Lindsay Bigda

Lindsay Bigda

When our MEDLIFE Ecuador team came to visit our main office in Lima this April, we sat down with Ecuador Director Martha Chicaiza, Field Nurse Maria Chavez, and Project Director Luis Cartagena to talk about development issues in Ecuador, and the effects of recent government interventions on the work that they do. Check out what they have to say about rural to urban migration in their country:

ruralecuadorA child cares for his animals in a small village outside of Riobamba, Ecuador

When MEDLIFE brings Mobile Clinics to the small villages of the sierra, where MEDLIFE works in Ecuador, the line of patients is often made up primarily of women, children and older residents. This phenomenon has prompted several volunteers to ask, where are all the men? And what about the young people?

Migration from Ecuador's rural areas to its city centers, as well as emigration to other countries, has primarily been a result of two economic crises – a collapse in oil prices in the early 1980s and a subsequent economic downturn in the late 1990s. The 1990s crisis spurred an especially large exodus, with most people headed to the US or Spain. The majority of those who choose to migrate to bigger cities are young men chasing urban employment opportunities; they are often trying to support families in their hometowns by sending back remittances.

"The conditions then [in the 1990s] were really bad," said Maria Chavez, who works as a field nurse for MEDLIFE in Ecuador. "There was no money, no opportunity."

Many rural residents choose to become economic migrants because they are unable to pursue higher education or feel stuck in low-income agricultural jobs. Larger-scale migrations have also occurred recently due to globalization, which has made travel easier and allowed residents to become more aware of other opportunities.

The negative effects of migration are notorious and include: instability for children, economic distress, tension between migrants and locals, cultural erosion, worker exploitation, and other social problems."Women who are left alone sometimes feel that they must choose between taking care of their animals and fields and taking care of their families," explained Luis Cartagena, who organizes and oversees community development projects in Ecuador. "What happens when a child needs to see a doctor far away, but the mother feels that she can't leave her animals?"

But Chavez also noted that there are positive aspects to recent migration, especially for indigenous groups. "It exposes them [rural residents] to other realities and helps them to better understand and claim their rights," she said. "Lately, there has been a lot of consciousness-raising around personal rights."

Both the urban and rural experience for indigenous people in Ecuador is tied up in the country's deeply rooted racism. Many indigenous residents self describe their main issues with city life as exploitation in the workplace and the prejudice they face solely for being of a certain race or color.

In the sierra, MEDLIFE patients of indigenous descent are often ignored or made to wait longer than their non-indigenous peers when trying to access social services, according to Ecuador Director Martha Chicaiza. "Going to a hospital can be daunting for anyone," she said, regarding access to health care. "But imagine if you've never been to a doctor in you life, and you have no idea how the system works. It's easy to take advantage of other people's ignorance or fear."

MEDLIFE Ecuador staff members agree that the quality of rural life has improved recently thanks to a slew of new government policies initiated under President Rafael Correa. Aside from improving the infrastructure in Ecuador's countryside, the president has also begun an aggressive push for transnational migrants to come home. The national "Welcome Home" program encourages migrants to move back to Ecuador by reducing custom fees and providing tax breaks for starting new businesses; the "Hecho en Ecuador" (Made in Ecuador) campaign encourages consumers to buy locally produced products.

According to Chavez, the government also wishes to curb the rural to urban migration within the country and is working on policies to encourage rural residents to stay put. MEDLIFE Ecuador has also contributed to the development of rural areas of the Chimborazo and Napo provinces through our Mobile Clinics, hygiene projects, and school projects, and will continue to assist in raising rural living standards.

"Now, more people are coming back to the countryside," Chavez said. "There is much greater economic stability."

May 17, 2013 3:56 PM

2013 MEDLIFE Student Awards!

awards2013-title

As the 2012-2013 school year comes to a close, MEDLIFE wishes to extend a big thank you to all of our student chapters, leaders, and trip participants. Thanks for your hard work!

Check out our first ever spring MEDLIFE Student Awards to learn more about our most exceptional student groups and leaders, including out best fundraising, education, and community service initiatives. Don't see your chapter on our list? Make sure to communicate all of your outstanding efforts to us at This e-mail address is being protected from spambots. You need JavaScript enabled to view it !

Award-best-chapter-mcgillComing off a record-breaking year in 2011-2012, McGill University has picked up right where it has left off. Currently on track to sending over 100 students on Volunteer Trips and hitting $10,000 fundraised, McGill's chapter has once again shown us the full potential each student group has to help our patients and our communities reach greater access to medicine, education, and community development. A special thanks to the outgoing members of McGill's executive board, whose passion and dedication have resulted in a exemplary student organization.

awards-newchapter-michiganIn less than a school year, our new chapter at the University of Michigan has materialized into a truly incredible chapter. They have recruited a large membership base and sent numerous students on Mobile Clinics. Meanwhile, the chapter's executive board members have quickly moved to bring their enthusiasm to our Student Advisory Board (SAB).

See the rest of the awards on our full awards page here!

In Ecuador, MEDLIFE is wrapping up its second Mobile Clinic of the spring break season. This week we're working in communities outside of Riobamba:

Riobamba update2 march2013

Last week, MEDLIFE also completed our first ever Mobile Clinic in the community of Esmeraldas -- on Ecuador's Northern Coast. We received a warm welcome from the communities near Esmeraldas, and had one of the biggest turnouts that MEDLIFE Director of Ecuador Martha Chicaiza has seen in the country. Local magazines and news channels came out to interview Martha and the MEDLIFE crew about our plans to continue work in the area.

interview 600MEDLIFE Director of Ecuador Martha Chicaiza being interviewed by a local reporter

The city municipality also invited MEDLIFE to meet the Mayor of Esmeraldas, who explained more about the region and even gifted students with t-shirts, inviting them to return for Carnaval. During the final clinic day, the mayor also presided over the inauguration of our first staircase project in Esmeraldas (which couldn't be 100% completed during the clinic week due to heavy rains). Residents from the community treated students to a presentation of their traditional music, marimba, as well as dancing and a communal lunch. 

MEDLIFE is excited to be off to a great start in Esmeraldas, and looking forward to a continued partnership with communities in this area. 

Lima's pueblos jóvenes are not like Brazil's favelas, or Argentina's villas, or the slums of Mexico City. While most of Latin America's shantytowns have been haphazardly thrown together, without state assistance, the founding of Lima's Villa El Salvador (VES) in the 1970s was unique.

The creation of Villa El Salvador, a formal settlement for urban squatters, was a response to the housing needs of over 4,000 families that had invaded land in an area known as Lima's Southern Cone. Under the Velasco regime, the central government partnered with the community to mutually create an urban plan and assign legal plots to families. Lima's desert location, with ample unused land, also contributed to the city's initial success in providing lots for low-income communities. VES remains an important case study for participatory democracy, and marks the first example of government-aided slum development on the continent.

VES old collage

Government officials, community members, and scholars alike recognize the importance of legal land ownership and well-planned urban development. Officials in Peru note the many benefits that property rights bring their residents, including access to credit, access to home improvement loans, and the ability to start new home businesses. Community members themselves are also acutely aware of how it can change their quality of life, especially by connecting them to permanent – not provisional – electricity, water, and waste disposal services. Residents we speak with often cite obtaining land title as a primary concern; without it, they worry that they will have no assets to pass down to their children.

World Bank report regarding a pilot land titling program in Peru indicates that "strengthening tenure security through property formalization in urban squatter settlements has a large positive effect on investment." A new document released by the U.N. In May of 2012 also highlights the issue of land title, linking it to food security and economic empowerment.

Yet political treatment of new settlements in Peru has varied widely since the 1970s with changes in government administration, swinging from absolute recognition of urban slum communities to their forced removal. These changes have resulted in a patchwork of settlements, rising up from the outskirts of Lima, which remain in various stages of development and legal recognition.

landtitle taller1

Our latest educational workshop was located in a small community in the Nueva Esperanza area of Via Maria del Triunfo. MEDLIFE will bring a Mobile Clinic to this same community in March of 2013.

During the workshop, MEDLIFE staff members presented on a number of health topics, including the importance of psychological health and sleep, preventative tests for breast and cervical cancers, and nutrition. Along with our usual preventative health topics, we also touched on – for the first time – the important issue of property rights.

biz crowd collage

As many of our supporters know, MEDLIFE Peru works primarily with low-income, informal settlements established just outside of the city of Lima. Poverty, terrorism, and a lack of opportunities in rural Peru have prompted thousands of residents to migrate to these urban slums. As these communities become bigger, more established, and better organized, residents begin to move toward legal formalization of their homes and communal spaces.

Yet, the country has struggled in developing a comprehensive plan for urban development. With changes in government administration, treatment of informal settlements has varied widely. The involvement of several different agencies, sometimes with conflicting policies, also makes the process of legalization a murky one to navigate.

Santos Abad, a government lawyer, explained the basics of acquiring land title, highlighting the primary agencies involved in the process: COFOPRI (government agency that deals with property formalization), the municipal government, and – in some cases – the court system.

Abad outlined an important law called the prescripción adquisitiva de dominio. This law states that an individual may gain legal land title simply by possessing the land, peacefully and consistently, for a minimum of 10 years. The government's 10-year rule is a seemingly adequate amount of time for legal owners to reclaim their land or, if they wish, take squatters to court.

Community members listened attentively and immediately began to ask questions. In addition to general information about legalizing their property titles, many wanted to know more about the intricacies of sharing property. What happens when you share a home but are not married? How can parents ensure that their homes get passed on to their children?

Residents have voiced a need for more education, in order to better understand their legal rights. MEDLIFE hopes to begin including this type of training, focusing first on property rights, in our upcoming educational workshops.

Stay tuned for more information on important issues regarding land rights in Peru, coming soon!

One of the most successful and unique student fundraisers we've seen over the past five years is McGill University's "tutorials" – two- or three-hour exam review sessions taught by student tutors with extensive experience in their subject areas.

This idea took root in 2010, when MEDLIFE McGill began offering the review tutorials to help science and engineering students prepare for their exams. Alan Blayney, a chemistry student and coordinator for the tutorials program, says the idea for the fundraiser came from their school's undergraduate student association. The group did a similar type of fundraiser, inspiring chapter members to take the idea and apply it to MEDLIFE.

alan mcgill

The tutorials first focused on basic science courses like calculus, physics, and organic chemistry. Later, the group expanded to include upper-level courses in physical and analytical chemistry, as well as the cell biology and economics departments, sticking strictly to concept-based courses (as opposed to those requiring memorization).

At first Alan alone taught the review sessions, using old exams acquired from relevant class professors to go over all class fundamentals. As the tutorial program grew, the chapter began to look for other tutors. Connections were first made through networking, and then eventually through an online application process, allowing leaders to be vetted by the group's executive board. The chapter looks for high-performing undergraduate or graduate students with experience in their subject areas and the willingness to put together review materials. 

MEDLIFE McGill charges $20 per final exam review and $10 for each mid-term review, which students pay at the door. Participants also receive a $5 discount for registering online. "The good thing about this type of fundraiser," Alan notes, "is that there is not a high start-up cost involved. The only expense is printing out the review packs."

The chapter also usually gifts tutorial leaders, who volunteer their time, with a "thank you" $20 gift card to a coffee shop or other place of interest.

Those who organize the tutorials work with the MEDLIFE McGill's marketing committee to promote the fundraiser as far in advance as possible. The chapter focuses on quantity; that is, getting the word out to as many students on campus as possible. They make announcements in relevant classes, use Facebook, hang posters, and send out the information via university listservs.

Alan says that it was important for the group to market the fundraiser not as a crash course, but as a legitimate review. Chapter members believe that, although the idea could be replicated at other universities, it works particularly well at McGill because of the studious culture. They also created a Facebook feedback form for students to fill out as a way to respond to complaints, evaluate tutors, and generally improve the experience. The group has also had a lot of success getting professors on board as promoters, adding legitimacy to the tutorials.

"Of course," Alan says, "there will always be professors who are against the tutorials." He explained that the main roadblock to launching the first fundraiser was simply finding out if it was against institutional policy; at McGill, it does not violate any university rules.

So what do these study sessions have to do with MEDLIFE? According to Alan, a chapter member attends each review session to provide a brief introduction to the organization and direct students to the website and Facebook page. Of course, all of the proceeds go directly to MEDLIFE's Project Fund. Over the years, the chapter at McGill has raised thousands of dollars through their tutorials and has consistently been an example of excellent organization, commitment, and successful fundraising.

Check out the group's tutorial page here!

February 4, 2013 2:06 PM

A New Home for Eloy

Thanks to your support, MEDLIFE patient Eloy Britto received a life-saving heart surgery last December. He was released from the ICU in January; however, doctors explicitly stated that Eloy needed a clean, ventilated area to rest and recover. Yet, MEDLIFE staff members knew that he was going back to a small, dusty home shared with two other families.

Two weeks later, MEDLIFE began the process of building Eloy a new, clean, and well-ventilated house. With a generous donation of land from the community, MEDLIFE staff members worked alongside residents to build a new home for Eloy's family. A new staircase project was also completed, allowing Eloy to safely walk to and from his new home.

Watch the video highlights from these projects below!

A New Home for Eloy from Medlife on Vimeo.

 

CorreaAs the February 17th presidential election approaches in Ecuador, many are taking a longer, reflective glance at what President Rafael Correa has achieved since he took office in early 2007.

A recent Reuters article reports, "Correa has won broad popular support by expanding access to healthcare, doubling state spending on education and turning rough dirt paths into proper paved roads." It also notes that, according to the government, Correa has "built 18 hospitals and 250 health centers across the nation."

Indeed, Correa – who describes himself as "left-wing" – has made it a top priority to increase spending on social projects. Many believe Correa is on track to winning the upcoming election.

Yet, implementation of Correa's health care plans has been slow. Like many other countries in Latin America, Ecuador's health care system is taxed by overwhelming demand and a lack of resources. Since the country began providing free public health services in 2007, it has struggled to keep up with a growing body of patients; MEDLIFE staff members in Ecuador have often seen residents begin lining up hours before dawn in order to seek medical treatment.

The health system in Ecuador is comprised of a private and public sector, with the public sector guaranteeing, as stated in the revised 2008 Constitution, "permanent and timely access, without exception, to all comprehensive health care programs and services" for all citizens. However, overall, this covers the health care of only 51 percent of the Ecuadorian population, according to a June 2011 paper by the Ministry of Social Development in Quito, the nation's capital.

The government funds 47 percent of outpatient and hospital services in the nation, in addition to the nation's largest hospitals for referrals. But according to World Health Organization (WHO) standards, there should be between 8 and 10 hospital beds available per thousand people. The number of available beds in the Ecuadorian hospital system in 2011 was only 1.7 per thousand; many hospitals remain at full capacity.

MEDLIFE's work in Ecuador has also changed under Correa. On the one hand, better government coverage of medical costs helps lift the financial burden on low-income families, as well as on MEDLIFE as an organization. On the other, quality is often poor and waits may be extremely long. A 2011 Wall Street Journal article said there were, at that time, "4,500 people on waiting lists for surgery."

These problems are evident in this excerpt from a recent blog post written about a current MEDLIFE patient in Ecuador:

Jose's first consultation for his condition was the entire family's first visit to a hospital. It then took three months to schedule a surgery for him.

A nurse walks by and says the doctor has arrived at the hospital. He is the only pediatric surgeon, working four days a week, and it is obvious. Dozens of families rise to their feet at the news, standing around the exam room door, silently hovering in a semi-circle of anticipation. Eventually, people grow tired and sit back down.

When patients are referred within the public system for treatment, many times they still fail to receive the treatments they need due to lack of resources, lack of confidence, cultural insensitivity, or a lack of understanding about how to navigate the system. For all of these reasons, MEDLIFE's role of advocating on behalf of our patients has become even more important.

You can read more about MEDLIFE's patient follow-up process here.


HygieneProject15 img2

In the community of Galte Yaguachi, located in the region of Guamote, MEDLIFE is currently planning to construct a new school room which will benefit over 100 children. Currently, due to a lack of infrastructure, classes at the school are given in rented rooms or community spaces. With the help of the local government, MEDLIFE has begun the necessary steps to acquire a donation of land to build on.

However, as a first step to improve the quality of life for these children, we also began the construction of sanitary bathroom facilities. Thanks to the community's hard work, this bathroom project was recently finished. Before, the children had to walk to the community's day care center or ask at nearby houses to use the bathroom; now they have proper facilities of their own.

After forming as a MEDLIFE chapter in the fall of 2012, the student group at UC Davis had a busy and productive first semester. Check out this interview with the chapter's president, Tamara Enriquez, about how the chapter was formed, some of their fundraising ideas, and the progress they made in their first few months.

UC davis groupWhat do you think about MEDLIFE´s work?

We think that MEDLIFE's work is exceptional -- our chapter supports it 100%! We wanted to start a MEDLIFE chapter because it combines medicine, education and community development. It is important to realize that much of the health disparities that we see in Ecuador, Panama, and Peru can be addressed by education and development, thus reducing the amount of medicinal treatment that a patient has to receive. However, not everything can be prevented with education and community development. So, when MEDLIFE does provide medical treatment, the treatment is quality care performed by local doctors. We like the fact that the patients we see will have access to health care even after we leave.

How did you first learn about MEDLIFE and why did you decide to start a chapter?

I spoke to some friends at UC Berkeley about my past experience going on a medical brigade and how I wanted to start another organization with some of my friends who were also interested. They explained that they were in MEDLIFE and, immediately after, we went through the process off starting a chapter at Davis. We wanted to start a chapter because we believed that the work MEDLIFE is doing is effective. We had an amazing experience during our first experience as part of a medical brigade, but we thought that MEDLIFE incorporated more factors into the big picture (sustainability, root causes, etc.) We're glad to be involved with MEDLIFE, especially because the staff is there for you 24/7. As a new chapter, you need as much support and advice as possible to get things rolling.

How do you go about organizing a fundraiser or event? 

We brainstorm potential fundraising ideas during our executive board meetings. The fundraising committee also brainstorms events during general meetings. The fundraising officers then present ideas to the rest of the members to see if they support them. We then have the media committee begin working on the advertising materials while the fundraising committee takes care of logistics (getting in contact with whatever company we are fundraising through, determining what percentage of profits our MEDLIFE chapter will receive from the company, etc.). If money needs to be invested into a fundraiser, the treasury officer takes care of this. Once all the logistics/finances have been set in stone and the advertisement materials have been printed out, we spread the word via flyers around campus and a Facebook event for each fundraiser.

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