took more pictures on the "actual" equator. 

Headed back into town for lunch at a place where they sell indigenous chocolate.  And yes, we bought some.  Now gotta get ready for dinner at Plaza Grande.

Hasta Luego.  Me Tired.

Monday, March 16, 2009

Tarjeta Postal

This is a gift to all my loyal blog readers.
If you have been reading:
1. Send me the answer to this question: What TV show does the family I'm staying with like to watch?
2. Send me your mailing address.

If you do the above 2 things, I will send you a post card.

Friday, March 13, 2009

El Bus


In the last couple of days I've had my first adventures on the Quito buses, without the gracious company of my host family. (They were taking me everywhere for awhile.) The buses are quite an experience here. There are tons of them, they are efficient, but not easy for the foreigner. Here's my bus trip today:

I leave the hospital at 8am. I'm walking up the street and think I see my bus crossing in front. So I start a slight run. As the bus is moving away, the fare collector (let's call him the conductor) sees me. He shouts to the bus driver to slow it up a little (Note: Not STOP). The back door flings open and I jump on. I'm on my way cruising down the Pan American Highway.

Now I have to figure out when to get off. All I know is that I get off right after the giant Movistar (mobile phone company sign). Got it. Got to get off quickly. Press the button on the bus, and I jump off. The conductor comes to collect my fare, and because he is in a rush and give him the change in my pocket. He runs back on the bus and I realized I gave him 50 cents! (It only costs 25cents. Oh no!)

Now the hard part: finding the special bus that goes to where I'm living. So I wait on the corner. Many buses go by. Their are all filthy diesel, so I breathe in the nasty fumes as they all pass.

[Side note: People don't have right of way in the streets and it looks like cars often try and run people over. But today a dog walked out into the middle of the highway and the cars stopped for him! I guess dogs get more respect.]

The buses have 20 names in their front window: all places they might, could, and will go at some point within the next 2 hours. My job was to find the one that said, "El Ejenuto" in GREEN on one of the many signs in the window (click on the picture above for a more detailed view of the difficulty of this). To help you with this, the "conductor" yells out a million places the bus is going as it is passing. I understand none of what he says, as it's kind of like the conductor naming the stops on the NYC subway. But they try to get people on their bus, so they make more money. (And are very nice helping people on and off.)

I waited about 20-30 minutes and no bus. (The bus I need doesn't come that often.) So I ask the bus time recorder guy if I'm in the right place. And just then, a bus with many signs, one of which says "El Ejenuto" in GREEN comes my way. I jump on and am on my way again.

When you want to get off, you tell the conductor guy, give him 25 cents and they slow down the bus so you can get off. (Unless you are an older person, in which case the bus actually stops.)

Well I made it home. It was fun. But wouldn't it be nice to be taken around on one of these:

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Wednesday, March 11, 2009

Same and Different

In this edition of my blog I'll talk about things that are similar, but different here in Ecuador.

Same: Lots of pharmacies all over the place
Diff: You don't need a prescription, except for certain drugs (like narcotics)

Same: They use toilet paper
Diff: They throw the used ones in the garbage, as they clog toilet (same as most developing countries)

Same: On the trolleys people are packed like sardines (just like Green Line Boston)
Diff: The trolleys are actually buses, and the fare is only 25 cents.

Same: Lots of crazy taxi drivers
Diff: They are mostly from this country

Same: You shake hands, or kiss/hug a friend when you see them on the street
Diff: You shake hands AGAIN when you say goodbye, even if you talked to them for 10 seconds.  This makes for A LOT of hand shaking.  I cut my right hand the other day and now every time I meet someone it hurts.

Same: People give you a hard time for being vegetarian.
Diff: No. Pretty much the same.

Same: They love to watch TV.
Diff: Malcolm in the Middle seems to be their favorite show.  (Based on my family's viewing.)

Same: Women get lots of ultrasounds in pregnancy and always carry the pics around
Diff: They often get minimal other prenatal care

Same: Drunk people get lacerations when drunk
Diff: After you sew them up, you can send them home drunk

Same: Kids go to school
Diff: They all wear uniforms to school, like good Catholics

Same: They play a lot of football on the weekends
Diff: They play fUtbol (i.e. it is soccer and not really football)

Same: Lots of dogs
Diff: They roam around all over without any collars.  And they bark ALL the time.

Same: The signs on public transportation are in Spanish
Diff: They are not also in English

Ok that's it for now.  This one took a lot of thinking. More next time.

Monday, March 09, 2009

Lack of Resources

My 24 hours shift yesterday was rough.  We had a mom who needed a STAT C section, and we don't do them at our hospital.  Then the baby had problems, and I was the most qualified there to help.  We finally rushed the baby to the larger area hospital.  But when the baby got there, they told us they had no ventilators for babies.   I guess some things cannot be done here, and I have to be comfortable living with that.

Afterwords I delivered a healthy active baby.  I hope the rest are just like that.