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.

before

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.

after

Observations:

  • 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 (graygeek@gmail.com) if you are interested in setting something like this up.

 

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