que tomas Tomas?: El Guabo

We arrived to the local health center in el Guabo, not far outside of Machala, and spent the first part of the afternoon in patient interviews, pre-op and unscheduled patients. There was also a television interview with Dr. R, Dr. G who arrived from the states and the local health center administrators. A candidate running for mayor was campaigning there as well.

We strolled down to a local hotel and diner which would be our meal source during the stay. I forced myself to eat a bit and we returned to our headquarters to begin the first cases.
We only had three procedures scheduled, but we didn't begin until 6 pm and the start was a bit slow.

We took a break for dinner at 9pm, by which time my stomach and appetite had completely recovered, and finished the last case at 11:30pm. We were staying in Machala, so it was close to midnight before we arrived in our rooms at the Hotel Ejecutivo, located one block from the city center, where there was a bit of construction taking place.

We were off for the health center in Guabo at 7 am and back in the quirofano movil, beginning the days cases.

There was a big south american soccer game that the local surgeons wanted to see, so we took a long break after two to watch the match. And J3 showed up, feeling much recovered.

We finished earlier than the first day, which was nice to have a relaxing evening before the next day. I jogged around a bit before we left. Machala is right on the coast, so with the high humidity I was sweating for almost an hour afterward, which makes jogging before work a tough call.

We post-oped patients from the previous days. Again, the larger procedures stayed with a nurse over night, but most were home as soon as they felt able. Patients were very grateful, and there were a lot of photos.

The television crew appeared again.

walking back from lunch. our presence was, well, a presence in this small town

We had a couple of interesting cases, including this parotid mass.

I also assisted Dr. S in a bedside lesion removal during which we fashioned mini-retractors, like a senn but smaller, from needles because the only pair was in the OR.
At the end of the trip, we had more photos.

And then, when we thought we were having dinner, the town hosts threw a party for us! It was also a health promotion meeting, so a group of 30 or so participants followed their leader in step aerobics for half an hour. They invited us to join, but before long the humidity was taking over. Afterward a dance troupe performed traditional dances and local songs from Guabo.

This was a wonderful end to a fantastic and inspiring trip.
We had one more night before a final post-op session in the morning and then the long climb back up to Cuenca.