Docs in Training in Rural Ecuador

As we move forward with our physician training program, I would like to share with you a few reflections. Last week, a 30 year old man was rushed into the Emergency Department at Hospital PVM after a serious motorcycle accident at 2:00 am. He was initially evaluated, stabilized, and hospitalized by one of our residents, Dr. Amanda Tene Rueda.

At 4:00 am, he developed severe respiratory distress and could not breathe. Amanda re-evaluated the patient, using a laryngoscope, allowing her to see deep into his throat and around his vocal cords. In short, blood was blocking his throat.  He was drowning.  

The resident proceeded to “intubate”– put a tube through his mouth and into his lungs to establish a safe airway for the flow of oxygen. The patient ultimately was transferred to a higher level of intensive care in the capital but survived and did well.

The point is, just a few short months ago, Amanda did not possess these much-needed skills to save a life. And save a life she did.

What impact are these physician residents having and at what cost?  Let’s look at what they will be able to do after finishing their 3 year residency.  Assume for a moment that a typical day for a Family Physician graduate from our program looks like this:  

• 30 patients attended in the office
• 6 emergency visits attended
• 2 childbirths
• 10 hospitalized patients.  

If they work 23 days/month for 12 months and do so for 30 years, their lifetime production in terms of patients attended is the following: 

• 248,000 patients attended in the outpatient setting
• 50,000 emergencies
• 16,000 childbirths
• 82,000 hospitalized patients

It costs AHD a mere $10,000 per year to train each of these physicians. That multiplied by the 3 year program is a total of $30,000. This is a stunning return on our investment and illustrates why we decided to invest in the people doing this difficult work.  We’ve invested many years and resources in buildings and equipment to alleviate the pain and suffering of the rural poor of Ecuador. It only follows that we now invest in the leaders who make it all happen.

David Gaus

Editors Note  
David Gaus, Founder, Andean Health and Development, Ecuador;                                               Regional Social Entrepreneur of the Year, Latin America, 2010

Andean Health and Development is transforming rural health in Latin America by providing at the community level high quality medical care and training for future rural healthcare leaders. 

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