Reflection: An unforgettable time in Ecuador and working in Pablo Arturo Suarez Hospital

It has been an incredible time in Ecuador which makes this an even more difficult time saying good-bye to everyone at the hospital, friends I have made, and the country itself. The privilege I have had to learn, work, and observe the healthcare system is truly humbling and I feel so grateful to return back to the United States safe and healthy.

I walked int11931685_10206815787186424_485108242_no my internship at Hospital Pablo Arturo Suarez pretty unsure of what to expect. Luckily, I realized I had a great amount of freedom and many opportunities to converse with healthcare professionals and patients everyday while performing my expected duties. A pretty big goal this summer was to learn Spanish medical terminology because I personally find it critical to be able to communicate effectively in another language as a doctor in our healthcare system. I found that over the course of the summer my knowledge expanded exponentially as I could keep conversations which conveyed medical information with patients.

Another goal which I accomplished which was inspired by the class called American Healthcare at Brandeis was to observe and compare and contrast the different health care systems. Keeping this goal in mind really helped me shape the conversations I had with my mentors and doctors at the hospital. I also learned a lot about how culture differences can really impact medical differences such as in the difference in privacy practices in Ecuador (which is very loose) compared to those of America (more strict). Although there were many differences that raised a red flag, the healthcare system was incredibly effective and is catching up to the west every day. As well, the cost of medical care is incomparably cheaper. If you go to this link, you can read how much cheaper it is to get basic procedures done which changes the quality of living you can have.

This experience has certainly helped me reaffirm by desire to pursue medicine as a career. Even more than reaffirm this passion, it has made me realize the privilege I have had growing up in the States and the great healthcare I’ve been able to receive. I realize more each day how important it is to give to those who don’t have access to healthcare the agency because of the tremendous impacts it can have on a persons quality of life. I know in the future I want to purse nonprofit/ volunteer opportunities here in America or other places in the world where this is a severe problem. By doing this, I know I want to expand my knowledge in public health and really focus on preventative/ holistic measures as mean of solution.

Mitad del Mundo--or the equator!
Mitad del Mundo–or the equator!

I would recommend anyone with an open mind, a passion for the medical field, and an ability to be flexible to volunteer at this hospital in Ecuador. Many times in order to get a fulfilled day it was up to me to take initiative and engage. A lot of succeeding and feeling accomplished each day came from a personal motivation to make the most of it. A personal goal/ reason for coming to Ecuador was to explore my own heritage and culture. I am half hispanic and immersing myself in Spanish and Latin culture was really wonderful for me to self-identify with. The ability to challenge myself with spending a summer in an unknown country and handle different mishaps along the way is by far what I am most proud of. As a whole, I would recommend anyone to travel and explore the country Ecuador–and even according to NBC News, it is possibly the best place to retire!

– Paulina Kuzmin ’17

Halfway in Quito, Ecuador- Hospital Pablo Arturo Suarez

El Pancillo statue which stands in the historic center of Quito

Working in the hospital for the last four weeks has been an incredibly fulfilling and engaging experience. Additionally this experience has illuminated the underpinnings of a foreign health care system first hand. From 7am-12p.m I assist the nurses, doctors, and patients to  the best of my ability in order to help the day run easier and quicker. The medical culture in Quito is quite different than that of the States- there is a much more relaxed and calm aura, even in the emergency rooms, female doctors and nurses spend full days in heels, and there is often many patients in a consultation room. Beyond these small observations, however, the desire to improve and get up to speed with western medicine is evident and exciting to watch. All of the doctors and nurses I have assisted have been warm, inviting-and love explaining everything they do in a way that I can understand. Life in Quito has also been very interesting. Ecuadorian culture has been wonderful to be a part of and observe-as it is heavily tied to family, Catholicism, and salsa dancing which serve as channels to meet locals. The history of Quito and Ecuador as a whole is also fascinating and the more I learn, the more I have come to understand the evolution and reasonings of the health care system here.

imageI have also had the chance to connect with many volunteers in the hospital from around the world. It has been really interesting to hear about their countries’ healthcare system in contrast to that of Ecuador. Given the opportunity to converse with healthcare professionals and learn hands-on has been an experience completely different from studying at Brandeis. I have gained many medical skills such as taking blood, stitching, and taking vital signs which are skills that I would not attain until later in medical school. I have also learned that 80% of Ecuadorians use the universal healthcare system, which is supplied by the government. Unfortunately, there are not enough hospitals to support the demand. Consequently, often the hospital I work at and others in Ecuador tend to be in hysteria, with as many people jammed into the waiting rooms as possible. A great article that discusses these issues can be found here. As the United States moves toward universal healthcare, I think it will be important to recognize the weaknesses of other universal healthcare plans to know how to structure and improve it. If you are interested in a quick synopsis of the healthcare system in Ecuador, PubMed does a great job.

San Francisco Plaza- Historical Center
San Francisco Plaza- Historical Center

A skill that I have gained and am continuing to work on is my ability to communicate in Spanish to the patients, doctors, and other healthcare professionals. More than becoming well versed in Spanish medical terminology, I have been more confident in approaching doctors and nurses and asking them about their experience and what they do. Finding the confidence to follow my curiosity in a very different culture is something that I was afraid I would be unable to do. I look forward to continue pursuing my curiosity academically, as a future healthcare professional, and as a visitor in a foreign country.

– Paulina Kuzmin ’17

Working in Hospital in Quito, Ecuador

My internship abroad has thankfully taken off smoothly and my first week at Hospital Pablo Arturo Suarez has been an incredible learning experience so far.

imagePablo Arturo Suarez is a public hospital located in the north end of Quito, Ecuador.  The significance of this hospital is the fact that it is indeed public and therefore many people from all over Quito and the surrounding areas come if they cannot afford private healthcare. Most of these public medical institutions are highly understaffed due to the shear amount of people that are constantly coming in and out. The mission of the hospital is to promote quality care by educating patients on the necessity of preventible care, recovery, and rehabilitation of all peoples regardless of status or ethnicity. This dedication to social justice in Latin America really inspires me to pursue learning about the injustices of the health care systems both internationally and at home-in America. If interested in knowing more about the hospital and all of the departments it offers, you can click here.

Looking down on Quito from Pichincha Volcano
Looking down on Quito from Pichincha Volcano

One of my goals this summer is to observe the Ecuadorian healthcare system, and to compare and contrast this system to the United States healthcare system. An important cultural aspect in Quito which is very unique, is the presence of an indigenous population(s). Many peoples seek healthcare from these public institutions; Pablo Arturo Suarez has made a point to label most signs in the native language. This brings up an issue that is often faced in America: cultural and language barriers and their effects on quality care. I hope to understand how doctors in Ecuador try to effectively communicate and explain certain treatments while ensuring the understanding of all patients. The indigenous population still very much treasures traditional and alternative medicine and it will be interesting to see how this coexists in a very modern city. If you are interested in Ecuadorian culture and the synthesis of peoples who live here I recommend visiting this site which gives some historical background.

Another goal for the summer is to become fluent in Spanish medical terminology and gain confidence in effectively communicating to Spanish speakers in regards to their health and treatment. As mentioned before, language barriers can cause detrimental effects on patients. In the United States, the second most spoken language is Spanish. I felt that as someone pursuing the medical field I should be bilingual-if not more- in order to be able to give the best care possible.

As far as my duties go at thIMG_5713e hospital, I generally assist in places that are understaffed and undertake projects of the day that need to be done. This includes taking patients vital signs, assisting doctors during procedures and surgeries, and organizing paperwork. I will hopefully get a well-rounded view of the way a public hospital runs in Ecuador and how a healthcare system works as whole.

– Paulina Kuzmin ’17