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October Update
Stewart & Anna-Claire Cusick

Ok guys, so up until now you have probably been thinking we are on some belated gap year with all the travelling and language learning.  However, we did actually come here to work in a hospital and I can finally confirm that we have started doing that!  We actually started on the 1st of September, almost 2 months ago now, which is hard to believe.  We have been busy and are very surprised at how quickly the time has gone.  Hopefully this will get you up to speed with our lives.
Anna-Claire's Job
Anna-Claire’s first week and a bit in the hospital was spent sitting in with other doctors, shadowing them to learn more medical lingo and how they treat their patients.  This also helped her to learn the systems for prescribing, testing etc.  After those initial few weeks, she got a bit antsy and decided instead of sitting in with one of the doctors she would take her clinic for her.  This helped her get more practice at leading the discussion, treatment plans etc.  Since then, she has been doing that every day and can see up to 12 patients on a good day.  This has really helped her to develop her confidence in the language and learn the different ways they treat people here with limited tests and money and especially the different thought processes towards medicine here compared to home.  Currently she is ready to start taking clinics by herself, however due to a multitude of reasons she has not started this.  Firstly, there isn’t enough patients currently for the paid staff to be keep busy.  Secondly, she can’t prescribe without her license so would have to review all treatment with another doctor after every consultation.  Thirdly, she can learn more with another doctor in the room for advice, especially when they are not so pressed with work at the minute.  However sometimes this can be very frustrating for her as she is used to being a doctor in the UK with much more responsibility and it can feel, at times, like she is back in her foundation years of medicine.

She is, however, going to start doing one evening shift to help the hospital cover these hours for emergencies.  She will be running this clinic on her own but will have another doctor on the same shift to sign off the medicine.  This is all very exciting as it should help the hospital to start up its emergency services and hopefully it will see more patients during the day.

On top of that she has been helping with Pharmacy to create a new list of medicines to streamline the number they carry in stock.  Currently the pharmacy is making a loss and with the main reasons being drugs going out of date or stock not being needed.  This is a big task as there are nearly 350 drugs to review and categorise and each doctor has their own preferences.  Anna-Claire is taking it on with much gusto and can often be found talking to other doctors, patients, nurses and sometime herself just to avoid it!
Stewart's Job
Stewart’s job started off slowly as they weren’t really sure if the hospital needed any mining equipment designed!  At first, he started off painting and wiring electrical switches and plugs.  He also learnt during this time that when the electrician says the circuit is not live not to take his word for it and instead check for himself, luckily it was just the switch that blew up and not him!!  Maybe this was the reason that he decided to go help the administration department, or maybe he just wanted to get away from painting.  But he did start to help in administration, initially by typing in timesheets manually into excel, which after 2 days probably drove him mad.  So instead, he decided to create a spreadsheet that would automatically upload the data rather that requiring manual typing.  After doing this they also got him to help out with a calibration schedule spreadsheet for the equipment in the hospital.
All this excel work must have drove him back to maintenance where they gave him a task of creating a list of materials required to renovate an old house into a new 25+ guest/volunteer house and 3 small houses for families of patients to stay.  This also required the design of an extension to the old house to fit the bathrooms for the 25 people.  Last week the guys started to remove the roofs of the 3 smaller houses as well as paint the steel for the new roof.  We are waiting on the delivery of the blocks to start construction so let’s hope that Stewart calculated the correct amount.

Also, he has designed 2 stainless steel crash trolleys for the emergency department.  This was more up his street and the steel is currently being cut and folded to be delivered for the maintenance team to weld together.  After that, he also designed up some more trolleys for surgery which should be ordered this week.
Finally, he has been back on the spreadsheets to create a log of the over 300 keys in the hospital, their owners, doors they open etc.  The previous software no longer works on modern computers, and the system is quite complicated with lots of different levels of master keys.

The plan, after this, is for him to start to make new digital blueprints for the hospital with door number, electrical, plumbing lines, gas lines, and oxygen lines.  This should keep him busy up until Christmas!
On the left below is the guest house and the on right is the family houses with the roofs removed.
Our visit to the communities in the Jungle
On the 7th and 8th of October we took a visit to some communities in the jungle with Voz y Manos and their water and latrines project.  This was a great experience where we got to see how the more remote people of the province live and, most importantly, the work of Voz y Manos.

The first community we visited was called Santiak and to get there we had to take a 1 ½ hour canoe trip after our 2 ½ hours drive in a pickup (which normally takes 4-5 hours by bus!) The canoe trip was pretty sketchy as the Pastaza River is a main tributary to the Amazon River, so is pretty violent and dangerous.  This community has no running water or toilets and the team was there to look at a suitable location to install a water pump in order to provide clean water to every home in the village.  We were only there a few hours before we got back on the river for another 30 minutes to go to a community called Mashiant.

The team had been to Mashiant before to install a water system and we were following up on the progress of a pilot toilet for the community. The team also inspected some damage to the water system.  The whole experience was great and a real eye opener to the struggles of the people in this area.  It was also very evident when comparing the health of the two communities and how much healthier the people of Mashiant looked with their clean, filtered water.  So much more happened on the trip but rather that us ranting on take a look at the pictures below.
Our Plans
We were actually planning to go back out to the jungle this week with the Bezemer family from Thursday to Saturday but this has just been cancelled as of today due to strikes and roadblocks in the country.  Instead, Anna-Claire is flying into the jungle tomorrow morning to help investigate an outbreak in a community there.  She is going with Jaap Bezemer, another doctor who is visiting shell this week and one of the hospital lab staff.  Prayer for this journey would be greatly appreciated and especially the treatment of whatever tropical disease they find in the jungle.  Stewart is extremely jealous as Anna-Claire will be flying over the Amazon and he isn’t not allowed to go cause he’s deadweight!

Also, on the 7-9th of November Anna-Claire will also be going to the jungle again with Voz y Manos and their medical caravan.  Stewart isn’t going because after the last time they said the people can’t afford to feed him! This is a joint enterprise run by Voz y Manos and involving the hospital in Shell and the MSP (the government medical service).
We have so much more that we could tell you about, what we have seen and done but we realise this update is pretty long already.  However, if you do want to hear more we will be speaking at the Latin Link “Ignite LITE” event on the 23rd of November at 7pm GMT.
Prayer Requests
  • As mentioned, the medical trip to the community with an outbreak.
  • Prayer for Anna-Claires’s future medical caravan with Voz y Manos and the hospital.
  • Anna-Claire’s application for her rural year for which she is currently collecting information and can begin applying for on the 6th of December.
  • Stewart’s Spanish, that he would be able to speak to more people during his workday as, due to the nature of his work, he is sat in an office by himself most days. 
We are extremely grateful for all your loving prayers and support.
Please become part of our work
For those of you who are interested in our support group feel free to contact Hannah Das  We meet once a month via zoom for prayer and a catch up.  We love to hear about peoples lives back home so please join us.
Support Link
Please see our contact information below.

UK Tel: +447969386770
Ecuador Tel: +593989899371

UK Tel: +447821224993
Ecuador Tel: +593989890445

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Stewart and Anna-Claire Cusick
Hospital Shell
Calle Asunción Cueva

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Stewart and Anna-Claire Cusick Latin Link · 4 The Folly, · Antrim, Co. Antrim BT41 1LY · United Kingdom

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