The motorboat loaded with foodstuffs slows, and Quito pastor Hugo Palacios shouts to a flood victim to come ashore.
"We bring these rations on behalf of the Ecuadorian Evangelical Confederation, " he shouts by way of greeting. "Do your children suffer from comezon?" Itching, or comezon, signals the beginning of skin disorders like dermatitis. When the reply comes back, "Si," Mr. Palacios gives step-by-step procedures: "Wash with soap and water, rinse with boiled water." He holds out a small bottle of hydrogen peroxide and two tiny tubes of anti-inflammatory cream. "Then put this on. And then finally, this. Be careful. Don't let the children get it into their eyes."
Throughout the afternoon, the pastor visits more than a dozen families. Only boats can access coastal properties on the Carrizal River in Manabi Province since flooding from El Niño has swollen all tributaries along Ecuador's Pacific coast. Some families said it had been a month since basic provisions were last brought by the Civil Defense.
At one visit, a mother and two boys approach the boat. One boy plunges in and swims the muddy river while the other stands on a log that residents had used to build a dike. Crossing the boy's belly laterally is a thin line of sores: dermatitis. The pastor urges the mother to treat them before they become infected. He tells her where to find free medical treatment in nearby El Tambo.
Health authorities fear that, even though they may be reaching the end of El Niño's vicious cycle of rains in Ecuador, they have yet to experience the frontal system behind it: epidemics of cholera, malaria, dengue fever, and other water-borne diseases brought on by months of flooding and stagnant water.
More than 200 cases of cholera were reported in March and April. A cholera epidemic in 1991 killed 714 people in Ecuador and sickened 52,000. And then there's malaria, which "hangs like a sword of Damocles above the coast," according to Quito daily El Comercio.
In the town of Tosagua, houses are surrounded by what appears to be a golf course putting green or carpet. On closer inspection, it is stagnant water topped by algae. Tosagua's sewage system backed up and city water lines were shut off after heavy rains in March. Sewer water pooled in front of town government offices. The fire department sends tanker trucks to the river nearby to pump water for domestic use. In Puertoviejo, the newspaper El Diario reports 42 confirmed cases of leptospirosis, another infectious disease transmitted through water-borne parasites and characterized by pain and fever.
Neighboring Peru also has a cholera problem; in March, Peru's reported cases shot up from 3,000 to 8,000 in just one week. George Alleyn, director of the Pan American Health Organization, said that cholera rates in Ecuador and Peru will again go up because of the flooding. He also expects cases of yellow fever and bubonic plague.