Healthcare in Ecuador

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.

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Hospital San Francisco is a new public Hospital built only 4 years ago.

Papa San Francisco in La Paz, Bolivia

The 8 of July 2015 was declared a national holiday in anticipation for the arrival of the Pope to La Paz, Bolivia. That about 80% of Bolivia’s population is Catholic, hospitals, schools and many businesses were closed so employees would have the opportunity of seeing the Papa, the Spanish word for Pope. Papa San Francisco was flying into to La Paz where he would spend four hours before leaving for Santa Cruz, the next city in his tour in South America. After arriving from Guayaquil, Ecuador it was planned that the Papa would be given a welcoming ceremony, later give a short sermon and then make his way down Avenida Mariscal Santa Cruz, a main street that runs through the city of La Paz. This is the same street that I would see the Papa for a whole three seconds after waiting for over 5 hours, just like many others surrounding me and pushing their way closer towards the street to have a better view.

Prior to the arrival of the Papa many billboards and posters strewn throughout the city greeted the Papa saying: Beinvenidos (welcome) Papa San Francisco, with a picture of the Papa smiling and waving beneath. The Papa himself is from Argentina, the first Pope that was elected from Latin America. As this was his first return trip to South America, and Bolivia one of three countries he would visit, the people of Bolivia were fervent for his appearance.

My roommate, Sara and I left our home stay after lunch and made our way down to the Plaza, ironically named Plaza San Francisco, where we waited among thousands of others for the arrival of the Papa. Shortly after leaving the house we became engrossed in swarms of people waiting for the Papa. People set out chairs claiming their space just like people in America might for Fourth of July parades. I have never been in such massive numbers before. No matter what side street we turned down or where we walked, there were people everywhere.

Many people were selling food, umbrellas Papa memorbelia such as flags and pins. I bought a pin with the Papa smiling on the front for one Boliviano, equivalent to about 15 cents. The Papa was supposed to arrive to the plaza around 4pm, but the sun began to set as we waited for the Papa in our little spot. The Papa was already 2 hours behind schedule. There was a news reporter not far from us saying the Papa was experiencing problems with the altitude. Many tourists before traveling to La Paz will read that the city is at an elevation of about 12,000 feet. When traveling to a high altitude such as La Paz many people experience symptoms as a result of altitude sickness. People around us began to wonder if we would even see the Papa because he only had one lung which would only seem to exacerbate the effects of the altitude, before he had to disembark to his next stop, Santa Cruz a city at much lower elevation in Bolivia.

My legs were killing me, we had left our homestay at about 2pm and now the sun was setting. I’m not sure how other people’s legs felt standing on cement for hours, but I was amazed by people’s desire to see the Papa. Little children, elderly women, people with casts or in wheelchairs all waited. Despite individual’s physical state it seemed all of La Paz, all 1 million inhabitants had flocked to this very street to see the Papa. When seven o’clock rolled around we heard word that the Papa was feeling better and he was making his way down Avienda and would be passing by shortly.

When the Papa drove by he was standing in the back of the car with a big oval shaped glass structure encompassing him (referred to as the popemobile). He smiled. He waved. Just like the posters we saw in town. We saw the Papa for about three seconds before he zoomed by. People were cheering, some crying. Many people holding electronic devices up trying to record the moment in which he would pass. People were joyful but also slightly surprised how quickly he passed.

The following day at work and classes, the only question that seemed to be asked was, “Did you see the Papa?” People talked about how crowded it was, how quickly it all happened, more interestingly was how people started calling him the “the Pope of the Poor.” How he had touched the head of women’s child and healed the infant. How the Papa promoted this and talked about that in his sermon, particularly about the “steps” Bolivia had taken to include the poor in the political and economic life of the country.

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Cuy as Medicine

Traditional medicine is still commonly practiced by many people in rural Ecuador. Traditional medicine is administered by a shaman, typically a woman who has been taught the skills by her mother and her mother before her. Each passing the skills on through the generations. Patients do not have money, they can pay in many other forms such as food products, labor, or other gifts.

During the third week of June, two other students from my program Emily and Cody joined me in a visit to Jambi Huasi, a traditional medicine clinic in Otavalo, Ecuador. We only spent one day in the traditional clinic as our other days were spent in nontraditional medicine settings.  Although I did not understand what was said during the visits with patients because the shaman spoke in Quechua, the indigenous language to this area, I was able to witness a very unique and special ceremony which a large percentage of local people deem meaningful in their history, culture, and still in modern day.

The morning we arrived to Jambi Huasi we were introduced to the shaman that would be working there for the day. There was already a father with his son outside the room waiting to be seen. He was brought into the room and explained that his son had been sick for a little over a week and was displaying symptoms such as a body aches, coughing, and was sleeping more than usual.

After the father finished explaining his son’s symptoms, he handed the shaman two eggs. The shaman placed the uncracked eggs in a bowl and picked several rocks from a lovely collection of rocks she had on the table in the corner. She leaned over the bowl and spoke words in way that appeared as if she was blessing them. She then put oil on the rocks and eggs and the boys head and began rubbing first the rocks then the eggs on the boys head, arms, legs, and torso to absorb the bad energy. She then placed the bowl on the floor and held the boy over the bowl and was shaking the boy as if she was trying to shake the bad spirits out of him, all the while chanting at the same time.

After she finished with the eggs she cracked them in the bowl. The way in which the yolk cracked would be interpreted by the shaman. She would then know the sickness the individual had and if the eggs and rocks had worked at absorbing the bad energy. During this whole process the shaman is speaking in Quechua, rending the body of bad spirits and or energy.

After the boy and his father left we were excused for lunch and told that after we returned we would be able to see a Cuy ceremony. Cuy is the Spanish word for Guinea pig, an important and sacred animal to indigenous people of Ecuador and many other South American countries.

Returning after lunch, we were led into a different room this time, but similar to the first. The shaman already had Guinea pig selected. We were told that the Guinea pig had to be of the same sex as the patient being seen. The patient that afternoon was a young woman who told us prior to the ceremony she was in the middle of treatment for parasites.

The shaman first began by saying a few words in Quechua. Then proceeded to take the live Guinea pig and rub it over the woman’s body, arms, legs and torso. The shaman continued this process until the Cuy was no longer moving and squealing. The shaman than sat down over a bowl she had prepared earlier. With experienced hands she made one vertical and two horizontal incisions on the anterior side of the Cuy.

She quickly skinned the Cuy and began examining organs such as the liver, kidneys, heart, intestines and stomach. If there was anything wrong with the organs of the Cuy that would indicate the problem of the individual. After the Shaman finished examining the Cuy. We all noticed the intestines of Cuy moving in the bowl beneath. This Cuy had parasites.  The Shaman had inferred that because this Cuy had parasites the woman in the room with us must also have parasites, which in this case she did.

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