Project Perfect World

Another team of Project Perfect World doctors, nurses, physical therapists, and support staff just completed another medical mission trip to one of the pediatric hospitals in Guayaquil. This particular trip focused on hand and spinal deformities. Below is a news video about the trip.

I mostly helped translate for a team of physical therapists and orthosists who helped make and modify splints for both patients who were recently operated on, and those who may have to wait for further surgery. Not all patients can be operated on, not only because of the time limit that the group of American doctors is in the country, just one week, but also because not all potential patients are good candidates for corrective surgery. One patient that was seen, for example, previously had her left arm amputated just below the elbow. Her right hand had only two fingers, her thumb and index finger. The orthopaedic surgeon was concerned that surgery on her right hand to improve mobility and function could end up compromising the little function she did have. Surgery, for this particular patient, would be too big a gamble. She was fitted for a splint in attempt to improve the web space between her two fingers.

I particularly enjoyed translating for the patient pictured above, a 15 year-old boy named Raphael. After explaining how to wear his new splint, one of the only questions that Raphael wanted to ask the doctors and physical therapist was why they gave him a splint with pink padding. When I translated the question, the therapist, pictured standing behind the patient, laughed and said that it was the softest material he had. Raphael also wanted to know if he could play Playstation when he returned home. After intially saying yes, the therapist caught the stare from mom, and then modified his response. Permission from mom was needed first.

News Coverage

http://www.hogardecristo.org.ec/enfermeras.html

The link above has two videos, two radio interviews, and a newspaper article about the work that the group of BYU nurses has been conducting the past two weeks. I am shown briefly in both videos. In the first I am helping draw blood for a hemoglobin test. In the second I am teaching a student how to complete a vision exam.

The White Women That Cure and Give Injections

The title above is not mine. It was published yesterday in one of the national newspapers of Ecuador called Expreso. Below is the link.

http://expreso.ec/expreso/plantillas/nota.aspx?idart=3278200&idcat=19351&tipo=2

Unfortunately, the only element of truth in the title is that the visitors are White. The team of male and female nurses visits schools in the Northwestern Perimetral region of Guayaquil, Ecuador once a year to complete an anemia study. The group, accompanied by myself and workers from the Hogar de Cristo Education office, will visit 4 schools over the next two weeks. The height and weight of each student is recorded, along with a preliminary vision exam, which I help run, and a quick poke of the finger with a lancet to draw just enough blood to measure the hemoglobin level of each student. The modern hemoglobin readers which the team brought down with them needs just a few drops of blood, and about 90 seconds to make a reading. Any hemoglobin level of 11 or higher is considered normal. Between 7 and 11 is diagnosed as anemia, and anything below 7 is diagnosed as severe anemia.

Up until today, the second day of the two-week-long study, most of the students have been on the borderline of anemia, with many readings between 11 and 12, although there have been students with severe anemia. One of the causes of anemia is an insufficient intake of iron, normally received through eating healthily, that is, a balanced diet. Each morning the team runs the height, weight, vision, and blood test circuit, then makes a few house visits to complete nutritional interviews with selected parents. The hope is that the nurses may be able to help teach parents cook more balanced, iron-rich meals.

Once all of the students are tested, the team of nurses will begin their study of how best to treat childhood anemia. The four treatment plans include a control group of just soy milk, which does have iron, but only 10% of the daily recommended intake. The other treatment plans include vitamin and iron supplements, anti-parasite pills, and the hypothetical ideal treatment of both vitamins with iron and anti-parasite pills. The group of nurses hopes to return in October, the end of the Ecuadorian school year, to re-test the students and determine which treatment plan proved most effective. So although this particular group of nurses from Brigham and Young University may, in fact, be white, they are not all women, nor are they either curing anything, at least not quite yet, or giving any sort of injections.

Rainy Season Photos

Below are photos of the rainy season in Monte Sinaí. The first is of a street I visit at least once a week to deliver diapers and formula to a mother and her child. The second is a picture of a canal that runs through the community and that, beginning this year, has caused flooding problems. It is easy to see that, after a steady rain, the level of the canal rises, and enters the homes adjacent to it. The Rostro de Cristo house in Sinaí, in fact, is only about 30 feet away from the canal, but our property is high enough that flooding has not been an issue, at least not any flooding due to the canal. The final photo shows our courtyard which, up until recently, regularly flooded with the rains. The area has now been filled-in with 3 truck loads of dirt and rocks. All of these photos give only a taste of what the rainy season is like. Cars become stuck and damaged from the deteriorating roads, water tanqueros cannot deliver potable water to residents, homes become flooded, and on top of all of that, children often become sick from the stagnant water, which only complicates the mosquito problem.

The Rainy Season

Right now Ecuador is about midway through its rainy season which has made many of the dirt roads on the outskirts of the city impassible. Vehicles regularly get stuck in mud. A friend of mine was actually riding a tricimoto, or a motorcycle with a platform attached to the end of it with a few rows of seats for passengers, when it flipped over onto its side. The sides of buses sometimes become completely covered in mud, making it impossible to see out the windows. Walking by foot can also be a challenge. I nearly face planted in mud when both of my feet became stuck in mud that was deeper than I had thought. When I have to, I wear rain boots that nearly reach me knees, and even they are sometimes to low to wade through the standing water on some side streets. Some blocks have only sections that are impassible, like the lowest part of the road between our house, and where we purchase our drinking water. Other blocks have become completely immersed in water. At one point, earlier last month, both of the ends of out block were so bad, that water trucks were not able to deliver water to our neighbors. After a week or so, neighbors got together to purchase a truck full of rocks to help fill the road. Normally, a truck would cost $15, but now the price has risen to $30. Neighbors are forced to pay the higher fee in order to get rid of the standing water around their property. Our own property had a flooding problem that was fixed only recently. The fill we used, a combination of dirt and rocks, along with the labor to actually spread and flatten it, cost over $200. Even then, a section of the property still floods after a steady rain.

The rainy season is not just an inconvenience, a transportation problem, something that will be all dried up once the dry season comes at the end of April or beginning of May. It is a health problem, too. Neighbors often wade through flooded sections barefoot, risking infection of bacteria growing in the standing water. One neighbor has had a reoccurring foot infection for the past four years. Every rainy season, her feet become covered in a fungus that leaves her feet dry and crusty, and make walking painful. Only after multiple visits to health clinics has she finally gotten the referring paperwork she needs to be seen at the hospital of infectious diseases in downtown Guayaquil. Mosquitoes also become more common during the rainy season, and this past week the Ministry of Public Health has driven around fumigating the neighborhood. La Secretaria Nacional de Gestion de Riegos, or National Secretary of Risk Management, an arm of the government that equates to that of the National Guard in the United States, has helped dig two canals in Monte Sinai, one nearly the length of the sector, the other just a few blocks. Supposedly, both are to be replaced by cement tubes that will be placed below street level so that none of the water is exposed. The canals have completely cut off any vehicle traffic, with each one about three feet in width. Any water delivery and trash pickup have likely been significantly effected, and this to an area that already had irregular access to both of these basic services.

Rain water is sometimes captured in barrels or though makeshift gutters that drain into a bucket or other tank, and while this can help cut down on the cost of water for laundry or bathing, it poses the same risk as during the rest of the year when water that is used for bathing or cooking is left uncovered and in containers that may not be cleaned regularly. Even the cistern of our house is cleaned only about once every other month. The lack of running water is just another health risk that those who live in the city do not really experience.

Electricity had been somewhat reliable since the summer, but with the rain, and sometimes without it, frequent outages have occurred. This usually only means that the night will be a little hotter, without ceiling fans, and that showers are bucket showers. Without our electric water pump to push water through our plumbing system, the only way to get water is to lower a bucket into our cistern tank. At least in our house, everyone seems to go to bed earlier when there is no electricity. A candle, or headlamp, has a way of putting a person to sleep.

A Missionary Within One´s Heart

I have reentered the U.S. after having traveled abroad about seven times, but in only one instance, the first, did I ever really have an exchange with the U.S. Customs agent.

Agent: What were you doing in Ecuador?
Me: I was on a mission trip.
Agent: Did you have any converts?
Me: No, it was not that kind of mission trip. It was more of an immersion trip . . .

Before I could say anything further, the agent had already resumed his typing, squinting, and stamping. I doubt he heard anything beyond the word, ´´No.´´ I am still not sure if he was genuinely interested, or just poking fun. Either way, I was reminded of the experience after reading a passage from Yann Martel´s book, The Life of Pi.

´´There are always those who take it upon themselves to defend God, as if Ultimate Reality, as if the sustaining frame of existence, were something weak and helpless. These people walk by a widow deformed by leprosy begging for a few paise, walk by children dressed in rags living in the street, and they think, ´Business as usual.´ But if they perceive a slight against God, it is a different story. Their faces go red, their chests heave mightily, they sputter angry words. The degree of their indignation is astonishing. Their resolve is frightening.

These people fail to realize that it is on the inside that God must be defended, not on the outside. They should direct their anger at themselves. For evil in the open is but evil from within that has been let out. The main battlefield for good is not the open ground of the public arena but the small clearing of each heart. Meanwhile, the lot of widows and homeless children is very hard, and it is to their defence, not God´s, that the self-righteous should rush.´´

There Is Only One World

In his book, Mountains Beyond Mountians, Tracy Kidder tells of an exchange between himself and Paul Farmer, the book´s subject and founder of Partners in Health, a nonprofit health care organization that provides first-world health care to third-world patients. Kidder and Dr. Farmer were waiting for their connecting flight in Paris´ Charles de Gaulle Airport when Kidder, reflecting on the futuristic architecture of the terminal, confessed how it seemed as though rural Haiti, at that moment, was ¨another world.¨ That sentiment seemed to light a spark in Farmer.

           ´´But that feeling has the disadvantage of being . . .´´He paused a beat. ´´Wrong.´´
           ´´Well,´´ I retorted, ´´it depends on how you look at it.´´
           ´´No, it doesn´t,´´ he replied, in a very pleasant voice. ´´The polite thing to say would be, ´You´re
             right. It´s a parallel universe. There really is no relation between the massive accumulation of wealth
             in one part of the world and abject misery in another.´´ He looked at me. He´d made me laugh.
            ´´You know I´m being funny about something serious,´´ he said.

While shadowing Dr. Farmer for his book, Kidder came to realize that Farmer´s mind was one that saw ´´intimate, inescapable connections between the gleaming corporate offices of Paris and New York and a legless man lying on the mud floor of a hut in the remotest part of remote Haiti.´´ For Farmer, of all the world´s errors, the most fundamental was the ¨erasing´´ of people, the ´´hiding away´´ of suffering. His big struggle is how people can ´´not care, erase, not remember.´´ Farmer is the kind of doctor who, while traveling, thinks of all fellow passengers as patients, and while his services are only needed on about one out of every eighteen flights, he probably would not mind if it happened every flight. The continuity and interconnectedness with which Farmer sees the world comes with a lot of burdens, but also frees him from the efforts that many people make to find refuge and distinction from their fellow human beings, the sort of refuge and distinction that is sought after with a phrase like ´´another world.´´

Like Haiti and France, Ecuador and the U.S. cannot be world´s apart. There is only one world. Describing one as being ´´another world´´ from the other only ignores the necessary link between the two. Ecuador may not have been a former colony of the U.S. but the abuse of American companies like Chevron within the country work to create just as much of an imperial power.

I recently spoke with a volunteer from Ireland who had been staying in Ecuador for five weeks. He was reflecting on the poverty that he had seen, when he added, ´´And to think that it is all by some accident of birth that I live like I do, and they live like this.¨ I think he was right to disconnect any difference there might seem to be between the rights of an Ecuadorian and someone who lives in Western Europe or the United States. Geography hardly determines a person’s right to clean water, food, and basic services like health care and education, but it often does determine a person’s access to them, with the developed countries of the world having been able to provide these to its citizens for nearly centuries, while other countries, still today, are unable to do so. What the volunteer came to see first hand were both the stark contrast in living conditions, and the fact that he could have just as easily been born into a life with so much fewer of the things he took for granted. The zip codes we live in determine so many of the services we have access to, but few people do very much to actually deserve any of these differences. Instead, we are born into tracts that largely impact our living conditions, and the wealth in some parts of the world is hardly earned independently of the developing world.

Old Year, New Celebration

The easiest way to imagine New Year's in Ecuador is to imagine the 4th of July in America, with just a few adjustments. I spent the afternoon downtown with a neighbor, walking about twenty blocks down a street, Seis de Marzo, known for its muñecos, or life-size paper-mache figures used to celebrate the New Year. Vendors lined the sidewalks, with their creations neatly arranged in rows, ready to be sold, and ranging from $5 to $100. Some vendors will still busy putting finishing touches on their muñecos with spray guns, while others charged 50 cents to take pictures with their larger creations, some as tall as ten feet. A few intersections had monstrous muñecos that must have been over fifty feet tall, and seemed to cover the entire intersection. The main street was full of muñecos, people, and food. Food carts were selling fried dough cut into French fry-sized pieces and sprinkled with sugar, shaved ice, ice cream, and other treats. It was the closest I have come to seeing a fair in Ecuador. It seemed that people were eating what they had until they walked past someone eating something even tastier, and bought one of those, too. Some carts were selling nothing but grapes, used for a New Year's tradition when the clock strikes twelve. The goal is to eat twelve grapes, one for every chime at midnight, before the final strike. This does not sound difficult, but the grapes are seeded, so unless you plan on eating the seeds, you have to work fast.

New Year's in Ecuador is more a pyrotechnic show than an eating contest, though, and, without a watch or a cell phone, it was not until fires started in the street that we were sure that midnight had come. The muñecos, dragged to the street, doused with gasoline, and set afire made for an odd site. It appeared as though there were simultaneous bonfires about every 100 yards down the street, all started at basically the same time. Just in case the paper-mache fires did not do the trick, small fireworks were thrown at the burning muñecos, making for a sort of bonfire that no one wants to get too close to. The muñeco fires were not the extent of the show, however, and the fireworks rivaled any backyard show I have seen. In fact, some of the fireworks seemed to be the same quality that are used for 4th of July shows in large cities. The most interesting variation Ecuador had to the typical 4th of July celebration was the use of sparklers. Just in case you thought sparklers were only fun to kids, it turns out that lighting a sparkler, and then throwing it into the air and seeing where it lands can bring just as much excitement to adults. I was not too sure what to think when I watched a girl hand a sparkler to her dad, only to have him toss it high into the air, and land in the street, nearly landing on somebody riding by on a bicycle. Once the paper mache fire died down, which was occassionally aided by a cup or two of gasoline, we enjoyed a typical New Year's meal of rice, lentils, and chicken. We also had hot chocolate and Christmas bread, which have been two treats that have been popular since the week or so leading up to Christmas.

Does America Help the Poor?

The American economist Jeffrey Sachs, in his book The End of Poverty: Economic Possibilities of Our Time offers a prescription to take real steps to ending extreme poverty by the year 2025. The title of the book can be misleading only in that Sachs does not propose the eradication of all poverty, but only the most severe form, which he calls extreme poverty, and defines as the inability to meet daily needs like food, water, and shelter. Those living in extreme poverty are in an entirely separate class than those without equal access to medical care and education, which Sachs defines as moderate poverty, and certainly separate from those who have daily basic needs met, and even access to public services, but earn only a limited income, which is defined as relative poverty. In fact, Sachs believes that the last instance, relative poverty, will always exist, but extreme poverty is not only economically possible to erase, but, he feels, that it which will define the accomplishments of the current generation.

One of the most basic steps that Sachs proposes is not even his own. Instead, it was proposed and agreed to 41 years ago in a UN General Assembly Resolution, and later reaffirmed as recently as 2002 at the International Conference on Financing for Development held in Monterrey, Mexico. The language of the agreement asks only for "concrete efforts toward the target" of giving 0.7% of GDP as foreign development assistance, but after 35 years, as the graph below shows, the United States falls miserably short of its promise. Unfortunately, only five countries have met the 0.7% promise, Norway, Sweden, Luxembourg, Netherlands, and Denmark. The rest, including the United States, fall short. In fact, the United States gives a little more than just a quarter of the goal, with just 0.22% of total Gross National Income, or GNI, offered as Official Development Assistance. Due to economic development since the original agreement in 1970, donor countries would now only need to give 0.5% in order to reach the necessary level to end extreme poverty. Yet, even with this lower requirement, the United States does not even make it half way.

Source: unmillenniumproject.org

The United States does lead the way in one statistic, military spending. America spends more than China, the UK, France, Russia, as well as the next ten countries combined. ODA, or Official Development Assistance, is clearly not a priority, but military expenditure is, and no other country than America even comes close in that regard. If you thought that the United States gave more money as foreign aid, you are not alone. Americans, on average, believe that foreign aid accounts for 20% of the federal budget, according to a 2001 survey by the Program on International Policy Attitudes at the University of Maryland. That guess is roughly twenty four-times the actual figure.

Merry Christmas

Are You Fluent?

Since 1952, linguists have used a list of 100 words, or some variation of it, called the Swadesh List to determine a person´s fluency before taking them on as experts of a particular language. The list is still used today, but mostly by linguists working to record dying languages at risk of extinction, those that have only hundreds of living speakers, and are not being passed on to future generations. The list consists of 100 carefully chosen, slow-to-change words. Since the objective of linguists is to create a written record of languages that currently do not have one, and are spoken by very few people, the list consists of especially static words. Of all the words across all the languages of the world, the words that make up the list are known for their uniqueness and stability.

One of the most common questions of people who speak more than only language is whether or not they are fluent, or at least what their degree of fluency is. While this list was not intended to measure a person´s fluency of any commonly spoken language, it does provide a start, a list of 100 not-so-arbitrary words that could indicate just how broad a speaker´s scope of vocabulary actually is. Notes in parentheses after words try to eliminate any peculiarities, such as, in #81 how smoke refers to a noun, not a verb, or in #85 whether path can refer to a street, it cannot. The list still allows for several ambiguities, at least in Spanish. #45, claw, does not specify of what animal. Normally, in Spanish, the word is garra, but for crabs it is pinza. Also, #56, bite, depends on whether it is of an insect, picar, or a large animal, morder. Below is the original Swadesh list. Words that I was not able to remember, other than the two Spanish peculiarities just mentioned, included louse, leaf, bark, flesh, grease, horn, tail, feather, neck, breasts, liver, sand, smoke, ashes, and round.   

Original Swadesh List

1. I (1^st person singular) - yo

2. You (2^nd person singular, 1952 thou & ye) - tú

3. we (1955 inclusive) - nosotros

4. this - éste

5. that - eso

6. who? (“?” not 1971) - quién?

7. what? (“?” not 1971) - qué?

8. not - no

9. all (of a number) - todo

10. many - muchos

11. one - uno

12. two - dos

13. big - grande

14. long (not 'wide') - largo

15. small - pequeño o chiquito

16. woman - mujer

17. man (male human) - hombre

18. person (human being) - persona

19. fish (noun) - pescado

20. bird – pájaro (small) or ave (big)

21. dog - perro

22. louse - piojo

23. tree (not log) - árbol

24. seed (noun) - semilla

25. leaf (botanics) - hoja

26. root (botanics) - raíz

27. bark (of tree) - corteza

28. skin (1952: person’s) - piel

29. flesh (1952: meat, flesh) - carne

30. blood - sangre

31. bone - hueso

32. grease (1952: fat, organic substance) - grasa

33. egg - huevo

34. horn (of bull etc, not 1952) - cuerno

35. tail - cola

36. feather (large, not down) - pluma

37. hair (on head of humans) - cabello

38. head (anatomic) - cabeza

39. ear - oreja

40. eye - ojo

41. nose - nariz

42. mouth - boca

43. tooth (front, rather than molar) - diente

44. tongue (anatomical) - lengua

45. claw (not in 1952) - garra

46. foot (not leg) - pie

47. knee (not 1952) - rodilla

48. hand - mano

49. belly (lower part of body, abdomen) - vientre

50. neck (not nape) - cuello

51. breasts (female, 1955: breast) - seno

52. heart - corazón

53. liver - hígado

54. drink (verb) - tomar o beber

55. eat (verb) - comer

56. bite (verb) - picar

57. see (verb) - ver

58. hear (verb) - escuchar o oír

59. know (facts) - saber

60. sleep (verb) - dormir

61. die (verb) - morir

62. kill (verb) - matar

63. swim (verb) - nadar

64. fly (verb) - volar

65. walk (verb) - caminar

66. come (verb) - venir

67. lie (on side, recline) - echarse

68. sit (verb) - sentarse

69. stand (verb) - pararse

70. give (verb) - dar

71. say (verb) - decir

72. sun - sol

73. moon (not 1952) - luna

74. star - estrella

75. water (noun) - agua

76. rain (noun, 1952 verb) - lluvia

77. stone - piedra

78. sand (opposite to following) - arena

79. earth (soil) - tierra

80. cloud (not fog) - nube

81. smoke (noun, of fire) - humo

82. fire - fuego

83. ash(es) - cenizas

84. burn (verb intr.) - arder

85. path (1952 road, trail; not street) - camino

86. mountain (not hill) - montaña

87. red (color) - rojo

88. green (color) - verde

89. yellow (color) - amarillo

90. white (color) - blanco

91. black (color) - negro

92. night - noche

93. hot (adverb; 1952 warm, of weather) - caluroso

94. cold (of weather) - frío

95. full - lleno

96. new - nuevo

97. good - bueno

98. round (not 1952) - redondo

99. dry (substance) - seco

100. name – nombre

Peace Corps vs Rostro de Cristo

The Peace Corps seems to be the most well known overseas service program, at least among college students. Many of the year-long volunteers now serving with Rostro de Cristo, including me, considered the Peace Corps at some point during his or her search for service opportunities. There are some big differences right from the start. For instance, Rostro de Cristo brings volunteers to Ecuador with the help of the Catholic Church. The founder of Rostro is a Catholic priest from Boston, Massachusetts. The Peace Corps brings volunteers to Ecuador, and around the world, with the help of the U.S. government. The mission of the Peace Corps is to increase the cultural competency of Americans, both of the overseas volunteers and those back home who that volunteer will return to, and, ideally, educate. The mission of Rostro is to provide high school, college, and parish retreat groups an opportunity to see the face of Christ among the poorest people in Latin America. It was mainly my experience on one of these retreat groups, while in high school, that made me want to return as a year-long volunteer.

Apart from the missions of the two programs, there are some practical, everyday differences. Peace Corps volunteers in Guayaquil, Ecuador receive a monthly stipend of $400, as well as a housing stipend. Rostro volunteers receive a monthly stipend of $50, as well as a food stipend. As for housing, Rostro has properties in two areas in Ecuador, Duran and Guayaquil, which house all of the program´s volunteers. The Peace Corps, on the other hand, places volunteers with host families for at least the first three months of service, then offers assistance in locating long-term housing. Depending on the situation, a bed and other furniture may need to be bought by the Peace Corps volunteer, as well as a burner for cooking, although all of these costs are covered by another, additional stipend. There seems to be more variety in what a Peace Corps volunteer looks like, and how they live. A Peace Corps volunteer in a city, such as Guayaquil, may live in a fully furnished apartment with appliances included, while a volunteer in the country may have little more than a roof over his or her head. At least, this has been the reality up until now. As of January 2012, Peace Corps volunteers, at least in Ecuador, will no longer live separately. Host families will be used to house all volunteers, which will likely take a significant burden off of Peace Corps volunteers to secure their own housing and purchase all the items needed to live day-to-day. This also brings up complications of living with a family in a foreign country with an entirely different set of customs and rules. Curfews, meal times, and even bathroom use might be challenges for future Peace Corps volunteers that, in the past, were not really an issue.

Even with the greater amount of expenses the Peace Corps volunteer seems to have, the vast difference in monthly stipends, with Peace Corps volunteers receiving 8 times that what a Rostro volunteer receives on a monthly basis, reflects a difference in mission, too. It seems impossible to say what a typical Peace Corps volunteer looks like and how he or she lives. The disparity between city and country living is too great to generalize the experience. When talking to a Peace Corps volunteer it seems necessary to know not only in what country they served, but in what city as well. Rostro volunteers, on the other hand, have a more uniform experience. All Rostro volunteers live in community with other fellow Rostro volunteers. Each community house is fully furnished with beds and appliances, and receives a weekly food stipend which breaks down to about $10 per person. Water and electricity are also provided, but internet is not. Part of Rostro´s mission is to live simply, so internet cafes are used in place of a home computer. Cell phones are also provided, but are shared among an entire house, so phone calls usually need to be coordinated among housemates. Everyone cannot talk with their parents on Sunday nights.

The community living aspect makes up the core of the Rostro experience. Nightly dinner and prayer are both done together, Monday through Friday. There are also safety restrictions which include a 12 AM curfew and a ban on taking buses at night. The Peace Corps also encourages its volunteers to be safe, but has a more lenient policy that ultimately places safety decisions in the hands of volunteers themselves. The sheer numbers of Peace Corps volunteers gives them a greater freedom in making decisions. Ecuador alone has over 200 Peace Corps volunteers. Rosto has a total of 13 volunteers split among two cities.

Just as the housing situation tends to be more lenient for Peace Corps volunteers, so is the weekly work schedule. Rostro volunteers typically work 40-hour weeks, although some of that time may be spent in the community visiting neighbors and helping children with homework. Peace Corps volunteers can vary from full 8-hour work days to just a few hours a week. Should a Peace Corps volunteer decide to begin a special work project, like providing free HIV testing, the Peace Corps will help collect donations through their website, and then send the money to the Peace Corps volunteer. Rostro values spending time with neighbors in the community over creating special service projects. There is also a vast difference in vacation times for the two organizations. Peace Corps volunteers accumulate 2 vacation days a month, which can be saved up to spend, for instance, a month back home during a person´s time of service. Rostro volunteers agree not to leave the country during their year of service, and receive just 5 vacation days for the entire year, although this time does not include 4 weekend retreats spaced at 3-month intervals during the year of service.

It is not just the in-country experiences that differ between Peace Corps and Rostro volunteers. While Peace Corps volunteers receive student loan deferments while in-country, and a partial loan cancellation upon their return to the U.S., Rostro volunteers receive no financial assistance in tackling student loans. Peace Corps volunteers also receive a readjustment allowance at the end of their service as well as special preference when applying for government jobs. Rostro volunteers either need to move back in with parents, or use personal savings. Of course, Rostro volunteers are not completely abandoned. There is a retreat for returning volunteers every fall, as well as a network of 150 Rostro alumni who are generous in assisting with job hunting and in helping readjust to life in America.

There are also differences in the application processes of the two programs. Rostro, for instance, requires applicants to write an autobiography as part of its application. A spiritual reference is also needed, along with that of a college professor, a college roommate, and an employer. At least two interviews are necessary before an applicant is accepted, each with a different director of the program. Both programs offer brief orientations before a volunteer’s time of service begins, but only the Peace Corps offers language training as part of the orientation process.

Both Peace Corps and Rostro volunteers recognize Duran and Monte Sinai as two of the poorest communities in the Guayaquil area. In fact, it is the very reason why Rosto has a presence in each one, seeking to be among the country´s poorest sectors. The Peace Corps, on the other hand, requires its volunteers to either be accompanied by an Ecuadorian, or have special permission from Washington, D.C. in order to work in these areas.

1 out of 505

When I arrived in Ecuador, I started doing HIV testing only at health clinics. Hogar de Cristo has five of them on the northern outskirts of Guayaquil. Sometimes, there are so many people who want to get tested, that we run out of tests, but normally after an hour or so of testing, we are left waiting for more patients to come. Rather than wait for more patients to come to me, I started working with other offices at Hogar de Cristo to get the word out, and schedule visits right in the community itself, at churches, schools, and homes. These visits almost always had more people than visits to the health clinics. I also started doing testing once a week from my office, where anyone could walk in and get tested. This has actually been the easiest way to test a lot of people in a short amount of time, since I do not even need to leave the office.

The visits to health clinics often include people who did not even know that HIV testing would be offered that day, but have come for another appointment or check-up. This was the case just yesterday when a 19 year old male had come with his sisters to the health clinic. By chance, that happened to be the day of the month that HIV testing was being offered. The last visit to this particular health clinic had been a record-low in terms of the number of people tested. I was prepared to do just a few tests, and then wait patiently the rest of the morning, for patients that would probably not come. After a few quick tests, the 505^th patient that I have tested in Ecuador walked in and sat down.

Most of the questions that I ask are exactly the same from patient to patient. By now, almost four months into my time in Ecuador, I have a set of statistics that I have memorized, and that I share with each patient. To get patients used to my accent, and to try and make them comfortable, I ask an easy, but open-ended question, ¿Cuándo fue la última vez que se hizo la prueba del VIH? This not only gives me a few seconds to try and find a clear vein, and decide from which arm I will draw blood, but it also makes the patient think back to their last HIV testing experience and what they may already know about HIV. If the answer is anything longer than one year, I remind the patient that since HIV does not have any symptoms, it is important to test every year so that, if they were ever to become infected with HIV, they could start treatment as soon as possible, and have a better chance at stopping the progression to the more serious, and developed stage of AIDS. If the answer is less than one year, they might be concerned about a particular sexual encounter, be pregnant, when testing is suggested during every trimester, or be a health care worker who has recently poked him or herself with a needle.

¨Hace cinco meses.¨ It had been only five months. The patient was a teenaged boy. He was neither pregnant nor a health care worker. He likely had a very real cause for concern. I went on with my normal spiel, the three ways that HIV is transmitted: through sexual relations, through blood, and from mother to child. In Ecuador, the risk of transmission is nearly limited to the first instance, sexual relations, which make up 98% of all newly registered cases of HIV in the country. I talked about the difference between HIV and AIDS, that a person can live for 40 years with HIV, that there is treatment, that the sooner the treatment is started the better. Like diabetes, living with HIV requires certain lifestyle changes, such as not using drugs, and always being sure to give the body the proper nutrition that it needs. HIV already hinders a person´s immune system, so the body needs every advantage it can get apart from the daily cocktail of ART, or anti-retroviral therapy. I did not even bother to tell him about the need to some back in three month for a second, confirmatory test. That is takes the human body about 3 months to produce the antibodies to HIV that the rapid test searches for, and so today´s test could not detect whether HIV had been transmitted just a few weeks ago. This was his second time. He already knew.

Before I could explain how the results of the test are read, that one line near the end of the test, where it says ¨C¨ for control, means that the result is non-reactive, and that the person´s blood is free of HIV antibodies, I saw the dark, purple line near the marker on the test for HIV 1. As the drop of blood runs chromatographically from one end of the testing membrane to the other, its passes by three testing strips, one for HIV 1, one for HIV 2, and a third, control strip. All previous 504 tests that I had done in Ecuador showed nothing for the first two testing strips, and a clear, purple line for the last, the control strip. I caught the eye of the Peace Corps volunteer who does testing with me in the health clinics. She would later say that she already knew. The patient was not making eye contact with either of us, he was playing music from his cell phone, trying to distract himself. This behavior had made the Peace Corps volunteer nervous. The fact that he had been tested just five months ago did not help either. She reached over my shoulder to grab another test. Maybe something was wrong. Maybe there was a problem with the test. I started another one. I tried to be quick about it, and begin explaining how he will have to wait for the drop of blood to run from one end of the test to the other. ¨What about the first test?¨ he asked. I told him that sometimes the drop of blood does not run all the way, sometimes no result can be read. It was true, but not in his case. I told him we want to run another test to be sure before we give a result.

The second test gave the same result, reactive. The Peace Corps volunteer had already texted to try and arrange for us to be driven to the infectious disease hospital later that day to have a more expensive confirmatory test run, the only way to know for sure if a person has HIV or not. She had run out of minutes on her cell phone, which, like all cell phones in Ecuador, is pre-paid. All we could do was wait for someone to respond to our text and call us. The patient had come with his sisters, and he suggested that he leave the room, while we brought in another patient. We could call him in after the next patient to talk more and give him the same result slip and information handouts that we were giving to all of the other patients. He left and we called in the next patient, his sister.

The sister´s testing went normal. Her result was non-reactive. As she was leaving the cell phone phone rang, so we were able to talk in private before calling in the teenage boy again. It turned out we would not be able to get a ride to the infectious disease hospital that day. The service was no longer being offered. The best we could do was bring the patient in to speak with a clinical psychologist, someone that spoke Spanish fluently, which neither I, nor the Peace Corps volunteer could do. We called in the teenage boy, and suggested leaving the health clinic right then and there, with us. We would go downtown, where we could offer more, and better, support and answer more questions. Since he was with his family, the patient wanted to leave the health clinic with his them, and then return, alone, in an hour. We all thought that it was a good plan. So we gave the patient the same thing we give all patients, a result slip, a pair of information handouts about HIV, and three condoms. His result slip even said that the test was non-reactive, just in case his sisters were curious.

We tested just a few more patients, and then decided to pack-up and leave. We agreed to meet outside of the health clinic, by the front entrance, and we did not want to make him wait. We waited for an hour and a half. He never returned. We tried to get some of the family contact information from the staff at the health clinic. We had only his name, no number or address. It turned out that the doctor at the health clinic was a friend of the family. She often ran into them in the neighborhood. In fact, she had ordered that the boy take the HIV test when she had completed a physical on him recently. He had been complaining of his throat hurting. Respiratory infections are one of the opportunistic infections sometimes caused by HIV. We left a name and number with the doctor, who promised both to reach out to the boy, and to pass along the note.

It had been one of the quickest testing days. We only tested 9 people, but it was also the most physically draining day, too. As we stood in from of the health clinic, waiting for the boy to return, we had no shortage of things that we could change for next time. For example, I could have stayed and continued testing, and the Peace Corp volunteer could have accompanied him downtown. We could have gotten his phone number. We could have talked to him longer, tried to answer more of his questions. We could have given him more information, comforted him more. Then we rationalized what we did do. He was an adult. It was his choice to leave. He was with his family and did not want them to know. He has the information he needs to get further treatment. It is up to him now. It is in his hands. We could not make him go with his anyways. Now it is up to him.

There really should not have been any reason for me to be nervous. I had practiced on 504 patients before him. I had plenty of time to practice, to prepare myself, to know what to say and what to do. Yet, he was still the first patient to be reactive. No matter how hard I practiced in my head, it was entirely different when talking to an actual person, an actual person whose life was going to be different from now on, and all because we happened to be offering HIV testing that day, at that health clinic.    

An Ordinary America

Recently, while celebrating the birthday of one of our neighbors, we were invited into a house just across the street, where there was another birthday celebration underway. Our group of volunteers happens to include a guitar player, and after we sang a few songs, we were offered Coke and crackers, an Ecuadorian staple of hospitality. We got to talking to the half-dozen or so adults that were there, and we answered their questions about how old we were, what we had studied, and whether or not we were married. They had a tough time believing that we were in our twenties and still not married. They admired how we had each graduated from college, but there we most impressed by the fact that we all lived together, peacefully. Also, Ecuadorians always find it funny that the guys of the house help to cook and clean, too.

After we had talked awhile, one of the adults appeared to have mustered up the courage to ask us some questions that he had always had about America. Can White people marry Latinos? Are there poor people in America? He had no idea that people from any race could marry one another in the U.S. He also could not believe that America had poor people and that people begged in the streets. He was certain that even if there were poor people in the U.S. they must have not been born there. After we answered his series of questions, he looked around at us and said, "So America is like any other country then?" We told him that there were certainly differences between Ecuador and America, but that America, too, had its share of problems.

The chance encounter we had with this group was one of the most rewarding during my first three months or so in Ecuador. It is not often that someone is able to have so many myths dispelled so quickly, and if it was not for the invitation to visit, we would have never even met, or shared anything about ourselves with one another. It is easy to see, however, where the distorted view of what life is like in America might come from, when most of the information people sometimes know about the United States come from the Hollywood movies released every month. Few movies give an accurate picture of America. Instead, they romanticize what life is really like, and leave those without access to any better mediums of information in the dark.

"Be a Teacher and a Student"

In his book, Confessions of an Economic Hit Man, John Perkins tells of an encounter with an Indonesian while traveling on business. What he is told can really be directed towards all Americans:

"Stop being so greedy, and so selfish. Realize that there is more to the world than your big houses and fancy stores. People are starving and you worry about oil for your cars. Babies are dying of thirst and you search the fashion magazines for the latest styles. Nations like ours are drowning in poverty, but your people don't even hear our cries for help. You shut your ears to the voices of those who try to tell you these things. You label them radicals or Communists. You must open your hearts to the poor and downtrodden, instead of driving them further into poverty and servitude. There's not much time left. If you don't change, you're doomed."

While the author, at the end of the book, acknowledges that there is no silver bullet to make things right, he does suggests cutting back on oil consumption, which has increased in the U.S. by over 50% between 1990 and 2003. He writes, "The next time you are tempted to go shopping, read a book instead, exercise, or meditate. Downsize your home, wardrobe, car, office, and most everything else in your life. Protest against 'free' trade agreements and against companies that exploit desperate peoples in sweatshops or that pillage the environment." The author does acknowledge that everyone must play a different role. Everyone has different skills and abilities, but the responsibility, in some way or another, fall upon each individual. "You can set an example. Be a teacher and a student; inspire everyone around you through your example."

The Inequality Map

Below is an op-ed written by David Brooks and published today, November 11, 2011, in The New York Times.

Foreign tourists are coming up to me on the streets and asking, “David, you have so many different kinds of inequality in your country. How can I tell which are socially acceptable and which are not?”

This is an excellent question. I will provide you with a guide to the American inequality map to help you avoid embarrassment.

Academic inequality is socially acceptable. It is perfectly fine to demonstrate that you are in the academic top 1 percent by wearing a Princeton, Harvard or Stanford sweatshirt.

Ancestor inequality is not socially acceptable. It is not permissible to go around bragging that your family came over on the Mayflower and that you are descended from generations of Throgmorton-Winthrops who bequeathed a legacy of good breeding and fine manners.

Fitness inequality is acceptable. It is perfectly fine to wear tight workout sweats to show the world that pilates have given you buns of steel. These sorts of displays are welcomed as evidence of your commendable self-discipline and reproductive merit.

Moral fitness inequality is unacceptable. It is out of bounds to boast of your superior chastity, integrity, honor or honesty. Instead, one must respect the fact that we are all morally equal, though our behavior and ethical tastes may differ.

Sports inequality is acceptable. It is normal to wear a Yankees jersey, an L.S.U. T-shirt or the emblem of any big budget team. The fact that your favorite sports franchise regularly grounds opponents into dust is a signal of your overall prowess.

Church inequality is unacceptable. It would be uncouth to wear a Baptist or Catholic or Jewish jersey to signal that people of your faith are closer to God. It is wrong to look down on other faiths on the grounds that their creeds are erroneous.

Income inequality is acceptable. If you are a star baseball player, it is socially acceptable to sell your services for $25 million per year (after all, you have to do what’s best for your family). If you are a star C.E.O., it’s no longer quite polite to receive an $18 million compensation package, but everybody who can still does it

Spending inequality is less acceptable. If you make $1 billion, it helps to go to work in jeans and black T-shirts. It helps to live in Omaha and eat in diners. If you make $200,000 a year, it is acceptable to spend money on any room previously used by servants, like the kitchen, but it is vulgar to spend on any adult toy that might give superficial pleasure, like a Maserati.

Technological inequality is acceptable. If you are the sort of person who understands the latest hardware and software advances, who knows the latest apps, it is acceptable to lord your superior connoisseurship over the aged relics who do not understand these things.

Cultural inequality is unacceptable. If you are the sort of person who attends opera or enjoys Ibsen plays, it is not acceptable to believe that you have a more refined sensibility than people who like Lady Gaga, Ke$ha or graffiti.

Status inequality is acceptable for college teachers. Universities exist within a finely gradated status structure, with certain schools like Brown clearly more elite than other schools. University departments are carefully ranked and compete for superiority.

Status inequality is unacceptable for high school teachers. Teachers at this level strongly resist being ranked. It would be loathsome to have one’s department competing with other departments in nearby schools.

Beer inequality is on the way down. There used to be a high status difference between microbrews and regular old Budweiser. In academic jargon, beer had a high Gini Coefficient. But as microbrews went mainstream, these status differences diminished.

Cupcake inequality is on the way up. People will stand for hours outside of gourmet cupcake stores even though there are other adequate cupcakes on offer with no waiting at nearby Safeways.

Travel inequality is acceptable. It is perfectly normal to have separate check-in lines and boarding procedures for airline patrons who have achieved Gold, Platinum, Double Ruby or Sun God status.

Supermarket inequality is unacceptable. It would not be permissible to have separate checkout lines at the grocery store for obese frequent buyers who consume a lot of Twinkies.

Jock inequality is unacceptable if your kid is an average performer on his or her youth soccer team. If your kid is a star, then his or her accomplishments validate your entire existence.

Vocation inequality is acceptable so long as you don’t talk about it. Surgeons have more prestige than valet parkers, but we do not acknowledge this. On the other hand, ethnic inequality — believing one group is better than another — is unacceptable (this is one of our culture’s highest achievements).

Dear visitor, we are a democratic, egalitarian people who spend our days desperately trying to climb over each other. Have a nice stay.

The Miniature Earth

It is your refrigerator, not your bank account, that puts you among the richest 25% of people in the world.

Project Perfect World

This past week Project Perfect World made a visit to a children's hospital in downtown Guayaquil, Hospital de Niños Dr. Roberto Gilbert Elizalde. Project Perfect World is an entirely volunteer-led organization that partners with Globus Relief to help supply and finance medical mission trips around the world. Ecuador is a convenient location for a medical mission trip from the U.S. since it lies within the same time zone, allowing doctors and nurses to begin work the same day that they arrive. The team of 22 volunteers was comprised of orthopaedic surgeons, anesthesiologists, nurses, and the volunteers from biomedical companies that helped raise the $50,000 needed to make the trip possible. After screening potential patients in the outpatient clinic of the hospital on Sunday, surgeries began Monday morning and ran through Friday night. By week's end, over 25 patients that ranged in age from 18 months to 17 years, received free orthopaedic surgery for deformities that occur just as often in the U.S. but are just treated faster. The most common surgical procedure was a DEGA/Varus, which consists in the removal of a section of a patients femur, and then the reshaping of the pelvic bone using the removed section of bone. Over time, the patient develops a healthy hip joint.

Of the medical team volunteers that did speak Spanish, most were confined to the operating rooms, making communication between the U.S. nurses and the Ecuadorian nurses difficult, not to mention between the patients' families and the health care team in general. The most important times for translation were during patient transports from the main floor to the OR, and back again. Throughout the week Ecuadorian medical students, along with a handful of Rostro de Cristo volunteers helped work as translators for what little time they could, usually between classes or other obligations. This past week was at least one tangible example of an opportunity or experience which I would not have had if it was not for my ability to speak English and Spanish. It also, together with my experiences in the health clinics of Hogar de Cristo, has reaffirmed my interest in medicine.

It's Not My Language

If you are a native English speaker, you have probably never felt what it is like to overhear a conversation in the language of your colonizers and not understand what is going on, nor are you likely to have ever spoken your own language with a person living in extreme poverty. English speakers have this strange bumper of comfort, both from the top, and from the bottom. White English speakers neither have to learn the language of an oppressor, nor speak in their own tongue to the poorest of the poor. One might think that it is the actual ability to speak English that allows for this phenomenon. That would be a terrible misunderstanding of the actual situation. For Americans, English is the language of our colonizers. Languages native to North America are now largely confined to reservations, areas that are not instrumental in the economic prosperity of most Americans, as English-speaking cities often are for those living in the developing world. This is to say that the average American does not face the challenge of learning another language in order to get ahead, an incredible privilege and advantage that often goes unrecognized. Not only do most Americans naturally speak the one language they will need to adequately provide for their families and progress in their careers, but they also would be hard-pressed to find someone who speaks their language and lives in extreme poverty. This language barrier helps keep "the other" at a comfortable distance. As if Americans already did not live a life substantially different and separate from the rest of the world - a life with more money, more privilege, and more opportunity - most Americans cannot even hold a conversation with someone who lives too differently than themselves. It is an American bubble that can only exist because of our economy.

The Spanish word for others is "los demás" or, literally, "the of more." It is a beautiful way to refer to someone who, for whatever reason, leads a lifestyle different than your own. English speakers have phrases like "those less fortunate" or "those less well off" but neither of these implies "the other" as, in any way, having something more at the same time. The Spanish wording, "los demás" seems to flip the whole concept on its head, as if to say, "Yes, they are different than me, but they are not anything less, but something more." "Los demás" seems to force the speaker to look inward upon his own limitations and faults. It is a phrase, then, that I think can be representative of the entire missionary or volunteer lifestyle, one that I have led the past three months.

Quotes and Sayings in Spanish

I have tried to make a note of quotes and sayings that I have found, either from reading or on the walls of offices and other spaces. Below are just a few, beginning and ending with well-known quotes.

"Yo dormía y soñé que la vida era alegría. Me desperté y vi que la vida era servicio. Serví y comprendí que el servicio era alegría." I slept and dreamed that life was happiness. I woke up and saw that life was service. I served and realized that service was happiness. - Rabindranath Tagore  

Aprende a nacer nuevamente desde el dolor, y a ser más grande que el más difícil de los obstáculos. Learn to be born anew from pain, and to be bigger than the most difficult of obstacles.

Por todo, demos gracias a Dios. For everything, we give thanks to God.

Felices dos amigos que se aman lo suficiente como para saber hablarse en silencia. Fortunate are two friends that love each other enough to know how to speak to one another in silence.

Quien persigue un elefante no se detiene a tirar piedras a los pájaros. He who pursues an elephant does not stop to throw stones at the birds.

"El lenguaje es fuente de malos entendidos." Language is a fountain of misunderstandings. - Antione d'Exupery

Hogar de Cristo

Unexpected Success

This past Friday I made a trip to downtown Guayaquil to hand deliver a letter to the coordinator of the HIV/AIDS program in the province of Guayas, which is by far the largest province in Ecuador with a population of over 3.5 million. The letter was only a few sentences, and asked for a donation of 10 boxes of condoms to distribute during HIV testing. The nonprofit I work at, Hogar de Cristo, had not been distributing condoms as part of their HIV testing program. I asked a couple of Jesuit novices who had been volunteering for the past month or so if they thought it would be inappropriate if the health office began distributing condoms as part of its campaign to prevent and control the spread of HIV. Neither saw any problem with it. So, with the help of a worker from Fundacion VIHDA, the nonprofit in Guayaquil, Ecuador that both trained me, and continues to provide support, I drafted a letter asking for a donation of 5,000 condoms from the Ministry of Public Health. The worker thought that a request of 1,500 might be more realistic. I took the letter to my supervisor at Hogar de Cristo, who is in charge of the five health clinics which operate in Northern Guayaquil, in sectors that are poor and under-served. I was prepared to be challenged regarding the idea of distributing condoms in the first place, but after looking at the letter, the only comment she made was that she wanted her name to be added to the bottom, and that a few spelling errors be corrected.

Even in downtown Guayaquil, the largest city in Ecuador, businesses are often found not by addresses, but by how close they are to landmarks. It took the help of at least 4 people for me to find the building which houses the office of Dr. José Muñoz, the coordinator of the HIV/AIDS program in the province of Guayas. Eventually, I found it, in an unmarked building next to a highway overpass. Without explaining either who I was or what I wanted, I was directed to his desk. I handed him the letter, which he took and read. He looked up and said that he wanted to support me, but that I needed to wait a bit. After his secretary verified the spelling of my name, he returned with a pair of letters for me to sign, which formalized the donation of ten boxes of condoms. After that, he began stacking the boxes on his desk. Since I was not really expecting for the process to be so easy, I had not even brought a bag to carry the boxes. He searched for a pair of plastic bags for the next few minutes, finally finding a few in the corner. I piled the boxes in the plastic bags, and left.

It did not take long for the donation to be put to good use. The following Monday I gave a pair of talks at a school about an hour and a half outside of the city, followed by HIV testing for any student who wanted to do it. All of the students were about 16 or 17 years old, and, as usual, the males were reluctant to do the test. Without fail, men are more afraid of needles than women. I can recall one, in a health clinic, who was nearly in tears, even before I inserted the needle into his arm. His wife was holding his hand, and laughing, but mostly laughing. It was at the school, though, that potential patients had another incentive to do the test, 3 free condoms. In addition to acting as an incentive, at least for this particular group of high school boys, condoms are a reminder that, in Ecuador, 98% of all HIV transmission is through sex, not through sharing needles, or passed from a mother to her child, and certainly not through mosquitoes or saliva, neither of which transmit the deadly virus. It is a blessing that mosquitoes, which by number of human deaths they cause, are the deadliest animals on the planet, are not able to transmit HIV. Yet, since human beings are sexual beings, the transmission of HIV through sex proves to be deadly enough. What is more is that HIV does not have any symptoms, so a person can live with the virus for 3 to 10 years both without knowing it, and without acquiring the more serious and deadly syndrome of AIDS.

What An American in Ecuador Looks Like

It is difficult to imagine what it would be like to have a person from another country come to volunteer in my hometown. If there was going to be a perfect parallel between my hometown and Monte Sinai, Ecuador, the imaginary volunteer would have to be be incredibly more wealthy than me and my family, and have traveled a distance far greater than I would likely travel in my entire life. It would practically be like having a visitor from the moon. The cost of traveling between the United States and Ecuador is not lost among Ecuadorians. Americans might be able to look at the cost as being only one paycheck, or as a vacation, but for Ecuadorians, or at least the average resident of Monte Sinai, the amount is nearly three entire years worth of income. No matter how hard any American tries to fit in with the culture and be respectful, the simple act of traveling to Ecuador is a reminder of just how wide the gap is between the American life, and the Ecuadorian life. No matter how simply any American tries to live during his stay in Ecuador, his citizenship, if not his skin color, makes him standout about as much as would an NBA athlete who decided to walk around on his knees for a day in an attempt to better understand the plight of short people. At the end of the day, the NBA athlete, because of his height and athleticism, has an ability that most others simply do not, including the ability to make massive amounts of money. The American, too, because of his nationality, has an opportunity that most Ecuadorians simply do not, including the ability to travel freely.