A round of taking blood pressure at section chicken and ropa B

¨Iiii´ve got no problems at all, you know, I´m perfectly fine. And everyone just gets sick: problems with the heart, problems with sugar, cancer… but not me, I´m as healthy as can be!¨ coos the lady of the first stall that we visit today. We take her daughters pressure, that´s usually twohundred-and-something over more than one hundred and thirty, while 130/80 is normal. ¨Maybe it will be a bit high today: I´m worried about a family member that´s seriously ill,¨ the woman says before we put the cuff around her arm. ¨High blood pressure, cancer… ha! Iii´m perfectly fine!¨ I hear the older lady say behind the counter, to no one in particular.

¨Two hundred and thirty over one hundred and fifty,¨ we measure. ¨You see? I do take my tablets, but I´m worried and tense.¨ She tells us about the symptoms, the treatment and the recent visits to the hospital with her relative. We sit together on the small bench in front of her stall for ten minutes, talking about what´s on her mind. In the end we write down her bloodpressure and we ask when she´ll go to the doctor again so we can give her her last measurements on a paper to take with her. ¨Ha! Doctors… I don´t need them. I feel great, ha!¨ Gladly she does: one high blood pressure like that in the family is more than enough.

Mother, daugher and Jenni, not from the story. (Photo taken and shared with permission)

Theoretically the people from the market can go to the subcentro, a clinic close to the market. Right there they can get free health services. But for a simple appointment they usually spend hours in the waiting room, which means that they can´t sell anything during those hours. Four times a month that would be for a weekly measurement. No, that isn´t totally free in the end. In January we´re going to work with a stand on the market, so people get used to taking their own responsibility, but until then we pass by the stall to take blood pressures, give information and help them making appointments at the subcentro if needed.

In the meantime we´re pretty busy designing a program for the street- / market-clinic, with the aim to make people capable in the end to make their way to the subcentro independently and to control their health problems. We looked for Ecuadorian protocols for high blood pressure and diabetes, we make ¨oficios¨ (proposals for collaboration) for the market´s boss, the subcentro and even the health ministry in Quito, to whom we propose our plans and who we ask for advice and collaboration, we check if we´re still working in line with the aims and objectives of CENIT and we make plans for the core part of our program: prevention and information. Besides, we design a training for new clinical volunteers with no clinical knowledge / experience so the program can continue after we´ve left. We´ve done two of five trainings already!

Jenni with a vendor, not from the story. (Photo taken and shared with permission)

But for now we still go from stall to stall with our gear and papers. At our next stop we do a blood pressure and English class combination, because there´s always a son around who studies English at the university on Saturdays and he loves to practice. His father likes to let us know that he remembers who we are: ¨Aaah, Jenny! Y… de Holanda!¨ He shakes my hand and asks apologizing: ¨Como es?¨ ¨Nelly,¨ I respond and I see his eyes lighting up as a sign of recognition. ¨Nelly… de Holanda!¨ We take the pressure of his wife, we ask how it´s going, we practice English for a while and we talk about family, Ecuador and the hopes and dreams of their son. If it´s true that half of the work in medical services is communication and contact with the patients, we seem to be doing pretty well. Our favorite grandma gives us a mini-corncob and a little piece of chicken with a conspirational blink of her eye, and after we said goodbye we make our way to the second hand clothes section, ¨Ropa B¨.

Grandma (R), father, Jenni, mother and son (L)  (Taken and shared with permission)

That is where we find our next patient. Her blood pressure´s not quite as high as some of the others, but she does have other complaints that could suggest a heart condition. She had an appointment for an ECG and a blood test for last week, but she mixed up the months so she missed it. Now she has to wait until februari (!). Her pressure is still high although they increased her medicine last month. ¨I´m sure other people have told you already, but do you take care of other things that are important too, like food or exercise?¨ Her eyes start to sparkle. ¨Oh yeah, I dance the salsa! A few times a week. Wait.. look, like this.¨ She gets up and gives an enthusiastic demonstration wiggling her hips and she takes my hands to invite me to dance with her. There we are, dancing the salsa (or something not quite like it) in the middle of the Ropa B section, while the other vendors  stand still and watch with a smile or shaking their head.

Dancing Nelly and Margaretha (Photo taken and shared with permission)

¨You two should go to dance with me sometime!¨ Who knows, maybe we´ll do that some time. And not only for the sake of the patient contact.
But for now we´ll just leave it to a little salsa at the market.

See you next week bailarina! :D