Health Care In Cuenca, Ecuador

Cuenca has the best quality of life of all major South American cities, according to international online rating service Numbeo. To make this determination they measured six different criteria like safety, pollution, cost of housing, general cost of living, travel and commuting time, and quality of health care. Over the seven plus years that I have lived here I have enjoyed the fact that Cuenca is widely considered to be the safest major city in all of South America and that the cost of living is incredibly low. This year I also experienced an amazing heath care experience. Disclaimer: This is my personal experience and I am unable to speak for anyone else, their experiences and opinions may be different. First of all, I want to let you know that I am fine, more that just fine, I doing really well! I am writing this post not for any kind of sympathy, I merely want to share the quality of the experience I had including the surprising cost of the health care here in Ecuador.

For more than thirty years I have experienced the effects of GERD (Gastroesophageal Reflux Disease). In simple terms, this means that the valve at the top of my stomach was herniated which caused severe reflux and stomach acid to enter my esophagus which caused pain and burning which over time damaged the lining of my esophagus. I had to take expensive medication for most of my life to limit the amount of acid in my stomach to control the discomfort and damage. There is a surgical procedure to repair the hernia and stop the symptoms but doctors have continually told me over the years that as long as the medication was working they recommended against the surgery due to possible complications. About a year ago the medication stopped working for me, so it was time to look at possibly having the surgery. Before the surgery could be scheduled there were numerous tests that I would have to undergo to ensure that this was the appropriate option for me. These tests were extensive and rather unpleasant and in the US would have cost upwards of $20,000 or more. These included an endoscopy, upper GI ex-ray series, extensive blood tests and a couple of more tests that I cannot pronounce, but involved having tubes inserted into my stomach via my nose and were extremely unpleasant. I do have the government health insurance which costs me $75 per month and would have covered 100% of the cost, but due to the red tape and time involved with using the insurance, I opted to pay out of pocket to speed thing up. The total that I paid for all of these tests and doctor appointments was about $1,500 and I was typically able to schedule each of these appointments within 24 to 48 hours.

I had to wear this device and have this tube in my stomach for 24 hours.

My primary care physician and my gastroenterologist both speak English, but most of the doctors, technicians, nurses, and hospital staff that I dealt with and who administered my tests spoke only Spanish. Many expats hire a bilingual medical facilitator to go with them to their appointments to translate and assist with paperwork. These facilitators typically charge $15-$20 per hour for their services. I chose to forgo this and go it alone. My Spanish is fair, however my medical vocabulary is limited, but I managed just fine. This would not have been possible without a facilitator if I did not speak Spanish. Everyone was very kind and patient and did everything they could to make my experience as painless and pleasant as possible, once I even had a nurse hold my hand and sing to me because she could tell that I was seriously stressed. Upon completion of all of the tests, it was determined that I was an ideal candidate for the surgery.

Once the gastroenterologist approved my surgery I had appointments with a cardiologist and the anesthesiologist to determine that I was healthy enough to undergo the procedure and then a nutritionist to build a postoperative recovery plan. All three of these specialist's fees were included in the fee for my surgery. Once these appointments were complete, the surgery was scheduled for the following Friday morning and would require an overnight stay in the hospital. I checked in on Friday morning and was wheeled into the OR at about 11 am. Before putting me under, the anesthesiologist asked me what music I would like to have playing during the procedure. I said I wanted to hear Emmylou Harris's beautiful voice, so I drifted off to Emmylou singing "After the Gold Rush". After an hour or so in the recovery room, I was wheeled back to my private room where I received IV pain meds and amazing care from a team of amazing nurses. I spent the night and went home the next day. The fee for the entire surgical procedure including: the doctor's fee, operating room procedure, anesthesiologist, hospital stay (including all meals and medications), and the nutritionist came to $1,500. All follow-up visits to the doctor were included in the total cost. I cannot say enough about the professionalism and kindness shown by all of the medical personnel involved. Add to that the costs for all of the pre-surgery tests, the entire cost to me for everything related to this medical event was about $3,000 and I paid entirely out of pocket, no insurance. I don't know for sure, but I think that would be less than my insurance co-pay would have been in the US.

The surgery was a piece of cake compared to the recovery. Post hospitalization pain medications were restricted to Tylenol as opioids are highly controlled in Ecuador, so I was in some intense discomfort for about a week. I was on a liquid diet for two weeks and pureed solid foods for another four weeks. My nutritionist delivered two blended meals to my house every day for the duration of my recovery at a cost of $35 per week. It has been nine months since the surgery and I am finally starting to feel back to normal. For the last several years I had to be careful about what I ate; no spicy or acidic food, etc. and I was on a lot of expensive medication. Now I can eat anything I want, I have no reflux or heartburn and I take no medication at all. One of the best parts of all this is I lost almost 30 lbs and have not gained any of it back! To sum it all up, I have nothing but praise for the health care here in Ecuador. Admittedly, this was one event and your mileage may vary. I want to send a huge thank you to all of the amazing health care professionals here in Cuenca and I am so grateful that I did not go bankrupt in the process. It is no wonder that people in the US frequently come to Ecuador to have major medical procedures done rather than have them done at home.

~Hasta la proxima!

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