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On the third day of our Ecuadorian adventure, we visited the
Provincial Hospital in Coca. Dr. Galo Chuncha was kind enough to
provide a tour and answer our questions regarding healthcare
delivery in rural Ecuador. Although the hospital was relatively
large, there was only one doctor on staff at any time, and he
usually only sees six to eight patients per day. The rest are just
sent away. Despite the popular belief that rural communities develop
a more close and personal relationship with their healthcare
provider due to the smaller population, the doctors in Coca do not
stay long enough to establish a consistent rapport. The doctors are
actually graduating medical students from Quito finishing their
community health rotations. This leads to inadequate patient care
from inconsistent methods and the inability to truly document
patient histories. The remainder of the hospital staff consists of
two nurses, two aids and a specialist. All healthcare personnel live
together in a home provided by the hospital.
The hospital is separated into various wards, separate men’s and
women’s rooms, and areas for pediatrics and oncology cases. Although
there is an emergency room, this hospital is not equipped to handle
any trauma cases, including premature and other complicated births.
The closest trauma center is in Quito, located over 8 hours away via
car. The unfortunate truth is that any real emergency may just
easily be renamed a casualty.
The outdated hospital equipment and facilities did not surprise us.
The lack of sanitation however was perplexing. It would seem logical
that a clean floor and graffiti-free walls would be a result of work
ethic rather than finances. Animals wandered the halls freely, even
amidst the surgical areas. Bed and patient linens were washed by
hand in what was probably contaminated water and then air dried. We
also were confused by the lack of privacy, and the patients’ blasé
attitude toward our curious eyes. This visit made me realize that
instead of complaining about our healthcare system, we should be
grateful for it.
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