Monday, May 4, 2009


I have been trying to ignore the swine-flu hysteria. But Maya and I are both feeling ill today, and I came home from work and driving Maya to violin and ballet classes and went straight to bed. Yesterday I took the train to and from New York and spent the afternoon in a packed theatre and a busy restaurant. I expressly chose the train as safer than the bus, and walked rather than taking the subway, but did not see New Yorkers wearing masks or altering their behavior to avoid illness. I have decided that this flu is like any other; we try to resist the flu by avoiding close contact with ill people and washing our hands. I usually travel to Mexico several times each year, but because of our plans for Ecuador, there has not been enough time for a visit to Tulum or San Miguel de Allende between now and our move, and I am feeling relieved that I do not have to make a decision to go or not to go. Listening to news on television or NPR is all about the swine flu, and my impression today is that the illness may be abating. However I also heard that the flu would wane in North America for the summer but return as a stronger virus in the winter. The virus's behavior over the summer in the southern hemisphere will be predictive of its behavior next fall in the United States.

This reminds me of the book 'Culture Shock' which agitated me when I read it in January. One chapter outlines all the diseases that we would be exposed to during our year in Ecuador and the inadequate treatment for most of these illness. Chagas disease could be chronic and debilitating and there is no cure. Dengue fever is transmitted by mosquitoes and there is no vaccination for it and it can be fatal! Our GI systems do not adapt well to the tap water therefore we will be using bottled water to brush our teeth and of course to drink. It is likely we will have diarrhea several times during our stay. Hopefully there will be no cholera outbreak while we are in Quito. The hospitals are very variable in the quality of medical care. The medical care for the wealthy is very different from that dispensed to the poor and disadvantaged. Of course that is no different than the way it is in the United States. Except that I think we will be one of the poor and disadvantaged when we live in Ecuador. Will we have enough to eat? Eric assures me that nobody starves in Ecuador. Will we have access to good medical care if we need it? What do we do if there is an epidemic of some sort?

Eric has assigned a project that is entirely my responsibility; that is to pull together the best first aid kit I can find. The implication is that Eric and I will be attending to Maya and ourselves for basic medical care. We will bring lots of Cipro and anti-malarial meds, ibuprofen and aspirin and the like, bandage materials, epipens, etc. We will have to add Tamiflu to the mix now: the H1N1 virus may be busy this summer in the southern hemisphere. We will have access to medical care, at least we will while in Quito and less so in the jungle. It will be the more complicated medical procedures and protocols which will be less available to us. I am most concerned about huge natural disasters; earthquakes and volcanic eruptions. Quito is not the kind of place that seems ready to manage huge volumes of injured people. There is little we can do or prepare for in such a situation. I will just cross my fingers and hope that we will be lucky and not have to face such eventualities. I am working on my optimism.

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