Ecuador’s Public Health Care System

HCA 350 Research Paper – Ecuador Ecuador is a democratic republic country located in South America with a population of nearly 16.5 million people. In 2008, Ecuador rewrote its constitution to grant and acknowledge particular rights to its people in an effort to provide a “good living” that included access to health care. Ecuador’s public health care system has vastly improved the health of many Ecuadorians but much still needs to be improved to reach and include all its citizens. This paper outlines the health care system as well as factors that impact the health of the people of Ecuador. Ecuador Demographics Ecuador is a beautiful country located in the northwestern region of South America and is bordered by Colombia to the north and Peru on the south and east border. Ecuador is the Spanish name for equator. It was named such because the country is located on the equator.

Although Ecuador is the fourth smallest country in South America, its geography is extensive and varied. Additionally, the Galapagos Islands located about 1,000 kilometers from Ecuador’s coastline in the Pacific Ocean belong to Ecuador. The mainland can be divided into three types of terrain, namely: La Sierra, which is the central highlands, the jungles of La Oriente in the eastern region and the coastal plains, which are known as La Costa. It is home to nearly 16.5 million people that includes close to a dozen indigenous groups which account for over 40 percent of the total inhabitants. Spanish is the official language of Ecuador however various indigenous languages are still common throughout the country. Quichua, the ancient Inca language, is the most popular of the indigenous languages and is the language of Quechua people (Ecuador.com). As with other South American countries, English is the most spoken foreign language. Ecuadorians are a multiethnic and multicultural mixture that include indigenous, African and European heritage.

Many Ecuadorians are a mix of European and Native Indian heritage commonly referred to as Mestizo. Religion is an important aspect of life in Ecuador. Ecuadorians are predominately Roman Catholic. Major Catholic holidays are national holidays with Holy Week (Santa Semana), the week leading to Easter, as the biggest celebration. Colorful processions celebrating the resurrection of Jesus Christ are held throughout the country with the biggest celebrations hosted in the cities Quito, Guayaquil, and Cuenca. Additionally, and in keeping with the Catholic faith, the Virgin Mary and many saints are glorified and worshiped. Ecuadorians also believe that natural disasters are God’s punishment for the collective sins of the people and God’s will dominates many of life’s events. The Ecuadorian diet is varied by region but is rich in vegetables and fruits. The coastal region enjoys plenty of fresh seafood, vegetables, and fruit. Ceviche is a common and very delish dish of lemon/lime marinated seafood, primarily fish, shrimp shellfish, or quid.

Cuy, guinea pig, is popular among the indigenous Ecuadorians. A favorite Ecuadorian dish is Llapingachos, potato patties made with cheese that resemble small pancakes served with fried eggs, chorizo and sliced avocado. Typical Ecuadorian dishes also include Spanish staples such as arroz con pollo (chicken and rice) and arroz con camarones (shrimp and rice). Fanesca is a hearty soup that combines various beans, grains and vegetables cooked in a fish broth and is a traditional dish to be served during the Holy Week. Factors that Impact Health It's important to note that Ecuador is classified as a middle-income country but is one of the poorest nations in South America. The gap between rich and poor became more pronounced in 1999 when there were rampant inflation and currency devaluation placing many of the middle class below the poverty line (Lombardo 2016). Many indigenous Ecuadorians in rural areas live in extreme poverty. This group show extremely high levels of child mortality and malnutrition. The poor living in urban areas lack fundamental necessities such as functioning water supply or sewage system. Both groups deal with low education levels, troubles with employment and very low rates of labor (Kliesner 2014). According to the Institute for Health Metrics and Evaluation, the top five leading causes of death in 2017 are heart disease, chronic kidney disease, stroke, lower respiratory infection, and Alzheimer’s disease.

Interestingly, the risk factor that drives the most death and disabilities combined is high body-mass index or obesity. Unfortunately, another huge health problem suffered by Ecuadorians is chronic malnutrition. Poverty perpetuates health issues such as shortened life expectancy and stunted growth for children, especially among indigenous communities in rural areas. Even though the public health care system provides free services for basic medication, doctor’s visits and basic surgeries, many hospitals and clinics are not equipped to properly handle all its patients. Ecuadorians wait for hours to be seen, hospitals and clinics are overcrowded and undersupplied. Many Ecuadorians go without proper medical services because private, well-equipped healthcare facilities are too expensive for them. Another factor that impedes proper health care for many of the country’s people is that the poorest of the nation, who live in the central provinces and rural areas, simply do not receive proper medical care. Clinics in these areas are understaffed, in poor condition and lack necessary equipment (Lombardo 2016). These indigenous communities must rely on traditional medicine, home remedies, and aid from foreign volunteer organizations. Description of Health System In the last decade, Ecuador has proactively invested in a public health care system for its people. Steps were taking in 2008 to rewrite the country’s constitution and establish a legal framework to achieve a goal of creating a society in which all its citizens would have “buen vivir” or “sumac kawsay” (English translation = good living) through eradication of poverty, promotion of sustainable development, and fair distribution of resources and wealth. (Aldulaimi & Mora 2017).

El Ministerio de Salud Publica de Ecuador or the Ministry of Health (MOH) was established and is responsible for developing and regulating the public healthcare system. The 2008 Constitution of Ecuador provides that health is a citizen’s right. This wasn’t always the case; prior to this development, Ecuador’s health care system was a complete disaster. Politically, the public health system was not addressed as it continued to crumble leaving the people of Ecuador to suffer dearly. Particular laws and funding restrictions prevented the Ecuadorian government from establishing a well-rounded health care system. Therefore, the system was forced to be privatized and the poor of Ecuador suffered the consequences. Although taxpayers paid less money for public health, the quality of care was horrific at best. Private medical companies ran the local hospitals and denied treatment to those that couldn’t pay. People dying at the footsteps of a hospital was an all too common story. According to the World Health Organization (WHO), Ecuador had one of the highest rates of preventable disease in all of Latin America, mainly due to the fact that most people couldn’t afford to visit a doctor. (Funez, 2017)

The public health care system has made tremendous strides to successfully improved the health of many Ecuadorians by providing health care services at no cost. The MOH is responsible for the management, control, regulation, and evaluation of health activities and services provided by both the public and private entities (Aldulaimi & Mora 2017). Other government contributors include the Social Security Institute (IESS). The public health system primarily focuses is to provide preventative care, such as immunization and health education, for Ecuadorians. Other areas of focus include family planning and tobacco cessation. Ecuador has enjoyed significant decreases in the areas of tobacco use, obesity, heart disease and other preventable diseases since 2007 (Funez 2017). Common Cultural Factors Ecuador is a multicultural country that’s population is a mixture of a variety of indigenous people, Mestizos (mix of European and Native Indian), Afro-Ecuadorian (African) and various immigrants from other countries. Ecuadorians enjoy a rich culture combination of all these groups, but Mestizos have the dominant culture. Ecuador is predominately Catholic and major Christian holidays are recognized nationally. There are several annual celebrations but the two biggest are carnival and Semana Santa (holy week).

Carnival is celebrated 40 days before Easter and kicks of the Lent season. This celebration is a combination of Catholic and indigenous traditions. Parades, traditional dances, music and festivals encompass carnival. Semana Santa is an entire week of celebrating Christ’s resurrection that leads up to Easter. Christmas is also celebrated with festivities beginning on Christmas Eve and will run through the end of Christmas Day. Ecuadorians are a family-oriented group and family, immediate and extended, are very important. Several generations of family typically live in the same household. Holidays, birthdays and other significant events are always celebrated with family. Many Ecuadorian families are still very traditional and old-fashioned with the man as head of the household and the woman responsible for raising the children and taking care of household chores. Ecuadorians are known to be very friendly, laid-back and welcoming people.

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