In Ecuador the government offers everyone care with a general practitioner, coving about 30 percent of the population. The Social Security Institute covers 18 percent of the population. Two percent is covered by the Armed Forces. Non-Governmental Organizations cover about five percent. Private services cover 20 percent. Government provided care has long waiting times and inadequate resources. Many Ecuadoreans pay for private consultations that often give better results than public doctors.

What happens if you need to see a doctor?
In Ecuador, public health is very delayed and difficult to access. With diabetes you need to go through several doctors so that at the end you will be sent to an endocrinologist. This is the principal reason why most people who can afford it prefer to pay approximately $40 for a 30 minute consultation instead of waiting months to get medicine or to have a 10 minute consultation with a specialist.

Who decides what doctors can prescribe?
The Ministry of public health, a public institute directed by the government, has the power to decide which drugs can or cannot enter the country.

Practically, what is it like to live with type 1 diabetes in Ecuador?
Living with diabetes in Ecuador is not easy. Ecuador is lacking in medical specialists who work exclusively in diabetes. Many people do not understand diabetes and they create many myths regarding the disease. Diabetes education is often very poor. Even doctors who work in hospitals do not really know how to deal with a diabetes emergency.

Insulins that the government provides are the Humulin N and Humulin R. Unfortunately the government does not provide Lantus and Humalog. If you want to use those insulins you must pay out of pocket which becomes quite costly. The government does not provide test strips and they cost about $40 for a pack of 50 strips. In Ecuador, insulin pumps are not an option for any patient unless someone donated it or if you have a lot of money to acquire one and the supplies for it.

What about getting admitted to hospital?
When you are admitted to a hospital and say that you have diabetes, the doctors try to use serums that do not contain sugar. However, if you are admitted unconscious the last thing that emergency physicians check is your blood sugar level, so it is very dangerous. It is important to use an identification that notes your diabetes so they know what to do in an emergency.

How does diabetes care vary throughout Ecuador?
In many places, natural medicine is used by people who have no education or sources to buy the correct treatment. The consequences of this are very severe and often lead many patients to death.

The care of a person with diabetes living in the city is a little better than for people living in the countryside. People in the city have more economic possibilities and access to medicines or doctors than people living in rural areas who must adapt to the health system of the government and do not have many options for care. In Ecuador, care is in generally the same but people who can buy better care do so privately.

The wonderful Dani Molina Sánchez provided this information about diabetes in Ecuador. Thank you, Dani!