Our first day in clinic commenced with blackberry juice and marmalade. As we loaded supplies onto a fleet of bright yellow trucks, parrots soaked in hues of green, red and mustard circled above us – ferociously guarding their guava trees. A scenic, twisting ride revealed Caparino, a small agricultural community blooming on the banks of the Misahuallí River.
On this cloudy Tuesday morning, we arrived at an old fashioned schoolhouse, complete with an enclosed shed and a series of stand-alone classrooms. We jumped out of the trucks, still enchanted by the dense splendor of the rainforest, to witness a Timmy clinic unfold. Like clockwork, students, physicians, nurses, pharmacists and community members set about fulfilling designated tasks. Tiny classroom desks were reshuffled, tarp was laid, wires linked and laptops booted. Within minutes, an exam suite, pharmacy, laboratory and triage kiosk materialized – each equipped with its very own electronic medical record. Over fifty brigade volunteers and helpers assumed designated positions and the healing commenced.
Patients flowed from one station to the next. We observed a seamless embodiment of ‘family medicine’ as families underwent height, weight and blood pressure measurements and then proceeded to see the physician. As the morning wore on, our modest waiting area swelled with new patients; the children grew rowdier and the slick Amazon humidity clung on to us. Despite this, clinical operations only became more fluid. The Timmy team examined more patients and dispensed more medications. Around mid afternoon, when bottles of anti-parasitics, antibiotics and vitamins were nearly empty, we were able to corner some of Timmy’s local partners to speak with them about health care delivery in the region and Timmy’s role in plugging inherent leaks.
In 2008, Ecuador adopted a new constitution that mandated access to health care for all citizens. To this end, the government has invested heavily in making care available to most citizens. The country boasts a pyramidal system of care delivery, with numerous “health posts” dispensing basic care. “Subcentros” provide additional services including contraception and prenatal care and more advanced “health centers” provide a spectrum of services. However, despite these commendable advances, access to care remains a challenge in the most rural communities of the Amazon. This is where Timmy steps in.
Timmy partners with the local Ministry of Health to find and serve the most remote communities in the heart of the Amazon. Over the course of the week, Timmy’s brigade would serve over six hundred patients and dispense even more prescriptions. While Timmy’s operations are invaluable right now, as one student reflected, “it’s a band aid” plastered over a deeper wound. In order to ensure continued health of this community, we need both Timmy’s services to remediate current conditions and long-term measures that will tackle the roots of these problems. Through the course of our journey, we encountered this issue often and worked with Timmy staff and allies to find and classify barriers to access. In our nine days in Ecuador, we continued to learn and be inspired by the people.