1. Traditional Medicine and Cultural Learning in Ecuador Ryan Norman
Photo taken from balcony of my homestay in Quito. Snow-covered peak of Cotopaxi volcano is visible in the distance.

2. Ecuador
We worked in three places in Ecuador: Quito, Otavalo, and El Oriente (marked by the red X)
Ecuador lies right on the equator.

3. The rural town of Otavalo
The rural town of Otavalo. The road in the picture is the Pan-American Highway.
A small group of houses in El Oriente (the Amazon forest)
Quito’s skyline, seen from the top of the Basilica church in the historic center of Quito

4. Medical and Cultural Learning
The program really appealed to me because in addition to providing medical services there was also a strong emphasis placed on cultural learning.
The traditions of the indigenous people have been well preserved in rural areas of Ecuador and they were very open to sharing with us in the hopes that we would be able to spread their ideas to more people.
LEFT: In the home of a traditional weaver. TOP: A spiritual cleansing. BOTTOM: Practicing hunting with blowdarts.

5. A Day in the Clinic We split into pairs to see patients
One pair worked the vision chart each day. We had glasses to give out to patients with vision problems (while supplies last).
All other groups collected the patient history, performed a physical exam, determined a diagnosis, and prescribed a treatment.
LEFT: A day of clinic in a town outside of Otavalo.
RIGHT: Two students working hard on vision checks.

6. A Learning Experience in Ethics
An unexpected aspect of global health that I was exposed to in Ecuador was the ethics of how we work with the community.
Creating a clinic that will no longer be there once we leave doesn’t help the community.
Touring medical facilities, especially with a large group, drains the facility’s resources, puts a greater burden on the health care providers, and intrudes on the privacy of patients.
LEFT: An emergency department we toured in Otavalo
RIGHT: A pop-up clinic near a market in Quito

7. Traditional Medicine
A curandero in Peguche demonstrated traditional healing methods and explained how they approach illness.
Illness is as much spiritual/energetic as it is physical. Illnesses are beings or people that visit your body. Each illness is associated with either hot or cold and identified as either masculine or feminine. Same goes for the plants used to treat the illnesses. They are treated by pairing masculine with feminine and hot with cold.
An egg cleanse being performed to clean the spirit.

8. Mother Nature’s Womb
Sweat lodges are used for energetic cleansings, healing, and spiritual growth.
The experience was divided into four sections that represented the four elements and lasted for a total of 3 hours.
Intentions were set at the beginning of the ceremony.
The sweat lodge was loaded with volcanic stones

9. The Challenge of Cultural Sensitivity
There is a very vibrant presence of traditional culture among the indigenous people of Ecuador. Many of them will only accept medical care that is provided in traditional methods.
In order to maintain care for this population, the clinic in Otavalo is staffed by both traditional healers and contemporary doctors.
To improve the conditions of health of the indigenous population of Imbabura, through the provision of alternative medical services and education for health and medical research, with the maximum respect for the people and their culture, in conditions of equity.

10. Free Health Care…
Ecuador provides free health care that focuses on preventive medicine. Private health care is often more efficient but only accessible to the rich.
Rural areas lack the health infrastructure of larger cities. Also, most of the population in the rural areas is poor, which means their access to care is limited
We crammed into a school room in a small town an hour outside of Otavalo. Jambi Huasi in Otavalo is their closest health care provider.

11. …You Get What You Pay For
Two of my morning were spent shadowing a primary care doctor at a clinic in Quito.
They didn’t have a single blood pressure cuff in the entire building.
The primary care visits seemed to function as triage patient visits. Simple cases were handled here. But many were referred out to a more specific specialty.
The waiting room at the Vicentina Centro de Salud in Quito.

12. LEFT: Jumping off a bridge, also known as “puenting”, over a river
RIGHT: A small Ecuador town tucked in between some mountains

13. The Cathedral of Quito, located in the historic center of Quito.
View of El Panecillo from the Basilica Cathedral in old town Quito.

14. Interhealth South America 2015 group at Yachana Lodge in the Amazon Forest.