Doctors, hospitals and pharmacies

We have been quite pleased with the quality of health care we have encountered here in Cuenca.  As we mentioned before, there are three major private hospitals, Santa Ines, Monte Sinai, and Hospital Del Rio (a new teaching hospital run by a US conglomerate).  The hospitals are clean, have modern equipment and are staffed by unusually caring personnel (something we seldom encountered in the US).  Next to the hospitals are the Consultorios, or office buildings where the doctors have offices and see patients. Many speak English and, if you have an English speaking doctor, he or she will often take you to a Spanish speaking referral and translate for you. It is also not unusual for a doctor to make a house call. How many of us can remember that happening? There are a number of public hospitals where military families, Social Security patients or anyone with a cedula can be treated at little or no cost. They are a lot less desirable as they are not especially clean and are extremely crowded. A patient must go to the hospital at four in the morning to get an appointment to see a doctor or be admitted except in an emergency.  Almost all the expats we know use private hospitals and have been quite pleased with the quality of service. Health care is inexpensive compared to the US and Europe and, we have heard, compares favorably with Canadian costs. Health care plans are expensive and are notorious in not paying claims. Most expats choose to self-insure and use a pay-as-you-go system. Pharmacies are all over town with a few chains like Fybeca, the largest. Many of the over the counter prescriptions and brands of cosmetics, dental, shaving, and other items you are accustomed to are available. But there are a few that are limited. Cold medications are few and far between possibly because we seldom get colds. The steady weather conditions rather than the changing seasons up North, may be why. There are vitamins but only a few like C, Ginko and other herbal types but, unusually, not B12 complex or minerals. Aspirin only comes in 500 and 100 mg sizes. Most medications other than narcotics can be obtained at the pharmacies without a prescription. The pharmacists are excellent in advising what to take if you describe your symptoms. There is usually a generic available if they do not have your exact medication. Bring an empty bottle so they can see the exact ingredients. Magazines for sale in the pharmacies are all sealed in plastic possibly to prevent you from reading them and not buying.  The pharmacies are small compared to CVS or Walgreens but are adequate in most departments. Dental care is inexpensive compared with North America and often up to US standards. When you sum it all up, the quality of health care, the cost and ready accessibility of medical help in the city of Cuenca, plus the availability of an enormous variety of fresh fruits and vegetables, makes good health something to look forward to here in the mountains of Ecuador.

Health

When we first made our plans to come to Ecuador, we asked our North Carolina doctor what we should do about potential altitude sickness. He recommended some expensive pills to take to ward off any side effects of arriving and staying at altitudes above 8000 feet. We were all rather surprised when we felt no effect of the altitude except some shortness of breath when we climbed stairs. We never used any of the pills and feel like we have adjusted to mountain living quite well. We have even been up to around 12,000 feet in the Cajas National Park though we did not do anything strenuous while up there. It was cold, however, and we needed to wear jackets and sweaters which is a real oddity here on the equator. Cuenca has a half dozen outdoor staircases that you climb to get from the river area up to the level of town. These stairs can be up to 100 steps each and it is fun to watch a family of Mom, Pop and a couple of kids race up to the top. We generally take a moment to rest half way up and are not surprised to see others doing the same thing. Then there are the futball players who are absolutely amazing. At this altitude, they race back and forth on the playing field seeming not to ever be out of breath. They must have the lung capacity of an elephant.
Even with the unregulated diesel fumes from the trucks and busses, the air here is clear and dry. Humidity is low and the temperature stays relatively constant. Around the second of December, a friend told us that he had seen a report saying that the temperature reached 81 degrees that day, a thirty year record high. We remark often that the temperature in Cuenca is near perfect, never too hot and never too cold. It is very special to read reports about severe weather in the States and look out the window in mid-winter at people walking by in T-shirts and jeans and flowers constantly in bloom. The weather may well be our favorite thing about Cuenca.

Health Care

There is a social security system here that provides health care to anyone who has residency. However, the Social Security hospitals are so crowded and busy that few expatriates use them. To get an appointment with a doctor at a Social Security hospital, people come at four in the morning to stand in line. There are a number of fine private hospitals where you can get almost any service required. Many of the doctors have trained in the US or Europe. Doctor visits are inexpensive at $20-30. After being accustomed to the long forms of health information required when you visit a doctor in the US, it is a little confusing when a doctor in Ecuador just asks a few questions and keeps no notes. But, they are thorough and spend a long time with you not the few minutes spent by doctors in the US. There are health plans but they are notorious for not paying claims presented to them. Most of us don’t subscribe to health plans but prefer to pay-as-we-go. Medicines are cheap compared to the US. Pharmacies dispense antibiotics and many other medicines after you describe your symptoms. Almost everything but narcotics can be obtained without a prescription. Vitamins and over the counter medicines are available but not all you are familiar with. Bring what you need in large quantities of items like Nyquil or laxatives. Then you will have enough until you discover whether your medication is available or not. We have ordered on line and had items we cannot find here sent via the mail but it is quite an expensive way to go. It is often better to find a locally made medication that will substitute for the one you have been using.