TDI Workshop 2001 Wrap-up Discussion

By Kristen Epley

For our final component of the 2001 Tropical Disease Workshop, our group met in a room at the hostel to discuss what we had seen and experienced on our trip.  Mario began the discussion by explaining how the workshops had gone in the past, and how each workshop had been different and unique in its own way.  We started off discussing our impressions of the Ecuadorian people, their culture, and their way of life.   One student stated that everyone we had met during our trip had welcomed us.  She said she felt that the people were friendly, caring, and very open to sharing their culture with us.   Everyone whose home we had visited welcomed us with open arms and was not shy to share with us the way they lived.  Another student who had been to Guayaquil, Ecuador the previous year reflected on the differences in the experiences she had partaken in.  Last year, she had the opportunity to go live in a poor community to offer her services and see how the people lived.  She said after that experience, she thought the country was a depressed nation with no resources or natural beauty because that was all that she had seen during her visit.  She stated that after participating in the Tropical disease workshop 2001, her eyes were opened to the county's beauty as well as richness.  She said that after getting to see the country and getting to know the people and their way of life, she thinks that their values need not change, however they should be given better access to healthcare and other related resources in order to improve their overall quality of life.

           The next part of the discussion began with a hypothetical question from Mario to a pre-med student.  If she were given a very large amount of money by a wealthy benefactor to be used to help solve some of the problems in Ecuador, where would she begin to spend the money? The student responded that she would give the money to public health facilities and spend the money to buy better medical equipment for public hospitals.  Another student said that she would spend the money to create programs that would aim to prevent diseases, illnesses, and hazardous behaviors before they caused more problems.  A participant of the group, who is also an instructor for Biological Sciences at Ohio University, stated that if she were deciding where the money should go, she would start spending the money on the schools.  The reasoning behind this was that students could learn about healthcare and ways to prevent illness and disease, as well as how take better care of themselves if it were taught in schools.

As a contrast to the former question, a second year medical student was asked what she would do to help the people of Ecuador if she had no money?  She responded by saying that she would gather people of the same views and ideals together and delegate according to need and ability.  People can accomplish astonishing things when they work together toward the same goals.

            The discussion took a turn when the participants were asked whether or not the people of Ecuador are truly happy with their way of life.  It was decided that they are probably as happy as are people of other cultures.  Although the concept of happiness is universal, different cultures may express this emotion in more ways than one.  While the people with whom we visited all had very positive attitudes and were a pleasure to know, some of the people were suffering physically and preventive measures were not being taken to help alleviate this suffering.  Small changes could be made which would make a large difference in the quality of health of these people. However, there are problems associated with making any type of change. In this case the biggest problem is trying to change people’s behavior without offending them.  Simple education issues could help. However, Ecuador’s government is not doing its part to help the people.  Corruption is rampant in the government, and a large part of the money that is being allocated for healthcare issues is grossly mismanaged. Many non-profit non-governmental organizations have been formed to combat this.  PLAN Internacional is one of these organizations, and is working to help the people of Ecuador.  They go into communities and teach the people proper sanitation, hygiene, and disease prevention methods.  We discussed whether or not PLAN was making a difference.  PLAN works with community leaders to help implement ideas.  The community leaders are well known and trusted by the community members who are more apt to listen to and take advice from them than from an outsider.  Our group saw the benefits from PLAN’s efforts when we went to the community of Valdez and saw that the people were learning how to properly store and use their drinking water.

            Next, our group discussed the different conditions we witnessed in the hospitals and clinics around the country in both rural and metropolitan areas. The private metropolitan hospital we saw was amazing.  It had all the amenities of a five star hotel, including private rooms with a balcony view and high technology medical equipment.  The clinic we viewed in the Cloud Forest was not owned by the Ministry of Health, yet it still was a public hospital. It was well equipped with the latest technology.  However, it seemed that more care could be taken in efficiently using resources.  For instance, the Director’s office was larger than the nurses’ station and not all the available rooms were being utilized, yet patients were crammed into a small emergency room.  The private clinic in Manta that we toured was excellent, but there were almost no patients there, apparently because of the high costs of obtaining care at the facility.  It was a nice medical facility, but when people are not able to access care in that clinic because it is so expensive, the purpose is defeated. 

We learned that in Ecuador, like every other place in the world, politics are an issue.  One of the graduate associates on the trip, who is from Ecuador, stated that he feels like things never get done. In Ecuador, there have been five presidents in four years.  The leaders are continuously overthrown due to corruption in the government and the subsequent mistrust of political leaders by the population.  It appears that the politicians are out to make money instead of helping the country prosper.

Towards the end of the discussion, we began talking about what we can do everyday to help make a difference in the people’s lives that we had met.  It was decided that we could draw from our experiences and tell others about what we had seen.   We can also help by furthering our own education in order to learn how and what we can do to help raise the standard of living in other countries and also in the areas of the U.S. that we will work in someday.   We know that we must not lose perspective on life, and we should enjoy our work and our lives and always have hope for the future.  The key to trying to help is to stay fresh and to not take the challenges of life too seriously. If we lose our perspective the problems that we have spent the last two weeks confronting will seem overwhelming. By doing things in our everyday lives we can help people, and even if we touch only one person, the effect will be ongoing.