By Rebecca Marass and Peggy Stelzig

            Our group met in Quito, the capital of Ecuador.  The first thing we did as a group was to tour two hospitals in the city: one public and one private.  There were stark differences that were obvious when we first arrived at each hospital.  The Public hospital was rundown, weather beaten, litter was present, and vendors were hawking their wares.   The hospital was on a major street where there was lots of traffic and air pollution.  On the other hand, the private hospital was a new building, tucked back into a quiet suburb with modern design.  It had quality landscaping with private parking. 

            Upon entering the public hospital, there was no reception desk, only a few benches to sit on and an area to catch an elevator.  The private hospital there was a modern, sleek reception desk with a waiting area and a drug store. 

            There were differences when it came to the different hospitals’ wards as well.  The public hospital had basic wards, such as neurology and internal medicine that were not further specialized.  There were few doctors present, only a few nurses running around to care for patients needs.  The private hospital had floors and wards that were specialized to certain.  Many doctors were present and even had their own offices with exam rooms.  Also, a noticeable difference was the empty beds in the public hospital because many patients had to be turned away due to lack of staff, equipment, and funding to care for them.  Most doctors worked a few hours at the public hospital and then went to their own private practice.

  When observing patient care in the rooms, the public hospital had six people to a room with no privacy curtains present.  The beds were just a thin, raised mattress with a sheet to cover the beds.  Non occupied beds had no linens at all.  Many of the procedures, such as draining an abscess, happened right in the room, while others watched, in an unsanitary environment.  The “Sharps” containers were simply used water jugs that were left uncapped under the solitary sink in each room.  During the short time we had to view the private hospital rooms, they had privacy curtains between the patients, which only numbered two to three in each room.  All beds had fresh linens that could be easily adjusted to the patients comfort.

            The public hospital is funded by the government, who only devotes a small portion of their budget into health care.  This results in the lack of equipment and staff.  A few doctors take advantage of their position and use the equipment that the public hospital does have to supply their own private practice.  This may be the norm but we met a surgeon who is dedicated to the public hospital and finds rewards not in salary, but in helping people.  This hospital is striving to become a private one so that it can offer better health care, but the actual constitution prevents the public hospital from doing so. 

The private hospital is able to have quality health care because they are serving only a select few in Quito, those who can afford health care and insurance.  Unlike the public hospital, they are actually able to make money to keep themselves in business.  It is impossible for the public hospital to make money because they offer free or low cost health care to the general public.  In larger cities, like Quito, there is always a large poor population that needs health care because of their living conditions.  The poor of Quito can’t afford to maintain their health because they struggle to even keep a roof over their heads. 

            In conclusion, the differences between the public and private hospitals can be summed up by the different patients that go there.  In the public hospital, only poor people went due to free or low cost basic health care.  Whereas at the private hospital, middle and upper class individuals came because they could afford better health care with higher quality equipment, doctors and more personal attention. 

            On a side note, the public hospital closed down due to health care workers strike because they haven’t been paid in several months.