The Ecuadorian Health System – One Real Life Experience

Both my wife and I want to thank the Ecuadorians who aided Sharon in her fall on the street and the ambulance crew that safely got Sharon to the hospital, the  care she received from the Emergency Room at IEES Hospital and the expertise of Dr. Romulo at Santa Ines Hospital.

The Accident:

Sharon was crossing Doce de Abril near  Av. Loja at 1:00 pm Tuesday 3/22. She tripped on the raised asphalt and fell in the middle of the road breaking the radius and ulna bone on her left arm with multiple contusions on her chin eye and forehead. The ulna bone was a compound fracture slightly exiting the arm.

A good samaritan helped Sharon to the side of the road and called 911 and Sharon was able to call me. I arrived at the scene about the same time the Ambulance came.  The Ambulance initially took Sharon to Santa Ines but we were refused service because her condition was not life threatening. Later I was told it was because the IESS system is extremely slow in reimbursing private hospitals and often does not pay the full amount.


IESS Emergency Room:

Sharon received good triage care at the IESS Emergency Room. Her arm  was x-rayed and she had an MRI to rule out a concussion. The resident read the x-ray and determined that she would need surgery to correct the compound fractures. The problem was that the only attending Traumatologist was currently in surgery and she would be 12th in line with a possible Friday surgery. No other hospitals in the IESS grid had openings and she was taken to a fifth floor hospital room to await surgery. I left Sharon at 10:00 pm to go home with an Ecuadorian friend.

Sharon met the surgeon at 10:30 pm and he argued with the residents in the room and belittled her for not knowing more Spanish after living in Ecuador for 5 years. Totally unacceptable for any doctor but abhorrent for someone with two compound fractures. There  were two other patients in the room who were upset by the doctor arguing.

Next Day At Santa Ines Hospital

Our Ecuadorian friend who was concerned about infection arranged for Sharon to see Dr. Romolu at Santa Ines. We made the decision to transfer Sharon to Santa Ines Hospital and go to private pay. She was immediately seen by Dr. Romolu and successfully operated on early Wed. afternoon. She spent the next two days in hospital and was released on Friday. The total cost of the operation and her follow-up care was very reasonable

Sharon now has a titanium plate and the prognosis for a full recovery are excellent.



  • Always carry your phone and a copy of your cedula
  • Few Doctors and fewer Nurses speak English
  • Your Spanish will suddenly vanish when you are under stress
  • Have more than one facilitator available that can translate and advocate for you
  • Don’t assume you will go to the closet hospital
  • Have an advocate with the power of attorney that can make decisions on care if your are not in a position to make that decision

Why We Were Fortunate And What Is Needed:

We were very fortunate to have  an Ecuadorian family that shepherded us through this situation. They not only were our advocates in translation but also a source for an excellent surgeon.

I would like to explore setting up a database of doctors and surgeons that would be available either on Facebook or another venue. This database should include the following:

  • Area of Specialty
  • Recommendation by others with first hand experience
  • The need for a facilitator to accompany the patient

Please contact me by email ( if you are interested in setting something like this up.


13 thoughts on “The Ecuadorian Health System – One Real Life Experience

  1. First, best wishes to Sharon. I had to go through the emergency medical system in Bogota with bad Spanish, on my own, but ended up fine. The data base you suggest is a great idea. So is getting much more serious about my Spanish!

  2. We have joined the Gringo911 service. It is $80 a year to join. When you join up, you complete your profile with all the information they will need in an emergency, such as: your name, age, blood type, what medications you are taking and/or allergic to, who to contact in Cuenca, who to contact in your country of origin, who your attorney is, who your primary care physician is, what hospital you want to go to, whether you have health care insurance or not, end-of-life care, etc.

    I highly recommend this service. Gringo911 gives you a card to carry in your wallet so if you are unable to communicate, hopefully the first responders will find that card. When they call the Gringo911 hotline number on that card, all of the information will be given to them from their database. Also if you are at home and have an emergency, there is another card you place on your refrigerator and the first responders are to look for it there.

    If you have family from another country that has to come to Cuenca, Gringo911 will coordinate that also and assist your family while in Cuenca.

    We just signed up and haven’t had to use it yet, but you never know when an emergency will present itself.

    Glad that Sharon is recovering. I,myself, have had two very bad falls (one needing an ambulance and ER visit). So I’m very careful now when walking around town and I recommend that people don’t walk alone.

    Sorry for the long comment but I thought it was important to share.

    Patty Grimm

  3. Horrible situation but nothing comparing to Polish health system.. One week ago they were proud to announce that their waiting list for ortopedic operations had reduce from 14 till 4 years.. yeap.. Thats Europe

  4. Thank goodness Sharon got to Dr. Romulo Idovo…He is a wonderful surgeon and lovely person. My husband broke his leg in three places and thanks to this great doctor he didn’t lose his leg.

    When my husband had a stroke we took him to Santa Ines where they stabilized him. Then we moved him to IESS. IESS only has residents on the weekends and, although competent, in that kind of emergency we wanted experienced specialists.

    Although we have access to caring Ecuadorians who assisted us in both situations, we are going to join Gringo911.

    Your idea has great merit, I will assist if possible.

    Susan McBride

  5. Those amazing x-rays sure tell a story about her terrible fall; I am so sorry but happy Sharon found quality care. A good lesson here for us ex pat wannabe’s. Best wishes to you both Sanford and Debbie (Bend, Oregon)

  6. I am with Gringo911, based in Cuenca. We are a 24/7 hotline, answering our phone in English, then interfacing with Ecuador 911 to dispatch emergency responders (medical, police, fire, civil defense) for non-Spanish speakers. Our members complete a comprehensive profile which enables us to communicate with first responders and medical personnel. We are also available to translate for members and communicate with hospital personnel relating to an emergency. In a worst-case scenario, we can contact next-of-kin in the home country, assist them with necessary paperwork for repatriation of remains, and interface with Embassy as well as local government offices. Full information on our services, as well as online enrollment, can be found on our website at

  7. Wow, Sharon! Just needed more excitement in your life. LOL! I’m so glad you are OK and healing nicely. I’m sure Lenny is waiting on you hand, arm and foot and the cats are curled up next to you. Love, Gerry in Oregon

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