Doctor's Review: Medicine on the Move

October 21, 2021
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I prescribe a trip to... Ecuador

An FM braves piranhas and caimans on a CME trip deep in the rainforest

My husband Ian, our 12-year-old son and I just returned from what I can only describe as a trip of a lifetime. We and 10 others were on an exceptional tour organized by Doctors-on-Tour (tel: 416-231-8466;, a Toronto based company. We spent almost two weeks visiting Ecuador, the Galápagos and the Amazon rainforest, before five of us continued on to Perú for another five days.

It’s difficult to choose what was the most spectacular part of the trip. We loved mainland Ecuador, and its lovely capital city, Quito, which has a rich history; beautiful northern Ecuador and Otavalo with a market that is a kaleidoscope of colours; the unique and not-to-be-missed Galápagos Islands and magical Machu Picchu in Peru.

As incredible as all of this was, I think that if our family had to choose the most unique and memorable part of the trip, it was the four days we spent in the Amazon rainforest.

The journey inland

Our group left early one morning from Quito. We were driven about five hours to Shell, a town on the border of the rainforest. We then split into two groups and boarded small airplanes. We flew about 50 minutes southeast over the canopy of trees, finally landing on a dirt runway deep in the rainforest and close to the Peruvian boarder. We were met by the staff from the Kapawi Ecolodge (tel: 011-593-2-600-9333; and ushered into a motorized “canoe” (a flat-bottom boat) for a 40-minute ride to the lodge.

Kapawi Ecolodge is unique. It's a model for sustainable tourism. Its construction was completed in 1996 by a private company employing Achuar craftsmen using traditional materials and techniques and incorporating eco-friendly, low-impact technologies. The Achuar are the indigenous people who have inhabited the rainforest for thousands of years. They are in complete harmony with nature and their surroundings. In 2007, the lodge's ownership was transferred to the Achuar people who now make up the majority of the staff.

Kapawi Ecolodge is situated on the banks of the Capahuari River which flows into the Pastaza River, a major tributary of the Amazon River. The Lodge can accommodate up to 40 visitors. The extremely comfortable accommodations consist of structures built in accordance with the Achuar concept of architecture: elliptical buildings on stilts with thatched roofs, each with a private bathroom and an exterior covered deck. Each of the individual “cabins” is connected by a raised boardwalk. The meals are lovely and the staff is friendly and attentive.

Swim with piranhas

But the activities are the main attraction. Twice a day there are excursions either on land or by boat and an opportunity for one in the evening. There is bird watching (enough to turn us all into amateur ornithologists); kayaking, swimming, hiking and fishing. An early morning boat excursion to the clay licks was exceptional: we saw hundreds of parrots and parakeets on the river bank ingesting clay and salt to balance their diet.

And one afternoon, a group of us was taken upriver by boat and had the opportunity to either kayak or float on a tube back to the Lodge (always under the watchful eyes of the guides). My son and I opted for tubes and floated gently downstream while my husband kayaked around us. True bliss!

It's an experience we won’t soon forget, although we were a little hesitant at first since there are lots of piranhas and caimans in the water. The guides assured us that swimming was safe: the caiman are nocturnal and the piranhas are only attracted by blood! We arrived back at the lodge to witness the so-called pink dolphins (who actually a pinkish-grey in colour) frolicking gracefully in front of us.

We also loved the night hikes. We set off in rubber boots supplied by the Lodge (needed on all excursions except boat rides) and donned our head lamps to discover an insect world beyond belief. Our guides pointed out and explained everything. Our son became a great “spotter” and when he looks at our pictures, he can still remember the names of the various insects we captured digitally. Then there was the thrill of being on a river cruise at night to spot caimans and have a family of five capybara (the world’s largest rodent) pop out in front of us.

Indigenous life

Our most unique experience, however, was an overnight visit to an Achuar village which was set in a large clearing adjacent to an abandoned runway. We set off in the late afternoon and were welcomed into one of the homes, the outer design of which was similar to our own cabins.

The experience was filled with rituals. Before any conversation was initiated, the woman of the house offered us chicha, a brewed drink made from manioc root that has been mashed, cooked, then chewed and spat back into the bowl.

The Achuar are very patriarchal, and all conversing was only with the man of the house. Our Achuar guide translated the conversations into Spanish and our Spanish guide translated into English for us. We had to introduce ourselves and provide some personal information, and the head of the household reciprocated.

For the overnight stay, our guides had brought air mattresses, tents and everything for dinner. There is no electricity and so once daylight is gone, people go to bed. Our guides cooked us dinner and the local women prepared some typical Achuar food for us to sample, which was delicious, as we dined under the stars. We were off to bed by 9PM, since the Achuar day starts before dawn. What a great and peaceful sleep! At 4AM we awoke and were again welcomed back into the same home and were served a very black tea.

Each morning, the Achuar drink about five full gourds, each containing the caffeine equivalent of five cups of coffee, and then go outside to purge themselves. This is a cleansing/detoxifying ritual also intended to strengthen the diaphragm for hunting with a blow gun (which is used less and less often now).

Before leaving we had the opportunity to try creating local crafts: the women hand-built clay bowls and the men worked at weaving combs. We then had an opportunity to purchase some of the local handicraft. This visit was truly a memorable experience that we never will forget, and impossible to adequately capture with words.

South American healthcare

We noticed that all the time we were in the rainforest it was a totally peaceful experience — no anxiety or stress. Must have been all that clean air! Amidst all of this travel and moving from locale to locale, there was still time for a CME component. There were presentations on various topics from members of our group; a discussion on Ecuadorian healthcare by a local physician in Quito; visits to both public and private hospitals; a presentation by a biologist in the Galápagos; a visit to the ship’s infirmary, and a hands-on introduction to natural and herbal medicines by our Achuar guide in the rainforest. There was also a local shaman who performed a cleansing ritual on one of our group that left us all agape!

This was a fabulous way to visit exotic places and still get first-hand knowledge and understanding of health care as it exists other than in our North American environment

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