In 2008, the new constitution of Ecuador declared healthcare must be accessible by all residents. Since this new mandate, Ecuador has invested heavily into public health which has resulted an in increase of the budget of Social Security health care services. There has been significant improvements in healthcare and public health in the last 5 years with this increased budget. New technology is being purchased in large facilities, increase in staff and changes in age restrictions and individuals with preexisting medical conditions who may now join “voluntary”. More people have been paying into social security with strengthening confidence in healthcare. Full and free medical coverage is being provided under this new health system. Overall, by allowing residents to pay into this new Social security health care program for a monthly fee of approximately $70, accessibility and quality of public health have only grown. I was fortunate to witness many of the positive impacts and obstacles of this new healthcare plan Ecuadorians are paying into.
Volunteering at several different clinical settings in Quito, Ecuador I was able to see many benefits of the new healthcare system. One of the ingenious benefits of this new health care system is that healthcare is completely free for children under the age of 5. This includes the cost of vaccinating children. Immunizations such as diphtheria, tetanus, pertussis, mumps, hepatitis B, etc. are free of charge. By providing these vaccines, Ecuador is able to prevent the resulting life threatening diseases in these children as well as avoiding the issue of parents refusing to vaccinate their children and compromise herd immunity, the overall immunity of the general population, as seen in Disneyworld.
Although immunizations are provided free of charge for children under the age of 5, the parents or the current guardians of the child do not always have the correct paperwork in place, thus the child cannot receive the immunizations. This is very troublesome because not only are parents not taking advantage of a free service being provided to their children, but they are putting others at risk as well.
Another service that is provided free is prenatal care. By increasing prenatal visits there is a corresponding decrease in poor perinatal outcomes. This is wonderful service as it is probably the most cost effective way in reducing prior and during pregnancy. However, as you move from urban to rural Ecuador, the utilization of this service declines. One of the Doctors I was following explained that this might be due to some rural people’s current mistrust of modern medicine.
There is a higher percentage of individuals in rural Ecuador than urban Ecuador that still practice traditional medicine. These individuals usually have little understanding of modern medicine and how it works as well as mistrust in the people who administer this type of medicine. Typically in rural Ecuador, when a pregnant woman, or her family, with these beliefs is giving birth often the birth occurs without complications; however, when the birth does not, usually the family waits until the woman has been in labor for a very long time and complications have become exacerbated. By the time the family brings the woman into the clinic it is almost always too late. The family feels that it is the Doctors or clinics fault for not saving the child and or mother. Thus, continuing the mistrust of certain individuals in modern medicine and the new Social Security health care program and the amenities it has to offer. Although there are great benefits being provided in the new health care program in Ecuador there are still obstacles to be addressed and overcome.
Hospital San Francisco is a new public Hospital built only 4 years ago.