By Rebecca Pfaff
Meharry Medical College
My first week here in Riobamba, Ecuador has been fantastic. In the mornings I attend rounds in the pediatric hospital with residents and attendings. Rounds are a lot like in Nashville except that x-rays are read by holding films up to the light and, of course, everything is in Spanish. Also, an epidemiologist joins us, and sometimes a dentist, though they rarely contribute to the discussion. It is amazing what an international language medicine is. Even with my limited Spanish skills I can follow, and occasionally contribute to, rounds with relative ease. After rounds I go with Dr. Cruz to his clinic on the first floor of the hospital. I enjoy working with Dr. Cruz both for his obvious skill as a practitioner and enjoyment of teaching, but also because he speaks very clearly, making it easier to follow him. In clinic we see 8-10 patients to fill out the morning before he and the other pediatricians head to their private clinics in the afternoon. There are no well child visits in the clinic, only hospitalization follow-ups and sick visits. Riobamba is the capital of Chimborazo Province and surrounded by mountains populated by small villages and farms. Families bring their children in from long distances to see the doctors. Pulmonary complaints are by far the most common with gastrointestinal a close second. In fact, the hospital has two large main rooms for inpatients, one for pulmonary complaints and one for gastrointestinal, with smaller rooms for infectious disease, neonatology, and other complaints. There is no importance given to privacy either on the wards or in the clinic. Curious mothers will follow the physicians as they round in the one large room containing 6-8 patients and in clinic other patients, nurses, pharmacy representatives, and administrators all walk into the examination room while the doctor is seeing patients.
After clinic I return to my host family’s house for the most important meal of the day, lunch. Everyone comes home from work and school to eat together. After this I head off to my medical Spanish language course. We are all in the fourth year of medical school in the U.S. and excited about starting residency soon but enjoying Ecuador a great deal in the mean time. I can't believe I have already been here a week, these 11 weeks are going to fly.