Appreciation is B;iss - by Melissa Tullock

What immediately struck me about life in Duran is that while most people are living in poverty, there is an overwhelming sense of happiness and community.  To me, that seems to be a large difference between here and home; it´s rare to find any American family that isn´t wanting more than they have.  Here, it seems most families are grateful for what they have and, importantly, for each other.  The children may not have a huge number of toys or the newest gadgets, but they do have a playground right across the street that they are happy to use at all hours of the day.  Likewise, the adults may not have everything they desire, but they have laughter and singing and a homemade hammock to pass the time.  There are various ways that they try to make some extra money, but they never seem unhappy or resentful about having to stop what they are doing to sell a soda or beer.  It´s a quality that is lacking in the United States, where even the newest technology isn´t enough and people would rather spend time on the computer than talking about their day.  When I discussed this feeling with a friend of mine, he said something along the lines of, ¨Ignorance is bliss.¨  But how ignorant can those in Duran be, with the mansions of Guayaquil just a short bus ride away?  They also know of all the vacation spots we are talking about visiting, like Montañitas and Baños.  In the case of Duran, I´d say it´s more ¨Appreciation is bliss,¨ and the fact that some things are missing doesn´t detract from what they do have.

American Culture - by Dana Schwab

Another observation I have made is that shirts with logos and things written in English are very popular here.  A few times I have asked my patients if they knew what their shirt sayings meant and they had no idea.  Many times they don´t make sense, but I would translate for them as best I could.  It amazes me that people would wear something on their shirts, advertising on their own body, and not even understand what it means.  If it´s in English though, it´s considered cool.

I grew up in a family that always supported me in whatever I wanted to do.  When I was little I was told that if I worked hard enough, I could do whatever I wanted to do.  I understand now though, that some of what I always thought was hard work, was actually a bit of privilege.  I am privileged because I live in the United States, I am white, I am an only child, and I have a very supportive family.  I´m starting to wonder how much this privilege contributed to my success.  The idea of being privileged because of being an American is new to me because of this Ecuadorian obsession and I wonder how much the privilege is because of the idealization. 

Working with Dr. Aguirre - by Cristina Kline-Quiroz

We worked with Dr. Aquirre in a small clinic in derechos de los pobres.  I really enjoyed working with Dr. Aquirre.  He was incredibly genuine, empathetic, and warm to the parents. 

 He saw several patients, mostly women and young children.  He seemed to recognized all his patients and they all seemed to like him.  In contrast to some of the other doctors we have worked with, he didn’t have an air of condecention  when speaking with the patients.  He met his patients at their level; taking the time to allow them to express all their concerns without dimissing any of them.  Everything was explained clearly and all questions were answered.  He took the time to do a thorough physical.

 I thought that he really cared for his patients’ health and well being.  I also thought that he cared for us  by the way he took the time to explain the history and physical for us and detail what was important and why.

Julio - by Emily Gray

Julio was my host dad. Although I didn’t actually spend a lot of time with him because of his work, I include him in my reflection because I learned some very important things from observing him.  During one of our very first conversations, he told me that although the families of the neighborhood were poor in money they were rich in heart and soul. Derecho de los Pobres really does demonstrate what he said. It just reinforced how true it is in the USA that so many of the richest people are the unhappiest. I also learned from him that you should never take for granted the family that you have.

Ruined - by Matthew Niehaus

It’s been 7 years since as a naive high school junior I traveled to Duran, Ecuador with a group of my classmates and two teachers to live in solidarity with the Ecuadorian people.  A great deal has happened in my life since then; I graduated from high school, moved to the Bronx to attend and graduate from Fordham University, applied and was accepted to medical school, and am now living in Philadelphia where in just a year and a half, will graduate and become a doctor—a prospect that absolutely terrifies me.  Life was easier before my trip, before truly knowing exactly the inequalities and injustices that are present in the world.  That trip, as one of my fellow classmates so astutely said, “ruined” us—it shattered the protective bubble we lived in, where it was all but too easy to get wrapped up in our “first world problems” that in today’s word, would manifest themselves as trying to decide between the Iphone or Droid, Starbucks or Dunkin-Donuts, Pepsi or Coke, BMW or Mercedes, and the list goes on.  In one week though, I will leave all my first world problems behind and return to Ecuador, this time as a somewhat jaded and sometimes confused young medical student.

I have been asked by many people over the past few months many questions about my trip.  The most commonly asked question, and one that I have been thinking a great deal about over the past few weeks, is “what do you hope to get out of this trip?”  First and foremost, I hope this trip reminds me why I chose to become a doctor.   I hope it reminds me of the awesome obligation and the immense responsibility I will have to others, whoever they may be.  To remind me of how blessed I have been, and continue to be.  

In one week I’ll be leaving behind my comfortable city apartment, my cell phone, constant and unrestricted internet access, and my family and friends to go and get ruined again—and I am looking forward to every minute of it.

Observations about the Ecuadorian life - by Ron Benjamin

Trying to see patience

There is an air of familiarity as I become more accustomed to my surroundings. I don´t know what to make of certain practices, however. When waiting for the bus stop, it is best to have a woman get on last because the bus driver doesn´t start moving if a woman is still getting on, otherwise it´s that man for himself. In the bus itself, people bump into others without thinking twice about it. No one gets up for the elderly woman or pregnant mother with children. I think if these are how a desperate people act, or simply survival instincts.

At the leprosy clinic I am fortunate to work with Dr. Martinez who has specialized in the disease. He calls in a patient who not only had Leprosy, but Leprosy Type 2, where red nodules encompass his entire body. His skin is dark, peeling, and he is a mere 95 lbs. The doctor tests his sensation by making him close his eyes and tell him if it´s a sharp or dull pain he is feeling. There is no response. The doctor looks at me and says, he feels nothing in this hands or feet. I think about how the other leprosy patients at least still have the pleasure to laugh from a foot tickle, but this patient seems removed, both from sensation and our current conversation. ¨He doesn´t want to take his medication¨, the doctor finally interrupts the silence. ¨Why not?¨ I ask. ¨It makes his skin darker, and that isn´t a good thing here¨. I´ve read about this. The darker the skin still symbolizes a status of class and though this man is in an isolated Leprosy clinic, these things must still matter to him. ¨He doesn´t care about getting better?¨. The doctor looks at him and then looks at me. Enough has been said.

On the bus back home I am standing in the entrance because the main cavern is simply too overcrowded. I see a woman with her daughter by her side get on the bus. She squeezes in and tries to hold a stable stance but the bus veers and she and her daughter nearly fall into a seated passenger. When I look again, I see a woman has moved over, and a seat has opened up for the mother. I wonder how this can be and see that there are now two mothers with their children on their laps, and understand there must be an unwritten rule between two mothers. I smile at the one who made room by putting her daughter on her lap. Patience is tried here, but it is also rewarded, I think to myself.