My wife, an APRN, and I had the opportunity to volunteer at a new medical clinic in the jungle of Ecuador, the Oriente. We were in a town called Guadalupe. We were at the Mission Clinic for one week in December 2001 when it opened. There is a local physician Dr. Jaime Ortiz who has been hired to attend once per week. There has been a stream of foreign dentists and physicians. The clinic has three examining rooms, 2 dental rooms complete with dental x-ray, a surgical suite including a scrub room and recovery, and a pharmacy. The surgical area will soon be functional. Although the pharmacy has limitations we were able to treat most of what we saw. The clinic will soon have a basic laboratory. There is x-ray, laboratory, and surgical services in a city (Loja) 2 hours away for the few who can afford it and when the road is passable.
The people were indiginous subsistance farmers with a few shopkeepers and miners. The gold mines are about one hour away. The oil companies are not in this particular region. There is malaria in the general area but little in the immediate vacinity. Similarly we did not see dengue or yellow fever. Mosquitos were present but not in great numbers. The water is not clean and that coupled with often the people sharing accomodations with their animals, giardia and worms were endemic. We saw some acute diarrhea and perhaps one person with typhoid fever. Many people had back pain (called kidney problems!) as well as depression, alcoholism, hypertension, and children with chronic ruptured tympanic membranes. We also saw all manner of other medical illness from dysfunctional vaginal bleeding to rheumatoid arthritis to parkinsonism to kidney stones. Some access to birth control is available in the city. Remarkably some people of greater means came from the city to this jungle clinic for second opinion, records in hand. Surgical supplies were present for suturing, draining, packing and casting, but analgesics and local anesthetics were deficient. Hopefully this has been rectified. The examining rooms are equipt but you may wish to bring a portable ophthalmoscope/otoscope as a backup as well as a glucometer, gloves, gel, and hemoccult cards.
The parish is clean and accommodations quite comfortable with our own rooms and hot shower. A volunteer dormatory is being constructed. The Nuns supplied us with preboiled water to drink and hearty meals safe to eat. We even felt comfortable eating the salads served to us by them, usually not a good idea in this setting. The Padre is from Austria. He has done remarkable things for his people in a place where the church does the social service tasks that are usually the purvue of the government. The government gives vaccinations sporatically and thus far this is not being performed by the clinic but perhaps in the future. The village is in the high tropical jungle along the main trade route to the amazon in Ecuador. It is poor but beautiful. I suggest that you be up to date for dT, polio, hepatitis a+b, and obtain yellow fever vaccine. You will need malaria prophyllaxis. I suggest a book Handbook of Medicine in Developing Countries by Catherine Wolf M.D. and Dennis Palmer D.O. Although mainly geared to the hospital it has usefull information in table format.
The weather is most pleasant. It is about 75*F during the day, sometimes warmer, and 65*F at night, again sometimes warmer. It rains every day. I brought scrubs and a laboratory coat to work in and was most comfortable and felt adequately attired. One has to be wary of crime in Quito or Guayaquil but I felt perfectly safe in Guadalupe, especially as a guest of the parish mission. The currency is the US dollar. It goes far in Ecuador. There is little to spend it on in the village. We did not have a chance to be tourists but the beauty of the surroundings and the reward of helping others who appreciated the effort more than made up for it. The Padre has a web site: www.guadalupe-ec.org. He also can be reached by e.mail: lindo@guadalupe-ec.org