The Republic of Ecuador is small country in northwestern South America, bordered by Colombia on the north, Peru on the east and south, and the Pacific Ocean to the west. Although Ecuador is considered a developing, middle-income economy and has made strides in improving its health care system in recent years, access to health care and educational services remains limited in rural areas.

“Ecuadorians living in rural areas continue to face many obstacles when it comes to the availability of health care services and health education – accessibility, sustainability, cost, transportation, and literacy level,” said Melissa Liechty, MSP, CCC-SLP, Speech-Language Pathologist, Communication Sciences and Disorders.

Liechty helped lead a brigade in Ecuador in June, which included 11 Communication Sciences and Disorders graduate and undergraduate students, three Nursing students, former CHS Assistant Dean, Peter Berres, and College of Nursing Assistant Professor, Mollie Aleshire. The brigade was the first of its kind in that its primary focus was health education, rather than health care delivery. The brigade was part of the ongoing efforts of Shoulder to Shoulder Global (STSG), a University organization, which works with multidisciplinary academic and community partners to improve the health and well-being of impoverished and underserved communities globally. 

“The June brigade focused on promoting health education and health literacy,” Liechty said.  “During this brigade our students presented a variety of health care topics to children and adults in Ecuador, in order to educate, and to hopefully prevent some common health conditions from occurring.”

The initial focus of STSG has been in Santo Domingo, Ecuador, where STSG has a year-round health clinic. The June brigade focused on three locations: the Jullio Jaramillo School, Casa Hogar de Jesus, a boys-only home, and Hogar de Ancianos, an adult home.

At Jullio Jaramillo School, the brigade provided health education to teachers and students. Topics included general health (hand washing and teeth brushing), exercise, nutrition, drug use, and sexual-health education. The group provided hearing screenings to more than 100 children and provided speech and language screenings to nearly 20 children, three to six years old. 

For Communication Sciences and Disorders senior, Sydney Barnett, the brigade was a chance to take her education beyond the textbook.

“I learned that when working with people from different cultures, it’s important to truly listen and not assume that you know what’s best,” Barnett said. “Your classes can’t prepare you for every person you meet in a clinical setting and people from different cultural backgrounds especially.”

At Casa Hogar de Jesus, a home for boys who have been removed from their homes, the group led physical activities, provided hearing and speech and language screenings, and helped paint a fence and gate. The brigade also assisted residents of Hogar de Ancianos, an adult home, by providing height, weight, blood pressure, and BMI checks, and hearing screenings. The group also assisted with various projects and provided adult coloring books and supplies.

Alyssa LeSeure, a Nursing senior, said the experience will have a lasting impression on her and that it made her a more culturally competent heath care provider. She also realized the great impact of seemingly small acts of care.

“The elder home had the most grateful people,” LeSeure said. “All we did was measure and weigh them and check their blood pressure, but it made a world of difference to them. A woman got tears in her eyes when she hugged and thanked us, and in that moment I realized how large of an impact you can have with such a small, seemingly inconsequential action.”

In addition to gaining cultural knowledge and hands-on experience providing health information and screenings, the interprofessional nature of STSG brigades is beneficial to students.

“The June STSG brigade offered a true interdisciplinary teamwork experience for our students” Liechty said. “They gained knowledge and appreciation of each other’s disciplines, and they learned the value of teamwork and collaboration.”

Liechty is hopeful that this and future health education brigades will have lasting, positive effects on the population. 

“There is a profound need for continued promotion of health education and health literacy in the area of Ecuador that STSG visits each year,” Liechty said. “The people of Ecuador are extremely appreciative of any assistance that is provided to them and tend to follow through with recommendations. We could absolutely see a decline in some of the conditions that are treated on the medical brigades with continued implementation of the education and prevention materials.”