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Craftsmanship - 57223

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Transcript of Craftsmanship - 57223

Ecuador
Located on the north west coast of South America
Language

Spanish
Strangers
will often shake hands, make eye contact , smile, during a first meeting.
Considered rude to do in Public:
• Yawning
• Coughing
• Eating
• Standing with hands on hips
• Elbows on table
• Wearing shorts

Water pollution
Deforestation
Soil erosion
Environmental deterioration
• Petroleum
• Most plants in South America
• Environmental degradation due to:
- petroleum production
- lumber production
- agriculture production


Over 9%
unemployment
• 40%
living under poverty line

• Child labor:
- low wages
- long hours
- no healthcare coverage

• Radiation exposure
• Exposure to unhealthy street animals
• Exposure to drug dealers
• Infectious disease exposure
• Noise (deafness)
• Wearing out of the body
- heavy loads
- long hours
- overuse of voice
• Risk for sexual abuse



Over 500,000
Ecuadorians reside in US
• Member of the
United Nations
• More than
100 U.S.
companies work with Ecuadorian companies
• U.S. works with Ecuador in
USAID

(Agency for international development)

• Leading importer of:
- Bananas
- Plantains
- Pineapples
Healthcare
Facilities
• Institutional hospitals (western)
• Folk medicines (rural)
• Mixture of both
• Main two hospitals
- Quito
- Guayaquil

•Western medical services
- Internal medicine
- Gynecology
- Pediatrics
- Minor surgery
- Dentistry


Common ailments
• Malnutrition
• Diabetes
• Heart disease
• Acute respiratory infections
• Diarrheic diseases
• Pesticides-cause of illness

Public services healthcare employees
• More than 17,000 physicians
• More than 5,200 nurses
Folk
Healthcare
Living in developing countries depend on traditional
healing systems as primary source of health care


• Equilibrium, harmony with nature = good health
• Illness = equilibrium altered
• Healing = harmony restored between sick & environment
• Health depends on compliance w/social norms, moral obligations.
Core beliefs:
• Respect for the Mother Earth (Pachamama)
• All living entities
• Mother Nature is sacred, key to cure any ailment
Example
• Indigenous people in Andean countries believe diarrhea is brought on by very specific causes, such as emotional states (anger, anxiety, freight)
• punishment by Mother Earth for failing to feed the earth sanctuaries, care for animals, participate properly in community activities, from bad wind, excessive cold, or indigestion.
Healers
Healers diagnose by:

• Tongue
• Urine illuminated by candlelight
• Fresh egg passed overpatient’s body
• Guinea pig’s innards—
animal has been held over sick person’s body for signs of person’s ailment
- If an organ of the animal looks sick, believed same organ is also sick in patient

Remedies
Traditional medicine
• Herbs
• Amulets
• Incantations
(eliminate disease, cleanse body)

• Over 900 plants used for medicinal purposes

Remedies
• Water
• Fresh plants
• Chamomile water
• Egg soup
• Onion soup
• Dried banana peels
• Cinnamon
• Chocolate & coca teas
• Bread, cheese
• Aromatherapy
• Lodotherapy
• Mudtherapy
• Flower extracts
• Crystals
Endure birth to obtain gift
Rely on God to guarantee positive outcomes of birth
Focus on well-being of child rather than quality of birth experience

• Home birth is common
• Increase in maternal, infant mortality
(lack of health resources, prenatal care)

• Use traditional squatting position
• Midwife

After birth
Lowland
kichwa
parents
Fast, strict control of their behaviors
Believed this feeds, strengthens baby
Sasina
Do not hold baby with head over shoulder in front of patient
(Believe face of baby will fall off)
Tie red string around wrist
(Prevent evil spirits, cross-eyed)
Avoid color purple
Provide chicken noodle soup
Hot soda pop
(cold causes illness)
Provide eggs to rub on face, body
(to absorb bad energy)
• Living donors must be recipient’s spouse, blood relative
• Rule aims to stop transplant tourism and organ trafficking
• http://stream.aljazeera.com/story/201504231421-0024706
• Paid by State, Social Security system
• Recipients: free
• Before 2007: $35-40,000
(does not include medications).

• http://www.andes.info.ec/en/news/organ-and-tissue-transplants-have-improved-life-1400-people-2007-ecuador.html

5.1 deaths per 1,000 population
Neonatal mortality rate: 10.8 per 1,000 live births
Maternal mortality ratio per 100,000 live births 64



School:
mandatory age 6-14, free
• Recent decline in education system due to
lack of funds
• Many drop out before age 15
• Public universities have an
open
admissions
(no tuition, admission based on aptitude test)

92% is literate
-high compared to other countries in South America
Ethnic groups

South American & European
Main religion
Roman Catholicism
Republic of the Equator
Close friends/relatives
will often greet with kiss or a hug.
Male to male:
close friends/relatives will pat shoulder.
Greetings are usually lengthy. A short greeting can be interpreted as disrespectful.
Male/female
:
man will wait for women to extend hand to shake his.
Drug trafficking
Child labor
Transshipment of cocaine
International Terrorism

• Decline in oil prices = decline in economy
• Illicit arm trade
• High crime rate
• Kidnapping
• Children less than 5 years:

- most beg for money

• Children 5-10 years:
- sell items for money
- perform
- clean cars

• Adolescents:
- sell merchandise (cashier)
Risk for injury with child labor workers:
Jambi Huasi (House of healing) clinic in Otavalo
• Located 70 miles north
of Ecuador’s capital, Quito
• Provides blend of modern & traditional medicine
Riobamba's Alternative Andean Hospital
• Private institution
-Western & Andean medicine practiced side by side
Institutional
Healthcare
practice
Each service also includes culturally appropriate counseling, health promotion activities.

Jambi Huasi
• traditional practitioners:

- doctor
(yachac)

- midwife
(mamahua)

- chiropractor
(jacudor)
Institutional
Healthcare
practice
20-30%
Without health insurance
Lack access to health services
70%
Covered by Ministry of Public Health
30%
80%

Mother Nature
Pregnancy
&
Childbirth
Home Births
Afraid of institutional births
(think doctors “cut up” too much)

Afraid to disrobe, stay in a cold room in the hospital
Important to have family with them
Indigenous people disrespected in hospitals
(do not speak the same language)
Breastfeeding
Favored because mother’s milk is free and known to be good to the child.
Some believe breast milk can decrease if their backs get cold.
Birth
Practices
Placenta
Burry it beneath the hearth or home-
tuplla
(symbolize warmth, fertility)
Bury placenta and umbilical cord near entrance of home
(prevent newborn from stomach aches, Mother, child will not fall ill)
Throw it in the river
(prevent thirst during lactation)
Superstitions
http://www.life-in-ecuador.com/ecuadorian-superstitions.html
Organ
Donations
Death & Dying
High mortality from:

• Diabetes
• Diarrhea
• Respiratory infections
• Heart disease
• Stroke
• Preterm birth complications
• Violence
• Traffic accidents
• Alcohol consumption
(risk factor of premature mortality)
Ecuador
About
Ecuador
Education
Greetings
Biocultural
Ecology
High Risk
Behaviors
Employment
Economy
Trade
Many use tradition practices
• Home remedies
Care from:

- relatives
- neighbors
- community members
• Traditional health care providers
• Cultural background
• Guidlines for culturally appropriate interactions
• Cultural beliefs (spiritual, traditional)
• Health seeking behaviors
• Expectations/healthcare life events
• Nursing care in Ecuadorian culture
Objectives
Accessible in hospitals, especially in
research & institutionalized
facilities
Money
is important factor in healthcare & necessary equipment
Rural residents lack access due to
distances
to facility
Technology
• National language
- Spanish
- Most common in country

• In American hospitals:
- Each facility has own policy’s regarding language translators

• At Lancaster General Hospital

- Certified LEEP interpreters
- Non Spanish speaking employees
- Have not completed certification
- Not permitted to interpret
Communication
• Alternatives
- Cyra-phone (phone)
- Odies (ipad, video)
Communication
• While greeting:
- give the correct salutation depending on time of the day
- good morning, good afternoon, good evening
- Call person by their proper title and respect
(Mr., Mrs., Surname)

• Be aware of your body language
- Ecuadorians are very in tune with body language.



Usually kind, friendly
Stand closer to you than what is expected in United States
While they are getting to know you-may ask question that may seem personal
Trying to get to know you
Being open, honest and non-distant—not consider you rude
May gain a favorable impression


Family
Roles
Common dynamic:

Men usually are workers, earn money
Women usually take care of family, house
Children are extremely important to family
Family
Roles
Turbana (Coral Gables, Fla.)
Attributes 82% of its business to South American imports, specifically from Colombia and Ecuador.
Nutrition
• Geographical diversity
- Pacific coast
- Sierra, Andes mountains
- Amazon forest
• European diet
• Primary meal: dinner
• Several courses
• Served at 2:00 pm
• 3 meals a day
• Breakfast, lunch, dinner

Coastal
Common foods

• Costal:

fish, tilapia, pork grubs, coconut, banana, guava, pineapple, orange, melon, papaya, mango, avocado

• Ceviche-
a typical seafood dish along the west coast of South America, ceviche is raw seafood
(and shellfish)
marinated in citric juice
(often lime or lemon)

Coffee
is wildly consumed.
Soda is often consumed
room temperature.


• Common dish:
Soup
- few variations per region

-
Coastal:

fish, coconut milk chowders

-
Sierra:

potato-based soups

-
Amazonian:
pepper-pot dishes
• Included with:
- Chicken consommé
- Cream of avocado
- Cow's foot
- Tripe soup
Andes
• Potatoes
• Corn
Exotic fruits of the jungle

- Araza, Cocona, Borojo, Chonta

• Consumed animals
- Monkey, turtle, guanta, chontacuro, (chonta worm), giant ants, snakes
• Combined with mandioca, banana

Pan de Yuca-
yuca root and cheese bread
Amazon
Region
Common Street Foods
• Patacones
- Fried green plantains
- Type of banana that is not as sweet
- quashed into thick pancakes

• Empanadas
- small baked, fried pastries with filling
- Coastal empanadas are made of plantain, filled with cheese, beef or shrimp

• Roasted guinea pig
• Choclo:
Roasted kernels of
(large local Andean)
corn that are a crunchy snack.
• Liquore
- “Chicha de jora”
- “Chicha de yamor”
- Made from fermented corn
• 75% of Ecuadorian population are Roman Catholic
- By asking them their religion, it could help those who are in need of spiritual health by getting the right chaplain to them.
References
Created by:
Alyssa Abern
Ocean Campbell
John Barnum
Corrine Henry
Mikayla Miller
Ilana Millhouse
Laura Schew
Megan Weinrich-Brunner






Caselli, I. (n.d.). Ecuador hospital mixes folk and modern medicine. Retrieved November 25, 2016, from
http://www.bbc.com/news/world-latin-america-18483584.

Cavender, A. P., & Albán, M. (2009). The use of magical plants by curanderos in the Ecuador highlands.
Retrieved November 25, 2016, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642781/ .

Ecuador 2015 Country Review. (2015). Ecuador Country Review, 1-255.

Ecuador Health Care- Ecuador Visas. (n.d.). Retrieved November 25, 2016, from http://
ecuadorvisas.comecuador-health-care.

Gain Insight Into the Religions of Ecuador. (1995, May). Retrieved November 25, 2016, from http://
www.ecuador.com/religion.

Health in the Andes: The Modern Role of Traditional Medicine (Part I) - The Globalist. (2013). Retrieved
November 25, 2016, from http://www.theglobalist.com/health-in-the-andes-the-modern-role- of-traditional-medicine-part-i/.

Nutritional failure in Ecuador: Causes, consequences, and solutions. (2007). Washington, D.C.: World Bank.

Pinzon-Rondon, A. M., Koblinsky, S. A., Hofferth, S. L., Pinzon-Florez, C. E., & Briceno, L. (2009). Work-related
injuries among child street-laborers in Latin America: prevalence and predictors. Revista Panamericana De Salud Pública = Pan American Journal Of Public Health, 26(3), 235-243.

Rough Cut: Ecuador: Country Doctors. (2002). Retrieved November 25, 2016, from http://www.pbs.org/
frontlineworld/rough/2007/06/ecuador_healthlinks.html.

Shamanic Healing, Ayahuasca Shaman, and Amazon Medicine. (n.d.). Retrieved November 25, 2016, from
https://templeofthewayoflight.org/shamanism-ayahuasca/ayahuasca-and-amazonian- shamanism.

Traditional Folk Remedies from Ecuador. (n.d.). Retrieved November 25, 2016, from http://
www.earthclinic.com/world/ecuador.html.

Worrell, M. (2008). Illegal abortion in Ecuador. Retrieved November 25, 2016, from http://
www.womenonwaves.org/en/page/1898/illegal-abortion-in-ecuador.

Spirituality
Practice freedom of religion
Folk Catholicism
is a mix of Catholicism and indigenous beliefs
Folk Catholicism plays a hug role in
rural
healthcare
In community life, public and private events are celebrated with
ornate fiestas
(especially rurally)

Ethics
President
Rafael Correa
plays a huge part in ethics because he aims to base the laws off his Roman Catholic Views
Informed consent
is a challenge with rural population
Informed consent is often accepted
verbally
after the patient has been educated (verbally)
Abortion is illegal (except in life-threatening cases, rape where the woman is mentally handicapped)
Euthanasia, assisted suicide are illegal
The new constitution introduces
political correctness
and opens the door to legalize these actions
Full transcript