Ecuador: Expat’s Experience with Emergency Medical Care in Rural Coastal Area

Posted on November 3, 2015 • Filed under: Ecuador, Ecuador Travel, Latin America Health

This is a post made by an expat in Ecuador on a Facebook group and involves a medical emergency her husband experienced while living on the coast of Ecuador.
This is a very long post about the availability of healthcare in rural areas on the coast and how important it is to know this in advance before considering a move here. No matter how well we had planned, there wasn’t any way to have planned for this:

On Tuesday, October 27th we had a medical emergency, in Montanita, that we weren’t prepared for. My husband passed out, hit his head, started having convulsions then was unresponsive for about 10 seconds. He started mumbling, vomited, started convulsing again and was unresponsive for what seemed like at least a minute or more, but was probably closer to 30 seconds.

We had 2 positive things happen during this experience, the rest negative.
1. The ambulance was there within 10 minutes
2. When approaching traffic they used the siren

When the ambulance arrived, 2 drivers, it was apparent that that’s all they were, came in with a back board. They had NO equipment and DID NOT check his vitals. They strapped him to the board, not stabilizing his neck, which I felt should have been done. Out they went. Going down the stairs Ray had come to himself enough to hold on to the board, they hadn’t strapped him tight enough.
They slid him onto a gurney(?) in the ambulance, not attaching the board to the gurney. As we went around corners and braked for traffic I was holding onto the board to keep him from sliding off of the gurney.

So, we get to the ER in Monglaralto, which in reality was a dirty, small town clinic. They carried Ray in still on the back board, putting him onto an exam table.
They took his blood pressure and pulse. Still noone checked his pupils to see if they were responsive. An aid had to get help from a Dr to insert an IV. Ray has crazy visible, raised veins.
There wasn’t what we would consider an admittance process. I wasn’t asked for any medical history or if he was on any medications. The only information they took was from his cedula (Ecuadorian ID card).
They gave me a small slip of paper with some scribble on it. I was very confused until I heard the word Farmacia. One thing I did know about hospitals and doctor’s offices here is that you’re told what medications you’ll need and you or someone else must go buy them. When I returned with the meds, they were injected into the IV. At this point we tried to turn on a lamp so the doctor could see what he was doing, it was unplugged. To reach the only outlet available, I had to hold the lamp up off the floor. The doctor snipped a little bit of hair, (probably didn’t have a razor), poured some rubbing alcohol on the wound and put in 4 stitches on the back of Ray’s head. They proceeded to bandage his whole head. At no time was there anything done to make him comfortable. He neck was tilted very awkward to the side (no pillows) and he had goose flesh all over. Luckily I had a sweater with me that I put around his shoulders and rubbed his legs to try to keep him warm.
I didn’t feel like I was being listened to (about the convulsions and Ray being unresponsive) I felt he at least needed a CT scan.
I called Hugo, the owner of the hostal we were staying at, and he showed within a few minutes and helped translate my concerns. They told him that Ray had an electrolyte imbalance, which was something we all knew, and that they would keep him for observation for 5 hours.
Within 5 minutes Ray turned quickly onto his side, sending the back board out from behind him, vomiting onto the floor. Thank goodness I was standing there to catch him or he would have fallen off of the exam table. Everyone stood and watch until I started yelling, in English lol, “Get over here and do something!” A nurse was taking Rays blood pressure and had some sort of problem with it. The doctor came over with the ambulance drivers and out the door they start going without saying a word to me. Ray says “Deborah, they’re taking me to the hospital in Santa Elena.” It was about 30 minutes away.
At this point I should insert that there were no supplies in either ambulance (pictures attached) There was an old oxygen tank and a dusty fire extinguisher.
This time he wasn’t strapped to the board OR the gurney. I was holding onto him with everything I had. The bandage came off…surprise, surprise.
At the public Hospital General Ray was wheeled in and put to wait in a hallway. When they took him in for the CT I watched before they closed the door as they stood back and had him move himself from the gurney (he was still on the back board) onto the CT table unassisted. No one seemed to care if he ended up hitting his head on the ground again.
Couldn’t tell you much about the hospital except it was bright, white and the halls were clean. The bathroom on the other hand wasn’t. There wasn’t a seat on the toilet, no soap or paper towels.
After the CT, back to the “ER” clinic. On the way the doctor and driver stopped to get something to eat, approx 15 minutes.
When we arrived we were told the CT looked clear. After laying on a table for about 10 minutes they told Ray to sit up…no assistance offered. Another 10 minutes to stand up…again no assistance. The doctor asked if he felt ok, Ray said yes, doctor said “You’re free to leave.”
We stood there waiting…and watching what seemed like a physicians assistant…go back and forth between patients…cleaning his hands on a pink hand towel in between. At this point it hit me that I wasn’t even sure if there was running water. Anyway, Ray looks at me and says “Do you think I’m supposed to take out my IV?” HAHA
We call the PA over, he takes it out, tells us the stitches can come out in 7 days. Out the door we walk, no wheelchair (at this point I’m not sure why this surprised me) and with no shoes…he had only come in with socks on.
Thank goodness we had our friend Hugo to pick us up and take us back to the hostal.
Not an experience we ever want to go through again, however something we have to come to terms with, living where we love to live.
Oh, and the cost, $1.25…………We just wanted to share our experience on the availability, or lack thereof, emergency care in order to hopefully help others make an informed decision.


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