"The days unfold as they come. At the start of the day, you never know what lies ahead."
Maarten Meijer, volunteer doctor
On the night bus from Quito to Puerto el Carmen, you see little of the surroundings. It is dark, and the bus gradually empties. At one point, the bus passes through a military checkpoint, and at the end of the journey you step off in Puerto el Carmen early in the morning. From here, you can only continue by boat.
The heat hits you immediately after the long journey as you get off the bus. Jacob is there to welcome me; Carolien had left for the Netherlands a few days earlier for the arrival of their baby.
Still sleepy from the long trip, I look around and wonder where I have arrived. Apart from the tropical temperature, you don't immediately realize that you are standing in the middle of the jungle. Together we walk to Hospital San Miguel.
It is impressive what Jacob and Carolien have built here. The hospital is located in a former Catholic boarding school deep in the jungle. The walls and floors are colorful. The hospital courtyard is open: birds fly in and out, accompanied by large insects and occasionally a tarantula or a poisonous snake. It is hot, and at least once a day heavy rain pours into the courtyard.
The days unfold as they come. At the start of the day, you never know how things will go. Some days are quiet. On other days, when you open the large blue steel front doors in the morning, people are already waiting. Many patients come from far away, often traveling for hours through the jungle and along the river. As a result, patients frequently arrive late and can be very ill upon arrival. Sometimes the work continues throughout the night. When the hospital doorbell rings at night, you never know what awaits — motorcycle accidents, snakebites, or childbirths.
A major contrast with the Netherlands is that we work here with a small, close-knit team, which means you do a great deal yourself. You treat patients from all medical specialties, providing both emergency care and general practice. You perform ultrasounds and take X-rays yourself. There are no medical specialists on site; we can only consult them remotely.
Another difference from my work in the Netherlands is that normally I hand over my patients at the end of my shift and cycle home. In Puerto el Carmen, the work never truly stops. You sleep within the hospital walls and live together with your colleagues. Working through the entire night because emergencies keep arriving is not unusual. You also develop a special role within the community. After a while, you know many people in the village — the local eateries, the small vegetable shop that sells produce once a week. People greet you on the street with "¡Hola Doctor!" and sometimes a quick consultation takes place right there in the grocery store.
At times the work is demanding and emotionally intense, far from home. Yet you always go to bed with a sense of fulfillment.
Besides medical work, there is always something happening around the hospital. We renovated the Mirador — the treehouse behind the hospital from which you can see Colombia across the river — which had slowly been eaten away by termites. In my spare time, I built a birdhouse for the hospital's adopted parrot, Miguel, who needed a larger home. Every week we played football with the hospital team and their families, went running in the tropical heat, and shared meals together in the evenings while talking about the sometimes unbelievable days we had experienced.
At my farewell party there was dancing and laughter. Looking around, I realized how deeply I had come to care for the people here. Their positivity continues to amaze me: despite many challenges, we laughed every day. There was always time for a conversation or a joke; you were always welcomed with a smile. You feel closely connected to the patients and share in their lives.
Back in the Netherlands, I often think about all the beautiful experiences — the work, the environment, but above all the people I had the privilege to meet.
Maarten
