Our guardian, Martin

Martin with Dr. Mimi's daughter

If Mari is our angel, Martin in our guardian. Martin (pronounced like Martina without the 'a'), is Mari's older brother and the coordinator of our mission. He makes sure we get to the church every morning and to our hotel every afternoon. He has been our tour guide around Quito, and counts our heads like a mother hen, rounding up those who lag too far behind (for some reason, it's usually me). Pickpocketing has been honed to a fine art here, so he is constantly cautioning us and keeping us within reach.

We insisted on visiting the local market a block down from the church where we have been working, because we've seen so many patients who work there, mostly middle aged women who look years older than they are and complain of back and leg pain from standing all day. Martin thought it was too dangerous, but we were undeterred, so he finally gave in today and walked us through. We had already seen half the people who work there, so it was like visiting old



 friends. The market is housed within a open-sided, graffiti covered cement and metal building. The air--heavy with the stench of rotting meat--hits us as we walk in. There are tiny meat stalls-- that hog's head is for sale--lining one wall. The middle hallway is bursting with color from an incredible array of fruits and vegetables, far more than is found in the US. A woman sits hunched over an old manual sewing machine in a third hallway--I remembered her from our first day, complaining of headaches and back problems, no surprise there--it's hard labor.  We see an acorn squash as big as a pumpkin.






Outside along the back wall are the grain stalls with burlap bags full of corn, beans, wheat and other grains. Children work along side their parents--one boy of 10 or so comes out with black rubber gloves on-- I wonder what type of work he is doing and how hard it is. A traditionally dressed woman sits on the sidewalk shelling some type of flat bean with her son. He asks me to take his picture- yay! Thanh and I take pictures, and his mother asks for money for the photography session-- seems like a fair bargain to me. The picture taking, however, has separated us from the group and poor Martin must retrieve us, with a sigh. I am sure he is very happy when we get into the van and head home. It was very instructive, however, to see not only how hard people labor, but where the neighborhood buys their food and goods.

Neighborhood market--notice the broken bottles that line the top of the walls

We were able to finally tour the market today because we actually finished on time. We had asked for less patients today (we saw 60), as Dr. Mimi (Choate) went to Camp Hope with Mari to do Pap smears on the staff, so we were a doctor down at the church. While Mimi did pelvic exams using an upside-down hospital bed pan and a headlamp in place of stirrups and a lamp in the blue infirmary at Camp Hope, we were once again greeted by a waiting room full of patients from 45 days old to 80 something. Gotta love family medicine. The last patient we saw yesterday-- the one who had helped me bring order to the chaos of the waiting room--was there with the rest of his family this morning. Since he had sat from 8 am until 4 pm with his two year old son the previous day, I took them as my first patients-- probably out of order (don't tell Martin! Martin had the clinic VERY organized today-- the #'s were stapled to the chart notepaper and every person had their own number and was seen in order). This family arrived from Columbia 8 days ago with their 45 day old baby, and they were concerned about him. The mother (20 years old) asked about her weight, as she sat and breastfed her baby-- she weighed 88 lbs, far below normal for a 20 year old. Her ten year old brother said "hello" in English, very proudly. We passed out a lot of vitamins and calcium and advice on diet. They were just the nicest family ever.

Remember Edison from our first day? The one with the seizures....his mother returned today with his seizure medicine level and reported he hadn't had a seizure since Tuesday when Dr. Carrie (Wilcox) increased his dose. But the mother was out of medicine and out of money-- and we had neither to give her. Angel Mari, however, has a friend who works at the Children's Hosp, and this friend was able to secure an appointment with the neurologist to see Edison next Wed. Normally to be seen at Children's, the parents have to stay overnight in the street in a queue in order to just be able to make an appointment to be seen in a few months. Score, Mari!

The true hero's of this story are the Ecuadorians who have dedicated their lives to caring for and about the poor in their midst-- from the pastor and his wife who provide breakfast to the poor every morning, to the social worker who is with us every day, to Mari and Martin who have given up their lives for two weeks to shepard us and are always doing something for Camp Hope, to the teachers and therapists and volunteers that allow this to happen. People are very appreciate of the time we spend with them, but the reality is they need care over the long term with followup and monitoring-- which we can't offer. I hope the longer term benefit will be for someone like Edison, who perhaps wouldn't have been able to get into the system without first being able to come to a free clinic. Maybe. No se'. Tomorrow is our last day of our church clinic in Calderon. Next week we begin our work at Camp Hope.