"Improving the health status of underserved populations through sustainable and comprehensive research, service and educational initiatives related to infectious diseases."

7th Tropical Disease Biology Workshop in Ecuador
Summer 2001

 


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Updated April 20, 2012
Created by:
T. Creamer & M. Grijalva 

 

For information about upcoming programs visit
the Workshops page or e-mail grijalva@ohiou.edu

 

Public Hospital in Portoviejo

By Tom Carter

Thursday morning we visited the regional hospital in Portoviejo, Manabi province.  This was the largest public hospital in the province with a capacity between 150 and 200 beds.  They had a staff of 500.  There were around fifty doctors and two to three medical students per doctor.  The hospital was divided into wards based on the sex and age of the patients.  The wards broke down into rooms based on pathology.  Each room had around six beds, with pediatrics having eight. 

                            

The entire health budget of Ecuador was recently cut from five to two percent and a half.  Being a public institution they were decimated by these cuts.  Except for a minor fee for lab costs, the hospital does not charge the patients.  The doctors’ salary after ten years of service is up to three hundred to three hundred and fifty dollars per month depending on duties and responsibilities.  Before ten years of service it is around one hundred dollars less than that.  A nurse will make nearly one hundred and forty dollars per month, then the salary will increase by fifty to seventy dollars more per month after ten years of service.  To support a family of five in Portoviejo it costs around two hundred and fifty dollars a month.  On a doctors salary you can scrape out a living.  Therefore, if you want to live better, travel a little, or have more children you need to find and extra job or be in private practice. 

                            

The hospital was dirty and run down.  There are private hospitals in Ecuador that are just as nice as the ones in the United States, but this one was comparable to the public hospital in Quito.  The wards all had doors that closed, but were left open to the outdoors, even though there were ventilation windows.  The pneumology/ pulmonology/ respiratory/ lung disease rooms were at the end of the ward farthest from the main hallways but serviced by the same nurses as was the rest of the ward.  Other than being out of direct contact with other patients, the patients in this ward were by no means isolated.  Respiratory infections are a big problem and are the majority of pathologies for children in Quito and in the provincial hospital.  In pediatrics the well newborns are kept with the sick newborns, not a very safe practice for neonates.  There were vendors from the street that had access to all the wards, though not to the patient’s rooms.  We toured the hospital with the administrator and were only able to steal about ten minutes from a doctor.  Many of my medical questions remain unanswered.  They seem medically competent but unable to provide any standard care procedures that require the technology we are accustomed to in the US.  They had no technology for dialysis, no respirators, and no incubators.  Seven months was the earliest a child could be born and be expected to survive.  The hospital was full of sick people most of whom had treatable diseases or were infectious.  There were also a few patients whom the hospital was unable to treat or who could not afford treatment at a private hospital.  These people were, in plain English, there to die. 

The medical care in Ecuador is seriously under-funded and the foresight of the government is seriously lacking.  American standards cannot be used to judge a public hospital in a third world country because they are not on the same scale.  The people were very nice and all of the doctors and nurses were very dedicated but their health care system could use a big shot of money right in the arm.