Q4 24+3

Hospital del Sur

Yesterday I began working at the Hospital del Sur- a 500-600 bed hospital on the southside of Quito. Because it was our first day yesterday, we had to go with the directors of the program to get everything set up. They also had to take everyone else to their respective clinics. So we didn´t get to go into the hospital until 11:30am and we are supposed to leave at Noon.

I´m not totally sure how to describe the experience... intense...sad...devastating
...overwhelming. We got split up based on what we are going into. I guess the don´t have room on the general medicine teams because they wanted me to stay in the ED. Within the half hour we were there, we started with a tour. I saw probably easily 70-80 people waiting to be seen. There was one person on a stretcher in the hallway covered in blood and yelling in pain. Another person had a hole in his chest that was being stitched up in the hallway. One person arrived via ambulance and had what looked like a gunshot wound in his abdomen (a gaping hole) also yelling in pain. He got taken to a trauma bay, had an IV placed and then was transported to another hospital. I also worked with an ob-gyn and saw two patients. One who doen´t know her due date and they had no info on and she was coming in for follow-up. Another, who possibly had pyelonephritis and was having contractions at 32 weeks. She was going to get admitted. What struck me the most was the tremendous lack of resources.

Today I worked ER triage. It was abdominal pain day. Everyone had diarrhea, fevers, vomiting. It was hectic. The resident I was working with didn´t even have gloves to use when starting IVs. The EKG machine consists of metal discs that you have to attach via suction. It´s hard to explain, but there is a bulb on the end of the metal disc and you squeeze the air out and then place the metal disc on the skin to get it to stick via suction. I had obviously never seen one of these before and it was an interesting experience trying to figure out how to get it on. The good thing about today is that I learned that my Spanish is much better than I thought. I was able to do histories and physicals on everyone without difficulty. I still have to learn how to write everything out though, and learn their abbreviations here which are very different. The medicines also all have different names here. I have to go back and learn all the generic names. I think that it will be a great experience and will give me a new found appreciation for the health systems in the US. But, I won´t know for sure until I have completed the experience.