For more than five years, we have worked alongside CECOMET in the prevention and control of neglected tropical diseases such as dengue, Chagas disease, leishmaniasis, and leprosy, as well as chronic conditions including diabetes and hypertension. Together with the Ministry of Health, these mobile clinics enable people living in remote areas to access medical care and follow-up for their conditions without having to undertake long journeys by boat. 

This year, 353 community outreach visits were carried out across 150 communities in the districts of Eloy Alfaro and San Lorenzo, where numerous cases of tuberculosis, malaria, dengue, Chagas disease, strongyloidiasis, and paragonimiasis, among other infectious diseases, were identified. During these visits, prenatal care was provided to 1,846 women and 7,223 children under the age of five received medical attention.

We share the experiences of CECOMET professionals who witness first-hand the challenges of working in the field to listen to, diagnose, and support patients. 

Geography: A Daily Challenge

Day breaks in Borbon, and boats arrive and depart from the waterfront, heading toward communities located along the Cayapas and Santiago rivers. There are no ambulances or large urban hospitals here. Healthcare moves with the tides, powered by outboard motors and the certainty that every journey may save a life. 

Borbon is the river hub of Eloy Alfaro District, in Ecuador’s Esmeraldas Province. It is a region of tropical rainforest, intense sunshine, and heavy rains where rivers, rather than dividing communities, connect them. Along their banks live Afro-Ecuadorian communities and the Cayapas people, also known as the Chachi, whose lives are deeply linked to these waterways. 

El Capricho, Santa Lucía, Cacagual, and Punta Piedra are among nearly sixty settlements spread throughout the area. For residents living along these riverbanks, a persistent fever, an insect bite, or an unexpected childbirth can become a silent emergency. 

Here, geography poses a daily challenge, making the work of the Ministry of Health and CECOMET truly transformative. For the past 30 years, CECOMET has operated in the region through its community epidemiology program, a continuous process of effective community participation based on empowering people through knowledge and analysis of their own health situation. Community health promoters play a crucial role in prevention, diagnosis, disease reporting, and patient follow-up, helping health authorities make informed decisions. 

This work is not only about treating illness; it is about being there beforehand, training local health agents, and building trust in places where access to government services remains limited.

In May, mobile health centers reached the communities of Santa Lucía, Cacagual, and Pampa de Oro, where Ministry of Health staff and CECOMET teams provided care to entire families. More than 400 people from these communities had the opportunity to receive free medical services.

Under the intense tropical sun, temporary medical clinics are set up in community spaces that gradually fill throughout the morning, turning into a true celebration of health. Care is comprehensive, ranging from obstetric services for expectant mothers and neonatal care to dentistry, health screenings, and general medical consultations. Special attention is always given to children and vulnerable groups, including older adults, people living with chronic illnesses, and pregnant women. 

The room is filled with the cries of newborns, the nervousness of those awaiting an injection, the smiles of patients receiving care, and the occasional complaint that comes with a busy day. Community health promoters help guide each patient and ensure that community participation remains strong during every visit. Trained by CECOMET, these men and women have become a vital link within the healthcare system. Distributing medicines, conducting home visits, taking vital signs, and measuring haemoglobin levels are among the responsibilities they carry out with dedication, often becoming the first point of healthcare for their neighbours. 

Discover in this video how collaboration between communities and healthcare professionals becomes a driving force for hope, dignity, and better health for all.