The past two weeks have been intense and overwhelming, Yesterday marked my third week in Ecuador, and sadly, I feel like time is going faster than I hoped it would. With all the traveling I’ve been doing, taking six classes in Spanish, and starting my Giving-Back Project, it’s not surprising that I’m losing track of time.
This week I began my Give-Back Project. I will completing a Community Health rotation in a rural clinic, the biggest of 8 that encompass the area of Quito. Every Wednesday until the last week of December, I will be going into the clinic and seeing patients, most of whom represent the under-privileged population of Quito.
Having grown up in Costa Rica as a member of the lower class, I thought I would be more familiar with the public health system in Latin America. My earliest of memories, and some of my worst, recall all the days that my grandmother woke me up at 5am to walk and get in line at our hometown clinic. Some days we got lucky, and other days were far more crowded and forced us to return the next day, once more before the sunrise. I thought my experiences were going to prepare me for my 6-hour weekly shift at the clinic, but needless to say, they didn’t.
I was put in the clinic immediately to see every patient that morning and take their vital signs, give injections, and perform heel prick tests on newborns. Right away, I noticed the differences in access to healthcare and resources in this country, and was forced to break out of my comfort zone. The shortage of medical resources in the clinic was evident, with the lack of gloves, hand sanitizer, and soap. I saw about 70 patients that morning; older adults, newborns, children, and women, but the most shocking was the amount of 12-16 year old pregnant girls. This clinic sees an average of 385 12-16 year old pregnant girls annually, a big number for such a small town, and on that morning I saw 5. Other children were showing signs of growth failure, and others presented high fevers. Being a nurse in Ecuador is completely different than being a nurse in the United States. I went from having 1-2 patients daily, to almost 70; from washing my hands or sanitizing before and after seeing every patient, to not doing so during my whole shift; from feeling victorious and joyous even at the face of illness, to feeling defeated and hopeless. As much as I want to believe that devoting my skills and time to this under-resourced clinic will somehow change something, I have begun to realize that this is a greater issue of our global society, one that denies decent healthcare to those who can’t afford it.
After my shift, I came home feeling sick and upset. The nurses at the clinic didn’t seem to want to get to know the patients the way that I was taught. One of them yelled at a 6 year old for breaking a thermometer, saying, “they won’t give me money for new ones! Doesn’t anyone understand that?” Nursing school has taught me that nursing is all about the connections you make with your patients, the care that you give to them, not just physical but also spiritual. At times when I’ve felt defeated knowing that there is no hope for my patient, I have survived knowing that at least I had to the honor of occupying a part of their day, of getting to know little details of their lives. Somehow, somewhere, nursing here became something different. With two nurses caring for all these patients, all therapeutical communication was lost. It’s not the nurses’ fault either; they have to see all the patients, handle the paperwork, and transport the paper work. The challenge isn’t getting through the day, it’s getting through all the patients.
That night, deep in thought I asked myself why I chose to be a nurse. My biggest weakness is my easy attachment to others, and that day my heart broke about 10 times. The time the nurse told the mom that her 6 year old daughter had fallen below the average growth range, and the time that the 13 year old girl expecting twins smiled enthusiastically, and the time that the nurse informed the parents of the newborn that their child wasn’t doing well. I came here to find knowledge and excitement about my future caring for others, but instead I’ve began to question everything I thought I once knew.