Yambiro

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Originally uploaded by alexandra_stanculescu.

For the second time this trip our whole group jumped in the back of a cattle truck for the fifteen minute ride up the hill from Otavalo to the Indigenous village of Yambiro. There are around 175 families living in Yambiro, farming and tending their animals.
Last week, we arrived in Yambiro in the early afternoon. We hopped off our cattle truck and after a bit of milling and the arrival of the village president, we gathered the village members into the half built village assembly hall and clinic. In the dusty air of the newly plastered walls, 80-ish people gathered to listen to a series of public health presentations we had prepared in our meagre Spanish. First came dental hygiene, then sanitation, water chlorination, nutrition and female reproduction. With great care and interest, the village president then translated each presentation into Quichua for the older generations who spoke no Spanish.
After the bulk of the presentations, we then set up a make shift medical clinic which involved jerry rigging a small corner of privacy in the large hall fluttering with people. Half sheet, half straw mat, the divider served to create a space where we would see four to six people at a time, often families with multiple generations, and as time passed, increasing numbers of interested family members peering over the divider.
Guided by Doctor Victor, a physician from Jambi Huasi, a clinic in Otavalo that offers both western and indigenous medicine, Kyle, Vanessa, Julie and I manned our stethoscopes and went to work to see the forty plus women and children that filled the hall. Quickly, I had to learn a new set of associations. A stomach ache most often meant parasitic infection, likely worms. A headache was likely to be untreated vision problems, and we looked at the conjunctiva of the children’s eye to detect anemia that was likely a result of malnutrition. Most everyone had stomach aches or headaches, or a combination of the two.
We had a makeshift pharmacy as well, distributing donations we had gathered prior to the trip: prenatal and children’s vitamins, ibuprofen, and antibiotics. We would have to return with antihelminthics another day. In all, not a lot to actually tackle the health problems of the community. And while I love working with patients one on one, it became utterly clear that all of our solutions were merely a stay of execution and that seeing patients was a drop in the bucket compared to an effective public health campaign.
Thus, in our second hop out of the cattle truck, we set about treating the animals that are intimately intertwined in the lives of the people of Yambiro. Now, I can tell you right off the bat that I know very little about injecting animals. What I did discover, however, was that the people of Yambiro has a very special way with their animals. Instead of holding down the pigs while they screamed and do they ever scream, the locals just scratch their bellies. The pigs love it and promptly tip over in a semi dreamlike bliss, making injections easy. In all we dewormed over 70 pigs, cows, and sheep.

La curiosidad mató al gato (curiosity killed the cat), or in this case the guinea pig.

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Originally uploaded by alexandra_stanculescu.

Don Juan, a grade school teacher, and his family invited us to their home in Pihal, a village ten minutes outside of Otavalo. We spent the morning walking up the steep hillside that most of his neighbors farmed in some capacity. Pihal is an indigenous village of 3000 and like most indigenous villages around Otavalo, they are being farmed as they have been for centuries. The people with houses down towards the valley have flatter, more fertile ground, while the people up this hill farm phenomenally steep slopes as their livelihood. Steep to the point that on our decent through one field, we had to sidestep so as not to go rolling down the hill. Apparently this rolling down a hill is a concept that has earned its own word in the local language of Quichua.

From the top of our hike, we could see the valley below: the large grids of flower fields and grass fields that now serve as major employers in the area, San Pablo Lake with the fabled giant asleep in its depths, Otavalo sitting at its side, several raised beds in the valley floor thought to be Incan burial sites, scattered villages with farms up the precipitous hillsides, and peaks in every direction.

After our descent, we were served a lunch traditionally served on special occasions in the village. Guinea pig in a hominy based soup, colorful salads, hominy, potato pancakes, and beef, all to be eaten with a giant wooden spoon. As with seemingly all of the home-cooked meals we receive here, we ate until we could hardly move and moved on to the afternoons presentation.

We had been hearing about this presentation for weeks preceding it. We were to meet a local traditional healer, a curandera, who would demonstrate a traditional diagnostic procedure using a guinea pig, as well as introduce us to some of the plants she commonly used to treat patients. As I love to get involved in these things, I volunteered for the diagnostic procedure. The curandera asked me to step into the middle of the a palm leaf mat. She then took a guinea pig from its coop in the family´s yard, brought it over and spent the next five minutes shaking it along the surface of my body. In the tradition of the indigenous people of the Andes, it is thought that in this process the guinea pig absorbs the energies of the patient into its body. The poor guinea pig. . . I stood there watching the trusted village healer with her wrinkled and leathery skin and traditional adornments go from front to back and then front again, shaking the squeaking guinea pig at me, tapping me occasionally. Eventually the guinea pig died. The process went on. At some point, the curandera deemed the process finished, whereupon she took the guinea pig to a basin of water and began to skin it. The trunk of the animal was skinned in under thirty seconds, and the curandera examined it for possible signs of maladies. She then took the knife and cut into its abdomen, inspecting its organs. She and another older woman began pointing at organs and discussing amongst themselves. “Do you have digestive problems?” she asked, poking at intestines. “It looks like you might.” The gallbladder looked like it would give me problems in several years, and with a concerned tone she pulled some pebbly thing out of the guinea pigs lungs, discussed it with her friend, and went on to the head. She told me that I carry stress in my shoulders and neck and that caused headaches.

I´m still not sure what to make of the experience. Do I believe her diagnosis? Not especially. And she seemed to leave things a bit unresolved. But as I stood there with curandera and squeaking guinea pig, I could feel the centuries of diagnosis that had come before me in this style, the paradigm of which this was a part, and a vastly different picture of how the human body was understood by the indigenous people of this area. As health and healthcare are intricately woven with culture, in this experience, I caught a glimpse of the truth of this different vision.

With the guinea pig in pieces, the curandera went on to tell us about the plants she used to treat patients for anxiety, digestive problems, and other common ailments. Surprisingly, many of them were familiar. Among her stash were catnip, St. John Wort, and peppermint.

So ended her demonstration and we went on to take a took a look at the intricate traditional embroidery that the women wear and sell. Apparently, it takes almost two months to complete one shirt by hand, and they sell them for $150-200. But I´ll leave those details for another time.

Come back again next time as we take our health professional student gig on the road to another local indigenous village and set up a clinic.

Otavalo

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Originally uploaded by alexandra_stanculescu.

I wander into the breadshop every morning on my walk to school, lured by the smell of fresh baked breads. I ask for whatever just came out of the oven. Today, it had sugar sprinkles on the outside. Deceptively sprinkled, I´d say, as the inside was filled with salty cheese. It was muy delicioso. Munching on the contrasts in my pancito on my way to spanish class in the morning, it reminded me much of this town of Otavalo, the city in which I will be living for the next five weeks: sweet, salty, full of contrasts, and not what you´d expect from the sprinkled outside.

Otavalo is tucked in a valley 35 miles north of Quito with about 25,000 inhabitants. Within half an hour of the town are 30+ indigenous villages with another 70,000 people. The town is famous for its artisan market which floods the streets surrounding Plaza de Poncho every Saturday. Having specialized in weaving since before the Incas, indigenous Otavaleños come in to sell their wears.

The contrast here comes in many forms. The daily mix of strong sun and rain, the wealth and poverty in one place, the dramatic mix of modernity and the old ways. My walk to school takes me down a ten minute stretch of the Pan American Highway. Some parts of the road are paved, others not, while some parts used to be and now are left to erode into the highway. Some people have SUVs, while others pile 20 into the back of a truck to get to their destination, a grazing cow and an internet cafe on the same block. The indigenous girl in full traditional dress stops to answer her cell phone and check her email.

To sell their crafts, Otavaleños have adapted to a global market and now, as many as 5000 are living internationally, sending money home, while their families continue to farm the steep slopes of the surrounding countryside, raising their animals and living in many ways as they have done for centuries.

I have settled in with my mestizo host family, Julio and Acacia, their two sons, and Acacia´s parents, and I have started school. As a class of 12, we spend the mornings in spanish classes and the afternoons with a medical anthropology focus, in discussion or visiting local communities. Looking at healthcare in Otavalo and the surrounding villages, we examine the integration of indigenous culture with the modern world. What are their traditions and beliefs? How do they view health? What is the current access to western or traditional healthcare? What types of nutritional deficits are there that lead to my being one of the tallest people around?

Like my pancito, this first bite is not what I expected. The picturesque indigenous world had a much richer, savory inside than the suger sprinkles would suggest. And as usual, my investigations are leading to more questions. Come back again to find out more about the diagnositic process used by traditional healers via guinny pig.

And take a look at my other pictures: http://flickr.com/photos/alexandras/

Sunday in Plaza de la Independencia

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Originally uploaded by alexandra_stanculescu.

It felt as though all of Quito was in the old part of town on Sunday. The weather was beautiful as we walked through Plaza San Francisco, Plaza de la Independencia, and marveled at the many churches scattered thoughout the area.

Plaza de la Independencia seemed to be the place to be on a Sunday in Quito. Hundreds of people filled the square, mostly gathering around some central point of interest. I struck me that in the US people don`t just gather on Sundays to hang out and engage in a communal social life.

On the steps of a church that lined the square, there was a public theater production. Three actors with mime-like painted faces entertained the crowd with their comedy for hours.

To the left was a group of five or six musicians performing for those sitting on the benches and the grass nearby. A few steps away was some type of preacher encircled by twenty five or some listeners gleaning biblical messages.

And another few steps away was a social activist, explaining to the people the current political situation, and advocating change. With 75% of the country living below the poverty level, the situation is extreme. Ecuador´s history rings with voices of the populist movement revolting against spanish colonialism and global expoitation, and this activist is no exception. His message made sense. Empower Ecuadorians, stand up against the corrupt government, initiate social programs to take care of the citizens, develop an ecomomic policy that will improve productivity. Look at the rest of the world, he said. Why should we be so far behind?

He spent a good bit of time berating the gringos for their expoitation of Ecuador. The current political drama involves Occidental Petrolium (Oxy), an American company that contracted with Ecuador to extract its oil reserves in a certain area of the country. Essentially, the Ecuadorian government negotiated a contract with Oxy that turned out to be not so favorable, especially in light of rising global oil prices. So, feeling exploited, and in an effort to keep the money in the country, the government decided to nationalize the extraction (or as it might turn out, contract with Venezuela, but that is another story) and boot out Oxy. Probably not the suavest political move as, at the same time, they are also trying to negotiate a trade contract with the US called the TLC, a South American version of NAFTA. Oil is Ecuador´s largest export and as such, has a huge influence on the country´s economy.

Its is an interesting time in Ecuadors history. They are living their longest democratic period in history. 27 years. And yet it hasn´t done much for the equality of the distribution of weath. Instability reigns. In a UN poll, more than half of the country said they would be willing to try a different type of governement if it would reduce the difference between the wealthy 10% of the country, and the 75% in poverty.