Non-stop Andean Flute Music

Eileen Chang here, signing in for Team Ecuador’s final blog post. It’s been an awesome three weeks, and I wanted to take some time to appreciate how far we’ve come and share our favorite highlights with you in the form of a picture/video montage.

When we first rolled into Ecuador, we really had no idea what to expect. We had spent months researching health care models and learning about Ecuadorian health care, but there is only so much you can learn without being there on the ground. We started our field work in Quito, where we interviewed government officials, public health experts, and doctors from Voz Andes, a private organization with decades of experience delivering quality health care in rural and urban Ecuador. With each successive interview, we had a step-change increase in our understanding of the health care landscape and our client’s situation. We started calling our interviews “knowledge bombs” because our minds just kept getting blown with all the new information.

After a week in Quito, we felt we knew enough to start outlining some initial recommendations. We knew that our visit to Pedro Vicente Maldonado the following week would help us contextualize our ideas. What we weren’t planning on was having our minds blown again after witnessing the hospital operations and talking with the doctors in the residency program. We were surprised to find that when we got there, no one had been notified that we were coming. The medical residents didn’t know who we were, what our project was about, and how it was any different from last year’s Haas IBD project. At first, they were a bit reticent to speak with us, as they had not yet seen any changes implemented from last year’s project and weren’t sure what to make of us. We did our best to explain the purpose of our project and our relationship to AHD, and positioned ourselves as advocates on their behalf. After all, we were there to identify ways to improve the residency training program. Whether they were impressed or simply took pity on us, they began to open up to us and gave us some very candid feedback about their experience at the hospital. We realized that the organization was not at all ready for the sexy technology-based health care models we had spent months researching. What they needed were the basics: Better equipment, resources, curriculum, and communication processes. We decided to scrap the research we’d done and start from scratch, using what we had seen, heard, and learned on the ground as a basis for our recommendations. We felt we owed it to the residents to represent their opinions and concerns and communicate to the advisory board concrete recommendations that would make a real and immediate difference.

After spending the last several days pouring our hearts into our final report and presentation – all the while listening to a non-stop barrage of Andean flute music being pumped on repeat through our hotel’s lobby speakers – we finally presented our recommendations to AHD’s board today. Our goal was to help them see what life was like in the hospital and understand nuances in the culture and communications of the organization that they would never be able to know from their seats in the United States. We were a little unsure about how our recommendations would be received, given our re-focus of the project and the hard-hitting findings we presented. The huge thanks they gave us at the end were a satisfying validation of our work. In their words, “We commend you for your insightful work… it would have been easy for you to build a wall around yourselves, but you were able to gain so much trust among the residents that they felt comfortable speaking so frankly with you – and told you more than they ever would have told us. After hearing you talk about the cost of inaction, we know how important it is to address these subtler issues.”

What more can I say?

I leave you with some photo and video highlights of our trip:

Frolicking in the park in Quito

Gorgeous: Old Town

Trying to pick John up in Bungalow 6

Get ready for some BBQ guinea pig!

Taking a rickety cable car across the jungle

Inca Monster!

Team Panama Hats

—Eileen Chang

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