el campo

We met back up in the afternoon to head back to Cuenca.
J2 and I were working with Dr. C in the morning, driving out to el campo, the countryside. We didn't know what we were doing or where exactly we were going, but after some difficulty finding 1-55, Dr. C picked us up and we headed out to Health Area #3 to meet the students he was supervising there in their rural rounds.
We checked in with the nurse in the health center and then headed out to a local elementary school to meet them. They were just arriving, two fourth years, and we walked with them out to the playground to be introduced to the elementary students who met there.
The whole school was assembled there, the children in red shirts and blue skirts and pants, and were lined up to sing the national anthem. It was a slightly surreal experience, with speakers hanging from a pole along the side of a flat dirt soccer field, the school bathroom in the far corner across the grounds, mountains crowding the background in the morning sun, the anthem crackling across the anachronistic speakers whose sound and appearance were reminiscent of a MASH episode. We were introduced: the doctor - a family physician from the outskirts of Cuenca who had been working in rural health centers and Cuencan clinics for 30 years - and the students, including us, the visitors who would be assisting in their screening physicals.
Today we had the five and six year-old boys for basic health screens of HEENT, heart, lungs, hernias and phimosis. Most of the exams were benign. Of twenty boys we found one case of phimosis, a bifid uvula and a heart murmur. Lots of boys didn't have underwear, and a few smelled of urine so we talked about this, discussing hygeine that would be brought up with the parents.
Interestingly, the unusual cases were brought to the teacher, who would facilitate the discussion with the parents.
It was raining heavily the next morning on our way to The University of Cuenca for a mobile surgery day, but upon our arrival we learned that Dr. V, the anesthesiologist, was ill, and the surgeries had been postponed.
We had enough time to make it over to VCM hospital to make the most of our day.

Ice cream highlighted evening plans. Mixx was the bomb, a coldstone kind of place that made their own product, including highlights like cerveza, sangria, tequila, and whiskey flavors. It was staffed by locals and one Canadian who seemed to always be there when we visited, giving us some extra attention that was appreciated. I never tipped ice cream servers before, but it was worth it. Plus there were three parlors in the San Blas center that was only a few blocks from our house.

The next day we were back out with Dr. C. This time we were making house calls.

morning milk and saddle

It was wet and we had a lot of walking to do. We met a recent University of Cuenca graduate who was training two students. Dr. C stopped everybody we passed on our path for a quick physical and update. The point is to identify conditions that needed attention when the local clinic was staffed or encounter those who are unable to make it to the clinic and require attention at their home.

This woman could barely see or hear. She was somewhere around 90, and was resting after binding these crops.

We visited a hat shop famous for Panama hats, which are made in Ecuador, but made famous by Teddy R who wore one to the building of the canal.

They cut and steam press the hats to order.

And the rain began again in earnest.

south cuenca from rooftop near the center