HOJA BLANCA, ECUADOR — Karen Topa Pila looks around the windowless reception area in the small health care station of Hoja Blanca, Ecuador, its pale yellow walls stained with patches of mold. "When did the electricity go out last night?" Topa Pila, a doctor in this remote corner of the country, asks. Her co-workers shrug, throwing worried glances at a small container filled with ice packs. It's only 8:30 a.m. one morning in December 2021, but outside it's already over 70 degrees.
