Overview
In El Salvador the health care system is seriously affected by the high demand of the population. The Salvadoran healthcare system is comprised of both publicly and privately run healthcare sectors. Generally the Salvadoran public healthcare facilities, especially hospitals, are under-staffed and poorly equipped. However, there are private health providers in El Salvador which offer a better standard of health services, although not up to the standards usually found in the USA or Europe.
The public system, which is the one offered to the poor living in rural and urban areas, has limited access to healthcare facilities but they provide the medicine for free, whenever they are available.
What happens if you need to see a doctor?
Public hospitals have emergency 24/7 services, but first you need to get registered by the hospital. They take your personal information and then depending on the case they treat you or they send you to the hospital that has the specialty you need for the treatment. Sometimes they try to give the service to the user but if they do not locate the resources they need, the patient is sent to another hospital.
Who decides what medicines a doctor can prescribe?
National Medical Direction (DNM in Spanish) is the organization in charge of the register, quality and guarantee of the medical supplies, so the DNM works together with the Health Ministry and approves or denies the availability or deals with any anomaly with the supplies. Hospitals receive the available medication they can prescribe from these bodies and the doctor then prescribes it.
Practically, what is like to live with type 1 diabetes in El Salvador?
Life with type 1 diabetes in El Salvador is hard. For people who have a good job and a regular income it is not as hard. However, for those who live in the rural areas it is a challenge to live with diabetes due to the responsibility that it requires. Some people have to decide between having medication or eating because they cannot afford both. They are not able to check their blood glucose level because if they do so they need to buy the strips themselves. The hospital only provides the insulin, not the strips nor the syringes or lancets.
What about getting admitted to hospitals?
Getting admitted to a hospital requires you to provide your personal information and of course you have to live near the hospital. It is important to mention that in El Salvador even though there are good endocrinologists you will probably be seen by a general doctor and not a specialist in the hospital. The only hospital that has endocrinologists is the Rosales National Hospital that is located right in the capital of the country.
How does diabetes care vary throughout the country?
As I mentioned before people who live in the urban area are the most fortunate with regards to hospitals and supplies because they have the opportunity to get treated by an endocrinologist. The worst part is for those who live in the rural areas. They are treated by a general practitioner and most of the time hospitals in rural areas do not have medications or there is not enough for all the people.
If we focus on the expenses a diabetic needs to pay, it requires an estimated amount of $50.00 monthly since the hospital only provides insulin. People often use the same syringe over a week or so in order to decrease the expense, and they do not check their blood sugar levels as often as they should. The hospitals provide vials of insulin that need to be kept cold, but some people in rural areas do not have a fridge so they keep the insulin it in a clay container just to protect it from the extreme heat.
We are so grateful to Irma Reyes in El Salvador for supplying this information for our map.