Deep in the Heart of the Andes: A Social Approach to Understanding Riobamba’s Health
By
Alaha Nasari
From the looming beauty of Chimborazo, to the rich caramel aroma of manjar de leche, life in Riobamba,
Ecuador is still deeply etched in my memory.
Exploring the rich history and culture of Riobamba through indigenous dishes, ancient monuments, and
local markets was only a part of my experience on the MEDLIFE Service Learning Trip I participated in
last May. Perhaps the most valuable lesson I learned was understanding how the MEDLIFE mission
translates into real-world impact.
As the birthplace of the MEDLIFE Movement, Riobamba is one of Ecuador’s poorest provinces. In
collaboration with a group of health sciences students from the United States, I worked alongside local
physicians and community leaders to provide care for the indigenous communities of Riobamba. We set
up Mobile Clinics in five different sites, where we observed and operated stations for vital sign
assessments, nutritional consultations, general medicine care, dental hygiene, and women’s health
services. We also assisted in constructing a home for a community member financially impacted by the
pandemic as part of our Development Project.
While observing physicians carry out these assessments certainly offered insights into clinical practice, I
learned most through my conversations with local leaders and healthcare workers. Through these
interactions, I learned the Riobamban narrative — a narrative built on a fragmented healthcare system
marked by government failure to prioritize rural community health, limited access to medical equipment
for diagnosis and treatment, shortage of healthcare professionals, inefficiencies with documentation,
restricted educational prospects for the younger generation, poor infrastructure, and transportation
barriers. My perspective, which was previously limited to the health issues we were addressing, now
included an understanding of why these issues existed to begin with.
Identifying the historical, social, political, and structural determinants of health is critical to resolving
healthcare challenges both in Riobamba, Ecuador, and on a global scale. Historical narratives that have
shaped a community’s access to healthcare can provide insight into persistent disparities that might
otherwise remain invisible. The social fabric of a society, from its cultural norms to its economic factors,
can explain health-seeking behaviors and patterns of illness and wellness. Political decisions, whether
local or global, can account for resource allocation and policy implementation. Meanwhile, structural inequalities, often deeply embedded in societies, impact everything from healthcare infrastructure to
socioeconomic disparities. Analyzing these determinants is the first step in developing a deeper
understanding of the root causes of health inequities.
It has now been a year since my time in Riobamba. As I reflect on my experience, I realize the challenge
lies in developing approaches that extend beyond a mere transactional engagement with the communities
we serve. My experience was far more profound than a simple accumulation of clinical hours. Instead, I
hope to internalize the lessons of experiential learning and transform these insights into actionable
strategies for long-term improvement. My service in Riobamba revealed to me how a social approach to
health is the cornerstone for not just delivering immediate aid but for inspiring ongoing momentum and
change. This translates into forging enduring connections with communities, remaining engaged with
their needs, and advocating for comprehensive, inclusive, and sustainable interventions – just as
MEDLIFE’s mission itself underscores.