Through our health care program, The Tandana Foundation aims to improve rural community members’ access to basic health care and support local rural health professionals in caring for their population. Tandana’s health care work has two stages: community visits by groups that include North American health care providers and follow up after these visits.
Our community visits are made possible through our Health Care Volunteer Vacation program twice a year and by custom programs we coordinate for hospitals or medical schools when possible. Volunteers including doctors, P.A.s, dentists, nurses, physical therapists, and willing assistants sign up for these programs and spend one or two weeks in Ecuador. Together with Tandana staff and local professionals including interpreters, these groups visit various communities in the canton of Otavalo. We coordinate with the Ecuadorian Consulates in the United States, the Ministry of Public Health, the Quinchinche and Gualsaqui Subcentros, the Mojandita Health Center, and the Union of Indigenous Communities of Quichinche. We have provided over 7,000 patient visits since we began the program in 2007.
Our Health Care Volunteer Vacation groups work mostly in communities pertaining to the Quichinche and Gualasqui Subcentros (rural health centers). We collaborate with Subcentro staff to visit the more distant communities that are served by their center. The Subcentro staff are mandated to visit these communities regularly, but are given no funding to do so and have very limited supplies of medications. With Tandana’s help, they are able to fulfill their mission of providing care in these distant communities, from which access to the Subcentro is difficult.
When patients arrive at the school, community center, or health center where we are working, Tandana staff and volunteers take their names, ask basic questions, and take vitals, preparing them to see the health care providers. Working with interpreters, the providers examine the patients, make diagnoses, and prescribe medications from our portable pharmacy. We ask a contribution of 50 cents per family for the medications in order to encourage patients to take responsibility for their health and to promote valuation of the medicines. Following our providers' recommendations, a nurse or other volunteer performs basic laboratory tests, such as those for H. pylori, urinalysis, pregnancy, and streptococcus, on the spot and does ear cleanings as necessary. We are also able to do ultrasounds during our visits. At this time, our providers fill out referral forms for any patients they feel need additional care, tests, or specialists.
During our community visits, we can also address dental, vision, pediatric, and preventative care needs. Volunteer North American and local dentists may use our portable dental equipment to fill cavities, extract teeth, and do preventative treatments such as sealants and fluoride. For vision complaints, we conduct vision screening, provide reading glasses to those who need them, and send those who require more specialized diagnosis and treatment to Fundacion Vista Para Todos. At schools, we weigh and measure the children, a nurse or doctor listens to their hearts and lungs, and we provide parasite medication if the children have not received it within 6 months of our visit. To round out our community visits, we also give educational talks on such topics as nutrition and family planning when time and human resources permit.
For all of these services, we keep records so that as patients return for subsequent community visits, we have their history available. Thanks to our new Electronic Medical Record system, we no longer have to haul around boxes of paper files, which lightens our load both literally and figuratively.
The second phase of our health care work begins after the visits to the communities have taken place. Tandana's Patient Follow Up Coordinator, Program Assistant, and interns review the referral forms and make a plan for where each of the patients needs to go. The staff communicate with the patients and advocate for them in the public health system. It is our goal that, through this process, patients learn how to use the system on their own.
The Tandana Foundation is committed to providing culturally- and individually- respectful care. Volunteers receive an orientation including an introduction to the local culture and a discussion of the cross-cultural aspects of our work. Our team always includes at least one fluent Kichwa speaker, and we take the time to listen to patients fully even while trying to be efficient so that we can see more patients. We promote a spirit of collaboration with local health care options, including both professionals in Western medicine and traditional healers such as shamans, yachaks, and sabios. We see our work as complementary rather than contradictory to that of traditional healers, and we make efforts to meet with, discuss with, and learn from local individuals with these specialties.