The clinic we visited in Pedro Vicente Maldonado, Saludesa, is a facility independent of government funding.  It opened its doors on December 16, 2000; this explains its modern architecture and high tech equipment.  Fundraising, outside donations, and money from patients have made it possible to include services such as an emergency room, operating room, and dental and maternity units in the clinic.  However, due to political and financial reasons, keeping the clinic operational and viable is a battle that is still being fought.

             The goal of Pedro Vicente’s facility is to allow it to grow into a primary care health center.  The mission of the clinical staff is to provide the service that the people want and to try and satisfy the needs of the patients first and foremost.  One problem the clinic faces is deciding the cost of health care for its patients, most of whom are “campesinos” with limited resources.  Several people of the community disagree with the idea of having to pay medical costs, especially when there are public hospitals in Ecuador that charge nothing.  Furthermore, close to 90% of the community cannot afford to pay more than 20% of the clinical costs.  In order to run it optimally, the clinic must charge a minimum of $20 per day of hospitalization.  Of the five doctors on staff, three of them earn approximately $300 per month and two earn up to $1100 per month.  Because the clinic’s funding is scarce, 20% of every staff’s paycheck must go to the cost of maintaining the clinic.

            Receiving health care in hospitals governed by the Ministry of Health costs Ecuadorians nothing, however, the medical care offered by many of those facilities is extremely poor in comparison to independent facilities in Ecuador.  This produces a domino effect-people who receive medical care from these poor facilities usually find themselves having to go back to receive more medical attention because their initial clinical visit was unsuccessful.  Pedro Vicente’s clinic is fighting hard to prevent the Ministry of Health from taking it over and causing a downward spiral for the clinic and for the community. 

            Although the battle continues, Saludesa is holding on to its initial goal of becoming a primary care facility.  Fortunately, there are enough people in the community that are either using or donating to the clinic to keep this goal realistic.