Final Thoughts

A lot has happened since we’ve been back on campus! Exams, practicals, projects and finals have come and gone, but we have not forgotten our wonderful experience in Portoviejo, Ecuador.

During the months of November and December, a few of us and some classmates partnered with Select Physical Therapy to organize a Toy Drive benefiting the families receiving wheelchairs through the Hope Haven West distributions. We were able to donate a box full of small, travel-friendly toys that the recipients are sure to enjoy!

As a final conclusion to this extraordinary trip, the Ecuador Four will be presenting our experience to the community on Wednesday, January 22nd at 6pm in room 115 at the Thomas J. Long School of Pharmacy. We hope that you will join us to learn more about what we saw, what we did, and how it impacted our lives forever.

Despedida (Farewell)

Today was the last day of the seating clinic and it was bittersweet. Bitter because this meant that our trip was coming to an end and this amazing experience will soon be just a memory, but sweet because most of the wheelchairs had already been distributed and the finals ones would be gone by the end of today. We were told that roughly 50 or so families had already been anticipated for the last day, meaning that it would be the busiest day of the week. In order to prep for a hard day’s work, we skipped out on our daily hotel breakfast and instead opted to return back to our favorite cafe in Portoviejo, Cafeteria Jean Pierre, for our meal. When we walked in, it was empty and we were greeted with a warm smile and handshake by our waiter from earlier in the week. Don’t worry, we did a much better job this time around and were able to place our order with confidence and ease, something the waiter definitely appreciated. Once we finished our nutritious brownies and cappuccinos (breakfast of champions), we made our way back to the hotel where our ride was awaiting.

 

As promised, we arrived to the church with families already waiting to be seen. We got immediately to work and maybe it was the fire from it being the last day or maybe it was the climax of a week of acquiring knowledge, but everyone worked with pure and genuine intention nonstop. It was an amazing process to be a part of and to observe as there were no wasted movements, everything was flowing very smoothly and proficiently. One by one, the waiting area of the church began to shrink in size and before we knew it, the last child had been fitted. The best part of the day was the fact that there was a smile on everyone’s face. From the US volunteers, Rotary members, and student translators to the staff of the La Vida clinic and the families of the children, everyone smiled. It was a bittersweet feeling to clean up the church after finishing our final day of distributions. In total, we seated the children and adults of Ecuador in 190 chairs, just 10 shy of our goal of 200. These numbers are pretty awesome, especially considering the road closures that were going on all week and our abbreviated shift on Wednesday. We ended up using almost all of the supplies that we brought with us, leaving hardly anything to spare, but we would have stayed another week to continue distributing wheelchairs and interacting with the community if we had the choice. 

The last Hope Haven Chair.

After finishing the distribution, we went back to the hotel to freshen up. One of the Rotary members graciously decided she wanted to take us to Montecristi, a city known for its artisan shops and handmade items, so we can do some souvenir shopping. We had a blast shopping in the area as we came across the famous Ecuador hats, alpaca shawls, and other authentic goods.

Once we finished shopping, we were immediately driven back to the Rotary Clubhouse in Portoviejo in order to attend the celebratory dinner. However, we were running fashionably late with our newly-acquired Ecuadorian accessories. So by the time we arrived, everyone else had been seated and waiting for us (cue grand entrance). We were greeted by a round of applause due to our fashionable appearance (and because we had finally arrived but more so because we were rocking our looks).

The celebration ensued and speeches were made by various members of Rotary, acknowledging the efforts of all organizations and people involved. Everyone received a certificate bearing the Portoviejo Rotary’s stamp and in addition to that, the US volunteers were each generously gifted with an authentic, handmade Ecuadorian hat (which take ~3 months to make!). We then enjoyed a wonderful 3-course meal and were bombarded by everyone to take pictures (is this what it feels like to be famous?). In all seriousness, the pictures were also a great experience as we all got the chance to share one final moment with all of the locals that had helped and taken care of us so much. Seeing how genuinely happy and excited they were to take pictures with us made us reciprocate those feelings equally.

 

The final goodbyes and hugs were said and given, and we returned back to the hotel. Once everyone was there, we took a few more pictures with some of the other volunteers and said our goodbyes to them as well. BUT…..before we could call it a night, we had to make one last obligatory trip to get frozen bananas! We all enjoyed that one final walk and banana thoroughly before returning to our rooms to finish packing and heading to bed.

This had turned out to be an even more profound and wonderful trip than we could have imagined, there was a lot of love and compassion shared these past couple of days and it is safe to say that everyone grew significantly and gained a much deeper appreciation for life. 

The Ecuador Four

Flood Gates Open

When we arrived at the church today, we were met by community members already waiting to be helped. This was a welcome sight after having to clean up early yesterday. We quickly assumed our stations and got straight to work. By the end of the day, we had seated 42 individuals, with all four of us taking a late lunch due to being so focused on seating. Creativity was kicked into high gear as we scrambled together our minds, experience and whatever materials we had left to piece together a seat that was fit as best as possible. It was inspiring to see the hard work and dedication of everyone involved to ensure that every person who needed it was seated that day.

    As we cleaned up our areas and prepared to head back to the hotel, Lonny informed us that we had an opportunity to visit the Archeological Museum if we were interested. Luckily, our new friend Matthew from La Vida, who also happened to speak both English and Spanish, was willing to accompany us to help translate! Still packed in dirt and sweat from the hard labor that day, we all packed into the vans eager to see what this museum was all about.

At the Arqueo Museo Hojas Jaboncillo, we learned about the Manteña culture and these special stone “U” chairs that were excavated from the land around 800-1100 AD. The seats were created for the elite of the indigenous people of the land, and each chair had a figure on it that was personalized and indicated rank within the group. Though most of the seats are being held in Washington D.C., we were able to see one fully formed preserved chair still in possession. The tour continued up the mountain to the archeological park, which required a 10 minute drive with the four of us sitting in the bed of a pick up truck. It was a bumpy ride to say the least!

Near the top of the mountain we saw various displays of what the land looked like back in the day and viewed some remains of where the natives would harvest their crops. We also saw the Ceibo tree and the holy stick tree, whose sap is used for healing, massage oil and bug repellent. It was another fun day of exploring!

And of course, we ended the day with another sweet dessert!

The Ecuador Four

Demonstration Day

Boy, what a day! We started off the morning with a team meeting to share seating ideologies and different ways to approach seating an individual with different presentations. Our seating specialists gave a synopsis on tonicity, spasticity, rigidity, and the different things to look for in order to find the best fit for a chair. It was amazing to have these brilliant minds help connect the dots of each seating puzzle and understand their logic.

Lonny of Hope Haven West and Kris, one of the seating specialists, gave an in-service to some local healthcare professionals on ways to adjust and refurbish the chair. We were told of one particular young man and his Hope Haven chair that had returned to a distribution after 10 years of use. Lonny regaled of the inventive modifications that the father had completed in order to accommodate his growing son. This story is a true testament to how durable these Hope Haven chairs really are. We find comfort in this knowing that we have distributed so many Hope Haven chairs so far, in addition to some specialized wheelchairs.

As mentioned previously, we were informed of the day’s uncertainty due to the protests and road blocks. While we were working with our first group of fittings, we actually saw a peaceful demonstration pass by the front windows of the church. This did not slow us down as we remained highly driven to serve our individuals with efficiency and proficiency. Unfortunately, this did keep many of our families from reaching the church, causing us to pack up early.

This would be an excellent opportunity to give a shout-out to the ever-accommodating Rotary Club of Portoviejo. These Rotarians have arranged the location of our clinic, our hotel and have graciously provided much-needed snacks and outstanding lunch for us each day (and there’s always dessert on the side!). Thank you to the Rotarians of Portoviejo for facilitating this week-long distribution; without your generosity, we would not be successful!

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On our way back to the hotel, we witnessed one of the effects of the fuel price hikes: a long line of residents waiting to fill up their gas cans at a local center. There were several motorbikes passing by with a gas tank or two strapped to the back of the seat.

With our early arrival home, we were able to find time to check out the shopping mall a few blocks away from the hotel (after another serving of frozen bananas mentioned in our previous post ;). The mall was set up fairly similar to malls we have back home – it even had a Carl’s Jr. and KFC in the food court! The jackpot of the night was the supercenter inside the mall, which we all referred to as “Target.” Here we found numerous snacks and chocolates made in Ecuador, and most importantly, coffee! We each left the mall with a bag full of gifts for home, a lighter wallet, and a sense of accomplishment.

Our dinner table was quite full tonight as all of us volunteers ate together at a restaurant nearby called La Barca. The seafood restaurant was a great place for us to be as we were the only customers there and our server made us feel welcome by putting on some “rock music en ingles.” It was a great way to end the day.

 

The Ecuador Four

The Adventures Continue!

Today we fitted almost twice as many children then on the first day of our distribution. We have all established a routine with our seating specialists and have have become more comfortable with the adjustments that need to be made to the wheelchairs.  We even got a chance to work on a complex case together! We were able to utilize our academia, critical thinking, and teamwork to create a perfectly fitted chair for a dystonic young adult. Being able to see first hand the impact we are making, not only in the children’s lives but also those of their family members, is enlightening and eye opening. We all have a new found love for wheelchair fitting and have gained a deeper respect for the importance of a proper fit.

While we’ve been busy fitting wheelchairs, 6 hours away in Quito, demonstrations have erupted due to an increase in fuel prices. These demonstrations have been rampant in various parts of the country however things are very peaceful here in Portoviejo still and it is difficult to tell that there is even unrest occurring. However, the demonstrations have resulted in blockages of many roads into the city therefore preventing many of our anticipated families from reaching the location of the seating clinic. Although we are not being affected by the demonstration they have been effecting the attendance of the seating clinic. We also received word that there is an expected national demonstration across the country tomorrow. Although this may significantly impact the number of wheelchairs distributed, we are moving forward as previously scheduled. We have also received assurance from the local Rotary Club that the demonstration in the city should be peaceful and should not impact us directly, 

Even with civil unrest taking place, the locals of Ecuador are very kind and generous. We continued to realize this today after the seating clinic, when we walked to dinner at a well known cafe. At this cafe, we were served by a very patient waiter who proceeded to calmly absorb all of the jumbled, poorly formed Spanish we attempted to speak when ordering our food and drinks. It did not help that this young gentleman was describing the entire menu rapidly to us in Spanish as we gave him looks of absolute confusion. But he was very accommodating and we somehow managed to order our food, which consisted of empanadas, capaccinos, and cinnamon rolls, all of which was absolutely amazing. Towards the end of our meal, we attempted to buy coffee grounds from the restaurant because of how good our drinks were after the waiter told us they brewed their own coffee. We all worked together to ask the waiter if that was possible to buy coffee grounds to take home, to which he responded with a gleeful yes. All of us instantly became excited because we had not been able to have authentic Ecuadorian coffee, a staple of the country, since the hotel we’re staying at only provides instant Nescafé (boooo). But our pure excitement came to a crashing halt as he brought out four to-go cups of coffee (make sure you speak enough of the local language if you’re traveling abroad folks, leaves less room for miscommunication!). After spending way too much time trying to order our food, enjoying it immensely, and failing to buy coffee to bring back to the US, we bid farewell to our wonderful waiter, who along with the rest of the staff, cheerfully waved us goodbye.

The Ecuador Four

Distribution Day 1

Hello from Ecuador!

          Today was our first distribution day and we were told it went differently than most distributions go. We’ll explain. On Weds, Oct 2nd, protesting in Ecuador began to dispute the fuel/transportation subsidies enacted by the government. This ended up greatly limiting passage through different roads including traffic on the Pan-American highway. We were told that word of our distribution had been spread throughout Ecuador and families were going to be traveling up to 8 hours to reach us and receive the help they’ve been waiting for.

       We first started off the day taking a van to the distribution site, a church called Temple Metropolitino. The chairs were being stored about 1 block away so we all walked the fully assembled chairs down to the church. The Hope Haven chairs were still in cardboard boxes partially assembled, so those had to be transferred over via car. We spent the first part of the morning promptly finishing the chair assembly before the families arrived. We were partnered up with “veterans” of prior seating clinics, several among whom were certified seating specialists. A majority of patients seated today consisted of diagnoses such as severe scoliosis, cerebral palsy, microcephaly, etc. Due to lengthy time spent transporting and assembling the wheelchairs along with the ongoing protest demonstrations in the area, less than an ideal number of patients were seated. However many lives were still positively affected, including ours as we quickly realized how profound this experience was going to be. Seeing the families bring in their children and hearing of their daily plights and the distance they traveled to get to us opened up a level of empathy, which definitely grounded us and made us understand how insignificant our own problems really can be.

          Time seemed to fly by as we worked eagerly and tirelessly until the end of the day. Some of the more challenging cases took up to 8 volunteers to assist with proper fitting in the wheelchairs. We came away with a better understanding of what this trip and these families require of us. We go into tomorrow with an even greater eagerness to help them and their communities. 

          As soon as we returned to the hotel to freshen up, we were off in search of dinner. We walked to a pizza place down the street from the hotel and stopped for dipped frozen bananas on the way back.

The Ecuador Four

The Arrival

21 hours, 4  “hot pockets”, and 1 foamy cup of coffee later, we finally hit the ground running in Portoviejo, Ecuador. We settled in on our first night by trying some delicious local seafood cuisine, which is extremely fresh in Ecuador due to its proximity to the Pacific Ocean.

We enjoyed the rest of the night by exploring the city. The city of Portoviejo is the capital of the Manabi Province. Portoviejo has experienced multiple earthquakes in the past few years that caused immense damage on the city’s infrastructure and economy. This was evident in our walk around town, with many of the buildings showing signs of structural damage.

Luckily, the devastating effects of the recent natural disasters were not evident in the spirit and hospitality of the people of Portoviejo. We were lucky enough to have breakfast with the Governor of Manabi, Leonardo Orlando, as well as the Rotarians of Portoviejo. They welcomed us to Ecuador, thanked us for our service to their people, and showcased the traditional food of Ecuador.

Later that day, we were invited to the home of one of the benefactors of the Seating Clinic, Paul and Flor of Fundacion La Vida. We were happy to spend some time at Crucita beach just across the street and “hang around” in the beach house.We ended the night with a walk to the Rotonda, a park not too far from our hotel. We were surprised to see so many people playing in the park, which was decked out with a rock wall, skatepark, and various amusement park themed activities. There was even a water show! We were also pleased to see that the park was very accessible and inclusive, with a swing and exercise equipment designated for individuals traveling in wheelchairs.

We have also been able to make it around town so far with our collectively limited Espanol. A language barrier will not keep us from getting our sugar fix!

Overall, our first introduction to Ecuador has been very pleasant. We can’t wait to start seating individuals in wheelchairs tomorrow!

The Ecuador Four

Visit to Hope Haven West Warehouse

Hi everyone!

Last Monday, the Wheelchair Seating and Sitting Mobility elective class took a trip to the Hope Haven West warehouse in Modesto, CA. We spent the morning assembling Hope Haven wheelchairs in preparation for shipping to Ecuador.

Many of the individuals we anticipate helping during the seating clinic will be children of all ages. Unlike the standard-sized wheelchairs you may be familiar with seeing, these Hope Haven wheelchairs come in various sizes to best fit each person. A properly fitted wheelchair helps to reduce pressure injuries, limit poor posture, and allows the individual to experience their community with their own eyes, looking ahead at the world rather than down at the ground.

These Hope Haven wheelchairs can be adjusted in seat width, seat depth, back height, angle of tilt, with side supports, harness straps, or a tray table. We’ve been practicing making adjustments for the different conditions we may encounter, such as scoliosis, post polio syndrome, Down syndrome, muscular dystrophy, and osteogenesis imperfecta, to name a few. 

Don, a Hope Haven wheelchair expert and multiple-year-distribution-trip veteran led our assembly efforts:

This is how each chair arrives at the warehouse from the manufacturer.

A smaller box of pieces and parts accompanies each set.

All laid out and ready to follow the assembly instructions.

Don gives us students some initial tips for wheelchair assembly.

Sierra, Aaron, and Don with the custom jig to assemble the Hope Haven Wheelchair frame.

KD, Don, and Jessica inspecting their work on the bottom of the chair.

An assembled Hope Haven wheelchair nearly ready for shipping. The (front) castor wheels will be added on. The (rear) drive wheels are placed strategically in the shipping box to allow for more boxes per shipping container.

Jessica Matias, KD Gill, Sierra Downum, Dr. Whitney Davis, Kim Phongprateep, Aaron Moreno with a fully assembled Hope Haven wheelchair.

We’ll need to remember to pack everything we need this week. We’re taking a few exams early in the next few days, then we’ll take the remaining exams and practicals once we return. The energy is high and the anxiety may be even higher. Stay tuned to see how everything goes!

Ecuador Four

Countdown to Ecuador: 6 days