Week #4 IESS and the coast

I started clinic week #3 in the hospital IESS which stands for Instituto de Ecuador de Social Seguridad. This is the hospital for all citizens who get health care through their jobs. So they pay into the health care system (like Medicare) and then they get health care through the designated social seguridad hospitals. According to one of the medical students, 20% of the population is in this system. The hospital is enormous and takes up an entire city block and it took me at least 15 minutes and asking 5 security guards to find the gynecology department. The hospital is filled with people waiting in lines leading to different doors and halls all labeled with every possible specialty: oncology, cardiology, rheumatology, dermatology etc. There are clocks everywhere but none of them are set to the right time! For some reason, the whole place felt kind of communist to me. I’m not even sure what this means but it just did.

It was hard to take a picture of the entire hospital because it was so big. Here is an attempt:

Here is one of the entrances

The facilities were all very nice and were much more modern than Hospital Maternidad (public hospital). I met Dr. Salazar and he was scheduled for 3 gynecology surgeries in the morning which I watched. One hysteroscopy (looking in the uterus with a scope) and 2 diagnostic laparoscopies (looking at the reproductive organs through the abdomen).

In the afternoons I continue to have Spanish classes. Spanish is coming along. Good signs: I can talk in past tense! My mind no longer floods with Swedish/Norwegian words when I am trying to say something . I think my patient interviewing skills have gotten tons better during the past 4 weeks.

The next day Dr. Salazar had clinic. IESS has electronic medical records! He saw about 10 patients for post surgery visits, surgery consults or for regular well-woman exams much like my preceptor in California.

The week continued with more surgery, colposcopy clinic and another day of regular clinic.

This weekend, Kibby and I traveled to the coastal town of Atacames which is just south of Esmeraldas. When we exited the bus we were flooded with tropical, humid air. The town of Atacames is a beach destination for foreigners and Ecuadorians and has lots of bars lining the beach.

Here is the sunset on the night we arrived

We didn’t have the best weather. Cloudy Saturday and a little rain on sunday. But you can see that this is not deterring any of the Ecuadorians from enjoying the beach. (It was still really warm and we got pretty burned through the clouds)

Apparently Ecuadorians eat ceviche (uncooked seafood marinated in lemon juice and seasoned with onions and herbs) for breakfast on the coast! I opted for the fried fish and bolón (which I thought would be ham/bologne but turned out to be a ball of corn filled with cheese). Very delicious.


But how the Ecuadorians love to dance! On the beach, in the bars at 2 pm, into the wee hours of the morning, they were constantly dancing. Old, young it didn’t matter. It was so cute and it made me wish that my culture had more of a love for dancing.

Here is a banana and fruit shop in Atacames. We saw tons of these on the way from the bus as well.

We had a relaxing weekend on the beach, ate well and danced and even went to a karaoke bar where our biggest success was summer nights from grease followed by a backstreet boys song.