Meeting with SNEM.  This is the group that fumigates against both malaria and dengue mosquitoes.  They have a fleet of trucks across the country that will spray whenever outbreaks are reported.  During the summer (the dry season), they will get info from the INH on where recent dengue diagnosis have occurred.  Then they travel to that house and spray the house, the street, and the eight surrounding houses.  This works in the dry season, but we should point out that it usually takes at least a week before someone can be diagnosed with dengue.  This means that the mosquito that caused the illness may have traveled far.  Dengue mosquitos, unlike the malaria mosquitos, are active during the day and can live almost three weeks.   A diagnostic device that has a fast turn around could have a profound impact on quelling outbreaks before they start, i.e epidemiological survelliance. During the winter months (the rainy season), they cannot come close to keeping up with the diagnosed cases of dengue, rather they just do there best to spray the streets.  This spraying is limited to the bigger cities, so of the course the rural areas receive no benefit.  

Our meeting with SNEM was very informative, and they play a huge role in vector control.

Checked out the hospital with the largest ER in all of Ecuador 

Guayaquil is a chameleon.  The stores can all be concealed behind metal garage doors for theft protection.  The hours of each individual store seem completely random, such that a street will change faces everytime you walk down it depending on which garages are open or closed. Pollution is cumulatory.  My lungs feel heavy with exhaust.

The park outside of our hotel was full of iguanas.

Back to Quito. Had an excellent comfort-food meal at the Welty’s when we got back into town.  Joining us for dessert was Laura, a sweet Polish women who made a small mistake and is now serving time in an Ecuadorian prison.  It is an all female prison, and many of the women there were tricked by boyfriends to try and smuggle drugs out of the country.  Some of the women trained themselves to be able to swallow very large plastic baggies full of cocaine.  They would start with small grapes and work their way up to swallowing the peeled baby carrots without water.  They would then proceed to swallow upwards of 20 baggies of coke.  In the past, the authorities would hold them in custody until everything was passed.  Now, they rush them to surgery to remove the baggies, becuase death would quickly result if a bag burst.

-Tanner