By Kristina Cesa and Alyssa K. Kunz

           The quality of health care services is of major concern to the citizens of every population.  The quality of a health care provider depends on a variety of factors including but not limited to: 1) ability to properly diagnose ailments, adequate technology, access to various medications, the duration of patient waiting period, and the comfort provided to the patient.  During the Summer 2004 Tropical Diseases workshop we had the opportunity to visit several both public and private hospitals in the city of Quito.

There was a huge difference between the public health care and the private health care provided.  The private hospital had plenty of staff and everything equivalent to a hospital in a developed country.  The technology and medical supplies needed to treat various ailments, from snake bites to diabetes, was readily available.  The rooms were separated from one another and provided for a comfortable stay for both the patient and their family members.  The hospital itself was very clean, sterile, and aesthetically pleasing to look at with beautiful artwork and complementary architectural designs.  The public hospital, however, had nothing of the sort and felt more like an institution than a place of healing.

Patients that arrive at the private hospital are greeted by nurses and quickly moved to patient care rooms.  Many of the doctors and nurses speak fluent English and Spanish.  The atmosphere created by the doctors aimed to make a visit to the ER as enjoyable as it can be.  The hospital itself was equipped with everything from a pharmacy to a cafeteria.  The patient rooms were luxurious, with couches for the families to sit on and personal bathrooms in the rooms for the patients to use.  If anything, the private hospital was a little excessive with many unnecessary luxuries.  The difference between the public and private hospitals seems very unfair, with one being so wonderful and the other being so run down.

Overall, the feeling obtained from the public hospital was that of despair, a sort of last resort for a desperate people.  The almost complete opposite was obtained from the private hospital where both the workers and the patients resembled more wealthy individuals.  The difference in the public and private hospitals does not simply stop at the general appearance or the number of qualified staff.  Major differences also exist in the price of the care.  An alarming number of individuals cannot afford the services at the private hospital even though the prices of the services are approximately 1/10^th of those in the United States.  For example, a visit to the private hospital for a general exam and both full chest and pelvic x-rays cost approximately $110 whereas the exact same procedures performed in a hospital in the United States would cost over $1,000 dollars.  The low cost of the excellent hospital care obtained from the private hospital was quite alarming to participants of this workshop due to the fact that such a low amount was considered extremely expensive by Ecuadorian standards.