travel and health | No Particular Place To Go

They Make House Calls Too

Posted on October 11, 2014 by Anita @ No Particular Place To Go 38 comments

It was a dark and stormy night (we’ve always wanted to start a post like that!). The rain was coming down hard, a rare event in Manta, and our power had just gone out. In fact, looking out our 11^th story apartment windows, it appeared that the power had gone out in much of the city. We decided to call it a night and started the usual preparations to get ready for bed. The screech from the generator powered intercom startled us around 8:45 PM and the security guard at the entrance to the property engaged us in a fractured dialogue involving our basic Spanglish with the attendant miscommunications. Finally, we came to understand that the physician we had seen twice to treat Enfermo’s bronchitis was at the entrance.

image from http://www.ipharmd.net/symbol/caduceus/blue_caduceus_medical_symbol.html

His daughter, Jema, a second-year medical student, came on the line and explained that she and her father were concerned about Enfermo’s health and were making a house call. After we shut our gaping mouths, we invited them up to the apartment and then hurriedly changed out of our sleeping attire and back into street clothes.

The back story is immaterial but through circuitous means the doctor had learned that the nebulizer he had loaned us for inhalation treatments was not working properly and they had come to investigate the possible causes of the problem. Upon deciding that yes, there was a problem with the machine, which of course didn’t work now because the power was out, the doctor and his daughter insisted that we get in their car and go to a pharmacy with power and test it there. So, with Jema driving, we set off into a black night and an entirely different view of Manta. In addition to the nonfunctioning street lights, many of the traffic lights were also unlit and we slipped and slid on wet, slick roads up and down the steep, winding city streets through a crazed checker board of darkness and illumination.

We found an open pharmacy and after turning on the device the doctor was able to ascertain that the compressor could not produce sufficient force to vaporize the medicine. This perplexed Dr. Cedeño, as it was a new machine, but he quickly thought up a solution. Once again, we set off through the rain-speckled, night streets in quest of another nebulizer at his office which was located in the teaching hospital at La Universidad Laica Eloy Alfaro de Manabi where he rounded daily. Upon our arrival at the university campus the doctor ran into his office only to discover that the equipment that he had envisioned loaning to us was no longer there. But, (Aha!) he had one other option, an older model in his office across town at the Clinica Americana where we had first met him.

Setting off on our quest once again, we talked about the improbability of this ever happening in the United States. A physician, with his medical-student daughter, making unsolicited house calls out of concern for the health of a patient. Both of them expressed incredulity at what we described and explained that it was quite common in Ecuador. Part of the physician’s job was to see the patient in the home, as necessary, and here the family would listen to the doctor and also be a part of assisting with patient care.

At last, with a serviceable machine in hand, we arrived safely at our apartment shortly before 11 PM and were deposited at the gates expressing our profuse, totally inadequate thanks for the care, concern and unbelievable efforts just bestowed upon us. Shaking our heads as we mumbled “incredible!” the thought dawned upon us that there had been no discussion of compensation. Only in Ecuador. Only in a land far away from where we once called home.

By Richard and Anita

In Sickness and in Health: Welcome to Ecuador

Posted on October 4, 2014 by Anita @ No Particular Place To Go 36 comments

View from our window

We arrived in Manta, Ecuador the first week of September and spent the first couple of days settling into our new apartment on the 11^th floor, stocking up the kitchen and looking at the Pacific view from our kitchen window (we’re in the lower rent unit which faces the city rather than the beach). And then… one of us (let’s use the Spanish word for sick, “Enfermo”, for our patient) was down with fever, chills and a gut-wrenching, racking cough that was accompanied by a growing sense of fatigue, malaise and a slowly increasing shortness-of-breath. And, not just for a short period of time but for days…

City view from the living room

When you’re traveling, health comes before everything else. Exploring a new environment or meeting other people just isn’t practical or even doable when you don’t feel well. Luckily, so far, when one of us has been down the other has been healthy and can run errands, track down a doctor or medication, heat up the chicken soup and generally act as a stand-in for mom, a cheerleader when the whining starts or an advocate when navigating a foreign medical system.

While we have a few health issues we’re generally fairly healthy but we’ve needed to find a doctor and /or dentist several times and in several countries in our two years of travel. When in need of medical care we’ve availed ourselves of our contacts to gain access to proficient heath care. We’ve asked the people from whom we were renting, reached into the expat community for advice and inquired through language schools or NGO’s where we were volunteering. It boils down to relying upon the knowledge of those who live in the community.

Once it became clear that Enfermo was not going to become well using our emergency supply of medications we reached out to find assistance. The fastest response came from our apartment manager who found a doctor who specialized in respiratory diseases; a pulmonologist by training. An appointment was set up for that afternoon and a taxi took us across town to the Clinica Americana, which, while only a block from the Malecon (the walkway along the beach), looked rather rundown on the outside and, while clean, old-fashioned looking on the inside.

Upon our arrival we were warmly greeted by the doctor who introduced us to his wife seated at the reception desk. The doctor spoke some English but called in his daughter, an outgoing second-year medical student, to join us and assist with the translation during the examination. We spent an hour in the doctor’s office during which he examined the patient and we all discussed Enfermo’s medical issues. We also engaged in conversations about the Doctor’s travels in the US to attend medical conferences and our travels in Central America. Before leaving, the doctor provided us with a prescription for medications we would need to pick up at the farmacia (most are available for the asking without a prescription). He most generously gave us samples of medications which we would need or were currently using. With a follow-up appointment in hand we willingly paid the nominal $40 consultation fee and departed.

The following week found us back for the scheduled appointment with the daughter again in attendance to assist with any translation difficulties. Poor Enfermo’s cough had improved but the feeling of fatigue and shortness of breath had become worse. A breathing treatment with a nebulizer was administered and the doctor doled out more samples of different antibiotics used in a combination one-two punch against the offender, bronchitis. He also graciously loaned us a nebulizer to continue a few more breathing treatments at home. Enfermo left the office a half hour later with new prescriptions, a third appointment date in another week and a more positive outlook about the prospects of a future recovery. We, again, gladly ponied up the nominal fee.

our favorite pharmacy!

There is an old saying that, “When you have your health you have everything” and at no time in our lives has that saying been more true than when we’ve been traveling. Being of the baby boomer generation we are much more aware of our health than, say, a traveler in the twenty to thirty year-old range. Realistically, we know that this is the best our health will ever be, right here and now. Additionally, we travel as partners sharing the fun and also the not-so-fun times that come with traveling as a lifestyle. We’re fully cognizant that pursuing our travel dream could come to a standstill if one of us becomes seriously ill.

Recuperating in our new home

Enfermo is much improved and, after being holed up in our apartment for an interminable period, we’re now looking forward to exploring Manta and Ecuador and sharing it with our readers.

By Anita and Richard September 2014