RealInternships: Casey Miles

The Foundation I am working at is called Fundación Metrofraternidad, and it is associated with Hospital Metropolitano, which is the best hospital in Ecuador and one of the top-ranked hospitals in all of South America. As you can see in the photos, the office of Fundación Metrofraternidad is brand new and beautiful. Personally, I think it is wonderful that the office is so nice and clean, because all of the patients are very poor and it’s important for them to feel as though they are valued and important enough to receive top-quality medical care in such a nice facility.

I spent the first month of my internship working directly with the Foundation’s social worker; she is the first point of contact for all patients who come to Fundación Metrofraternidad. I spent my days working with her in her office, talking with patients, taking medical histories, and opening electronic medical records for new patients. This week, however, I have started working with the medical side of the Foundation. In addition to helping the two nurses file lab results and locate patients’ medical records to prepare surgical notes, my most important job is organizing the Foundation’s pharmacy. All of the medications that Fundación Metrofraternidad gives to patients are medical samples that doctors at Hospital Metropolitano receive and send directly to the Foundation. The samples arrive from the hospital jumbled in big, black garbage bags. I spend the first 4 hours of my day taking the medications out of the bag and organizing them by type of medicine; not only do I have to check the expiration date of all medications to make sure certain types of medications will be functional for the patients, but I also have to figure out what each type of medication is for. It has been quite a learning experience to say the least. After sorting the medications during the morning, I spend the afternoon placing and organizing the medications on the shelves. As you can see in the photo, the pharmacy is a rather confined space, so it has been a challenge to organize the medications in a limited space. It might sound boring to organize medications, but I am truly enjoying it and looking forward to the next few weeks when I can improve the organization system in the pharmacy to make it easier to navigate for the doctors at the Foundation so that they can write prescriptions with greater ease and serve more patients the medications they so desperately need.

During the first week of July, my supervisor at Fundación Metrofraternidad gave me the opportunity to go out to the jungle of Ecuador to work with one of their partner organizations, Timmy Global Health. So, I hopped on a bus and rode for six hours out to the city of Tena, Ecuador. Every day during the week that I was in Tena, I spent the morning hours in the office of the government-employed Health Promoters talking with the Health Promoters and helping them make calls to patients to inform them of upcoming medical appointments either in the jungle town of Tena or in the capital city of Quito. Below is a photo of the building that houses the Health Promoters and everything to do with public health in the entire province of Napo. This single building serves as one of a few free clinics for the entire province of over 80,0000 citizens.


Each afternoon, I went with two Health Promoters to drive out to visit the rural villages in the province. To reach the villages, most of which were at least two hours away from Tena, we drove in a pick-up truck and trekked across rivers, gravel roads, and even had to take a ferry to cross a river to reach an exceptionally rural village. Each day we visited between six and ten communities; each community was a variation on a theme and looked a lot like the photo below.


Upon arriving at each community, we approached the house of the president of the community to greet him and converse. First, we informed him of the next date when a medical brigade would be near the village. Due to the fact that the villages are so rural, it is nearly impossible for the villagers to receive health care (other than the rituals performed by the local “chamanes,” who are the spiritual leaders of the communities). So, once a month, a group of Ecuadorian and international doctors travels out to various communities to give as much care as is possible out in the rural locations. If the doctors encounter patients who have more serious needs than the doctors can take care of on-site in the villages, the doctors refer them to hospitals and clinics in Tena and Quito. So, the second half of our job out in the villages was to pick up any patients who had medical appointments in the next few days to bring them back to Tena with us. One village that we arrived at happened to be in the process of electing their new president. The photo below is of the community meeting.

The election of a new president is a celebratory event, so I was served the traditional celebratory drink of Cheecha. In the indigenous culture, it is highly disrespectful to refuse any item you are presented with, so I drank the Cheecha; Cheecha is a not-so-delectable drink made of mashed potato fermented in its own juices and then mixed with river water. Although drinking Cheecha is something I do not plan to do again anytime soon, the community gathering gave me a wonderful opportunity to talk to numerous community members about their health related to their rural jungle lifestyle. I sat with the community members, drank Cheecha, and basically had a Q&A session about health concerns. I felt as though I was able to help community members on a 1-on-1 basis with a variety of medical concerns, and I successfully did it all in Spanish, which helped make it an even more memorable and meaningful experience.

All in all, my summer working with Fundación Metrofraternidad has been a series of one eye-opening experience after another. From sitting in the office in Quito listening to heart-wrenching and informative stories of the patients to having the chance to learn about rural health care while driving around with native Ecuadorians in the jungle, it has been an amazing experience

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