Ecuador went from chaos to decent services in the public health system

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Guayaquil’s Abel Gilbert Ponton is one of the 40 hospitals internationally accredited. Photo: MSP

Guayaquil, Feb 2 (Andes).- Hilda Ocaña sadly remembers the times she had to go to Hospital Abel Gilbert Ponton to “beg” for medical care for her and her elder father.

She remembers the times when she had to go to the hospital early in the morning at 04:00, sometimes amid rain, and wait in long lines to get a “ticket” to be provided assistance.

She saw how some people did not wait in lines and was even taken by security guards to enter. “It was known that if you bribed them they would let you in but I didn’t have money so I had to queue,” she said.

But she adds that the drama was not over once you got a ticket. When buying medicine, she had to go to a private pharmacy to get them since the health center did not even have essential medicine in spite of the fact that the Constitution guaranteed free access to health.

Hilda’s obstacles at that time were “normal” for all citizens who got “used to” walking around smelly aisles, rooms filled with patients with no air conditioning systems, very old elevators, unhealthy stretchers and infrastructure in bad conditions.

Guayaquil’s Abel Gilbert Hospital before being restored. Photo: MSP

If someone was about to enter the surgery room, family members had to buy gloves and and surgical caps for the surgeon because it was “normal” back then not to have such medical items.

Poor people literally died outside hospitals if they did not have money to pay for a private health center.

There were strikes, most of the times because salaries were not paid and as a measure from minority groups to pressure to have some labor privileges through collective contracts.

Given this chaotic situation, in March 2007, President Rafael Correa decreed a state of emergency in the public health system and his goal back then was to recover old establishments. “Besides having a country destroyed, health is one of the most destroyed things and we will not tolerate this. For this reason we are declaring the sector in emergency in order to fix the current situation and then move forward with plans and programs,” the president said back then.

One of the first things in such declaration was the approval of 4.500 new professionals for doctors to provide assistance in two different schedules, thus, preventing people from going to the hospital at 05:00 to get a “ticket” to get assistance.

With the approval of the 2008 constitution, it was guaranteed that budget for Health and Education was going to increase 0.5% of the Gross Domestic Product (GDP) annually, ensuring the right to get free services too.

Since then, the Ecuadorian health system began to experience a change with the construction of new health centers, clinics, restored hospitals, more doctors and other health workers to guarantee assistance 24 hours a day.

The government’s program to restore the sector prioritized urban and rural areas neglected during decades by former governments that did not built one public hospital in the last 40 years in cities like Quito and Guayaquil, the most crowded in the country.

Contrary to those periods, 13 new hospitals were inaugurated in the last decade and 18 are under construction. In such period, 11 emblematic hospitals in the main cities were restored, according to official information. 

The new restored Abel Gilbert Ponton Hospital recently received quality accreditation from Canada. Photo: MSP 

One of the recently inaugurated hospitals is located in Guasmo neighborhood, in southern Guayaquil. This hospital, with capacity for 400 beds, becomes one of the largest in Ecuador.

This modern hospital, fitted with top technological equipment, is projected to benefit a population of 3 million inhabitants in the coastal province of Guayas.

With the inauguration of a hospital in Monte Sinai and another built by the Social Security in Los Ceibos neighborhood, Guayaquil exceeds standards of the World Health Organization of having 2 beds per thousand inhabitants.

Besides these hospitals, the government has inaugurated 61 health centers with human and material resources including them in the basic hospitals category. 34 new health centers are being built in all regions.

Hiring professionals was another factor for improvements in this sector. Since 2008 to 2015, 34.000 doctors joined the public system including doctors from around the world experts in family care in rural areas.

This goes hand in hand with a human talent training program. The government has also granted more than 3.200 scholarships to and 400 professionals are trained in family medicine.

With changes implemented, citizens trust the public system again. In 2006, 16 million appointments were reported and 39 in 2015 while the vaccination scheme went from 11 to 20 free injections with an investment of nearly 60 million dollars.

Without such investment, the entire health system would not have become what it is now. However, political opponents have permanently supported media outlets in criticizing the government of President Correa’s social investment policy

Guayaquil’s Hospital General del Guasmo is one of the recently inaugurated hospitals. Photo: César Muñoz/Andes

“There is no better savings like a good investment.” This is how the chief of state has responded to questioning from his opponents who try to make others forget about the disastrous condition in which the country’s institutions were before his administration.

As a result of the program to recover the health system, 40 hospitals from the Ministry of Public Health (MSP) have gone through an evaluation process and improvements in health services that meet international standards, accredited by Accreditation Canada International (ACI).

According to Hilda, those moments were left behind. She is now provided health care in a restored Abel Gilbert Hospital which received gold accreditation on January 30 after scoring 96.9 on health service excellence focused on patients’ security.

Where there were dirty aisles there are now modern facilities and dignity, says this woman from Tungurahua who permanently gets specialized care and totally free medicine. “I only hope the new government remembers that the poor have rights too,” she claimed.