TIMMY GLOBAL HEALTH CHONTAPUNTA ECUADOR MEDICAL SERVICE TRIP REPORT DEPAUW UNIVERSITY 5-17 JANUARY 2014

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1 TIMMY GLOBAL HEALTH DEPAUW UNIVERSITY 5-17 JANUARY 2014 MEDICAL SERVICE TRIP REPORT CHONTAPUNTA ECUADOR

2 MEDICAL SERVICE TEAM CHONTAPUNTA, ECUADOR In January of 2014, the Depauw University team traveled to Napo Province to support Timmy Global Health s programming in the Amazon Basin of Ecuador. Started in 2011, the Amazon Basin program is now one of the fastest growing programs within the organization. Timmy offers medical services to 15 of the most vulnerable and atrisk communities in Napo Province, generally too small or too difficult to be reached by the Ministry of Health. Communities within Timmy s Napo network are split into two circuits, one hailing from Misahualli, the other based further out in the Chontapunta region. Travel can be challenging to reach Timmy s communities, which are a mix of both indigenous Kichwa populations as well as settlement colonies. Under the purview of the local Ministry of Health, Timmy works hand-in-hand with Patronato, the social service arm of the provincial government. Timmy partners with Patronato to provide quality medical service to more than 600 patients per service trip. Besides providing logistical support and transportation, Patronato offers local expertise through a number of health promoters sent with each team. The promoters are an invaluable asset in helping with Kichwa-Spanish translation and facilitating understanding of local traditions and customs. Timmy Global Health also contracts with and provides training for a designated community health promoter in each site, enhancing understanding of intricacies of each community and providing a more effective patient referral process. ATTENDING PHYSICIANS Gaby Arteaga MD Diana Licuy MD Miguel Calvo MD Mauro Pazmiño MD Luis Gualsaqui DDS Glenn Silcott Jr. MD David Hoover MD Orlando Tapia DDS Sharon Hoover MD Luis Villamarin MD

3 CLINICALPROFILE Powered by TIMMYCARE 8partner communities were served in mobile medical clinics In total, we treated 775 PATIENTS WO TOP DIAGNOSES 15% 10% 10% 9% Fungus Gastritis Genral Pain Parasites 7% 6% 6% 6% 5% 4% Headache Pharyngitis Urinary Tract Infection Genral Malaise Low Back Pain Cough POPULAR PRESCRIPTIONS MEDICATION TIMES PRESCRIBED Ibuprofen 191 Acetaminophen 190 Albendazole 108 Amoxicillin 66 Clotrimazole 66 Ranitidine 48 Ocular Lubricant 37 Naproxen 35 Sulfamethoxazole/Trimethoprim 35 Loratadine 31

4 TIMMY GLOBAL HEALTH indicators of health impact: How many patients were referred to a partner hospital for further treatment? What percent of patients have chronic conditions, requiring regular care? How many community patients were returning for care after previous visits? 68 14% 34%

5 MEDICAL REFERRALS with HEALTH PARTNERS AMAZON BASIN REFERRAL SYSTEM Since the program s inception in the Amazon Basin, Timmy Global Health has partnered with Stadler-Richter hospital in Archidona, just outside of Tena, the capital of Napo Province. Patients seen during clinics who need more specialized care are sent to the private hospital, where they are able to receive lab exams, x-rays, ultrasounds, and emergency care. Specialists in gynecology, orthopedics, pediatrics, and general surgery are also available for consults. With the assistance of the community health promoter and Patronato promoters, patients from rural areas are guided though what would otherwise be an intimidating and confusing process. One hundred percent of patient costs are covered by Timmy for all patients coming from the Amazon Basin. At times, a patient with even more specialized needs with come to a Timmy clinic. In cases where Archidona Hospital is unable to provide the level of patient care needed, patients are transferred to the country s capital city, Quito, where Timmy partners with the Tierra Nueva Foundation and its Hospital Padre Jose Carollo, also known as Un Canto a La Vida. Timmy works in collaboration with the Tierra Nueva Foundation year-round to perform follow-up care with critical patient cases and expand health services to those who lack access. Hospital Padre Carollo serves as Timmy s largest referral center where patients from the coastal, Amazonian, and Andean region are referred to through community medical service trips. Of the 68 referrals made, 30 cases were labeled high priority. 34 referral patients were female and 34 were male. Pediatrics 7 Ophthalmology 5 OBGYN 4 Every year, Timmy donates $24,000 to facilitate patient follow-up care. Due to the remarkable growth in the number of volunteers trips (increasing from 5 to 16 in the last 2 years), Timmy is looking for innovative ways to continue providing support to its ever-increasing patient population. Laboratory Exams - 4 ENT - 4 General Surgery- 4 Gastroenterology - 2 Orthopedics 8 REFERRALS WRITTEN: 9% of total clinical population Non-specified referrals 22 Internal Medicine- 2 Ultrasound - 2 X-Ray - 2 Endocardiogram- 1 Electrocardiogram - 1 Cardiology - 1 Family Medicine - 1 Mammogram- 1 Physical Therapy- 1 Urology - 1

6 OUR PARTNER COMMUNITIES CENTRO PALMERAS January 7 Number of patients seen: 91 Percent of total who were returning patients: 40% Rate of patients referred: 5% Centro Palmeras is a small community situated along the Napo River and a fair distance from the nearest city. This community consists of approximately 30 families, all speaking a mixture of Kichwa and Spanish. There is one school in the area, but the community lacks basic electricity and water services. SAN RAFAEL January 8 Number of patients seen: 51 Percent of total who were returning patients: 24% Rate of patients referred: 14% San Rafael is an island community with roughly 10 families in total. Members of the community speak both Kichwa and Spanish. Residents of surrounding communities attend Timmy clinics, even though its unique location lacks potable water and relies exclusively on river canoes for transportation. Such barriers make it a particular challenge for San Rafael to receive and maintain regular health services. This community also hosts various cultural demonstrations, bringing travelers from all over to enjoy their traditional customs WO WO Parasites 18% Back Pain 5% Flu 12% Fungus 5% Gastritis 7% Pterygium 5% Urinary Tract Infection 7% General Pain 4% Low Back Pain 18% Pharyngitis 16% Fungus 10% Back Pain 8% Abdominal Pain 6% Gastritis 6%

7 COMUNA LOS RIOS January 9 Comuna Los Ríos is another port town nestled conveniently between nearby towns. Members of the community speak mainly Spanish. Although there are only 20 families on site, there is both a school and an Evangelical church within the community. This town does have electricity, but they lack potable water. Number of patients seen: 78 Percent of total who were returning patients: 47% Rate of patients referred: 10% Fungus 18% Headache 12% General Pain 9% Abdominal Pain 8% Gastritis 8% Low Back Pain 8% WO 57 SAN PEDRO DE SUMINO January 10 Number of patients seen: 131 Percent of total who were returning patients: 27% Rate of patients referred: 10% San Pedro de Sumino is a bustling tourist port, central to our communities in Chontapunta. With approximately 50 families, two schools serve the community. Some families have access to both electricity and running water. Timmy is currently partnering with the community to provide a center for heath education and services. 99 WO Fungus 10% Cough 8% Gastritis 8% General Pain 6% Low Back Pain 6% Abdominal Pain 5%

8 JATUN URKU January 12 Number of patients seen: 100 Percent of total who were returning patients: 28% Rate of patients referred: 3% Jatun Urku is Kichwa for Big Mountain and it represents one of our first adopted Timmy communities in the Amazon Basin. The majority of community members speak Kichwa as well as Spanish. It is a small community with approximately 20 families and lacks access to basic health services, including water, electricity, and phone communication. There is only one small school in the community. Relatively isolated, it is difficult for community members to gain access to basic health services. Jatun Urku is a prime example of why Timmy decided to extend its services deep into the Amazon Basin in order to make health care more accessible for those who need it. 62 WO Parasites 19% General Pain 11% Headache 11% Cough 10% Gastritis 10% NUEVO PARAISO January 13 Nuevo Paraiso, or New Paradise, is a community that has existed in the Amazon Basin for quite some time, yet it has been recently adopted into our Timmy health circuit. The majority of community members speak Spanish. With access to electricity and running water, one school serves the 30 families of the community. There is a strong Evangelical presence within this community. We are excited to have added this new community to our circuit. Number of patients seen: 89 Percent of total who were returning patients: 27% Rate of patients referred: 10% 58 WO Parasites 36% General Malaise 21% General Pain 17% Gastritis 15% Fungus 8% Low Back Pain 7%

9 SUMAC SACHA January 14 Number of patients seen: 114 Percent of total who were returning patients: 29% Rate of patients referred: 11% Sumac Sacha is Kichwa for Buena Selva or good jungle and represents another unique Timmy community. This particular community has been overseen by a local petroleum company. The company has helped build schools, and has provided electricity and potable water for the community. Forty Kichwa and Spanish-speaking families benefit from basic services provided by the petroleum company, but their proximity to oil drilling poses a public health hazard WO General Pain 23% Parasites 23% Gastritis 17% Urinary Tract Infection 14% Cough 13% Headache 13% RUNASHITU January 15 Number of patients seen: 121 Percent of total who were returning patients: 46% Rate of patients referred: 12% Runashitu is Kichwa for Small Person and it represents one of the oldest communities within the region. This community consists of approximately 50 families, where everyone speaks a mixture of Kichwa and Spanish. Runashitu is known as a gathering place for the nearby communities; they are usually the first to help facilitate local community events and coalitions. This community has both electricity and potable water, as well as two schools. Their unique role within the region makes them a valuable asset within our programming WO General Malaise 19% Parasites 19% General Pain 18% Gastritis 14% Cough 12% Fungus 10% 61

10 ON-SITE DENTAL SERVICES During the DePauw service trip, dental services were offered to patients in the Chontapunta region for the first time! In partnership with Patronato, Dr. Orlando Tapia and Dr. Luis Gualsaqui worked alongside the medical clinic performing dental cleanings, fillings, extractions, sealants, and fluoride treatments. Students had a blast shadowing and observing, while also counseling patients on proper brushing and hygiene practices. In total, 194 patients were treated by the dental team PATIENT BREAKDOWN BY COMMUNITY Sumac Sacha Runashitu Centro Palmeras Jatan Urku San Pedro de Sumino San Rafael Comuna Los Ríos Nueva Paraiso

11 A special thanks to all medical professionals and volunteers for their service and commitment to improving access to quality healthcare within our communities. TIMMY GLOBAL HEALTH E. 22 Street, Indianapolis, Indiana