Outbreak Investigation: Ecua Stomach

This blog post is going to be a special treat for all of my Infectious Disease Epidemiology friends (lemurs, if you will). I have prepared an outbreak investigation about my recent bout of Ecua Stomach, which happened to be the worst I've experienced.

In Ecuador, the Day of the Child (Día de los Niños) is a pretty big deal. As a result, I spent the morning in a party for the children of Estero de Plátano, which happened to include a cake. The cake was left out for about 3 hours before we ate it, and probably longer than that since it had to get to Estero from Atacames. Regardless, I have a pretty cavalier attitude about the strength of my stomach and I ate it anyway. Sometime after dinner, I begin to hear the stomach rumblings that signaled trouble on the way. Early the next morning, the worst case of Ecua Stomach I've ever had began.

My philosophy on Ecua Stomach has always been that you just have to let these things run their course. At Day 3, my philosophy changed and I was ready to try anything. Unfortunately, Day 3 was a Saturday and the Health Subcenter wouldn't be open again until Tuesday. So I took some random pill that I bought from a tienda. Which sort of worked, but not really. Next, I submitted myself to an especially interesting cure: having an egg rolled all around my body and being crossed. At which point the egg is cracked and put in a cup of water to see how much of the sickness it pulled out of my body. Surprisingly, this remedy also failed.

On Tuesday, Day 6, I went to the Health Subcenter where I was given some random pills that I had never heard of and some rehydration powder to mix with water. I don't know what the pills were, but they worked. Finally. After 6 days of becoming very well acquainted with the bathroom in our hostel, I felt like a person again. And now I'll know better than to be overly smug with my "stomach of steel."

So, my faithful IDEpi folks, what did I have? Assuming it was the cake that did me in, I would put the incubation period at about 6 or 7 hours. I would guess I was probably headed toward the end of my symptoms by the time I took the pills, so duration of about 6 to 7 days. The fruit on the cake may have been the actual culprit, or it may have been your typical fecal-oral contamination through little kids touching the cake while they desperately tried to wait 3 hours to eat it. I await your answers.

Ahora mismo, ya viene

The two weeks since I touched down in Quito have passed in kind of a whirlwind. I spent a few days in the Yanapuma office getting ready to go to the coast and left after only having been in Quito for 2 days. Since arriving in Estero, I´ve completed bacterial cultures of different water soruces, done 20 household surveys about water, danced salsa, gotten stung by a jellyfish, and helped build a hostel.

When comparing this trip to Estero to my time here last summer, the contrast is fairly striking. While last year I was frustrated by the lack of real, solid work to do, this time I´m exhausted by how much work there is. The Artisan´s Group is racing against the clock to finish building their hostel, the Women´s Group spends every Sunday making ceviches and almuerzos to sell to tourists, and every afternoon from 4 to 7 is spent in the library helping with homework. And in between all of those responsibilities I was also trying to fit in my water project. Luckily, I´ve finished all of my water stuff for now and I can focus on other things for Yanapuma.

Amidst all the changes, there are still things that remain the same. I still spend Saturday nights with ¨los muchachos,¨ who delight in asking me when I´m going to bring my sister for them to marry. The two main (and only) drinks in Estero are the national beer, Pilsener, and aguardiente. The answer to anything regarding time is always ahora mismo (right now) or ya viene (it´s coming right now), while the reality could be a wait of an hour or two. And of course, the most important thing of all is not to be ¨brava¨ (grumpy).

I have a little less than two weeks left on the coast, at which point I´ll be headed back to Quito to continue working in the office and looking for a job. I´m keeping my fingers crossed that I´ll be able to pull that off as well as I did with my water assessment!

Thoughts from the Command Center

I'm currently sitting in my almost-empty room in what my friends lovingly call "The Command Center," and what most people would refer to as my bed. Although it is now only the mattress and box springs since my bed frame is gone. People call it the Command Center because it is where I've spent a great deal of the past two years writing papers, catching up on email, watching Hulu on my computer... and occasionally sleeping as well. The Command Center is about all that's left in my room at this point. My parents drove away yesterday with all of my possessions save what I'm taking with me to Ecuador in a few days. So, devoid of the normal distractions of my room I'm forced to reflect on the last two years and my upcoming trip.

For the last two years, I've been held hostage by Washington University. While I was a Brown School student I stopped reading for pleasure entirely, severely restricted my social life, and took on a mind-numbing amount of debt. And now I am a bright-eyed new (almost) graduate excitedly looking forward to a life free of interminable group meetings, endless reflection papers, and reading done on the elliptical for lack of any other time. Unfortunately, I'm also staring down the barrel of that mind-numbing debt paired with pending unemployment. While you might imagine that employers would be breaking down the door to have such a self-aware, transdisciplinary social worker/public health practitioner, that has so far not been the case. So I'm off to Ecuador to find myself, and hopefully (and also more importantly), a job.

As usual, I'm resurrecting my blog since I'm headed back to Ecuador. My activities this summer will include:

-a bitchin' water quality assessment

-managing community development programming Estero de Plátano (a rural community)

-The Great 2011 Job Search

-managing my complicated Ecuadorian social life

-self indulgent reflection through copious amounts of journaling and whatnot

-lazing on the beach

-getting a tan

So stay tuned as a I find out about water quality, navigate a complicated social scene, continue my epic job search, and attempt to handle whatever else gets thrown at me.

The End of the Journey... well, this journey anyway

I arrived back in my St. Louis apartment today, after a grueling 7 hour drive without air conditioning in the heat wave hitting the midwest. I spent several hours catching up with my roommates and several more watching bootleg DVDs with them. Now that I'm back here and ready to start the school year, it finally feels like my summer journey is over.

I felt a million miles away from St. Louis for the majority of the summer, and I think a part of me felt that I wouldn't end up back here. But here I am. I guess I feel like I should be able to encapsulate my summer into a few pithy lessons learned or something to that effect. Unfortunately, that isn't quite the case.

I think the best I can come up with is a list of some of the things that I'm glad to have back and some of the things that I'm really missing...

It's always the small things that seem to be the most important. I'm really excited to be able to really unpack for the first time in three months. To be honest, I've been looking forward to putting my clothes in a closet for weeks now. And to be able to leave my shampoo in the shower, now that's really something. Just generally settling down again is going to be really amazing. Having internet and cell phone service is nice I guess, but I kind of learned to enjoy going days without communication.... but I guess now it's back to the race against my inbox.

It pretty much goes without saying that I miss the people in Ecuador. After two tours of duty, I've amassed a pretty significant list of friends and colleagues... and of course a boyfriend. As always, leaving the people is the hardest part. I miss the sound of Spanish all around me, and the volcano Pichincha looking over my shoulder. And I never thought I'd say this, but I miss la hora Ecuatoriana. The idea of rushing to beat a clock for the next 9 months makes me almost physically ill.

So I guess that's that... back in St. Louis for the self-flaggelation that is a dual degree program. An experience only made bearable (and even occasionally enjoyable) by the people who go through it with you.

Until my next trip down south...

Cipro: My new best friend

When I decided to resurrect my blog, I didn't really consider the lack of internet access. So here I am again, trying to fit a month of activities and news into one post.

I walked into my last three weeks in Estero with the responsibility of everything on my shoulders. The person responsible for the projects in Estero left the foundation the week before I went back, so for my week in the office I was desperately trying to soak up all of the knowledge that I could about everything going on there... and failing for the most part. So I came back with a three page work plan and the knowledge that in the office, I am now the person who knows the most about this community. For those of you who know me well, you know that I was a mixture of nerves and ambition.

As far as work goes, the three weeks passed pretty much as normal. Successes, setbacks, and plenty of time conversando and relajando. The new volunteers arrived for my last weekend in Estero so I was playing hostess and trying to cram 2 months of knowledge into their poor heads in two days. Luckily for them, I mixed in catching pulpo and a killer despedida.

We ended up leaving Estero at a dead run trying to catch the last bus that would leave for the day. It was leaving about and hour earlier than we had expected, so after begging the driver to wait for 15 minutes, I found myself running through town to get everyone together and onto the bus. We all made it, by some miracle, and that was the end of my time in Estero de Plátano.

I arrived in Quito with a disgusting cough and plenty of body aches and the like. After watching me hack up a lung for the weekend, one of the new volunteers, Allie, gave me some cipro to knock out whatever I had. After a few days of popping pills, I finally started to feel like myself again.

I was supposed to finish my practicum on August 2nd or 3rd, but I'm still here in the office. Since I'm the one who knows the most about Estero at this point, I feel a lot of responsibility to leave people well-informed. Luckily, I have complete confidence in the abilities of the new volunteers. It's always hard to know if the work you've done will have any sustainability when you leave, but leaving it in good hands does a lot for peace of mind.

Where to begin...

When I decided to resurrect the blog, I´m not sure I realized how incommunicada I would be... So I´ll try to pack 3 insane weeks into one super-post.

Before heading out to the coast, I spent the weekend in my favorite place in Ecuador, Baños. The volcano Tungurahua was still erupting a bit, but I decided to entrust my safety to the Virgen de Agua Santa, who is the known protector of Baños. I spent the weekend singing karaoke with friends, drinking canelazos, and riding motorcycles up the summit of the active volcano. I´m not sure that it was a wise idea to get as close as possible to an erupting volcano, but it was exciting! I didn´t get to see any lava up close, but I did get to hear it rumbling as it was erupting and I saw lava from the house... probably better that way...

I left on an overnight bus from Baños on Sunday for the coast. Theoretically, I should have arrived at about 7 am in Atacames where I would take another bus to Estero de Plàtano. However, as usual, my plans didn´t quite work out. At about 5 am, while it was still dark, the bus stopped. I woke up to find that there was only one other passenger on the bus. I asked the driver what was going on and he pointed to further on up the road where it seemed to be on fire. Other buses were also stopped and I saw people getting off to walk. Given that it was dark, I wasn´t really sure where I was, and that there wasn´t another gringo in sight, I decided to stay on the bus for a while to see what happened. I waited for probably 2 hours when finally I ran out of patience and took off walking. It turned out that the road was on fire because the people were doing a protest that involved stopping traffic. This is apparently a fairly regular occurence on the coast and is known as a "paro." I walked through the paro, caught two different buses and hitchiked to make it to Estero de Plàtano. The family that I'm staying with lives on the other side of a river, and unfortunately there is no bridge. We are at the mouth of the river so the water rises and falls with the tide and sometimes it´s possible to walk through when the water was low. So I walked through. The water wasn´t that low. I arrived at the house exhausted and soaked up to my waist. Welcome to Estero de Plàtano...

I really don´t know where to begin trying to explain my three weeks in Estero. My work generally involves helping at the school, attending lots of meetings where nothing seems to be accomplished, talking with everyone, and swimming in the ocean. Ok, well it´s more complicated than that, but that´s kind of the gist. There is a lot going on in Estero, but the population seems to suffer from a lack of motivation. And a lack of a functioning clock apparently since arriving 2 hours late to a meeting is a regular occurrence. I think given some time we might be able to get somewhere, but my boss told me this week that she´s leaving the foundation, so it might be pretty difficult.

All that said, living in Estero has been a pretty unforgettable experience. I lived with a family with 7 kids, 6 of them girls. I watched two or three telenovellas in their entirety. I broke an outhouse and almost fell into the lake of poo waiting below... I stepped on a fish with spines on it´s face which became lodged in my foot while walking through a river. I caught fish with my bare hands with the kids from my house. And my closest friend in Estero is a drag queen named Michelle. Unforgettable to be sure.

I´m in Atacames now waiting for my bus to Quito. I´ll have 7 hours in the bus to think and be alone after three weeks of being with people essentially 24 hours a day. After showering with a bucket of cold water for three weeks, you can imagine how a girl like me is jonesin´for a rock out shower...

Ya listo

I think it's fair to say at this point that I'm having a bit of a rough start. My computer was stolen over the weekend, which was a pretty massive blow. I bought it for myself to start grad school, upgrading from my ancient Dell. I was pretty down about that for quite a while but I'm starting to get over it. I went to the mall of stolen goods, Montufar, to look for it, but had no luck. I just can't believe there's an entire mall of stolen goods... I guess that serves as a bit of an indicator of the state of law and order in Ecuador.

Work is not going quite as I would have expected. I am spending this week "planning" my next three weeks in Estero, but the fact of the matter is that very little planning is actually happening. My supervisor looked at the program plan that I spent an entire semester slaving over and basically told me that we wouldn't actually probably do any of that. The plan as of right now is to go, talk to the people, and build relationships. You might imagine that I do not need a week of 8 hour days in the office to get that down on paper. So... I'm doing a whole lot of nothing. And it's boring.

I don't know if I'll ever get used to the very different work style of South America. Everything is much more laid back and being goal-oriented is not a familiar concept. Sandwiching my first year of graduate school with two stints in Ecuador may have provided the most drastic contrast possible...

In the social arena, things are kinda mas o menos. I've met quite a few other foreigners at my hostel and Spanish school so I never lack for social activities. And despite the legendary flakiness of Ecuadorians, I've managed to see almost everyone in Quito that I wanted to in one week. Now that is impressive. There is more boy drama than I thought humanly possible. And it is some of the most ridiculous drama I have ever encountered, and coming from me that really means something...

So tomorrow I'm off to Baños for the weekend. I've been waiting for this ever since my arrival. The volcano is still erupting, but I'm just gonna trust in God like they always do in Baños. I'm leaving for the coast directly from Baños. Three weeks of no internet and climbing up a mini-mountain to get any cell phone service. Oh, and showering out back with a hose of course. Ya listo...