Dr. Schwartz Discovers Fields of Dreams on His Medical Trip to Ecuador
Published in PAMF Connections, November 18, 2011 Joseph Schwartz, M.D., a family medicine doctor at the Fremont Center, writes about his impressions and experiences during a recent medical service trip to Ecuador with his son, Jared, and the University of Notre Dame Timmy team.I woke up with a startle and a feeling like someone was slowly driving an ice pick into my neck. Very quickly, I realized that I had dozed off on the plane on our way to Ecuador and as part of my mileage plus privileges, in addition to seats squeezed together like sardines, I had the honor of sleeping in positions that are fit for a contortionist. Sadly, I also realized that I had already maximized my ability to sleep on a plane and we had not even taken off yet!
My thoughts quickly turned to our medical service trip to Ecuador. It occurred to me that this time, everything was different – different country, different child companion, different group on the trip, different altitude and thankfully, different insects (hopefully, none). So, I wondered, what would this trip really be like – mostly: are the social and medical issues that burden the Ecuadorian people similar to what I saw in the Dominican Republic? Are they hampered by similar prejudices and inequities or is their plight controlled by different factors? Would we be able to contribute in a meaningful way to their lives?
Upon waking on the first morning, I could barely restrain my exuberance – not a single mosquito bite to be found; in fact, not a single mosquito anywhere in the vicinity! And no roosters crowing at 3 a.m.! Unfortunately, my joy was brief and after astutely looking over at Jared and his chattering teeth, I brilliantly surmised what my body had been feeling for the last few hours – it was freezing! Well, technically about 45 degrees, but far different from the sweltering heat of my prior trips. I felt quite fortunate to be wrapped in the llama-haired blanket until I caught a quick glimpse of myself in the mirror and realized that my eyes were swollen like a raccoon and I looked like Rocky Balboa – it seems that llama hair and my body have a love/hate relationship.
We spent the next days travelling to deliver medical care by day and counting pills by night; both had their own set of challenges. I strived to develop a Zen-like approach to counting vitamins for two to three hours and I readily admit that I failed. I have been meaning to write a letter to the vitamin manufacturers begging them to simplify their packaging. The Notre Dame students and Jared developed truly brilliant techniques that might someday earn them a Nobel Prize, but I labored at a pathetic pace of about 20 vitamin removals an hour for the first night or two. I was quite relieved to actually start seeing patients so that I would no longer have to undergo this humiliation.
Our medical teams ventured out to small villages 30 to 45 minutes outside of Quito to deliver medical care. The contrast between the majestic beauty of the Andes surrounding Quito and the abject poverty within the villages was stark. Most of the villages had a bombed-out look to them – buildings with no walls and just skeletons of structures; trash filling the streets and the fields where the children played. Very little running water or electricity anywhere. Cows, chickens and pigs wandering through the villages using it as their “restroom.” Of course, this description could apply to other third world countries, but the spirit of the people is what again, amazed me the most. Of the roughly two hundred patients that I saw over that five days, every single one of them was kind, respectful and dignified. Most of them smiled in the face of whatever adversity they were facing and they were happy with whatever we could do for them, which many times, was very little.
There was one specific day that depicts the true spirit of the people that I am trying to describe. We finished seeing patients early in the afternoon in what seemed like the most remote and poor village we had been to. I had developed bronchitis and laryngitis by that point in the trip and was relieved to be stopping for a break. As we packed up, the patients that we had seen insisted on taking us on a tour of their village. I thought to myself, what is it that they could actually want us to see? We slowly walked down the dirt path, around some of the biggest pigs I had ever seen (in fact, Jared very nearly tripped and took a mud bath with one of these mammoth pigs) and it was soon obvious what these villagers wanted us to see. Amidst this squalor, were some of the most beautiful gardens and personal farms that I have ever seen – they were growing their own broccoli, coffee, squash, corn, tomatoes in neatly and adeptly irrigated small gardens. Granted, I was slightly feverish and possibly hallucinating, but this was a scene straight out of the Field of Dreams or the Garden of Eden. Earlier that day, I had seen a young girl with a severely infected ear from an ear piercing gone bad – she had a severe wound with pus and dried blood surrounding the ear and was developing early signs of a dangerous infection called mastoiditis. Yet despite her condition, I remember her bright smile and the look of pride on her face as she and her mother rushed to give us a tomato from their amazing garden.
As we sat the last night and received the gracious words from some of the local officials and our leaders thanking and praising us for coming on this trip, I couldn’t help feeling perplexed. The people who deserved praise and gratitude were the ones living in these villages. They had persevered and were the ones who made gardens out of rubble. And until I can truly understand how these people can continue to smile despite their hardship and cultivate beautiful farms without any real tools or resources, I am just going to have to keep returning on these trips.
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