Medical Missions

7:00 AM.  I had a somewhat short but restful night in the hotel.  After repacking all the things for the river trip, I then finished my book finally turning out the light about midnight.  The hotel provided a hot breakfast of scrambled eggs, Mora juice, bread and hot cocoa.  The Mora juice was straight from the blender and was delicious.  Mora is like a raspberry and is a favorite fruit here. 

Jane and I left the hotel about 7:30 and met Raquel at HCJB headquarters.  We then left Quito for San Lorenzo.  The mountain scenery was spectacular as we wound our way through the Andes to sea level and San Lorenzo.  I was feeling the altitude a little this morning with a slight headache and some nausea.  Breakfast helped but getting to sea level was the trick.  I did experience some motion sickness enroute to San Lorenzo.  Once there I took some Dramamine and my symptoms disappeared.  I wasn’t sure what the road to Borbon would be like or the canoe trip so I thought the Dramamine would be a good choice. 

We unpacked the car and I was able to get my laptop configured for email.  I sent Phyl a quick note.  We then went to a phone cabin for a call to Ft. Wayne that Jane needed to make.  I took advantage of the phone and made a quick call to Phyl and surprised her.

Jane and I then went to Borbon and found this place very congested with some sort of festival.  We had to work our way around town on some other streets and finally found the canoe.

The streets were narrow and crowded with people and vehicles of all types.  I did not get a picture of the area where the streets were totally packed with people.  We did drive through there but had to just creep along as people would not get out of your way until you almost touched them with the car.  They didn’t seem to be bothered by a car moving though the crowd.  There were merchants selling things and people just milling around.

Borbon was much like San Lorenzo although San Lorenzo does have some paved streets and a downtown area.  You saw the three-wheeled carts powered by bicycle pedals carrying people and things long the streets.  The streets were packed dirt and mud holes and litter as well as dogs everywhere.

I’m not sure how this big semi got in there.  There were men loading it with lumber.  The trailer was sitting across an intersection and men were carrying lumber from a big stack next to a business walking about a block up the street to load it on the truck. 

We passed the local meat market.  This type of business one would see most anywhere.  I don’t know how the Board of Health would view this practice.  I remember seeing similar sights in the Dominican Republic and the Philippines as well.  The meat is raw and hanging on hooks and usually there are lots of flies buzzing around it.

Along the river front was this little park area that had some benches and places where one could sit and let the world pass by for awhile.

This truck was driving along with a long pipe in the bed.  The pipe was dragging on the ground.

A look at the river as it flows past the waterfront at Borbon. 

While waiting to get in our canoe, I watched a couple men carrying lumber from a floating raft of large pieces of lumber.  This raft apparently came from up river and they had stopped it here.  These men would go in the water and get under the large pieces and then haul them up the bank and across the street to a large stack of lumber and off load them there.  These pieces were probably 8 to 10 feet long and 6 to 8 inches wide.  They looked like railroad ties.  These guys were barefoot climbing up a wet and slippery bank with this piece of wood on the shoulder.  The one guy had a towel he would put on this shoulder to give a little padding.  I imagine these pieces of wood were quite heavy even when they would be dry.  I stood and watched them make several trips carrying one piece at a time up the slippery river bank and over to the wood pile.  They didn’t stop to rest and didn’t seem to be really straining with the amount of effort that I would have to exert to carry these pieces of wood. 

One guy is up near the top while the other is coming out of the water.

This man was one of our motorists, the guys who took us on the river.  Our canoe is sitting there waiting for us to board.  He and another man were our drivers.  Jane said Raquel uses this canoe and these motorists all the time for her river trips.  He was packing the canoe with our gear and the things Raquel was taking along for her work.  There was a lady on the edge of the bank doing laundry.  That scene we saw all the time along the river.   

The canoe was long and narrow.  Jane, Raquel and I sat on plastic lawn chairs that had the legs cut short.  Our supplies were packed near the bow and covered with plastic to keep them as dry as possible.  It is all ready for us to get on board.  I sat in the first lawn chair with the bags sitting in it.

We are leaving Borbon.  The canoe cut through the water generating a small wake.  It actually was fairly stable in the water in spite of being long and narrow with a round bottom.

The top yellow marker is at San Lorenzo.  The yellow line is the Colombian border.  The middle marker is Borbon.  The bottom marker is Zapallo Grande.

We followed the Cayapas River, which is visible on this image as a fine blue line.  The trip with the powered canoe took about 3 ½ hours.  I went on Google Earth on the Internet and was able to download the images above.  This allowed me to zero in from satellite images to where we were going and see it in good detail.

This is a closer view of the river and the area around Zapallo Grande.

This map was drawn by Raquel and it shows the various villages that she visits on the various rivers.  Zapallo Grande is the 5th red dot from the bottom of the picture near the middle.

Raquel is as nurse who oversees the river blindness treatment effort for HCJB and the Ecuadorian government.  All of the dots on the map represent villages she visits at least twice a year to administer the medication for river blindness.  Because of her effort, this dreaded disease is all but eradicated in Ecuador. 

A typical shot of the river bank.  At times the river bank was low and flat.  At other times it was a steep hill.

This was a small village along the way.  Canoes would be moored at the water’s edge with steps or trails leading up the bank to the homes.

Another village showing the typical houses common to all the villages.

Steep river bank with lots of vegetation.

Another village.

Coming up to Zapallo Grande.

The steps leading up the river bank at Zapallo Grande.  The building at the top is the hospital.

Once we arrived at Zapallo Grande we unloaded the boat.  My duffel bag was covered with ants!  There was a major cluster of ants stuck between the outside pockets.  I think they were already building a big nest in the time the duffel sat in the canoe.  I had to do a lot of brushing and shaking to get rid of all the ants.  Welcome to the jungle! Our quarters are very primitive and should be interesting.  I do have a nice mosquito net that totally covers me like a house.  The net lies on the bed with the mattress inside it.  I have the bed made and soon I’ll be heading there for some sleep.

Looking from the front porch of the dormitory where we slept and ate to the hospital.

Our neighbors on the other side of the dormitory.

The lodging is a step down from San Lorenzo – more like the Chicken Hilton in Santo Domingo.  Somewhat of a culture shock compared to home!  Yet, I feel God called me here and Jesus wants me to walk with Him here for the next few days.  I feel confident He will provide and care for me. As we pulled up to Zapallo Grande on the river it appeared to be a village of several hundred people.  We went for a half-mile it seems along the shacks (homes) before we came to the spot where we would disembark.  I remember the pictures Dan & Judy Smith showed of their river ministry on the Amazon and its tributaries.  Zapallo Grande must appear much like the villages they visited.   

The clinic area is a building on stilts as is the lodging building next door.  Both buildings are sizeable.  The lodging has 4 bedrooms, kitchen, dining area and sitting area.  There is an Ecuadorian dentist who works for the government.  He works here for 22 days and then gets 8 days off.  A physician also works here with the same arrangement.  A nurse who works with Raquel and a physician who is either in his last year of training or in his rural year arrived to stay with us as well.  This nurse and physician will be traveling each day up river to various villages to distribute river blindness medicine to the people.  We will be working in the “hospital” next door to see patients.

My bedroom.

My mosquito netting is in place.

The community toilet facility.

The kitchen area.  We poured boiled water into the white 5-gallon bucket which filtered the water as it drained into the bottom bucket.

The front room.  Jane and Raquel slept on mattresses on the floor.

The bathroom sink.

The shower.

The team at a meal.  From left to right, Annabelle, a nurse who helps with the river blindness medication distribution.  Jane.  The fellow in the white shirt at the end of the table was a physician out of medical school who also was helping Annabelle.  The fellow standing in the yellow shirt was the general practitioner who works for the government and is assigned to Zapallo Grande.  The other fellow in the white shirt is one of the helpers and also works as a motorist.  The fellow sitting in the yellow shirt is a dentist assigned to Zapallo Grande, also works for the government.

Raquel is at the end of the table.  She is the one in charge of the river blindness project.

A local lady was our cook.  Here she is smashing plantain into a thick paste.  She is beating the plantain with a rock in one hand onto a large stone on the counter while Raquel fills plates.