One vaccine down, four to go. It was a tiny bite—an incensed mono ardilla(squirrel monkey) had drawn just two drops of blood from my hand when I removed him from a tourist at the Parque Amazónico. This tiny scratch, however, ended in an eight-hour round-trip for the first vaccine and four-hour trips for the remaining four shots (which are still in process).
At various health centers around Tena, people looked at me oddly when I explained that I needed the vaccine:
“Parecía que tenia rabia, el mono?” (Did it look like the monkey had rabies?)
“No,” I replied.
“Pues, vigilarlo y podemos conseguir la vacuna si sea necesario. Todavía hay tiempo.” This did not exactly assure me, so here I am scribbling away in a squeaky desk chair at 7:23 a.m. in Hostal Millenium in Quito, where I thought I’d never stay.
After having gotten the same unpromising response at two medical facilities in Tena, I walked into the Hospital Metropolitano in Quito with a sinking heart. I was expecting, “we don’t have the vaccine,” or “why would you need that?” as I had already heard at the Tena Hospital. Instead, when I explained that a monkey at El Parque Amazónico had bit me, the nurse immediately knew why I was there. “Necesita tratamiento de rabia, cierto?” (You need rabies treatment, right?) Everyone was amazingly kind and understanding; they didn’t bat an eyelid that I had come all the way from Tena to Quito—a four-hour trip—just for this: they helped me no questions asked.
This whole medical “adventure”, if you will, has given me new perspectives on the Ecuadorian healthcare system as I have experienced it, and has also fostered several realizations about its culture and attitudes towards sickness.
For example, when I tried to explain to my host parents the necessity of treating my monkey bite (however small it was), they scoffed openly and even became annoyed with me. My dad, who continually says that he knows the world “up and down”, said,
“I’ve been bitten by culebras (snakes), and nothing ever happened to me.” His raised eyebrows gave an extra added bit of authority.
“Snakes don’t get rabies,” I replied.
“I’ve been bitten by dogs, too,” he retorted. “And you know what I did to it? I killed it.” He said this as if any ailment the dog might have passed into his system would have died in his bloodstream when he gave it the fatal blow. Eventually I got my mom to side with me, as mothers are prone to do in medical situations. She agreed it was better to get treatment if it made me feel better, and after all, there was just a rabies outbreak in the deep jungle involving thirty infected villagers and a host of mad bats.
The big difference in Ecuador between city and country dwellers—a difference that in my opinion is much less prominent in the United States—is that city people are much more prone to worrying. In the city you kind of have to: no matter where you are, there’s some sort of danger lurking about, regardless of the city or country. Robbery, car and pedestrian accidents, mugging, creepy people following you…when a medical emergency comes up, people immediately jump to the “what ifs”; what if I have rabies? What if it’s something serious? What if I die? What if…let your imagination run wild, the possibilities are endless.
In the rural areas of Ecuador, people have bigger things to be worried about and easily recover from minor blows such as cuts and scratches. Money is scarce; people are much more concerned with where their next meal might come from to spend time and energy searching out and receiving a vaccine against a virus that will probably never appear.
The “rural” approach is often present even in hospitals and subcentros (clinics) in Napo, where I live; doctors are excellent when it comes to prescribing things with actual symptoms and are stringent about getting as many people essential vaccines—sarampión (chicken pox), tetanus, and yellow fever among them—as possible. But when it comes to getting a rabies vaccine for an illness that will most likely never materialize, it’s not important because there’s a lady waiting over there whose baby won’t breastfeed, and an elderly man who is waiting for surgery to give him partial sight so he can go back to work.
The city attitude is, “If I get rabies I will die.” (I think this is perfectly rational, seeing as it’s true)
The rural one is, “You won’t get rabies, nothing will happen.”
In my opinion, most estadounidenses (United States citizens) will err on the side of caution when it comes to personal health and the uncertainty it can often afford. I thought that I’d adjusted pretty well to many customs and attitudes of Ecuadorian culture—it now doesn’t bother me in the slightest if I’m an hour late or end up six inches deep in mud in the jungle. When it comes to health, however, my quest to avoid contracting rabies has taught me that I’m a city dweller (and an estadounidense one at that) through and through. And proud to be it, too…I’ll take five vaccines over rabies any day.