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Health and Nutrition in Amazonian Ecuador

Language of Instruction: English 

Contact Hours: 45 hours, 3 cr 

Instructor:  Trisha Lopez, PhD and Tod Swanson


Course Description 

The course is designed for premed majors and others planning careers in health related fields.  It explores major issues in global health as applied to the context of Ecuador and the Amazonian region.   These include the negotiation between biomedical assessment of health risks and solutions on the one hand and those of the indigenous medicine practiced by a majority of the population on the other.   By focusing on the concrete case of the Amazon the course prepares students to understand the increasingly global context of contemporary healthcare practice. Highly recommended for premed students.  The course imparts skills and experience that will be useful in working in cross-cultural medicine anywhere. 



Learning Objectives 


Learn how to listen to patients whose understanding of illness is culturally different.

Learn to understand health care policy comparatively.

Learn how chronic diseases and health problems sometimes result from development itself.

Understand the challenges of providing quality health care in low-resource environments

Understand how changing diet is affecting indigenous populations.

Understand how key health risks such as STD, diabetes, suicide, alcoholism, or domestic violence are shaped culturally. 

Understand the connection between physical and behavioral health issues under differing cultural conditions. 



Course Contents 

Week Lecture/Activity    Topics Covered   Readings 



Course requirements:


Journal. Each student will keep a journal of their reflections on the materials in reading and lecture, field trips and other experiences.  Students will be expected to submit journal entries every week, with a minimum of 4 entries per week.  (25% of grade)


Participation.  Student are expected to come to class ready prepared and ready to participate in class discussion. (25% of grade)


Final essays.   Each student will submit a final essay.   This will be an essay written in response to a set of questions provided by the instructor in the second week of the class.   Students will be asked to integrate materials from readings, lectures, field trips and other experiences, along with some independent research in a coherent essay which will also address alternative policy and practices. (50% of grade)  




Monday  June 5


Week 1:   June 5-10 The Ecuadorian Health care system and the problems it seeks to address


Monday  June 5      Arrive in Quito

Tuesday  June  6    Travel to Iyarina

Wednesday, June 7         Swanson, “Introduction to the History and Geography of Ecuador."

Thursday, June  8            Trisha Lopez.  Introduction to the course

                                           Swanson, “Quichua understanding of the (shared) body: Implications for Illness and Healing.”   The                                                  limpia: cultural conflict over emergency assistance.   

Friday,  June 9                  Trisha Lopez  

                                           Swanson, Quichua Shamanism and its implications for contemporary health.


Saturday and Sunday June 10-11 :  

Work on Independent projects.


Week 2 (June 13-17):  Traditional Diet, and Health Consequences Dietary Change,


Monday,   June 12                         

Tuesday,   June 13           


Wednesday,  June 14        

Dr. William Waters   The Ecuadorian Health Care System

Dr. William Waters   Policy Alternatives: The Impact of Ecuadorian Social Protection on Health


Thursday, June 15  

Dr. Wilma Freire and Dr. William Waters,  Health and Nutritional conditions as shown in the Ecuadorian ENSANUT survey    

Dr. William Waters,  Aging and the demographic/epidemiologic transition, with a case study of indigenous older adults.


Friday, June 16                    


Saturday and Sunday June 17-18


Week 3-4: (June 20-24) Medical pluralism: Innovative experiments in integrating traditional medicine


Monday,  June 19                Visit to Amopakin: Native midwife hospital

Tuesday, June 20                 Visit to Rural health clinic in Chonta Punta 

Wednesday, June 21           Visit to Tena Hospital

Thursday, June 22    

Friday, June 23                     Make chicha and maitus and traditional foodsThe limpia: cultural conflict over emergency assistance.


Saturday and Sunday June 24-25


Monday, June 26                Prepare interview questions.                      Cultural competency in a multi-cultural setting

Tuesday, June 27                Interview patients in Quichua homes

Wednesday, June 28          Course windup. Looking toward the future of global health, policy options and alternatives.

Thursday, June 29              Travel to the airport


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