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- 1. RUNNING HEAD: HEALTHCARE IN ECUADOR Carpio 1 Healthcare in Ecuador Final Research Paper Jessica Carpio HCS 400 Dr.Lewis
- 2. Healthcare in Ecuador Carpio 2 Healthcare service is a universal necessity to sustain a long healthy life. Although it has been scientifically proven that access to healthcare is necessary to live longer, not everyone has access to it. Across the world, different countries tried different methods on what they assumed the most ideal healthcare would be for them. Unfortunately, there has been a lot of trial and error. Over the course of Health Care Sciences this semester, it has been discussed how different countries can create an ideal healthcare system for their citizens that is affordable, public, and good quality. This particular paper will explain healthcare in the country of Ecuador. Ecuador is a small country located on the west coast of South America. It is rich in culture and has many years of tradition living today. Health trends and ¡°buen vivir¡± lifestyles will be discussed throughout this paper. Abstract: healthcare, Ecuador, public health, buen vivir
- 3. Healthcare in Ecuador Carpio 3 Ecuador¡¯s current president Rafael Correa, has made it a mission since his election in 2006 to create a ¡°citizen¡¯s revolution¡± in the country. A citizen¡¯s revolution is one where the people of the country are in charge instead of the capital. His main objective was to develop a society where all the citizens can live good lives through access to important institutions such as a sustainable economy and healthcare. His goal was to provide a healthcare system with high quality service for everyone. The new idea of healthcare was inspired by a ¡°buen vivir¡± way of life, meaning ¡°good living¡±. ¡°Buen Vivir¡± entails delivery of free, high quality, public healthcare passed in 2008. His goal was so that all persons, Ecuadorians and not, be able to get access to healthcare in his country. In 2008 the attempt to rewrite the Ecuadorian Constitution occurred, however the healthcare system was already set as a free market which made it difficult to change. Today the Ecuadorian government and MOH (Ministry of Health) are the primary organizations responsible for trying to develop a universal public healthcare system in Ecuador. The Ministry of Health is a part of the government that focuses on issues related to the general health of the public. Most recently these organizations have worked to increase accessible healthcare and intervention programs to the general public in some of the poorest cities of Ecuador. The MOH has worked to develop private facilities, build public hospitals, and recruit adequate physicians. Things seem to be looking good for the people of Ecuador. An article by the Huffington Post raved about how great and affordable healthcare was in Ecuador. For just $70 a month,
- 4. Healthcare in Ecuador Carpio 4 citizens and legal residents are able to obtain healthcare membership per their own choice. The new healthcare plan is managed by the country¡¯s social security administration. It revoked age and pre-existing health condition that restricted people from being able to affordable healthcare sound somewhat similar to the ACA, Affordable Care Act? The new health system provides full medical coverage, dental care and free or discounted prescription medicine. The ACA does not provide dental care, so Ecuador wins that part. Big cities like Cuenca, Quito and Guayaquil benefit positively with the new healthcare system, the people living in these areas are also able to afford $70 a month. The struggle has been to reach out to communities in the southern coast of Ecuador such as Las Mercedes. Las Mercedes is a poverty stricken community; studies conducted back in 2009 and again in 2013 revealed that communities like Las Mercedes are not provided with high quality health care services. That research also showed because Las Mercedes is so poverty stricken it has high percentages of reported dengue fever and malaria. Other infectious diseases were not even put into record because of low quality health care services for the populations not being able to record it. Malaria is a serious disease caused by a parasite that infects mosquitos which then feeds on humans. People who are infected with malaria get very sick with high fevers, shaking chills, and flu-like symptoms. Dengue-fever is a mosquito borne viral disease. It is the fastest growing tropical disease in South America. Studies have shown that dengue fever is easily influenced by climate and unsanitary human behavior. On the coast of southern Ecuador, a
- 5. Healthcare in Ecuador Carpio 5 city called Machala suffers immensely from dengue fever; there studies have been conducted to verify that ecology and social context influence the spread of dengue fever. Warmer air and water temperatures increase larvae development thus creating more biting rates. An article studied suggested that Social Communication strategies were necessary to decrease the rates of dengue fever in these communities. ¡°Social mobilization and communication interventions should be developed to increase community members¡¯ dengue knowledge and more importantly to promote the adoption of preventative behaviors¡±, (Stewart). Ecuador suffers more than just from infectious diseases. The most recent reported leading cause of death in Ecuador recorded in 2013 by the WHO, World Health Organization, was Ischemic heart disease, killing 8.4 thousands people. Other causes of death were: stroke, lower respiratory infections/disease, road injury, kidney disease, diabetes mellitus, interpersonal violence, HIV/AIDS, hypertensive heart disease, cirrhosis of the liver. Life expectancy for Ecuadorians is 76 years old compared to the United States is 78, which is not much different. Like here in the United States, natives suffer from nutritional deficiencies as well. Some areas of Ecuador suffer from iron deficiencies. Children in rural areas are known to suffer more from iron and zinc deficiencies, like here deficiencies are first noticed through quantitative measures such as height, weight and age. It could be an environmental affect or biomedical factor. The country of Ecuador is difficult to breakdown because the climate varies all
- 6. Healthcare in Ecuador Carpio 6 throughout the county. The climate and culture change too. Rural areas such as the Andes Mountains have a different way of life and eating habits that could be affecting their health. People living in the Andes use traditional medicine/practice for thousands of years. Some of them use modern medicine in conjunction with their traditions. It is almost the equivalent of an Amish person in PA seeking medical attention in a hospital. People living in the Andes are known as indigenous people and there are an estimated 42 million living in South America. Their basis of good health goes alongside living with a balance of nature in their lives which is why they choose they stay there because they believe if they leave it will interfere with the balance. Traditional medicine also plays a big role in their culture. The WHO states that at least 80% of indigenous people rely on their traditional healing practices as a primary source of healthcare instead of seeking modern healthcare services. President Correa is aware of Ecuador¡¯s indigenous population, instead of frowning upon their culture and traditions there are healthcare services that exist to meet the needs of the indigenous people when they need it. The Jambi Huasi clinic in Otavalo, which is 70 miles from Ecuador¡¯s capital Quito, is an example of a nearby clinic that specializes in caring for the indigenous people. The clinic trains volunteers on how to treat and educate local Andeans. The name Jambi Huasi is translated to ¡°house of health¡± in the indigenous people language which is Quechua. The clinic provides a combination of both modern and traditional medicine.
- 7. Healthcare in Ecuador Carpio 7 Traditional remedies include the use of herbs, amulets, guinea pigs, and incantations to eliminate disease or cleanse the body (Chelala). Traditional medicine examines the tongue and urine of the patient; it also examines an egg that has been passed around the patient¡¯s body. The same technique is used with a guinea pig; it is passed all over the patient¡¯s body and then internally examined for signs of ailment that could be a signal to where the patient may be sick. Traditional medicine is vital for Andeans, because it respects ¡°Pachamama¡± which translates to Mother Earth. One example of how correlated Mother Nature and health are, is believing diarrhea is brought on by anger or anxiety as punishment by Mother Nature for failing to feed the earth and/or care for the animals. Each sickness is cured by a specific cure such as water from fresh plants or egg and onion soup for diarrhea. The clinic has a physician, a midwife, and a chiropractor and provides services such as internal medicine, gynecology, pediatrics, minor surgery, and dentistry. The clinic received much praise for being so inclusive for the people of the Andes Mountains. The clinic has said to improve the health and quality of life of the indigenous women of Ecuador and was awarded the International Award for the Health and Dignity of Women by the United Nations in 2006. The same way this clinic exists to meet the needs of a particular population is exactly the same effort the United States makes when building community centers, urgent centers or rural health networks. Patient advocacy is a growing field in today¡¯s healthcare, the same way volunteers are being trained to understand the Andeans is the reason why we have such a demand for patient advocates today. An advocate is a supporter,
- 8. Healthcare in Ecuador Carpio 8 believer, or spokesperson who can work well with other members of your healthcare team such as your doctors and nurses. The problem arises with something known as the biomedical model of healthcare. The biomedical model of healthcare suggests that disease originates from individual cellular abnormalities. The model entails that instead of providing preventative health care to the public the government acts upon to provide ¡°episodic¡± emergency style healthcare instead. This is not ideal; this model acts more reactive than proactive. The new idea President Correa is trying to implement promotes preventative care and health promotion to effectively address infectious diseases nationwide. The ¡°buen vivir¡± model has been difficult to instill because of the neoliberalism free market mess that was left behind from before Correa¡¯s election. The ¡°free market¡± purposed low-cost, quality healthcare to everyone but never occurred because all the funding went towards clinical services in large hospitals. In 2005, Ecuador suffered severely from extreme low costs compared to other South American countries. Since the destruction of neoliberalism, the MOH has greatly influenced the overall healthcare of Ecuador. Instead of the biomedical view point, the MOH has moved to a more ¡°socialized medicine¡± view point. Social Medicine looks at economic, social, environmental and political conditions and examines how all those factors can contribute to the control of widespread diseases. It is important to examine some biomedical factors such as medicine, science and research but environmental factors as pointed out by social medicine can cause great impact on spread of disease. In the recent years,
- 9. Healthcare in Ecuador Carpio 9 Ecuador has worked to install an adequate sewage system in hopes to decrease percentages of communicable diseases. The MOH has also worked heavily to provide health preventative education in communities suffering from poverty on topics such as teen pregnancy and use of drugs. Utilization of healthcare services varies greatly in socioeconomic status, age, gender and urban/rural residency both here in the US and Ecuador. Both countries participate in profit and non-for profit organizations. Since Correa¡¯s presidency, and involvement of the MOH, rates of access to healthcare have increased from 16 million patients in 2006 to 38 million patients in 2012. Ecuador ranks 111th while the United States ranks 37. It is safe to state that Ecuador has a good thing going for them. Not all healthcare reform is perfect, new policies take time to instill and issues will always accompany that. Poverty stricken communities can be found all over the world, even the United States struggles with poor populations, thus Ecuador should not be pointed out for their struggling communities. The world as a whole should work together to conquer poverty because that seems to be an area where a lot of countries struggle with. ¡°Affordable¡± healthcare could mean a big difference between two people. While $5 to one person can be considered extra change, it could mean the burden of a prescription drug cost for another. That is the only area struggling continuously between Ecuador and the United States.
- 10. Healthcare in Ecuador Carpio 10 Works Cited Chelala, C. (2009) Health In the Andes: The Modern Role of Traditional Medicine (Part I). The Globalist. Ibarra, A. Ryan, S. Beltran, E. Mejia, R. Silva, M. Munoz, A. (2013) Dengue Vector Dynamics Influenced by Climate and Social Factors in Ecuador: Implications for Targeted Control. Plos. Doi:10.1371/journal.pone.0078263 Lopez-Cevallos,D and Chi, C (2010). Health Utilization in Ecuador: a multilevel analysis of socio-eonomic determinants and inequality issues. Health Policy Plan. 25 (3 209-218), doi:10.1093/heapol/czp052. Peddicord, Kathleen. (2014) Full Medical coverage for just $70 per month-new healthcare option for residents is one more reason to think about retiring to Ecuador. Huffington Post. Rasch, D. and Bywater, K. (2014) Health Promotion in Ecuador: A Solution for a Failing System. Health, 6, 916-925. Doi: 10.4236/health.2014.610115. Yanez, Andrea. (2013) Public Health Policy in Ecuador under the ¡°Buen Vivir¡± model of Development, between 2007 and 2011. Grupo FARO.