Advice for the Extranjero in Ecuador: Health Care

So lets say you’re something like me when it comes to taking care of yourself. I have been to a doctor in the last year for the following reasons:

  • A 2nd degree burn on my leg
  • An infected cut on the bottom of my foot
  • A 2-month long bout of “traveler’s sickness”
  • A broken chunk of seashell in my foot
  • Sliced hand from washing dishes
  • Testing for malaria, dengue, and parasites to determine why I get a chills, fevers, and shakes every 3 months
  • A broken tooth

I’ve also taken many friends and clients from work to the hospital, usually all food poisoning related, a couple of surfing accidents and bad partying decisions. My accident-prone personality, along with the weak-stomached, extreme sport loving, partying friends that I keep, and the fact that I’m in charge of the medical volunteering program at the school where I work, all have made me a veritable expert on how to get health care here on the coast. Wisdom that I shall now impart to you so when you inevitably make your own bad Montañita decisions, you will know what to do in the aftermath.

Hospital Público:

PROS:

Price – This is where it’s at if you are a budget consciences penny-pincher like me. The law here is, that if you walk into a public hospital, it doesn’t matter if you’re Ecuadorian, a tourist, a resident, or of questionable legal status, they will give you any care, treatment, or medication that is available, 100% free. I had an orthodontist check out my broken tooth and repair it for FREE. I went to the ER and had several stitches and shots of anesthetic put in my hand for FREE. I’ve gotten antibiotics, pain meds, tetanus shots, and IVs of fluids and banana bags for FREE.

Language – The FREE part for me is enough in itself, but there’s another perk. A lot of the doctors in the public hospital I use are residents from Guayaquil and here on the coast for a few months of rotations. The fact that they are younger city-folk means that most can speak passable English. While this is not so essential for me anymore, is was a pretty important factor for me when I arrived and probably for any of you non-bilingual travelers out there. There’s nothing worse than trying to find the words light-headed or dehydrated in a dictionary when you can see straight. (It’s mareada and deshidratada, in case you ever need it someday.)

CONS:

Old – It’s a public hospital, so some of the equipment is older and falling apart. Like examining table in the ER. There’s a big chuck missing. They are still using old school scales and checking blood pressure the old school way. Many of the medical volunteers I’ve placed at the hospital find this is kind of interesting and kind of fun. They know it’s the way that people used to take blood pressures, but they’ve always had a digital machine doing it. When I’ve helped weigh babies with the medical volunteers, we did it by weighing the mom while she was holding the baby and then taking the baby and weighing the mom by herself. When I got my tooth fixed, the doctor used an archaic looking metal syringe thing (you know, like in the BioShock video game), to give me the pain-killer. The thing is, the job still gets done. It may be more time-consuming, and look crazy, but you get from point A to point B.

Slow – There are lots of poor people in Ecuador. This means that there are lots of people using the free hospital. Exacerbating the problem is that waiting in a line and taking turns does not seem to be a part of the culture here. If you are waiting to get your chart around peak times of day, be prepared to fight in a throng of people, packed in and shoving each other to get to a small window. You think I’m kidding? Wait until you get here. It’s a circus. Since I have not been able to bring myself to push someone out of the way, I literally never make it to the front of the line since everyone else is happily shoving me back. My solution is to come at strange hours when no one else is around, or make friends with the doctors so that I don’t have to wait to begin with. Yes, I know it’s just another form of cutting the line, but if it doesn’t involve trampling a sick old woman, I’m at peace with it. My suggestion to you all is to just go straight to the Emergency Room, grab someone in scrubs and bug them until they put you where you need to be.

Natal Unit –  My friend Jenny is having her 4th child now. When I asked her why she doesn’t want to know the sex beforehand she said she didn’t trust sonograms. This is because with her first child, they told her it was a boy when it was a girl. With her second child they told her she was going to have twins, and she didn’t. With her third they couldn’t find the baby for a really long time, and starting telling her maybe she wasn’t really pregnant. Let me add that Jenny is an average healthy woman, so the problem isn’t with her womb. Saskia, a doctor who was volunteering there, came back from her first day a bit in shock. She described the process as being something out of the 60’s. For example, for every vaginal birth, an episotomy is routine. I don’t have the time or desire to open up that controversy, but you can go right on ahead and google what that is and why that it’s so alarming… but not in front of little kids. My friend Karen was present at a C-section as a translator. Instead of having a barrier separating the incision from the rest of the mother, they just tied her hands to the bed so she wouldn’t put them into the incision during the procedure. Doesn’t that sound like a magical moment?

HOW:

If you are in the area and need a hospital, it’s in the village of Manglaralto. Take a cab straight there, or take the bus, say ‘Hospital Manglaralto’, they’ll tell you where to get off. The ER is around the left side. The lab results are the first window to the right, the medical records is the second window. Unless you are going to the ER, you need to pick up your own chart at that window before doing anything. If in doubt, just grab someone in scrubs, look confused, and someone will help you.

Clínicas y Dispensarios:

PROS:

There are two around these parts and they are fantastic. They have kids programs where once a month, children signed up are brought in and checked for proper weight gain (child malnutrition is a problem around here), given preventative care, and all the correct vaccines for free. They have a nice organized lab, (not like the scary one at the hospital), well stocked pharmacy, and specialists that come in from the big cities once a week. They are clean, relatively modern, and people wait their turn. If you want a real consult in the privacy of an examining room this is the way to go.

CONS:

The doctors do not speak English. Luckily for us, medical words in both languages are mostly based in the Latin, so the Spanish and English are pretty similar. Still, this can be difficult and not what you want to be dealing with when you’re sick. Also you have to pay. A consult is between $3 and $5… I’m sorry did I put that in the “Cons”? I meant to put that in the “Pros”.

HOW:

There is a clinic called Santa Maria del Fiat in Dos Mangas. It is run by a bunch of nuns and a dude from Sweden. Behind the clinic is the church and the building where the nuns live, so it has a cool old timey atmosphere. It’s off the beaten track a bit so take a cab and ask for the “Finka Clinica”. (I have no idea why it’s nickname is the Finka, since that means farm, but whatever.) Ask for help at the first window you see when you walk in. Though the doctors only speak Spanish, the girls who work in office are usually volunteers from Germany or Sweden, so they will probably be able to speak English. Be aware, over the last few months they have been cutting back their services more and more, so they might not be around much longer.

The other clinic is in San Pedro and is called Dispensario Futuro Valdivia. It is run by a super sweet German and Swedish couple and is modern and very well-organized. It’s also a Catholic run place but they have a newly renovated building, more professionals working there, and have a much better stocked pharmacy. They have most of the services you would need. Only the director, the German woman, can speak English though, so don’t forget to bring your dictionary.

Hospitales Privados

PROS:

Totally modern. Can do any procedure that you would find in a hospital in the US.

CONS:

It’s priced like the States as well. God save you if you don’t have health insurance. Ok, I’m being a little unfair, it is cheaper than the States. I’ve heard Guayaquil is the place to go if you want fake tits or cosmetic dentistry. It’s high quality work at a much cheaper price. So, if you want your face, boobs, or ass lifted, come on by, other wise steer clear.

HOW:

I know there are nice hospitals in Guayaquil, La Libertad, and Manta. Other than that, I have no clue or interest. You’re on your own.

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3 thoughts on “Advice for the Extranjero in Ecuador: Health Care

  1. No sé por qué cuando un extranjero no latinoamericano viene a Ecuador o a Latinoamérica le pasan todas las cosas que enlistaste al inicio. Nací en Ecuador y he vivido aquí por 25 años y lo único que me ha pasado es “Sliced hand from washing dishes”, una vez y por descuidada… En la vida no he conocido a nadie que le haya pasado todo eso, jaja. Está casi erradicada la malaria, claro a menos que te vayas a lo profundo de la selva y tomes agua del suelo, me imagino que algo así, jaja.

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