As a surgical resident interested in global surgery and expanding healthcare in low resource settings, I hope to work with Cinterandes, a non-profit organization dedicated to addressing unmet surgical needs in low resource regions of Ecuador. Cinterandes' mission is to bring quality surgical care to remote regions via their unique mobile surgical unit. I hope to contribute to their efforts by assisting in their upcoming mission trips to patients living in remote regions in Ecuador without reliable surgical care near them. Cinterandes has sought to not only understand patients' barriers to care, but also address their barriers by bringing surgical care locally to the people. By participating and learning from Cinterandes, my involvement will make a difference in the lives of the people I will have the opportunity to serve. It will also contribute to the development of my own growth as a culturally competent leader in healthcare and global surgery.
The patients living in remote regions of Ecuador will benefit from this project. They are a largely underserved and under-resourced population that face significant barriers in accessing timely and quality health care services, barriers not only limited to distance to healthcare facilities, knowledge barriers, and financial means amongst others. Through Cinterandes, we are able to bring quality surgical care directly to these marginalized populations, who are in need of these surgical procedures but do not have the means necessary to obtain appropriate healthcare. Cinterandes is also working in helping patients who are part of these rural communities develop trust in the local medical system and bridge the gap in providing appropriate healthcare service.
The expected impact will be seen both at the individual level and at the larger global level. By providing surgical care directly to patients, Cinterandes will improve the health of the patients treated. Their efforts will improve the overall health of these patients and improve trust in the local medical system. From a provider perspective, this project will provide me with invaluable experiences that I hope to carry with me as I pursue a career in global surgery, population health, and individualizing surgical care. From a larger, global perspective, the surgical work performed by Cinterandes will help address the unmet need for treating surgical diseases in rural communities of Ecuador. Their model is one that I have been inspired by and one that I hope to use as a foundational block in my future career as a surgeon and one that has the potential to be replicated in other, similar low-resource settings.
We had the opportunity to serve the local natives in a small community in Ecuador called Macas, which is a small town located just outside the Ecuadorian Amazon. The last time the Cinterandes mobiles surgical unit was at Macas was several years ago, so it was meaningful to have been able to return with the surgical team to this particular location for this trip. We were greeted by the local community along with the prefectorial mayor. They held an inaugural ceremony for a newly renovated building upon our arrival, which was to become the new Center for Specialties for Health Services in Macas. From then, we proceeded to evaluate over thirty patients who had been seen at the local primary clinics for surgical evaluation and booked a case that evening for our first patient.
The next several days were a whirlwind, as we continued to operate on the patients we had seen. Our cases were diverse, from vasectomies to inguinal hernias to umbilical hernias and excision of cysts and soft tissue tumors. One particular case that left a lasting impression on me was our last patient, who had not been seen on the initial evaluation day, but had arrived on the last day we were operating. He was from the Amazonian jungle, and said he had trekked through the jungle upon hearing that we were in Macas. He had an elbow mass that had worsening symptoms for which he wanted treatment. We were able to squeeze the patient in as our last case and he was so grateful at the end of the case, which ended well into the evening. The patient stated that he would likely have never received care for it otherwise.
This trip helped me experience what it meant to bring surgical care directly to the people. It allowed me to envision what breaking barriers to surgical care and bridging trust looks like. Overall, this was an invaluable experience and I thank Dox Foundation for supporting me in my endeavors.
