Whenever you visit a foreign country, especially for health care, there are certain pre-conceived notions you have on arrival. In my previous medical travels through South America, I have generally found these notions to be ignorant and false. For example, the first time I was in Ecuador, I remember being extremely impressed at the level of primary care provided to patients. Everyone had their mammogram, shots, and physicals up to date (or at least those that were coming to see us in the free clinic). Some of the more surgical and emergency cases, however, appeared to be in need of improvement. As we have observed the Ecuadorean system during our research time, I have made it a point to ask opinions of everyone in the chain how it is working and what can improve. The following is not meant as a critique, as I have been very impressed with what already exists and is currently improving, and more as an insight into what we are helping progress here in Cuenca.
Health care is considered a right in Ecuador and is free to everyone, including myself if I happen to fall climbing a waterfall (see below, don't worry the fall never happened, but I do know the entire EMS system if it did). They also have a second tier option, which is insurance purchased by your employer through the government and allows entrance to a different hospital, followed by a third tier which is private. With everyone having access, basic care is being wonderfully taken care of. However, many physicians have complained about the lack of resources to treat as many emergent patients as come through their doors, especially on the Friday nights we have been there, where 20 patients can be standing in a room of eight beds. The regional hospital where we have been observing has sixteen surgical/clinical emergency, three trauma, and seven ICU beds to cover two million people. These numbers can push things back down the chain, where an ICU patient must wait in the trauma bay, making a trauma patient wait in emergency, making the ambulance that just arrived with a car accident wait in the hallway until it can enter emergency. Rather than giving a negative impression, I am actually amazed with what is done. If I am ever in a crisis, I'll take the Ecuadorean doctors I've been working with, who are geniuses at making the most out of their limited resources. I have gained respect for the level of care they are able to provide in whatever circumstance they are placed. As the resources continue to come in, and they will for a nation on the rise, my physician colleagues will fully showcase the wonderful medical skills I have been privileged to witness.
Along with this, we are excited to help deepen the skill pool of pre-hospital workers. As we finish our data collection with our time at the 911 call center, we are seeing areas where we know what we are doing can have huge benefits. By helping to organize and standardize the system into an MIVT format, we believe the standard of care can continue trending in an even more positive direction. On Monday we begin the training!
 |
| Final draft of the implementation card we will hand out next week, printed and laminated by the government |
As always, I like to update on the FUN we're having down here. Cuenca is truly a hidden gem and keeps surprising us with more to do in and around it each day.
 |
| First Bowling Championship between LATE and VCU. We were proud to take home the trophy on the last roll. |
 |
| Our FAVORITE yogurt cabin out in what we call the "Swiss Andes" surrounding Cuenca |
 |
| The Chorro de Giron, thanks Caro for the great adventure! |
 |
| Ingapirca, the largest Incan ruins in Ecuador, 2 hours outside of Cuenca |
No comments:
Post a Comment