Tuesday, April 24, 2012

Using the public hospital in Cuenca......made my friend smile.

My friend, Diana, who lives in Cuenca, had an interesting experience last week with her teenager involving the public health services of Ecuador.   I found her entire experience intriguing as Cuenca is a large city with the usual red tape when it comes to services.   I am sure I would never have done as well as she!!

 Last Week my teenager announced that his finger was swollen and green, so I looked at it.  Okay, so that's gross.   How long has it been like this?  Oh, I don't know, a few days.   Yikes!!

Here in Cuenca, Ecuador, we had been going to a private clinic near our home for our health care needs, but the cost was $18.42 per visit with no insurance.  The doctors there are great, friendly, professional, and went to medical school in those fancy rich countries like Canada, the U.S., and various parts of Europe.  Okay, so you're thinking, what's the problem with $18?  Well, it might not sound like a lot, but when your monthly budget is only a few hundred dollars, it does start to add up.   It adds up especially when you end up having to return several times.

Good directions!

So, it was time to check out the public clinics which are free to everyone.   The first problem was that nobody could tell us where our public clinic was.   Apparently everyone in the city is assigned a public clinic based on their address.  We went to a different public cliinic and they told us we should just go to the public hospital.

The   next problem was finding the public hospital.   We were told it was the hospital of Vergel as well as its general vicinity.  We took the bus to the right area and started looking for the "Hospital de Vergel" with no luck.  At that point, we started asking people.  Eventually we were directed to the correct building which had a long name, none of which included the word Vergel.  It turns out that Vergel is the name of the part of the city where the hospital is located.

Emergency room

Once inside the building, we were overwhelmed by the sheer size and chaos of the place.   Seriously, a person could do their running practice in this building on those really rainy days.   If you ran down every hallway it would surely add up to a few miles.   There were crowds of people everywhere waiting, waiting, for what we didn't know.  We found an information desk and showed her the green finger.  Ewww!!  She explained the directions to get to Curacion.  We took the necessary turns and found the right room.  Unfortunately, the person there told us we would have to take the finger to the Emergency Room.  We followed the directions she gave us (we thought) to a big open room with a crowd waiting and asked about getting the help we needed.  The people there told us the finger issue was not serious enough to warrant a trip to the E.R.  They told us we would need to go to our local public health clinic at Feria Libre, a huge open food market near our home.

At this point we were unsure how to proceed.  I was discussing it with my son as we walked back toward the hospital entrance, noting that the people at the E.R. had told us to go to the local clinic.  My son interrupted, "Um, mom, that was the Audiology Department."  I turned around to look at the sign and, sure enough, it said "Audiologia".

A REALLY long name.

We returned to the Information Desk to ask how to find the clinic. ¿Que pasa?  We explained.  She said there IS no public clinic at Feria Libre.  Then she took pity on us.  She abandoned her post to walk us all the way back to Curacion, where she exchanged a few words with the same woman who had sent us away the first time.  Ninety seconds later the woman from Curacion was directing my son to come with her and for me to wait outside on the bench.  I did not hear any screams, but when my son returned the finger was bandaged, presumably no longer green as all the green seemed to be in his face.  When we discussed it later, he said he was sure that at the PRIVATE clinic they would have used an anesthetic.

He sat on the bench with me for a while until the nausea went away.  During that time the woman from Curacion reappeared and told us we would have to go to the E.R. to get some medicine to prevent a re-infection.  She walked us through various hallways to point us in the right direction to find the E.R. explaining that she could not write a prescription.  Everywhere we went people seemed surprised to see the extranjeros (Foreigners) in the public hospital.

There was a small crowd at the E.R. and two little reception areas connected to the waiting room.  We asked the person working at the first one what to do and she said we needed to talk to the person in the other room.  That person was not there and it occured to us that maybe a lot of the people there were also waiting for this person to return.  Apparently the locals were paying attention because when someone came out of the E.R. area, one of them told him the extranjeros needed help.  That man then approached us and took us to an office inside where we spoke to a doctor who wanted to see the prescription which we did not have.  She wanted to know the story of the finger after which she took us into a big E.R. room where people sat smiling with bloody bandages, amazed to see the extranjeros there.  A doctor who was clearly busy was very pleasant in writing a prescriiption for us and directed us to fill it at a pharmacy.  I really didn't know if we would have gotten the medication for free if we had looked poorer, but we were very happy to have the finger on the mend and left to find a pharmacy.

I think he´ll live.

We were never once asked for any information on our finances or immigration status.  Apparently their services are free for anyone who walks in.  This is SO different from the health care system in the U. S.!  We also have Canadian friends here whose doctor explained to them that medical professionals are required to work some number of hours each week at the public clinics or hospitals, indicating that the care is really just as good, albeit more chaotic, to get.

Upon reflection, we felt very well cared for at the public hospital, having had so many people go out of their way to help us.  And it was yet another of many cultural experiences, something we are not likely to stop having anytime soon!


  1. Wonderful blog and wonderful story abut how "socialized medicine" works and doesn't work. Made me smile..

  2. I think it better described as "universal healthcare" as opposed to "socialized medicine". This sounds so familiar with several hospital visits when we lived in the Dominican Republic, from minor foot and head surgery to a full blown heart attack! There is much the first world can learn from a compassionate society even with some of the "speed bump" learning experiences.

  3. Local infections are often treated with a procedure known as "incise and drain". The area is cleansed and a surgical blade then opens the area to allow the infection to drain and is then loosely wrapped. Local anesthesia does not take well due to the infection in the affected area. This is common practice in private and public care. Your son did NOT get 2nd rate care by not being given a local to numb the area.