Which country did you visit? Ecuador

Year of visit: 2017

Which region/city were you in? Cuenca- Azuay

Name of hospital/clinic: Mix of local hospitals and GP's (rural) and mobile surgical truck

Government run hospitals and truck was a charity

Rural and Urban location

How long was your placement for? 8 weeks

Planning the elective

Why did you decide to go there?

I wanted to go to a developing country that was in a part of the world I'd not been to. I also was hoping to get my medical Spanish better. I loved the sound of a mobile surgical truck as they did monthly trips for a few days a time into remote villages in the amazon to deliver healthcare and perform surgeries. Ecuador is also a really interesting country where bus travel is easy!

How did you come across this opportunity?

I found the organization online.

What funding sources did you use?

Through a combination of small bursaries from trust funds especially for medical electives in developing countries, working in a café to save up, and help from the university.

Was accommodation arranged for you?

Yes- the charity can put you in contact with a lady who hosts medical elective students. I lived there with 3 other medical students from the UK and USA. It was a good way to meet people to explore with.

What was the total cost of the elective?

£3000 (flights + accommodation + placement fee with organisation)

Were there any unforeseen difficulties?

I found that if I hadn't spoken Spanish well, I would have struggled with getting around and maybe gotten into some sticky situations as it is rare that people there spoke English.

Placement experience

Did you undertake a clinical elective? If so, please describe your experiences:

Yes- it was very varied, I did days at the rural GP's and going with local medical students on rural projects. I also spent time in hospitals on obs & gynae wards, general medical, surgery, paeds and did a night shift in A&E. On the rural trips into the Amazon I helped scrub in theatre and did the post-op monitoring as well as helped run the pop-up GP clinics.

Describe the support and supervision at the placement:

Really good support, there is a lady who is in charge of the administration there who contacts you to see what your interests are so she can specifically organize placements in those areas. She carries out an induction too.

Wider community

Did you interact with the wider community? If so, describe your experiences:

Yes- I made friends with local medical students who took me out on projects in the surrounding rural areas to help the local community. i.e. we went to help clean and rebuild a local elderly lady's house.

I also volunteered in the afternoons at a charity called 'Hogar de Esperanza' who house and help people with HIV. I worked closely with one lady helping her with physical rehabilitation so she could look after the 2 children.

I attended a local international church as well as went to a few services at the local Ecuadorian church.

Describe the area you were living or working in:

A big town in the mountains of Ecuador, pretty central. Easy Taxi from Cuenca airport to the host house. A few hours bus ride from the beach, and the jungle and volcanoes. A bit chilly though!!

Describe key things you learnt about the culture you were in:

Ecuadorian culture is very warm, everyone likes to say hello to everyone. I possibly came off slightly rude at the start when I didn't realise this, but quickly caught on…

Salsa is a huge part of the culture, we went to the local weekly Wednesday salsa evenings at 'La Mesa'

Describe what you found easiest/hardest to adapt to:

There is also a drinking culture where I was which was difficult to say no to, as I could not often explain easily in Spanish. I also found it hard as a young woman on my own- I would recommend going with another person as I sometimes felt vulnerable.

Value

What have you gained from this elective?

I learned a lot about rural surgery on this elective, seeing how little resources they have but how it can go a long way if used well.

How has this experience shaped your thoughts about your future location/specialism in medicine?

It encouraged me to continue developing my interest overseas medicine as I realised this is what I feel most passionate about. I realised how privileged we are here in the UK with NHS resources.

What has God taught you?

God taught me on this trip that we are never alone. Going on my own there were times I felt lonely and wished I'd gone with friends but this also gave me lots of time to grow in my relationship with God. I'd only been a Christian for about 1 year at the time so this was an important period of growth. I also realised how he uses us all in places that can seem so random, how he led me to find the charity 'Hogar de Esperanza' and used my (lack of) medical skills in such a simple way.

What advice would you give to anyone else considering an elective in this setting?

I would recommend going if you don't mind going somewhere not too warm. I would go in a pair or small group and would possibly do 4 weeks here (Asking to go on the amazon trip) and 4 weeks in another nearby country. Stay with the host family as they were so welcoming and the host knows all about the programme and where to find everything. Make the most of being in a country where things are (relatively) nearby and use your weekends to go exploring. Feel free to get my contact details for ideas for exploring!