On a visit to a small school compound in Valle Alto, a poor rural community in the humid hills of Cumandá, Ecuador, Maria, PJ, and I met with a new patient named Alex Javier Chafla.
Cumandá was overcast and hot. We walked on gray dusty roads surrounded by thick clusters of palms and ferns to the community school. There were two buildings, the older one L-shaped and strung together with orange and yellow painted bamboo, and topped with thick sheets of corrugated tin for a ceiling. The newer building was constructed by MEDLIFE Ecuador in February 2012, and is one long room of thick concrete walls with wide windows. Currently, we are working on building another school house for the over 70 children between four and twelve years old who attend.
When we arrive, it’s recess. Children suck on packets of light-pink colored yogurt and scrabble in the dirt to win soccer games without any distinct goal posts. Then they line up for a turn to cool their faces and quench their thirst from a spigot of potable water next to the one bathroom stall. The line is long and children push up against one another in excitement. A young girl gets squeezed out of line and falls into a muddy puddle. A young teacher helps her up and hugs her, reprimanding the unruly line.
After the students rush off to their classrooms, Maria, PJ, and I greet Alex in a small room with a plastic table and a few chairs serving as the principal’s office.
Alex is 18 years old, and slight in build. He is wearing a bright red and white striped t-shirt, with golden yellow embroidered logos and numbers across the chest. His hair is long, gelled upward on the top and buzzed on the sides. Alex sits a bit slumped in his seat with his hands clasped together. He has a hard time making eye contact when he speaks. Essentially, he’s a normal teenager.
And typically, his condition is considered a normal side effect of puberty for young men. Alex has the beginnings of gynecomastia, or the “development of abnormally large breasts in men.” Currently, he has a small lump beneath his left nipple.
Though more than half of boys develop the condition during puberty, which can range between 10 and 20 years of age, it usually disappears over a few months. Alex is toward the end of puberty, and his condition has persisted. The possible causes for gynecomastia other than typical hormone changes can be serious health threats. Chronic liver disease, kidney failure, and testosterone deficiency are some of the more common reasons. Genetic defects, an overactive thyroid, and tumors are more rare.
Alex speaks in a soft whisper as he answers our questions. His long lips barely part. At first, he said that he was not nervous to be treated. He later adds with uneasiness that it would be his first time getting medical care, especially in a hospital. “I am a little nervous but I have to confront my sickness,” he says resolutely.
Alex found MEDLIFE Ecuador after a Mobile Clinic came to his high school, Colegio General Antono, in Valle Alto. After seeing a clinic doctor, MEDLIFE was able to assess his family’s financial needs. Currently, they are bringing in less than $80.00 per month to support a family of eight people.
The family was verified to receive aid. When Alex found out, he says, “I felt good, sure that I would see a doctor.”
There have been additional financial constraints as well. Alex’s father, Segundo Alejandro Parapi Chafla, 42, has not been able to work driving his taxi for about four months due to hemorrhoid surgery. Alex admits that it has “affected the family a lot.” His mother, Maria Cenada Chaflas, 35, works at home taking care of Alex’s five younger brothers. They also care for a mentally disabled uncle.
However, unlike many poor rural families in the Valle Alto community of Cumandá, Ecuador, the family owns their own house. They do have electricity, though more than three people sleep in each room.
Currently, Alex is slated to see a doctor next week. It is a three hour bus ride to Riobamba from his community. For now, the doctor ordered an x-ray of his left breast and a series of laboratory tests for when he arrives at the hospital.
Rachel Hoffman is a MEDLIFE media intern working out of Riobamba, Ecuador