DiBello Studies Gender in Ecuador’s Public Health Sphere

In the heart of Ecuador, there is a guinea pig farm. There are about 100 of the furry creatures scurrying around while their owner, Alessandra, raises them. To the locals, these guinea pigs are called “cuy,” and they are in their most desirable form when cooked on a plate. After over half a year of living in Quito, Ecuador working in public health, John DiBello, MCAS ’20, imagined he would spend his final days in the country relaxing in a park near his host family’s home. Instead, he found himself taking an hour and a half long bus ride to be with Alessandra, eating cuy for the very first time from her farm.

Beginning in January of 2019, DiBello spent the second semester of his junior year bouncing between the Universidad San Francisco de Quito Medical School and the rural town of Pifo. Alongside Iván Palacios, director of Global Health at the university, DiBello dedicated himself to investigative work and research in health care. Before venturing to Ecuador, however, DiBello took part in service work much closer to home.

Early on in his time at BC, DiBello knew he wanted to help people whenever he could. While balancing school with being a member of BC’s marching band and the Liturgy Arts Group, DiBello also immersed himself in caring for those in need in Boston. He worked as an intern at Boston Health Care for the Homeless, Action for Boston Community Development, and Newton-Wellesley Hospital. But these interning opportunities in Boston were just the beginning of DiBello’s drive to help others. 

After working in Boston, DiBello made the decision to spend the latter half of his junior year doing work beyond the United States’ borders. Once he traveled to Ecuador to study abroad, DiBello spent a significant amount of time in Pifo. It was in this small, quiet town about an hour outside of the bustling capital of Quito that he helped care for the elderly population. Whether it was doing yoga with a group or taking patients’ blood pressure, DiBello helped make the often daunting world of health care feel like a family for the patients of local clinics. 

When he wasn’t working, DiBello lived in the home of an Ecuadorian host family. From the very first day of his arrival, his host parents, Ingrid and Rubén, welcomed him as if he were part of their family. The close relationship he developed with them, he said, was one of the most memorable aspects of his experience.

“They wouldn’t just go to bed because it was late,” DiBello said. “They made me coffee, chatted with me, and listened to my horribly broken Spanish.”

Once the spring semester ended in May, DiBello left Ecuador to return to the United States. But he wasn’t satisfied with just one semester abroad. So DiBello applied to return to Ecuador for the summer to continue similar work in public health. After explaining his plan to continue said work, he received a grant through the Clough Center for the Study of Constitutional Democracy, which is run by the law school campus. The center’s internship grant for undergraduate students allowed DiBello to head back to the country that had been his home for months in order to continue helping the community. 

Upon returning for June and July, DiBello concentrated his research and work on gender equity, specifically in adolescents. Though there has been a push for empowerment for women and their reproductive and sexual health in the past 20 to 30 years in Ecuador, DiBello said Palacios explained how the existence of rape culture was still a big problem. 

DiBello dedicated time to investigating a multitude of topics, including male attitudes toward women, the power imbalances that lead to unwanted teenage pregnancies, abusive relationships, and psychological violence—all which remain common in Latin America. Such investigative work is particularly relevant in Ecuador, as the country currently has the third highest teen pregnancy rate in Latin America.

“We’re asking the question of ‘why?’—why is it that young girls are being forced into these situations, knowing that, if we’ve tried to address questions of gender interactions without any real progress, we should also be focusing on not just women, but men in promoting equity,” DiBello said.

DiBello helped Palacios start a program, which went by two names, called Grupo de Adolescentes or Club Social de Verano, which translates to “Adolescent Group” and “Summer Social Club,” respectively. These clinics, or “centros de salud,” were located in the towns of Pifo, Lumbisi, Puembo, and El Quinche. They serve as safe spaces for teenagers to visit during summer vacation, which DiBello said are essential to building trust between Ecuadorian teenagers and health clinics. 

Now up and running, the clinic is sustained by the university and its medical students. There,  local teens can stop by and have fun in a productive way, while also feeling safe and comfortable.

“The idea is that health education isn’t necessarily just visiting a classroom once a month to talk about a topic, but instead, using [a] social model of the clinic not just serving as a clinic, but as a community center,” DiBello said. “From that perspective, your clinicians are not just people who treat you, but care for you in the community.”

The opportunity to simultaneously work alongside doctors and researchers in the university and with both young and old locals alike perfectly combined DiBello’s interests, he said. While researching and focusing on the more investigative work touched on his passion for public health, spending time with patients and making them feel at home incorporated his love for the humanities.

This experience also allowed DiBello to explore a variety of interesting concepts, such as why certain people appear to be more valued by society than others. His work in the clinics with the local elderly population gave him the chance to understand these people—not just on paper, but in real life. Those interactions became the most important takeaway from his trip, he said.

“During the quiet moments where I would get to hold the fact that my experience was so unique—like a bus ride back that I’d have by myself—I’d just think about how I had been so wonderfully welcomed into the lives of people who didn’t necessarily have to welcome me,” he said. 

The relationships he formed with the locals showed DiBello how different Ecuadorian culture is from life in the United States. Even something as basic as an introduction varies. While Americans might ask people what they study or do for a living, Ecuadorians ask to hear about their families instead. These ways of life, he said, can teach us about our priorities as a nation. 

“Here, time doesn’t mean showing up perfectly to appointments, but time is measured in relationships,” DiBello said. “It’s learning to live a little bit more. I’m trying my best to carry that back here, which is very difficult.”

With his Ecuador experience behind him and his senior year underway, DiBello looks to a potential future in medical school—which he said he’ll seek to balance with service opportunities like the ones he had in Boston and Ecuador.

While he’s thousands of miles away from Ecuador now, DiBello’s work didn’t end once he arrived home to BC. He and Luke Murphy, MCAS ’20, continue to finalize the data they collected with Palacios at the elderly centers. Murphy traveled to Ecuador the semester before DiBello to pursue similar public health work, largely fueled by his interest and studies in biology at BC.

The two had known each other since freshman year through being in several classes together, but they connected on a deeper level after working at the same site with Palacios. Once it was DiBello’s turn to travel to Ecuador and Murphy returned home to BC, they remained in touch and bonded over working in the same places in Ecuador with some of the same medical students.

“Over the summer, I got a FaceTime from [John] on the first day he was working with the adolescent club,” Murphy said. “He and [the med students] were talking together, and I got to see the work they were doing. It was fun.”

Though Murphy said some of the work he and DiBello continue to do, such as cleaning up data about the elderly Ecuadorians at the center, is remedial, having DiBello there has made the experience far more enjoyable. Even being thousands of miles from the work sites, both are still making an impact on the lives they had touched in Ecuador.

With his last semester at BC underway, DiBello reflected on what such an immersive trip meant to him. The experiences he had and the knowledge he gained in the public health field on his trip, he said, will assist him in the career he plans on pursuing in his future. And the way he learned to bond with others will stay with him for a lifetime. 

“I’ve learned that it is sometimes worth spending an extra three hours on a bus to share a meal with somebody,” DiBello said. “If we all lived like that, we might be a bit healthier and a bit happier.”

It was that very final day in Ecuador that perfectly encapsulated what his trip meant to him, DiBello said. When the community at the clinic for the elderly heard he had never tried cuy, they took him to see Alessandra at her guinea pig farm. The two were strangers, but that didn’t hinder her from inviting him to spend his last day with her. Because of Alessandra, his host family, and the hundreds of Ecuadorians he met during his time abroad, DiBello has started trying to make relationships the center of how he lives his life.

“There’s real power in connecting with people and allowing yourself to have love, food, plantains, and, sometimes, cuy,” DiBello said. “I would love to live like that every day.” 

Featured Image by Leo Wang / Heights Staff

January 20, 2020