Update on the Water Filters

Mary Rose Day (she participated two years ago) and her husband, Brian Day, are in Riobamba for the September 2011 program.  Their main objectives are to follow up on the water filters and plan the next steps:

Update

We met with Carmen (President of Fecaipac), Juan (representing el Consejo Provincial), and Dr. Maritza last friday and proposed an expansion of the pilot program in Puchara Quinche which appears to be a huge success after just 8-12 months.  Dr. Maritza gave her powerpoint presentation showing initial data from water samples taken in 2008 in Cacha.  We all spoke with Carmen and Juan about our mutual belief that the next feasible step in expanding this project would be to place filters in all public facilities, such as clinics, schools, guarderias, and colegios in Cacha.  27 filters would be needed for this proposed expansion, costing $25 per filter.  ($675 initially and $405 every 2-3 years for replacement ceramic parts)

Carmen and Juan seemed very interested in the project and found the intervention to be simple and economical.  They expressed interest in eventually expanding this availability of filters to ALL communities in Cacha.  I mentioned our 2 current ideas for payment from the public:  1) direct payment with cash vs. 2) payment via Mingas.

The public opinion seems to be that $25 for a filter is very expensive, although the estimated average annual income for a family in Cacha is $2400 (estimated by Dr. Maritza).  The public is VERY interested in the idea of mingas as a payment alternative.  I mentioned my idea of having the Consejo and Fecaipac fund the filters in return for TRASH REMOVAL services provided by mingas.  Everyone seemed interested in that proposal.

Today, we are waiting for a phone call from Carmen.  She and Juan were going to speak with local leaders yesterday at a big meeting in Machangara and ask for their support to fund the expansion to schools.  They were very confident they would get the money.

Today, Brian and I are going to make an instructional video (2-3 minutes long) about how to use the filter and how to clean it.  We’re making the video in english (for future students), spanish, and kichwa (with help from Segundo).  Once it’s edited and fixed, we’ll take the projector up to Cacha next week and start showing the video and passing out handouts in some of the larger communities.  That’s the plan for now.

I’ll write again as soon as I get news from Carmen.

Preventing mountain sickness

Participants ask about what should they bring or do before going to Riobamba,Ecuador. We usually tell them to throw sunglasses, sunscreen lotion and hat in their bags, the sun in the Equator line is vicious. Yes, it is nice in the morning, but once it gets up there-right on top of you-it might still be nice,but the rays are very strong for the skin, eyes and head. Another thing we usually tell participants, is about high altitude sickness. Riobamba and Cacha are between 3,000 and 3,500 above sea level, we tell them to take it easy the first days, do not eat much at night, drink nice herbal tea and sleep early, by the fourth day it is okay.

Dr. Jorge has asked me to post an article that tells more about how to prevent this mountian sickness, believe me, the symptoms feels like Atahualpa’s revenge!

Article on Preventing Mountain Sickness

Who is CACHAMSI’s Founder?

Cachamsi was at the AAFP National Conference of Family Medicine Residents and Medical Students. It was held in Kansas City, Missouri during July 28 through July 31,2011. This is Cachamsi’s third year attending the conference. Dr. Duchicela was the exhibitor and was very satisfied meeting and engaging with family medicine residents and medical students. Dr. Duchicela  has been working in rural family medicine for almost 22 years and almost as long serving as a faculty preceptor and associate professor for the University of Texas Medical Branch in Galveston.

 

He and his wife Juanita chose to live in Weimar,Texas, where he was offered a position at the Youens Clinic.  After becoming a partner about twenty years ago the name changed to Youens and Duchicela Clinic. His experience as one of the town’s doctor has been enriching, treating a diverse set of population including patients from German/Czech, Black and Hispanic descent. After many years of practicing as a rural family physician and teaching hundreds of medical students, residents, nursing and physician assistant  students, he realized the urgent need for medical students, residents, and other healthcare professionals to communicate well with the Hispanic patient.

 

 

These experiences helped him decide to offer an immersion language program.  He noticed that medical students and residents tried very hard to learn Spanish within the medical context, but they very seldom succeeded in acquiring the language skills to adequately communicate with their Hispanic patients.  They were too busy and there was no available structured program that could offer an effective methodology.  He saw the need to create an institute specialized in teaching medical Spanish.  This facility would be built and developed in Ecuador.  This small South American country is  safe, diverse and friendly.  It is also Dr. Duchicela’s birth place, a region where one can find areas where English is not spoken at all. The Central Ecuadorean highlands provided great language professors, a multitude of health centers, and a special indigenous community close to Dr. Duchicela’s heart.  He felt this institute would not only help the Hispanic patient in the U.S. but would also help the indigenous people of central Ecuador.  

 

In 2000, Dr. Jorge (as he is known in Weimar to differentiate him from his younger sister, partner, family physician Dr. Olga), began the tedious and slow work of meeting and establishing relationships with physicians, hospitals, government leaders, families, and potential members of the new institute in Riobamba, Ecuador.  Why Riobamba?A quaint, small, colonial city surrounded by majestic volcanoes and drenched in history and its indigenous culture, Riobamba (from the Kichwa word ricbamba which means the walking plane) became the place where the Cacha Medical Spanish Institute was going to be built.  The name Cachamsi came later as medical students would call the institute and program by its acronysm, Cacha MSI (Medical Spanish Institute).  By 2004, he had all the major components ready to offer an integrated, focused, immersion experience to participants of the institute.  He saw this school as a way to bring United States health professionals, community members, and Ecuadorean health professionals together to accomplish the missions of Cachamsi:  To improve the health of the Latino patient in the United States and enhance the health and education of the indigenous people of central Andean Ecuador.