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MEDICAL SERVICE TRIP REPORT

MISAHUALLI|ECUADOR

TIMMYGLOBAL HEALTH

4TH ANNUAL MSFT TEAM

NOVEMBER 8-17 2013

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MISAHUALLI, NAPO, ECUADORMicrosoft - Caradigm traveled to Napo Province

in November of 2013 on the fourth annual trip tosupport Timmy Global Healths programming inthe Amazon Basin of Ecuador. Started in 2011, the

Amazon Basin program is now one of the fastestgrowing programs within the organization. Timmyoffers medical services to 15 of the most vulner-able and at-risk communities in Napo Province,

generally too small or too difficult to be reached bythe Ministry of Health.

Communities within Timmys Napo network aresplit into two circuits, one hailing from Misahualli,the other based further out in the Chontapunta re-

gion. Travel can be challenging to reach Timmyscommunities, which are a mix of both indigenousKichwa populations as well as settlement colonies.

Under the purview of the local Ministry of Health,Timmy works hand-in-hand with Patronato, the

social service arm of the provincial government.Timmy partners with Patronato to provide qual-ity medical service to more than 600 patients per

service trip. Besides providing logistical supportand transportation, Patronato offers local expertisethrough a number of health promoters sent witheach team. The promoters are an invaluable as-set in helping with Kichwa-Spanish translation and

facilitating understanding of local traditions andcustoms. Timmy Global Health also contracts withand provides training for a designated commu-

nity health promoter in each site, enhancing un-derstanding of intricacies of each community andproviding a more effective patient referral process.

ATTENDING PHYSICIANSAbimbola Adike, MDInternal Medicine

Cecilia Allauca, MD

General Medicine

Gaby Arteaga, MD

General Medicine

Shawn Hake, PA

Womens Health

Craig Matthews, PA

Emergency Medicine

Jean Miller, MD

Family Medicine

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CLINICALPROFILEPowered by TIMMYCARE

7partner communities

were served in

mobile medical clinics.

CHILDREN

ADOLESCENT

S

ADULTSWOMEN

MEN

In total, we treated

610PATIENTS

TOPDIAGNOSES

MEDICATION TIMES PRESCRIBED

Ibuprofen 177

Acetaminophen 176

Albendazole 147

Metronidazole 92

Calcium 69

Amoxicillin 66

Clotrimazole 66

Ocular Lubricant 63

Loratidine 48

Ferrous Sulfate 43

POPULARPRESCRIPTIONS

211

60

339

370

240

Parasites

Osteoarthritis

Fungus

Gastritis

Generalpain

LowerBackPain

Headache

Dermatitis

Anemia

13%

7%6% 6%

4% 4%3% 3% 3%

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indicators ofhealth impact:

1

2

3

TIMMYGLOBAL HEALTH

How many patients werereferred to a partner hospitalfor further treatment?

What percent of patients havechronic conditions, requiring

regular care?

How many communitypatients were returning forcare after previous visits?

127

30%53%

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MEDICAL

REFERRALS withHEALTH PARTNERSAMAZON BASIN REFERRAL SYSTEMSince the programs inception in the Amazon Basin, Timmy Global Health has part-nered with Stadler-Richter hospital in Archidona, just outside of Tena, the capital of

Napo Province. Patients seen during clinics who need more specialized care are sentto the private hospital, where they are able to receive lab exams, x-rays, ultrasounds,

and emergency care. Specialists in gynecology, orthopedics, pediatrics, and generalsurgery are also available for consults. With the assistance of the community healthpromoter and Patronato promoters, patients from rural areas are guided though

what would otherwise be an intimidating and confusing process. One hundred per-cent of patient costs are covered by Timmy for all patients coming from the Amazon

Basin.At times, a patient with even more specialized needs will come to a Timmy clinic. In

cases where Archidona Hospital is unable to provide the level of patient care needed,patients are transferred to the countrys capital city, Quito, where Timmy partnerswith the Tierra Nueva Foundation and its Hospital Padre Jose Carollo, also known as

Un Canto a La Vida. Timmy works in collaboration with the Tierra Nueva Founda-tion year-round to perform follow-up care with critical patient cases and expand

health services to those who lack access. Hospital Padre Carollo serves as Timmyslargest referral center where patients from the coastal, Amazonian, and Andean re-

gion are referred to through community medical service trips.

Every year, Timmy donates $24,000 to facilitate patient follow-up care. Due

to the remarkable growth in the number of volunteers trips (increasingfrom 5 to 16 in the last 2 years), Timmy is looking for innovative

ways to continue providing support to its ever-increasing

patient population.

Physical Therapy 4

Non-specified referrals31

Ophthama9

OBGYN15

Gastroenterology 3

InternalMedicine

17

GeneralSurgery

2

ENT

6

Colonoscopy 1

Cardiol

ogy6

Echocardiogram 3

Family Medicine 2

Orthoped13

REFERRALS WRITTEN

21% of total clinical population

Of the 127 referrals made, 8 cases (6.3%) w

labeled high priority. 80 referral patients were

male and 47 were male.

Laboratory Exam7

Ultrasound 4

Neurology

8

Urology9P

ediatric

s

7

MRI 2

Dermatology 1

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TAMIAHURCU November 11

Tamiahurcu is Kichwa for La Montaa de Llu-

via or rain mountain. There is one school with-

in the community that serves all 60 families.Here as well, members speak both a mixture

of Kichwa and Spanish. The community has

electricity but lacks potable water. In general,

Tamiahurcu lacks access basic health servicesand also presents with transportation challeng-

es, making Timmys clinics a valuable addition

to the community.

SIGNIFICANT DIAGNOSESParasites: 13.6%

Abdominal Pain: 12.6%

Gastritis: 10.7 %

LAS GALERAS November 11Las Galeras, or The Galleys, shares a local folklore tale of two tigers that lived in the nearby mountain tha

would come down and kidnap community members. It is safe to say that tigers do not inhabit the area, bu

it is always interesting to learn about local legends. There are 50 families living in the community, all speak

ing a mixture of Kichwa and Spanish. There is one school in the community, however lack of electricity anpotable water in the community makes access to basic health services more challenging.

SIGNIFICANT DIAGNOSESParasites: 14.7 %

Tonsilitis: 8.4%

Osteoarthritis: 6.3%

General Pain: 7.8%

Headache: 4.9%

Low Back Pain: 2.9%

CHILDREN

ADOLESCENTS

ADULTS

30

3216 15

31

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

56

34

39

6

45

Pharyngitis: 5.2%

Low Back Pain: 4.7%

WOMEN MEN

Number of patients seen: 54

Percent of total who were returning patients: 46%

Rate of patients referred: 11%

Number of patients seen: 90

Percent of total who were returning patients: 64%

Rate of patients referred: 9%

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JATUN YAKU(6 DE MARZO) November 14Jatun Yaku is Kichwa for Ro Grande or big riv-

er. Situated right above the Jatun Yaku river, ap-

proximately 60 families in the community speak a

mixture of Kichwa and Spanish. There is one small

school in the community known as 6 de Marzowhere Timmy clinics are run. The community is

fortunate to have electricity and potable wateravailable locally.

SIGNIFICANT DIAGNOSESParasites: 12.4%

Osteoarthritis: 8.0%

Fungus: 7.2%

Number of patients seen: 122

Percent of total who were returning patients: 30%Rate of patients referred: 17%

CHILDREN

ADOLESCENTS

ADULTSWOMEN

MEN

57

24 14

4

63

Gastritis: 5.6%

Anemia: 4.0%

MUSHUK ALLPA November 13

SIGNIFICANT DIAGNOSESOsteoarthritis: 8.2 %

Parasites: 6.7%

Gastritis: 4.9%

Hypertension: 4.5%Headache: 4.5%

Mushuk Allpa is Kichwa for A New Land. Thiscommunity was the very first location Timmy ad-

opted within the Amazon Basin and has progressedwell within the past years since the partnership

began. There are approximately 30 families living

in this community with access to both electricityand potable water. No school exists, but residents

are close enough to other schools that this does

not pose a problem. This particular community has

taken the health of their community very seriously,

and many have even stopped drinking chicha, a

traditional homemade fermented, alcoholic drinkmade from yucca, because of the health issues

associated with drinking. The community leaders

continue to celebrate the collaboration between

Timmy and Mushuk Allpa with a special dinner forvolunteers and local partners at the end of each

service trip.

CHILDREN

ADOLESCENTS

ADULTWOMEN

MEN

47

2517

12

43

Number of patients seen: 72

Percent of total who were returning patients: 48%

Rate of patients referred: 15%

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PUNICONTONA November 15

Punicotona is a rather isolated community

within the Amazon Basin and one of Timmysnewest and largest with nearly 70 families

within the community. Families speak a mix-

ture of both Spanish and Kichwa. There is one

school within the community to serve all 70families. Due to its remote location, this com-

munity lacks reliable electricity, potable water,

and phone service, making it particularly dif-

ficult for community members to stay in touch

with individuals both in and outside of theircommunity. Their location makes it a particu-

lar challenge for our programming.

Number of patients seen: 64

Percent of total who were returning patients: 48%

Rate of patients referred: 22%

SIGNIFICANT DIAGNOSESParasites: 15.8%

Fungus: 6.9%

Dry/Irritated Eyes: 5.9%

Gastritis: 5.0%

Anemia: 5.0%

Headache: 4.5%

CHIL

DREN

ADO

LESCENTS

ADU

LWOMENMEN

44

4325

4

36

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ON-SITEDENTAL

SERVICESDuring the Microsoft ser-vice trip, dental services

were offered to the Ama-zonian communities by

Timmy for the first time! In

partnership with Patronato,

Dr. Pedro Ortizand Dr. Luis Gual-

saqui worked alongside themedical clinic performingdental cleanings, fillings,

extractions, sealants, and

fluoride treatments. Theyalso counseled patients on

proper brushing and hy-

giene practices. In total,

179 were seen by the twodentists.

PATIENT BREAKDOWN BYCOMMUNITY

Tamiahurcu

JatunYaku

Punicotona

ElCalvario

LasGaleras

Llushianta

MushukAllpa

42

36

28

2118 17 17

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TIMMYGLOBAL HEALTH

www.timmyglobalhealth.org22. E. 22 Street, Indianapolis, Indiana

A special thanks to all medical professionals

and volunteers for their service and com-

mitment to improving access to qualityhealthcare within our communities.