First, I apologize that there are no pictures to make this post more exciting.
I spent my third week of clinic working with a family physician at a public clinic on the far north side of Quito. The bus ride took over an hour, and required switching buses at the bus station, but it was kind on neat to see another area of the city. Clinic patients were seen on a first-come, first-served basis, and the vast majority of them were children. Many of the children came in for "control del nino sano" or CNS visits, which are the Ecuadorian version of a Well-Baby or Well-Child exam. This provided a great opportunity for me to perform exams, and review stages of development. A number of children also presented with common complaints such as cough, diarrhea and constipation.
Many of the children with diarrhea and constipation were given dietary advice, as they were often drinking too much juice or taking in too little fiber. One 4 year old boy had presented with diarrhea earlier in the week, and returned to the clinic a couple days later after giving a stool sample. His test was positive for roundworms (ascariasis) and he was prescribed albendazole for treatment. This case brought up and interesting discussion, and we learned that parasitic infections are so common in Ecuador that the general population takes a prophylactic dose of albendazole and secnidazole every 6 months. This was also personally relevant, because as visitors to the country, we had to take the same medications as soon as we returned to the states. Yikes!
A number of children had coughs, and the Doctora often attributed this to the change in the weather. October is the start of the rainy season in Ecuador, and evidently it is pretty common for people to experience cold-like symptoms during this time.
Finally, we were in the clinic during one of their vaccination days, and were able to spend time with the nurses while they administered the pneumococcal vaccine to many children. It was interesting because the mothers would bring their children into a room where the vaccines were given, and there was a long line waiting outside. Unfortunately, each child in line would then witness the vaccination of the child before them, and would be screaming even before they sat down. Additionally, the nurses didn't make an effort to hide the needles, which only added to the fear factor. It seems that since the vaccines are only available in the clinic on certain days, they just need to make sure they can get through as many children as possible.
Overall, this was a great week. I learned more about Ecuador's public health system and how it effects children and families in the country and some of the common health problems that children face. This week was also very helpful because I really felt like I was able to understand more Spanish, and participate more with the patients. Those language classes were really making a difference!
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