Occupational Therapists in Ecuador – Part I // Quito and Our Community Sites

Over the summer, some of my classmates and I from our Master’s in Occupational Therapy program traveled to Ecuador for three weeks to work in different community sites. Not only did we have the chance to exchange ideas and use occupational therapy in an international setting, our adventure consisted of so much more. We traveled to the Cloud Forest within the Andes to live with the sustainable Yunguilla community, hiked within the Amazon Rainforest, immersed ourselves in the world-famous and colorful Otavalo Market, and more. This photo essay is comprised of two parts, with Part II being available soon.

A major thank you goes to my mentors and peers that accompanied me on this trip; you all truly made this experience absolute magic.

What is Occupational Therapy? Why Were OT’s In Ecuador?

Occupational therapists help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Some examples of common OT interventions include helping a child with Autism Spectrum Disorder participate fully in school or helping someone with a traumatic brain injury in recovery help to regain their lost skills. It’s quite the remarkable profession (may be slightly biased).

It is important to note that we were not in Ecuador to “save” or help people in Quito because we think they need our help or thinking our practice in the States is better. We traveled to Ecuador to exchange ideas, not to promote ours. The Ecuadorians we worked with taught us how they view OT practice and their work while we shared our perceptions of the profession. It’s a brilliant idea, and we found it essential that we were not promoting our privilege, and not validating the Western Savior Complex in any shape or form.

With that brief introduction out of the way, welcome to Ecuador, reader.

Warm Beginnings

Ecuador really is a vibrant culture, their ancestry is of traditional Spanish heritage influenced by Amerindian traditions and African elements. Quito, the capital of Ecuador, is a city resting high in the Andes, whose colorful homes look like Lego building blocks contrasted to the high and mighty mist-covered mountains surrounding the city. Quito is warm and relaxed combined with overflowing market streets, shaman healers, and fourth-generation hatmakers.

Ecuador has many traditions that are heartwarming that many of us wish we were able to adapt into our lives back home in the States. One of my favorites is how important it is to greet someone, even a stranger, using the time of day. For example every morning, we would greet each other with “Buenos Diaz” (Good morning). Another great cultural norm is how time is conceived in Ecuador. Typically, Ecuadorians are not rushing or speeding through the day like a traditional American, that is something that many of us brought back with us. Ecuadorians have a colorful view on life, something that is reflected even in their architecture.

When my class first arrived in Quito, we spent our first few days exploring the city. We visited and climbed to the top of the Basilica de Voto Nacional, walked through Quito’s central square during a political demonstration, and during sunset we traveled to the Virgin of Quito, an immense wooden sculpture presiding over the passed-volcanic hill, El Panecillo.

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Every morning, we watch the morning glow shine through this floral tree that grew through the center of our hostel, La Casa Del Sol.

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Every morning, we received freshly squeezed juice. Ecuadorians drink freshly-squeezed juice like we drink water; and let me you, juice from Ecuador will be the best juice you will ever have.

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Our class joined with a few students from the OT program at Boston University, and one of them was Jenna. I miss her warmth and the thoughtful reflections she brought into the group.

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Lauren and Vicki, two wonderfully extroverted and hilarious classmates from my cohort at St. Kate’s. Their laughs and energy were undeniably infectious.

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Inside the Basilica de Voto Nacional.

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Public displays of affection are not an issue for Ecuadorians. One of my close friends, Alex, had the brilliant idea of me capturing her while catching this beautiful display of love.

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The stairs leading to the top of the Basilica became increasingly narrower as you were reaching the highest point of the 400ft tower.

 

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The Central Square

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We felt like we were on top of the world.

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Stray dogs ran rampant around Ecuador. It would be nearly impossible for you to leave your home, go to work, and not see at least one dog pacing around.

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Our view from one of the highest points in Quito.

Solo Explorations

“Funny enough, being alone helps me to feel less alone in our big world.”

Due to the intense and rigorous nature of the program, personal time was extremely limited during our trip. When I learned we had one afternoon off, I made it my goal to explore portions of Quito we have not visited by myself. I’m not exactly sure why I genuinely enjoy traveling alone. Maybe it’s the challenge of forcing myself to be self-reliant. Every new corner or person you see feels like a quiet little thrill of an accomplishment, and it’s amazing what you see and hear when you are not spending much of your time conversing with a companion. Exploring alone authentically allows me to sink into the feeling of the place. Funny enough, being alone helps me to feel less alone in our big world.

During our afternoon off, I crossed the busy city of Quito. I remember taking a cab during the time when school is over and children swarm the streets. We essentially were driving through a sea of people, and it felt like both a colorful mess but also alive. The business of Quito was like no other city I have lived in. I reached new heights in parts of the city we had not yet visited, met two children that were playing near a graveyard, even made friends with a prostitute.

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Two boys playing outside a graveyard at the top of a hill.

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An Ecuadorian cemetery,

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Tierra Nueva

My community site while in Ecuador took place at Fundación Tierra Nueva, a clinic located in Southern Quito. Tierra Nueva was created upon the belief that all Ecuadorians should be able to afford and have access to health care. This clinic offers primary and specialty care at low cost, and is the main source of health access for the working poor in Quito. Tierra Nueva indirectly serves the marginalized communities in the surrounding rural areas. During our time in Quito, Angie, Taylor, Pam (our traveling companion OT) worked in the pediatric area of

“Part-way through their mass, they invited us up front. We introduced ourselves, and they clapped and cheered.”

During our time in Quito, Angie, Taylor, Pam (our traveling companion OT) worked in the pediatric area of the clinic as well as the geriatric side within their day-program. We quickly became friends with the workers at these sites, especially the pediatric OT’s that allowed us to work alongside them.  When learned from our OT mentors that therapeutic services are not as known in Ecuador, so many Ecuadorians are unable to advantage of the services that are available to them.

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Aracely, a pediatric OT we worked with and a new friend.

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Working with the geriatric day-program was both a treat for us as well as the Ecuadorians. During one of the first days we were there, we joined the clients for their daily morning Bible Study. Part-way through their mass, they invited us up front. We introduced ourselves, and they clapped and cheered. I hope they know how much their love that day made us felt; it was validating and warm, having 40+ strangers rooting for you and excited to allow us the privilege to enter their lives.

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They were such a joy to watch; their laughter and cheers filled the room.

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“Honestly, life in Ecuador was made so easy due to the kindness of its people.”

Throughout our time with the clients, we danced with them, laughed, led therapeutic exercises, learned about their personal lives, and we grew together. One day that really affirmed of our bond with the community was the first day we danced. After mass, a couple of women were slowly waltzing and dancing around the room, surrounded by the rest of the congregation. Then, with it not even being the fourth day there, one of the women waltzed over to me and asked me to dance with her. At first, I looked over at Pam and my peers to make sure this was okay/to make sure I was understanding the exchange the kind woman and I were having. Her and I started to dance and laugh, and it started a ripple effect. Many others from the congregation stood up along with my peers, and we danced and all laughed together. It was then I realized how different the warmth is here in Ecuador compared to the States. I learned that Ecuador had an abundance of kindness. A stranger will invite you to their home for dinner after five minutes of conversation and will share everything about their children and lives after one cup of coffee, a comfortableness you would have a hard time finding so rapidly in the States. Ecuadorians do not construct barriers like we do in the States. Honestly, life in Ecuador was made so easy due to the kindness of its people.

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Our first, of many, dance parties.
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Taylor (or Tay), was a valuable asset to our group during our time at Tierra Nueva. She is certified OTA, and her knowledge and experience along with her entertaining personality helped our group solidy our connection with the community.
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Pam, our incredible companion OT from Columbia. Spanish is her native language, and she was vital for helping us transcend the language barrier.
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Angie with our Robert de Niro.
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Her laughter always filled the room.

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This gentleman always brought his guitar with him as well as his old guitar songbook.

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We created a back rub circle, and it did not take long for things to get goofy.

Saying goodbye is always more difficult than what you expect, and leaving this community was no different. When the clients learned that we were not returning after today, the tone of the room suddenly changed. We all became emotional. We knew the community impacted us but we had no idea how much we impacted them until now. Clients beckoned for us to come over and give hugs, clients we became close with started to cry, and a fun day rapidly changed to being an extremely hard day. I remember holding the hands of one the clients I became close with. It was the sweet woman who asked me to dance with her during our first few days here, and she started to speak to me. Though I was only able to translate a small part due to my novice Spanish skills, the way she was looking at me and holding my hands with both of her hands, I could feel and understand what she was saying. We embraced. We hugged for what may have felt like minutes to everyone else but to us, felt like a second.

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Otavalo and the World-Famous Market

CONTENT WARNING: SOME IMAGES CONTAIN GRAPHIC CONTENT AND MAY DISTURB SOME READERS

For a day, my class traveled two hours north of Quito to Otavalo. The city of Otavalo is a place where Ecuador’s indigenous Andean population has thrived for thousands of years. Although many of the citizens live in poverty, the socio-economic status of the community is high compared to other indigenous groups. While in Otavalo, we visited Jambi Hausi. Jambi Hausi is a clinic that integrates Western medicine with traditional, indigenous medicine to help provide the needs of the ancient and medical system this population is used to. Besides there being medical doctors, in small rooms live the parteras (midwives), women who carry out traditional medicine. The two main cleansing methods involve a raw egg and a live guinea-pig. A white-brown guinea-pig is used for diagnosis, and the belief is that the guinea-pig can absorb the ailment from a person’s body. A partera shakes the guinea-pig around a person’s body, which in turn kills the guinea-pig from the rapid convulsions, then it is opened up and then examined.

“At a certain point, it was clear to me that the guinea-pig had died.”

One morning we were allowed to participate in a session. Lauren and Stephen volunteered for the cleansing. Holding the guinea-pig around the neck, the partera began to shake it all over their bodies. At a certain point, it was clear to me that the guinea-pig had died. Naive western sensibilities took hold of me which in turn made me feel unsettled. I then made the decision to challenge my preconceptions and beliefs to continue observing and learn about this practice. After the guinea-pig had died, it was then cut open in a metal bowl and the partera examined its insides and made conclusions about Lauren and Stephen’s health (which were not completely inaccurate).

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A partera working at the Jambi Huasi Clinic

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Lauren and Stephen both volunteered to receive the cleansing involving a live guinea-pig.

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Our partera cleaning up after the cleansing.

After our visit to Jambi Huasi, we explored the famous Otavalo Market. The Market takes place in “Poncho Plaza” and is a rainbow of textiles. Blankets, alpaca-wool sweaters, scarves and more light up the finest craft market in South America. Crowds swarm through the market and overflow into the surrounding streets. Though many tourists come to visit the market, it is a place of history and tradition, continuing artisan practices that are centuries-old. Like the rest of Ecuador stalls, bargaining is a hallmark part of their culture. Many of us (surprisingly) well bargaining for products while also respecting the seller.

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I made an immense mistake upon meeting this woman, and our encounter is still something I work up myself about. While I was walking around with Alex within the Market, I felt a light tug on my shoulder. I turned and saw her, with this same exact impression. My naivety thought she was welcoming Alex and I to Otavalo. I said “thank you”, and Alex and I went along our way. Later when we found her standing outside of our bus asking for money did I realize my mistake. I was angry at how easily I assumed she was here for us and looked over the fact she was asking for money. More about this is explained in Part II, but never assume someone’s situation and really attempt to step out of your Western-centered mindset.

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Quick Essential Guide to Quito

  1. Just like everywhere else in the world, Quito does have its share of robberies and petty crimes, so make sure to take small precautions. Pickpockets commonly occur on the bus system and extremely busy areas of the city.
  2. Altitude sickness is common due to Ecuador being nearly 10,000ft above sea level. Make sure to take a few days to get used to the altitude before serious hiking or climbing.
  3. Be mindful about the amount of tap water you ingest. Our class was told to stay away from drinking tap water during our stay. Many of used tap water to soak our toothbrushes and were fine; I recommend not drinking gallons of it.
  4. Take advantage of almuerzos. Almuerzos are lunches (typically between $2 and $4) that have three courses. Many restaurants have them, so be sure to ask.
  5. Carry tissues with you everywhere you go. In Ecuador, toilet paper is not typically provided and do not place used toilet paper/tissues in the toilet. They will have a special container for used toilet paper/tissues.
  6. Bring and wear sunscreen. Ecuador literally resides on the Equator, so you are very close to the sun. Put on sunscreen everywhere your skin is exposed even if it’s a cloudy day.
  7. DRINK AS MUCH JUICE AS YOU CAN

OT’s in Ecuador – Part II // Yunguilla and the Amazon Rainforest will be coming soon.

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