I’m 25 years old. I should get my physician’s degree next month from the University of Guayaquil in Ecuador. But now with the pandemic, who knows. I’m finishing my year-long residency at the obstetrics-gynecological hospital in Guasmo Sur, a poor neighborhood.
The residents fought for a decent salary. The Ministry of Health wanted to pay us just $300 and we got $450 (the minimum wage is $400).
There are not enough medical staff. Many doctors are ill or taking care of, or mourning, their relatives. Or simply resigning, resenting the lack of essential supplies. Then who’s available to go to the frontline? Those with a contract: graduates and residents. We are the ministry’s cheap labour force.
Only my sister and I have jobs in my family. She moved and now lives alone. I was raised by my grandparents, who have died, and I’m living with my uncle. My aunt, his sister, helps us take care of the house and the food. My family depends on me.
“Doctors get better protection, but residents, just a gown and a cap.”
Commuting to the hospital, I see desperation and mess as social distancing is ignored. I see low-income people fighting to put the bread on the table, but also those who think this is a holiday, and it hurts.
I arrive at the hospital and the entrance door is crowded with patients and relatives. Some of them have travelled long distances as other facilities are overloaded.
This is not a COVID-19 hospital. It’s for pregnant women and obstetric emergencies. On a regular shift, we assist more than 20 deliveries, more than 20 Caesareans, and there are fewer and fewer of us. We are exhausted.
On my last 24-hour shift, they gave me an N95 mask and warned me there wouldn’t be a new one for my next shift. Doctors get better protection, but residents, just a gown and a cap. I take my own goggles, not those that perfectly fit over like the snorkelling, but at least they prevent in-front contact with fluids.
‘How fucked up is this career?’
Two rooms were put aside to isolate COVID-19 patients and give them decent attention. Recently we had a pregnant woman with respiratory symptoms and decided to refer her to a COVID-19 hospital. We used our last “astronaut gear” for the transfer, but when the patient arrived, they said they had no room and sent her back.
There are no tests at all here, not for patients or for staff. No ventilators or drugs either. Some ill colleagues went to other hospitals to get tested but they were rejected as there were no testing kits. If we can’t prove we are infected, then we can’t get certified sick leave.
We’ve been exposed to patients with the symptoms. Some colleagues have got the virus. It seems I did too. I have mild symptoms and today I missed my shift. This was my main fear, to get sick and infect my family. When I think about it I say to myself: ‘Damn it, how fucked up is this career’.
“There are no tests at all here, not for patients or for staff. No ventilators or drugs either.”
Many of my colleagues are feeling sad. Emotions are high. It’s painful to see patients demanding, treating us badly sometimes. They are not aware we do all we can, although what we can is not enough.
I can’t give my real name. A few days ago, a colleague resident at the Guayaquil Hospital denounced the lack of supplies and protections in social media. Her comments went immediately viral and hit the news. The hospital responded by suspending all the residents, accusing her of being a liar and warning about ‘consequences’. The ministry notified us we’re not allowed to give information and would be fired if we did so. They want to silence us.
I’m a feminist. I joined the group Mujer y Mujer in 2018 and since then my whole perspective changed. I began to empower myself, to be a person with a voice and with the ability to say ‘no more’. And I met women who did this beautifully, strong, skilled women.
I don’t show myself as a lesbian yet. I did it once with my family, and it went wrong. They know, but don’t accept it. Then, to avoid conflicts, I decided to focus on my things until I feel prepared to handle this with all my weaponry, my diploma, my independence, and then say: this is mine and you should respect it.
I feel love for this career. You help others, you want your country to move forward, you want to make this situation over. And also to change the mainstream medical perspective. I don’t want to be one more doctor. I want to give a message of hope and motivation. I’m interested in critical gynecology and obstetrics and would like to study in Mexico. I hope I can.
[As told to Diana Cariboni]
Ecuador is one of the countries worst affected by COVID-19 in Latin America, and has one of the highest death rates. The port city of Guayaquil, with a population of approximately three million people, is at the epicentre. The hospital system is struggling, morgues are full and corpses lie for days in houses and on the streets in the tropical heat waiting to be collected. Over 40% of confirmed cases are healthcare workers. The country does not have universal healthcare. The government has declared a state of emergency and there is a curfew.