My First Experience With The Medical System

A few weeks back I managed to acquire a stomach infection which gave me an ongoing case of diarrhea. I thought it might go away on it's own, but no luck. This prompted me to involve myself with the medical system here in Cuenca.

Cuenca has both private and public hospitals.

The private hospitals are pay-as-you-go or your bills are paid via your medical insurance (which is purchasable in Ecuador). 

I have no direct experience with medical insurance (at least not yet), but I have heard that it can cost anywhere from $68 to $150 per month depending on your deductible. These plans usually include medical, optical and dental.

If I become a citizen of Ecuador (which I can do after living here for 3 years), I will be eligible to use the Social Security hospitals. This costs (if memory serves) $60 per month and covers all medications and hospital stays. I am not sure if dental and optical are included.

So far, all I have experienced is the "pay-as-you-go" scenario.

The first visit was to see if I could get them to give me antibiotics to try and get rid of the Ulcerative Colitis (UC) I have had for about 25 years. 

I believe that my UC is caused by a bad bacterium, because probiotics will control a flare-up. If it was caused by a virus (as is the mainstream belief by the medical community) then probiotics should be of no use. Or at least that is what I think.

I went to Mount Sinai hospital here in Cuenca and the consult fee was $40. The office time was approximately 20 minutes, but it could have been longer if I had wanted. The doctor was a Gastroenterologist. 

Aside:   You do not have to see a General Practitioner (GP) to get a referral in this country. You just pick a doctor, pay the fee and have your appointment that same day. You can even see a doctor in his office up until roughly 9 pm at might for a consultation.

The doctor had the same view that doctors in Canada have regarding my UC condition and that is that antibiotics will not do any good. He suggested that I have a colonoscopy as I had not had one in several years. The cost for this would have been roughly $550. I say "would have been" because I never went for the appointment.

Nieve, my Ecuadorian girlfriend, has many connections in the medical community (as she works at the Social Security hospital in Administration). She set up an appointment, one evening, for me to see another Gastroenterologist at Hospital del Rio (another private hospital). The cost for this consultation was $25.

This appointment was motivated by the fact that I had ongoing diarrhea. After telling the doctor that I had a history of UC, he was very reluctant to prescribe antibiotics as he was suspecting the diarrhea was caused by my UC and not by an infection. I tried to assure him that the diarrhea I was having was nothing like the diarrhea I have when I am having a UC flare-up. He prescribed more testing. This meant that I would have to go another 3 or 4 days before getting any antibiotics. I had already had the diarrhea for 5 days by this point.

Later that evening, I mentioned my frustration in getting the problem resolved to Nieve. Miracle that she is, she called her sister (Lorena) in Guayaquil who happens to be a doctor of tropical diseases.

Over the phone Lorena prescribed an antibiotic (Ciproflaxin (500mg)) and other supportive medications and off we went to the pharmacy. Nieve read the list of meds to the pharmacist from a hand-written note she had made earlier and $100 later I had everything I needed. Basically, if you know what you need you can go to any pharmacy, pay your money and get anything you so desire (including antibiotics).

I started taking the antibiotics that night and the next day my diarrhea was gone. I completed the course of antibiotics in 5 or 6 days. The jury is out on whether this antibiotic got rid of my UC as well. All I can say at this point is that my gut feels pretty good. I give many thanks to Nieve for saving the day.

There is also an indication in this write-up that prices vary widely depending on the doctor and/or hospital you attend. I am curious as to how much a colonoscopy would have cost at Hospital del Rio given that the consultation cost is much lower.