6/17/04 (Thursday)

Up by 4 AM to shower and get ready for our day of travel. Jane is to pick me up by 5 and we are off to San Lorenzo. She didn’t want to travel there yesterday because the last leg of the journey would be at dusk to dark and possibly unsafe. We will see some patients this afternoon into evening and start developing our surgery schedule. Our anesthesiologist arrives on Sunday so we will begin our surgeries Monday morning. Quito is almost 10,000 feet up and 10 miles from the equator. Jane says the climate is the same year round, 70s in the day, 50s at night. San Lorenzo is at sea level and will be warmer…much warmer.

9:30 PM. After a 5 hour trip through some spectacular mountain scenery, including volcanos and snow caps, we made it to warm and humid San Lorenzo.

Clinic entrance

House where we stayed

Intake Room, vital signs

Medical doctor

Pharmacy, Clinic office

Patients waiting to be seen

Operating Room

Jane's office

The Post-op Ward

Post-op beds

The small clinic has some nice guest rooms, 1 operating room and 3 clinic rooms. A general medical doctor was seeing patients and a dentist was also working. Jane and I started seeing people who arrived very early and were waiting. By 9:00 PM we finished with 30 patients, scheduled several big surgeries and sweat gallons in the hottest room I have worked in. My clothes were soaking wet. The day went slow because Jane was translating what I was telling her about the problems we encountered. One lady has cervical cancer by biopsy and is probably a Stage 1B. Radiation therapy is not available and the patient has no money to seek any care in Quito. Jane and I decided to do a radical hysterectomy in hopes of stemming her disease. She cried and her husband cried. It was a difficult time.

The people patiently waited all day to be seen. Some waited at least 12 hour or more. They were very thankful to have the opportunity to get medical care. The clinic is in a very poor area with homes similar to the poorest areas of Santo Domingo, D.R., or in Manila. Quito is much more upscale and definitely cooler.

Jane and I are going to eat and review the day and then hit the sack. Tomorrow is another big day. We will see patients all day tomorrow, all day on Saturday and then rest on Sunday. Monday will start a week of surgery all day, every day.