At sparrow fart one sunny Monday morning we made our collective ways, bleary eyed, to somewhere I cant remember now in order to board the Cinterandes minibus to Palmar. I sensed this journey was going to be a bit dry so the first action I took, to inject a little fun into the looong journey, was to set up a sweepstake on the time it would take to arrive at our destination. By the time we hit Parque National de Cajas the responses had been recorded in a completely fair and impartial manner and we settled in for the ride. The journey took a total of 6 hours 47 minutes, which meant I lost, although I’d like it to be known that if we hadn’t stopped for a (delicious) seafood lunch at a random sand-side ship restaurant then I would’ve won. I hate losing.
The beach came complete with roaming cows!
As soon as we were dropped off at the centro de salud, run by a south Korean nun and a German nurse/midwife (I think), we were confronted with the task of sifting through the patients they had identified as being suitable for surgery. Because of the transient nature of our visit to this sleepy fishing village the patient selection was meticulous. Patients need to be able to withstand the anaesthetic and operation well, as they are only kept overnight at the centro de salud and follow up is by telephone. Therefore, if patients have health problems such as untreated hypertension (high blood pressure), heart problems or current infection the risks of surgery outweigh the benefits. This selection process meant that of the 30 or more patients who needed surgery only around half were suitable. We worked late into the night taking histories and pre-op-ing the patients, the operating list was drawn up, we ate, we slept.
Breakfast was at 7.30 and operations started at 8am. A circular system developed whereby students took it in turns to scrub in on cases either acting as scrub nurse or assisting, then looking after their patient in recovery before returning to the truck for another case when their patients’ observation period was up. We worked in pairs and mainly stayed with patients we had met the previous day, this meant my cases included a laparoscopic cholecystectomy (keyhole gallbladder removal), a small child with an inguinal hernia and a young man with an epididymal cyst. That evening the lovely ladies at the centro de salud cooked us a huge dinner but before we could retire, exhausted to our beds we were whisked into the minibus, still attired in scrubs to take a post dinner wander around crazy Montanita, the nearby surf town known all over Ecuador and South America for its incredible parties and great waves. As we wandered past the hippies, the travellers and the people who looked like they really had a story to tell I noticed that everyone was looking at this motley crew dressed in blue pyjamas wandering aimlessly through the sandy streets and I realised that if the folk of Montanita are looking at you funny then you really are in trouble…
The crew hit up Montanita
Wednesday was our last day of operating, it was more of the same but the cases were perhaps slightly simpler as we were leaving the next day so wouldn’t be around should unexpected complications arise. Anyway, after we had wrapped up at the clinic the big boss people took the decision that we should go for a fancy dinner to celebrate. Of course, a fancy dinner in one of the small villages on the Pacific coast of Ecuador is not the same as a fancy dinner in say, London or New York. So we sat on uncomfortable chairs and chose our treats from sticky laminated menus while every member of staff watched the on-going football match on a tv the size of a greeting card. We were told, with no hint of irony, that the food would take a while, because of the aforementioned, very important, football match. Luckily a random Swedish guy someone seemed to know turned up with a bottle of whisky which was passed around without mixer, much to the dismay of my taste buds. I could tell you about the rest of the evening, but I will spare you the details, because it involved a trip to Montanita, cocktails, a bottle of the local lethal liquor Zhumir on the beach and a lot of dancing.. besides, what happens in Montanita, stays in Montanita…
Getting to work in the truck
p.s. you can read the official details about our trip on the Cinterandes website here 🙂