A doctor’s perspective: Delivering health services amidst the pandemic


Doctor Julio Ruano is a native from Guayaquil, Ecuador. He has provided medical services to CI children since 1993 and currently works at Community Center 5, located in the Flor de Bastion community, where he provides care to an average of 450 children monthly.

It has been more than two years since this worldwide pandemic has modified our lifestyles, altering the way we work and how we reach those in need.

At first, mandatory quarantine sent us home, and we were unsure how we could continue delivering on our mission. But tech tools and creativity allowed us to serve our kids in the best possible way. Many of us were fortunate enough to find almost anything online, and continued functioning remotely: Food, entertainment and more. Everything just a click away.

Remote medical care

​​​​​​​​​​​​​And it has been absolutely critical for medical professionals to do the same, providing our much-needed services. Early on, medical care was achieved using WhatsApp video calls to interact with patients. It was admittedly a limited beginning that helped keep things going and enabled us to help those in need. Through phone calls, patients received instructions for care and medications.

If more treatment or emergency care was needed, we provided admission orders for hospitals, handing them directly to children’s parents. I did this from my own house, no matter the day or time. Given the collapse of the national health network and the high case rates, people were urgently seeking medical care. Restrictions on movement and transportation created serious challenges for those searching for medicines, especially in poorer and more rural areas.

​​​​​​Were it not for the continued support of our sponsors and donors, many children simply would not have had access to health services during the pandemic.

The contribution of our sponsors was undoubtedly key in preventing further complications and likely even saving some children’s lives.

The problem of finding medication was identified and resolved by the excellent work performed by the staff in our organization. Remote medical care was and still is complemented by giving patients the chance to obtain medicines at nearby pharmacies that have signed agreements as Children International providers.​​​​​​​

Adapting as we ride the waves

After the first pandemic peak was over, we were able to get back to work at our community centers, giving us the chance to provide close, personalized service. During the time we returned to the centers, we detected and managed COVID cases within our sponsored population, possibly helping prevent worse complications. Common and traditional diseases were also treated with success. All the medical care has been practiced with utmost safety to help ensure workers and kids are safe.

After one successful and fruitful return to the community centers, we were forced back into lockdowns due to government regulations as COVID cases increased once more. Remote medicine then continued as our way of reaching kids in need.

We are better prepared each time there is a lockdown. Our IT department even developed a central telephone line so children and parents can call to book a medical consultation with the doctor in charge of their center. The patient booking system provides for a more accurate and organized service.

During a city-wide spike in January ‘22, hundreds of children who were infected with COVID were treated via telemedicine while our centers were forced to close. Entire families were ill. Practically everyone had at least a couple of sick people at home.  

Looking ahead with hope

Now our city is emerging from those waves, and the decline in cases has been so dramatic that mask mandates have been lifted. Our community centers reopened (on a restricted basis) in mid-March, and in May, schools began welcoming students back to in-person classes, although capacity restrictions remain in place. Students have the choice between virtual and in-person schooling.

The last two years have been full of challenges and changes to all our lives. The key to success is knowing how to adapt. And adapting effectively is critical when your mission is helping those most in need.


Jul 25, 2022

Julio - Thank you for the work that you do to care for the children - it is clear that your actions come from a place of love. I think you summed it up beautifully for all of us. “The key to success is knowing how to adapt”. Like you said, each time we adapt, we are better than the last! Namaste, Peggy

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