medica service trip report -...

MEDICAL SERVICE TRIP REPORT

TIMMYGLOBAL HEALTH

QUITO|ECUADOR

UNIVERSITY OF NOTRE DAME 19-27 OCTOBER 2013

PHOTO COMPETITION WINNERPhoto taken by Josh Whelan of Quito and the stratovolcano Cotopaxi on October 25, 2013 in Quito, Ecuador.

QUITO, ECUADORMEDICAL SERVICE TEAMNotre Dame’s Timmy Global Health chapter traveled to Ecuador and to the world’s second highest capital from October 19th- 27th, 2013. An outstanding group of medical professionals accompanied the student leaders during their week of service. Together they provided direct medical assistance and healthcare services to low-income and marginalized communities of south Quito. Through their efforts, Timmy’s partner organization, Tierra Nueva, was able to reach and serve more people.

In ten communities, the group organized and participated in primary care clinics. Throughout their time, the volunteers explored the realities of the patient population, traveled to a nearby Andean city market, and witnessed a memo-rable sunrise from volcano Wawa Pichincha.

Timmy Global Health has provided continuous care for the past 8 years to its partner commu-nities in south Quito. In 2013 alone, over 7830 patients received medical services; medica-tions and follow-up care by Timmy’s network of medical professionals and its partner hospital, Padre Carollo.

It is Timmy’s mission for Notre Dame student volunteers and healthcare professionals to fos-ter global awareness and humanitarian values so that they may be empowered to actively en-gage in fighting health disparities in the future.

Thank you Notre Dame for your yearly commit-ment to the people of south Quito, Ecuador!

ATTENDING PHYSICIANSSarah BoylesPhysician Assistant

Sue DeshpandePhysician Assistant

Frank MezzacappaPulmonologist

Michael O’ConnorAnesthesiologist

Don SolominiPhysician Assistant

CLINICALPROFILEPowered by TIMMYCARE

10partner communities were served in mobile medical clinics.

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

In total, we treated

697PATIENTS

TOP DIAGNOSES

MEDICATION TIMES PRESCRIBED

Albendazole 250Ibuprofen 244Acetaminophen 128Hydrochlorathiazide 86 Rantitidine 81Calcium Supplements 66Fish Oil 63Ocular Lubricant 61Lisinopril 51Omeprazole 42

POPULAR PRESCRIPTIONS

13739

521

509

188

Parasites

Hypertension

Gastritis

Osteoarthritis

General pain

Headache

Dry, irritated eyes

Allergy

Diabetes

Osteoporosis

URI

36%

22% 22% 21%16%

8% 8%5% 5% 5%

Michael O’ConnorAnesthesiologist

Don SolominiPhysician Assistant

indicators of health impact:

1

2

3

TIMMYGLOBAL HEALTH

How many patients were referred to a partner hospital for further treatment?

What percent of patients have chronic conditions, requiring regular care?

How many community patients were returning for care after previous visits?

75

72%

45%

MEDICAL

REFERRALS withHEALTH PARTNERSQUITO REFERRAL SYSTEMTimmy’s primary partners are the Tierra Nueva Foundation and its Hospital Padre Jose Carollo also known as “Un Canto a La Vida.” Un Canto a la Vida a 138-bed hospital acts as Timmy’s main referral partner, receiving Timmy patients from rural areas and managing Timmy’s patient social work fund. Timmy works in collaboration with the Tierra Nueva Foundation year-round to perform follow-up care with our critical patient cases and expand health services to those who lack access to it. Hospital Padre Carollo serves as Timmy’s largest referral center where patients from the coastal, Amazo-nian, and Andean region are referred to through our community medical service trips.

Every year, Timmy donates $24,000 to facilitate patient follow-up care. Due to the remarkable growth in the number of volunteers trips (increasing from 5 to 16 in the last 2 years), Timmy is looking for innovative ways to continue providing support to its ever-increasing patient population.

Non-specified referrals

20

Ultrasound7

OBGYN9

Ortho-pedics

6

Internal Medicine

7

Neurology -

3

ENT - 3

Pedia

trics -

4

Remaining Referrals (one each):- Cardiology- Colonscopy- CT Scan- Dentistry- Echocardiogram- Gastroenterology- Dermatology

Opht

halm

olog

y -

4Ge

nera

l Sur

gery

- 4

REFERRALS WRITTEN 11% of total clinical population

Of the 75 referrals made to Hospital Padre Jose Carollo, 10 cases (13%) were labeled high priority. 49 referral pa-tients were female and 26 were male.

X-Ray 6

Physical Therapy - 3

Urology - 3

Mammogram - 2

- Laboratory Exams- MRI- Plastic Surgery- Psychology

VENECIA October 21

Venecia, known formerly for its abundant mountain springs, nowadays is an urban community where Spanish and Kichwa are still spoken, but where only one of its famous springs remains. Women travel to the remaining spring to hand wash their garments and to gossip. The diet of this community is restricted by income and therefore they have little control over their nutritional development.

The surrounding area does have basic services such as water, elec-tricity, telephone and sewage system but they are still plagued with the common urban problems of income disparity that prevent them from obtaining a high quality of education or medical services. The community members identify robbery, drug abuse, assaults and family violence as the community’s weaknesses.

Number of patients seen: 58Percent of total who were returning patients: 43%Rate of patients referred: 16%

SIGNIFICANT DIAGNOSESParasites 25% Gastritis 24% Hypertension 19% Osteoarthritis 18%

Constipation 10% General Pain 9%Allergy 8%

PARTNERCOMMUNITIES

CHILDREN

ADOLESCENTS

ADULTSWOMEN MEN

43

2510

1

57

STO. THOMAS

Timmy Global Health has been providing medical services to these two adjacent communities of south Quito, Sto Thomas and Garrochal, since 2005.

Sto. Thomas, having been first settled, counts on basic services like telephone, road, transportation, water and electricity. The municipality purchased the materials for road construction, but it was the community that came together in a “minga” to build their roads. The completion of the roads meant that other basic services could become more acces-sible. Garrochal, on the other hand, was only first settled 18 years ago, and had to pay for their own materials and labor so the roads have not yet been completed and some of the homes still lack basic services. The land is swampy and is prone to floods. The nearest health center is 30 minutes by foot, and only offers emergency services and lacks other health services and a pharmacy.

The needs are so great that Tierra Nueva’s mobile medical unit serves these communities on a weekly basis. There is a significant group of health promoters that are responsible for patients in each community and that work voluntarily to promote a sense of unity and wellbeing.

SIGNIFICANT DIAGNOSESOsteoarthritis 34%Hypertension 30% Gastritis 13%

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

57

13

7 5

58

Diabetes 7%General Pain 7%Parasites 7%


LA VICTORIA October 22

The people of Victoria are industrious; they work as construction workers, porters, vendors and domestic employees. A health ser-vices center, recently opened, has begun providing health services to the area. However, the “subcentro” as these centers are known are ill equipped to meet the demand. More importantly, they lack medication to treat the aging population.

Most of the patient population in Victoria is elderly and suffers from chronic conditions such as hypertension, osteoarthritis, and chronic pain. Health promoters in the community have assigned patients in the area that they follow up with regularly between Timmy’s medical service trips to do regular blood pressure controls and perform good body mechanics exercises. The chronic patients have come to rely regularly on their medication from the medical service trips and the community services of their health promoters for the management of their disease. In the coming years, it will be important to address these needs by fine-tuning the services provided, such as sending physical therapists to the area.

SIGNIFICANT DIAGNOSESGeneral Pain 42% Hypertension 35% Gastritis 29%Headache 20%

S. DOMINGO CUTUGIAGUA Majority of the community members are natives to other highland regions such as Riobamba, Cotopaxi, El Oro, and Loja. Both Spanish and Kichwa are spoken and nearly 90% of the members own their homes while the remaining 10% are tenants. There is a lack of leadership that has led to disunity, violence, and crime between the community’s different sectors. Each sector uses a different water system and water studies have found certain water sources to be contaminated. Santo Domingo de Cutuglagua belongs to the Machachi municipality and therefore does not receive basic services from the Quito municipality. Their rural identity is apparent in their raising of livestock that contributes to the poor hygiene in the area. The community’s strengths are the presence of a school, pharmacy, nursery, Community Board and health promoters.

SIGNIFICANT DIAGNOSESParasites 52% Gastritis 27% Osteoarthritis 21%

Osteoporosis 18%Diabetes 15%Dry/Irritated Eyes 15%

CHILDREN

ADOLESCENTS

ADULTS

54

125

2

59

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

61

20 18

5

58

Hypertension 17% Pharyngitis 15% General Pain 15%

WOMEN MEN



HERMANDAD October 23 Formerly a colonial hacienda, the area where this community lies used to be known for its fertile lands. Eventually the land was sold off and distributed to immigrants who migrated to Quito in their quest for better life opportunities. Nowadays, homes and roads mostly occupy the land, but some areas are still used for agricul-ture and the community continues to be known for its delicious Andean corn harvest.

The area continues to breed livestock and about 30 families live here. During dry season (May-October) the people suffer greatly from dry/irritated eyes, allergies and upper respiratory infections. When Timmy Global Health first began providing medical services, the community had no access to basic services. The community has had an upward battle and though they have been slowly gain-ing access, some of the surrounding areas continue to not have access to water.

SIGNIFICANT DIAGNOSESGeneral pain 26%Hypertension 17%Osteoarthritis 15%


CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

3815

124

37

Gastritis 11% Dry irritated eyes 9%Lower back

MERCADO MAYORISTA October 23

SIGNIFICANT DIAGNOSESParasites 56%General Pain 25%Gastritis 20% Photophobia 12%

The largest produce market in Ecuador is home to a unique school called Transito Amaguaña. Named after a female indig-enous leader, the school boasts a bilingual and bicultural cur-riculum. The children that form part of this school are at risk of becoming or continuing as child workers, and for this reason are enrolled in Tierra Nueva’s Child Labor Eradication Program. The families of the surrounding communities are migrant families that moved to Quito for better work opportunities and all mostly work in the market. Kichwa is widely spoken in this community. Timmy Global Health began offering health services to this com-munity on January 2011.

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

56

25

14 7

60


Hypertension 7% Osteoarthritis 7%

LA COCHA October 24

SIGNIFICANT DIAGNOSESParasites 51%Hypertension 35% Gastritis 33%

MUSCULOS Y RIELESOctober 24

The Ecuadorian Railways Company, now a designated national cultural patrimony, used to operate in this community before it went out of service nearly 20 years ago. The railways had been devised to connect the Pacific coast to the Andean highlands. The unique name of this community “Muscles & Rails” is at-tributed to its history. The land of this community was liquidated to the workers of the railway stations as a way to compensate them for the loss of their jobs. This important Ecuadorian icon was reopened in 2013, but the tracks that run through this com-munity remain closed.

This community is plagued with high alcoholism and domestic violence incidences. The community has attained access to ba-sic services and a sewage system is currently under construc-tion. People complain that too many unattended livestock and pets roam the streets affecting the quality of life of the com-munity members. This community is known to have the highest incidence of parasites and critical patient cases.

SIGNIFICANT DIAGNOSESDry irritated eyes 37% Vision Loss 35%Anxiety/Depression 20%Headache 17%Abdominal Pain 13% Diarrhea 13% General Pain 13%Parasites 13%


CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

34

12 16

1

29

The Tierra Nueva Foundation began providing services to this community in 2000 when Padre Carollo was growing his mission of providing health and social services to the peripheral com-munities of south Quito. It wasn’t too long after when Dr. Chuck joined his cause and began providing services to the people of this community. In 2002 Timmy Global Health began gathering resources to begin sending foreign doctors and donated medi-cines to the impoverished people of La Cocha.

Since then, Timmy has been able to witness how the people of this community have begun to gain more access to basic ser-vices such as roads and electricity. Moreover, Timmy has had the opportunity of serving this community for 10 consecutive years.


CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

58

27

14 0

71

Osteoarthritis 26%General pain 24%

NUEVA LOJA October 25

‘El Beatario’, a sector located in south Quito, is comprised of numer-ous communities. Nueva Loja is one of the many communities from this sector that were built around the gas storage units of PetroEcua-dor, the largest oil company in Ecuador.

In recent past, PetroEcuador and the Municipality of Quito came to an agreement to re-locate some of the families living in El Beatario with the intention of diminishing the safety and health risks associated to living in such close proximity to a gas pump. PetroEcuador since then has invested in social programs to benefit the families living here. PetroEcuador has partnered with Tierra Nueva and Timmy to offer health services in the area.

Timmy began providing services in ‘El Beatario’ in 2010 and hopes to expand its outreach in the various communities that form part of the sector. SIGNIFICANT DIAGNOSES

Parasites 54% Gastritis 24% General Pain 18%

SAN JUAN DE TURUBAMBA (11 DE MAYO) October 25Located at 3,000 meters (10,000 ft) above sea level 11 de Mayo is a community that bears the name of its founding date, its surrounding areas are known as San Juan de Turubamba. The land was purchased from a fraudulent landowner and the community has had to face a never-ending struggle to avoid expropriation. The nearest health services center is 45 minutes by car and 2 hours on foot, with no access to emergency services or pharmacy. There are no transportation lines that serve this community.

11 de Mayo has founded and grown award-winning community gardens, their award money has been invested into wood artisanal workshops for women that could learn new skills and earn independent incomes. They have focused on women empowerment and providing good nutrition for their children. Though this area lacks basic services such as electricity and sewage, they are incredibly well organized and motivated to improve their quality of life.

SIGNIFICANT DIAGNOSESParasites 52% Gastritis 27% Osteoarthritis 21%

Hypertension 17%Headache 9%

CHILDREN

ADOLESCENTS

ADULTS

54

2220

8

48

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

54

21 185

58

Hypertension 17% Pharyngitis 15% General Pain 15%

WOMEN MEN

Number of patients seen: 76Rate of patients referred: 8%


TIMMYGLOBAL HEALTH

www.timmyglobalhealth.org22. E. 22 Street, Indianapolis, Indiana

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