Medical Care and Life's Surprises

The last two weeks have been hectic to say the least. Just as clearing away one’s home and belongings in the states can be time-consuming and pressure-packed,finding a more permanent place to live and to furnish can be another busy period after one arrives in Cuenca. At first, I had the comfort of returning to Cuadra Dos, which was fully-furnished and in a neighborhood with which I was familiar from my visit of last summer. This made the first month basically a vacation month of making new friends, getting reacquainted with friends from last summer; and getting reoriented to the layout of the city, the street locations, the locations of new and familiar haunts, and walking neighborhoods I had yet to visit as I searched for an apartment.

Moving into the studio apartment in El Centro became the second phase of resettlement, as a temporary way station until I found a more permanent home. My two weeks of living in El Centro was spent getting oriented to living amidst numerous churches and monasteries, especially during all the pageantry of Holy Week. Luckily, my studio faced the monastery gardens, which was the more quiet side of the building from the street noise.

Normally, I would take the elevator up to the fourth floor to my studio, and walk down the stairs when descending. Another example of how Cuenca reminds me of the 1950’s was just about to be experienced. As I began my ambitious stride down the stairs ready to begin another exciting day in Cuenca, my feet suddenly took off from under me just like when one loses his balance on ice. I traveled down the stairs on my back side with my rump taking the brunt of the fall, but with my back striking one edge of the step in particular. Luckily, I believed the worse moment of impact was above my kidneys and below my shoulder blade, as such I assumed my ribs were protected.

What contributed to this calamity? Was it my own clumsiness? Actually, a worker was down on the next flight waxing or polishing the wooden, parquet-like stairs. First, I did not see him as he was on his hands and knees as he worked. Second, there were no signs placed at the top of the stairs warning of the slippery condition of the stairwell. Obviously, since no one is scheduled to work at night, the only “appropriate” thing to do is wax the steps during working hours while people are using the stairways. Third, if Ecuador was the United States circa 2011, the owners would have had one hell’uva law suit on their hands for failing to put up those plastic “beware of slippery stairs” signs, or better yet, “slippery stairs, use elevator only". The U.S. attorneys have not transformed Ecuadorians into a litigious society yet. Here the attitude is one of self-responsibility. I should have been careful, and while people came to my aid, as one lady added, “You should hold the railing when using the steps.”

At any rate, I was a little sore, and assumed I would be sorer come manana. Otherwise, I figured it would just take time for the soreness to dissipate. I went about my business for the next few days, but by Saturday I was in a great deal of pain in of all places, my left side. Now I was concerned that maybe I did fracture or at least had a hair-line fracture to one of my ribs. I decided, not being a great lover of pain, it was time to see a doctor. I didn’t know what to expect in terms of doctor availability, since it was a Saturday and the day before Easter. I went to the Mt. Sinai Hospital emergency room. A physician who spoke English was found, and he was later followed for whatever reason by another physician who took over from him who also spoke English. My waiting time was short, and would have been quicker if I did not need an English-speaking doctor. The nurses spoke little English, but we managed to make ourselves understood to one another, and they were very conscientious to my needs. An x-ray was taken, and as I had thought there was no bone damage, just some meshed, mash of muscle tissue that would take two to four weeks to heal. To relieve the intense pain, I was given a shot, followed by another shot which the doctor explained was a shot specifically for the local area of pain. I was also given patches to wear daily over my side that provided time-released, pain-relief medication throughout the day; and I received a prescription for Celebrex, another pain killer. Even though medication can dull pain, pain still has a way of wearing one down. However, I had way too much to do to just sit around and relax for a few days, and now after ten days it’s as if I never suffered an injury.

Many of you who read the blogs regularly will not find the following information as anything new, since it has been reported repeatedly by expats who have needed medical attention in the past; but for those of you who don’t read other blogs on Cuenca or Ecuador the following should prove quite informative:

Medical care in Cuenca is generally excellent. The doctors will take time with you in a way that generally does not happen in the United States assembly-line production of patient care. The modern facilities at Mt. Sinai were very good, and on par with the best hospitals in the United States. Mt. Sinai Hospital is not an exception to the rule as some kind of show-case hospital. There are many quality hospitals in Cuenca. When I first called my primary care physician that Saturday, I had left him a message. When he failed to return my call, that is when I decided to go to the emergency room. The next day on Easter my doctor called me to apologize for being out of town on Saturday, and not being available for me, and he wanted to know how I was doing. Physicians in Ecuador are known for making house calls as well when necessary. For those of you old enough to remember--Marcus Welby is alive and well, and living in Ecuador.

The cost for both of the physicians who treated me in the emergency room along with the x-ray, two shots, the patches, and the Celebrex was just under $150.00. What does it cost just to step into an emergency room in a United States hospital? I had a follow-up visit with the emergency room doctor at his office a week later. There was no charge.


The following article appeared in "Cuenca High Life", and provides an excellent account of medical costs in Cuenca:

Medical tourism industry sees Ecuador and Cuenca as a hot market; say costs are among the lowest in the world

Posted By Admin | Published: April 15, 2011 11:37

Although the low cost of health care in Cuenca has long been a draw for foreigners relocating to the city, it is beginning to catch the interest of international medical tourism companies.

Alex McClellan, a former U.S. hospital administrator, says he expects to see increasing numbers of foreigners take advantage of Ecuador´s low medical costs. And, he adds, Cuenca is poised to capture much of the market. McClellan, who has worked in the medical tourism industry in Mexico, Inida, China and Malaysia, says he is forming a Quito-based company and plans to center much of his service in Cuenca. “We have brought our first clients to the city and have been very impressed with the results.”

According to Ecuador´s Investment Corporation (INVECE), costs for major medical procedures generally run just 7% to 10% of those in the U.S. and many European countries. McClellan adds that medical care in Ecuador is substantially cheaper than that in better-known medical tourism destinations, mostly in Asia and Central America, often by as much as 50%.

INVECE director Xavier Patiño has compiled a cost comparison list of medical procedures in the U.S. and Ecuador, including:

A heart bypass: $130,000 in the U.S. vs. $10,000 in Cuenca. A heart valve replacement: $160,000 vs. $15,000. Repair of a cerebral aneurysm: $200,000 vs. $10,000. Insertion of a heart pacemaker: $150,000 vs. $10,000. Hip or knee replacement: $43,000 to $51,000 vs. $8,000 in Cuenca.
Patiño says that it is not just foreigners coming to Ecuador for medical care. “We see many Ecuadorians who live in the U.S. come home for services.”

Xavier Crespo, a Cuenca native working as a financial advisor in Miami brings his family home twice a year for medical check-up and dental work. “The savings more than pay for the trip and we get to spend time with our family.” He adds: “From personal experience I can say the care is actually better here than in the U.S. The doctors are able to spend much more time with paitients and don´t have to rely on all the tests that doctors are required to perform there.”

Dentistry is another area where patients see a large price differential. Cuenca dentist Nelly Sacoto says she has seen a rapid increase in the number of foreigners coming to her practice for care. She points out that she can install a porcelain crown for $200 while the procedure costs $2,000 in the U.S.. “Because many dentists in Cuenca have training in the Europe and the U.S., foreign patients have a higher degree of confidence in the local dentistry.”

Another Cuenca dentist, Marcelo Guillén, says he is seeing many foreign elderly patients. “There seem to be more and more retirees moving to the city and many of them are pleased with the dentistry here, especially in the area of aesthetic reconstruction. For them, it is very economical in Cuenca.”

McClellan, who says he has established relationships with two Cuenca hospitals and more than a dozen medical specialists, cautions that there is much more to good medical care than cheap prices. “It is important to work with an organization that has a solid track record in medical tourism. For potential patients, it is definitely a buyer-beware situation.”
http://www.cuencahighlife.com/