MY EXPERIENCE AS A GRINGO STAYING IN AN ECUADORIAN PUBLIC HOSPITAL
On June 14, 2018, my husband Chance and I, Brenda McCarron, gringos from Canada with no Spanish were on a property tour with Amy Prisco who is an Ecuadorian Realtor living in Salinas, whom also is fluent in Spanish. We were looking at properties along the coast and our first stop was a beautiful home in Balenita that was for sale. We were viewing the property and I was coming down the stairs from the second level when I missed the bottom stair and fell. I knew I broke my one foot as I nearly passed out from the pain and the foot sort of flopped and the other foot hurt pretty bad as well so I thought if may also be broken. It turned out the right foot just had a broken edema that would heal by itself in time but the left foot had 2 broken bones between the ankle and a bone chip.
Lucky for us we had Amy with us as she has a Masters in Spanish so was our interpreter throughout. She was our Angel through this whole ordeal. Amy called an English doctor in Salinas but he couldn’t come until 2 pm and this happened about 9 am. The woman who owned the home, Nancy, suggested taking me to the hospital in the city of Santa Elena so that is what we did. Since I had injured both feet, with much difficulty we got me into the car to the hospital.
After putting a partial cast on my broken foot to keep it stable, the hospital admitted me. They moved me into a large open room without curtains between the beds and hooked me up to an IV. I assume they gave me pain medication as I didn’t seem to be in that much pain. My experience in the waiting room was scary. There were no pillows or blankets and it was cold as the air conditioning worked well. We had a bedpan issue and they took the bedpan away and left me on a wet bed for the night. It was a big open room without curtains and they had a small divider which they used for privacy when you had to go. It was too small to offer full privacy so my husband, Chance, held up the blanket which Amy lent us from her car. Amy asked them to change the sheets after this incident but they never returned so we tried to dry the bed as best we could and I laid their on a wet bed until 6:30 the next morning. Needless to say I was scared and thinking “What did I get myself into?”
Once they moved me into a ward I felt much better and started to relax a bit. The ward was about the size of our 4 bed wards at home but with 6 beds in the room. It had a bathroom with the sink outside. All the patients had bone injuries. The room had curtains between the beds, a bathroom and a pillow and a light blanket on the bed. I started to relax a bit. They didn’t give me a gown but I removed my wet clothes. My husband got me some dry ones the following day.
We were told that surgery may be the following day, Friday, but more likely Monday and if there were emergencies possibly Tuesday. On Monday the doctors came in as a team and went around the room discussing the patients and letting them know when surgery would be. He got to me and told me it would be Friday. That is 8 days after my accident. I was distraught and started to cry. Once they left I called Amy and asked her if there was a private hospital that could do it. I was concerned that if we did wait until Friday I could get bumped and it wouldn’t then be until the following Monday. Amy called Dr. Guzman an English doctor in Salinas and he came to see me. He told me that they could move me and that there was a trauma surgeon he works with that could do the surgery for me; however, after checking with someone, he came back and told me the surgery was moved up to Wednesday so he didn’t think it was worth it to move me to have the surgery one day earlier. I agreed.
On Tuesday, the following day, the doctors came on their usual morning rounds and told me surgery was still Friday. I was very disappointed but decided at this point it was hardly worth it to move.
What I learned from my Experience
There is a wait for surgery in Ecuadorian hospitals unless you aren’t stable or at high risk: at home we would have had the bones set within 24 hrs. They took pretty good care of me in the meantime however.
Family looks after non-medical care, such as use of bedpans or help to the bathroom or anything else non-medical. This includes at night, so family members were there all the time except to go have something to eat: at home the nurses perform this duty but are happy to let family members do it if they are willing. At home family members usually come to visit but aren’t there constantly unless the patient is extremely Ill or dying. So family members slept in their chair.
In Ecuador, there were a lot of staff and all had different jobs. I changed beds 4 times before I got into the OR and mostly different people moving me. Probably the reason the sheets never got changed in the Emergency is that it was someone else’s job and after observing how things worked during my stay, I think the sheets probably had to be accounted for or changing them was someone else’s job. In the ward the sheets were changed daily and they were very efficient at it even with you in the bed. I noticed they did a count of the sheets when they came in to the ward– not sure if it was because they were accountable or just needed that many for the room. I would suggest having a bed liner or 2 with you in case needed between sheet changes.
Hospital was very clean. They swept and mopped the floors daily and were quick in cleaning when anyone left.
Security staff were thorough in ensuring that they didn’t let anyone in unless they knew the person in the hospital and only a family member beyond visitor hours. I always felt safe.
We found the Ecuadorian people very accepting of us and treated us the same as others. They are a very curious people, going bed to bed to see what happened to everyone and jumping in quickly whenever anything was needed, from help to the bathroom, into bed, picking up something that dropped, and when I fell in the bathroom on my discharge day, one of them ran across the street to get Chance. He was staying at the hotel just down the street and there are open air eateries across the street as well so perhaps she had seen him there before. Not sure anyone would have done that for me had I been at home in Canada. They seemed to be very family oriented and everyone knew everyone’s business. I think if 2 or 3 people (family members of patients) at home went to someone and wanted details of a conversation or an event, that person most likely wouldn’t answer them or may even tell them to mind their own business. One day one of the patients was crying and I caught a few words. It seemed that a family member wasn’t going to pick up a prescription or maybe not going to pay for it, not sure, and all of them congregated around her to comfort her. From my experience they are a very warm people who are very family oriented.
No food or drink was allowed to be brought into the hospital – not sure on the reason for this rule.
Food wasn’t bad, much better than I expected. Most of the soups I didn’t care for and breakfasts weren’t up to much, 2 pieces dry bread with a piece of cheese that covered half the bread or a hard-boiled egg with the bread and a small dish of fruit as well – maybe a few grapes or some watermelon cubes. The people in there seemed to like it alright and couldn’t understand why I didn’t eat the bread: As North Americans I think we are spoiled. Lunch and dinner were pretty good and tasty. Always soup, and usually meat and rice with a vegetable and sometimes more of a stir-fry or a flavored rice with chicken dish and one night we had potatoes. It was enough – I never felt hungry.
You are expected to bring your own blankets.
You are expected to provide ice if you need it.
You are expected to bring towels and facecloths and soap to wash with.
Chairs for the family member attending are not provided. They are brought from home.
Doctors look at your case as a Doctor team so you can be sure you are getting good care.
Nurses although they don’t perform some duties our nurses at home would do, they are very efficient at what they do. They ensure your IV is working fine, give pain medications, check the IV insertion point on a regular schedule – this was nice. And a nice addition was that they all seemed caring. At home a lot of people go into the profession because it pays well so you get many nurses that aren’t very caring.
You were given a good sponge bath every day if you couldn’t get up, which included me, since I had injured both feet or they would assist those with more mobility with a shower or family members would assist them.
They have qualified surgeons and I felt confident in my surgeon’s abilities and am thankful for the surgeon that operated on me. They froze the bottom half of me. I wasn’t impressed with the anethesiologist.
Rather than a prescription we were given medication to take home with us, all at no charge.
On discharge, we were told no cost since it was trauma. It seemed no one paid if it was trauma but were charged otherwise.
My hope is that by sharing my experience, if anyone ends up in an Ecuadorian hospital they won’t be as scared as I was since they will know how the system works. I had good care and had I known how things worked, it would have been much easier for us.
In addition, if any gringos are reading this that do not speak Spanish, learn at least the basics. Had it not been for our angel Amy Prisco, I’m not sure what we would have done. I want to publicly thank her for all her assistance through this process. Who would have known that out of tragedy we would made a friend as we did with Amy Prisco. Knowing Spanish or at least the basics would have made the experience less scarry.
I would also like to thank Luis who drove us to where we needed to go, helped us to get crutches and lent us a wheelchair for the rest of our stay. I would also like to thank the owners of the apartment we rented, Ceceila & James Flannery, who put minutes on our phone card and got us groceries on our return and even brought us over pizza and visited with us.
Conclusion: Ecuadorian Public Hospitals aren’t so bad.
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