End-of-Life Care, Hospice, Mexico, Palliative Care

World Palliative Care and Hospice Day – A Note from Guadalajara, Mexico

Juntos Contral El Dolor team
Juntos Contral El Dolor team

I have the honor of serving as an observer at Juntos Contra El Dolor (United Against Pain), a palliative care hospital and hospice in Guadalajara, Mexico.

Its founder, Dr. Susana Lua Nava, is a graduate of the medical school at UAG (Universidad Autonoma de Guadalajara).  She did further training in the Canary Islands with Dr. Marcos Gomez Sancho, considered a highly-regarded thought leader in palliative care.

Dr. Lua, also a nun, is dedicated to creating an integrative model for Mexico which addresses the needs of not only the patient, but of the family as well.

Her non-profit produces educational seminars on palliative care for both professionals and the public.  On October 29, 30, and 31 Juntos Contra El Dolor is sponsoring a 20-hour continuing education international conference at Expo Guadalajara entitled “Crisis en Salud: Amenaza o Crecimiento?” (Health Crisis: A Threat? Or an Opportunity for Growth?).

Pain management pioneer Dr. Marcos Gomez Sancho of Spain will focus on the “Culture of Death in the Latin World”, and “Dying in Peace.” Other themes include morphine vs. marijuana, the psychological struggle in patients with terminal diseases, how the family handles a crisis and makes decisions, interventions when pain is difficult to control, nutrition, and more.

Juntos Contra El Dolor is located in the parish of San Bernardo (Mezquitan Country), known for its dedication to social justice. There is a day center for Down’s Syndrome children, a drug and alcohol live-in re-hab, a senior home, and the hospital.

Juntos Contra El Dolor serves all regardless of socio-economic standing, religious preference, age, or race.  See http://www.JuntosContraElDolor.com.

Above is a photo of the Juntos team.  Dr. Lua is in the center.


Ecuador, Ecuador Senior Living

Ecuador National Treasures – The Three Marias (Las Tres Marias) – Singing Sisters from Ibarra

Every older adult is a treasure.

I am blessed to encounter many such treasures.

Here’s how I got to meet Ecuador national treasures Las Tres Marias, The Three Marias, senior singing sisters from Ibarra…

I was at Quito’s new airport waiting for the driver. A car pulls up, a man in a starched white shirt jumps out and with a lot of enthusiasm waves. Lo and behold, it’s Luis, an Afro-Ecuadorian. It’s the first time we have met. He is going to accompany me for a site visit to a luxury senior living home and then to my hostal. On the way to my appointment I ask where he’s from. Ibarra he replies. “Do you happen to know The Three Marias?” I ask.  The stars are in alignment, of course he does, and he can make the arrangements and drive me to meet them!

So a few days later, Luis picks me up in the La Floresta area of Quito for what will be a long, yet amusing, day trip.

First stop, the Otavalo market where we will ask and ask for one of the sisters through Luis’ Afro network. The market is huge and extends for several blocks. It takes over 30 minutes to locate Maria Gloria’s place on the sidewalk. All of a sudden (I was beginning to wonder) there she is with a huge grin on her face.

Maria Gloria travels every Friday and Saturday by bus (over an hour, sometimes two) from her home in the Chota Valley to sell produce from her garden, usually plantains, avocados, and guyabitos. I found her to be open-hearted, humble, and gracious.  She is also unabashedly honest.  “We are products of colonialism.  We have always been slaves, first of the Jesuits, and then racism.”  How did you learn to sing, I asked?  “My parents taught us to sing when we were children, and my father played in a band.”

Maria Gloria Pavon of Las Tres Marias
Maria Gloria Pavon of Las Tres Marias singing trio

We say good-bye to Maria Gloria in Otavalo and head for Chalguayacu in the Chota Valley, way past Ibarra. Ibarra is the largest town on the way to the Colombian border. When we arrive in the village (approximately 2000 inhabitants and completely Afro-Ecuadorian), lots of kids rush to surround the car. And there beside the car, on the sidewalk, are Maria Rosa Elena and Maria Magdalena Pavon.

Maria Rosa is 75 (not confirmed) and the oldest. She sells liquor out of her home. Every Saturday morning she takes a bus to purchase the liquor in Ibarra. She doesn’t say more, other than she has a husband.

Maria Magdalena is a curandera (a healing person) and has diabetes. I found her to be a gentle soul. She likes to go to the senior center each weekday to meet up with about 40 others. The senior center is not open on the weekend, otherwise we would have made a point to stop there too.

Wendy, Maria Rosa, Maria Magdalena
Wendy, Maria Rosa, Maria Magdalena

The sisters have never studied music. Their homes (all on the same street) have no running water and the tile roofs don’t appear to be sturdy. They love to travel and told me they wish to be invited to play in Cuenca. In 2012, Ecuador’s Ministry of Culture bestowed upon them the Bicentennial Medal of Cultural Merit for their unique style of music.

On the way back to Quito, a bonus. Luis brings me to meet his wife Silvia and daughter Alexa who live in a village down the road from Chalguayacu. Luis shares a flat with other family members in Quito during the week. He hopes to move his wife and daughter to Quito soon.  As you can feel from the photo, they have sweet energy.

driver Luis, daughter Alexa, wife Silvia
driver Luis, daughter Alexa, wife Silvia

The links below introduce the music and the Chota Valley of The Three Marias…





There are 1.2 million Afro-Ecuadorians. Their ancestors have been in the country since the mid-1500’s.  A brief, well-written history about them is at the link below…



Ecuador, Ecuador Senior Living, Emergency Preparedness, Expats, Health & Wellness Mexico, Living Abroad

Cotacachi Health Chapters, Ecuador End-of-Life Planning Discussion

On June 7, 2015 I had the pleasure of speaking to the Cotacachi Health Chapters group at Gran Hotel Primitivo about End-of-Life Planning for Norte Americanos. (Cotacachi is a charming Andean city 2 1/2 hours from Quito).

My hosts were community organizer Caroline Goering – a true delight – and a team of other amazing, supportive people – Dan and Janda Grove, Mike and Linda Munhall, and Bill and Ann Henry. What to do in case of a health emergency, especially if you don’t speak Spanish, is their focus.

Caroline introduces Wendy
Caroline introduces Wendy Jane Carrel
Cotacachi Health Group, June 2015
Cotacachi Health Group


school marm...
school marm…

We discussed physicians, who to call and why, transportation, the importance of having end-of-life documents prepared, attorneys and notaries, cremation options, and disposition of remains to North America.

Fortunately, bi-lingual nurse practitioner Mary Grover, a former Peace Corps volunteer, can be of service to the estimated 200 expats in the area. I introduced Mary to those who had not met her.

A special thanks to CHC for the invitation. I was exhausted by the time I arrived, but content to meet a group that understands the importance of planning ahead, just in case, when living abroad.