Do you have a ‘Care Community’ in Cuenca?

Jul 27, 2020 | 2 comments

By Miriam Drake

During your residency in Cuenca, there will be times when you are sick for a day or two. It could happen that you are ill for a longer period of time or your illness is so severe that you can’t get out of bed, walk down the hallway, prepare something to eat, let alone go outside. Perhaps you could be in unbearable pain. This is the time when your membership and participation in a Care Community will come in.

A Care Community is a group of 10-20 expat neighbors and friends who pledge to be there for each other in times of crisis or medical need. This is a critical component of your survival in Ecuador. When you put out a request by email or phone to your group, those members who are available will respond and help you while you are housebound. At other times, you will selflessly be there for others in their time of need.

Because of the beautiful family system in Ecuador, an Ecuadorian has many relatives near to support him or her in their time of financial, medical, or marital crisis. The medical system in Ecuador naturally revolves around the assumption of these large family groups.  And that system works just fine. Now enter expats from all over the world into this culture. We expats come here in ones and twos and we know practically no one and possess minimal Spanish!  This sort of isolation can and does work in a developed country, but is of little use to you here when times get tough. A large family group has survival value in Cuenca!  It is your caring tribe.

Richard, Stephens and Miriam.

Don’t wait until you are alone lying in a hospital bed to discover that the nursing staff isn’t monitoring you very much, and you haven’t been bathed.  This is not the time to realize the need for expat support and medical advocacy! I don’t care how well you speak Spanish, without a large family group, the Cuenca healthcare system is incomplete. This is why I suggest you join or start a Care Community. You can begin by getting together for potluck dinners and other activities. Get to know these folks and form social bonds. Enjoy each other’s company and be there for each other.  It’s a large expat family composed of members you choose to include.

Set up the “Care Community contact group” in the contacts section of your email service. This is a group listing of the email addresses of your tribe. When you or others need help, all you do is send one message out with a click and it goes to the entire group.  When you feel awful, or another member feels awful, it’s great to have this reliable resource.  In this case email is a wonderful tool.  It’s that simple.

When you have a life threatening medical crisis such as a heart attack, shock, or something else needing emergency care or immediate hospitalization, contact your power of attorney or registered nurse. In this case, it is your POA (Power of Attorney) who sends an email to your group asking for volunteers to help with needed tasks.


There are many ways members can help each other in times of medical crisis and recovery: shopping for food or medicine, running errands, sitting at the bedside, listening to the patient, reading to the patient, playing games with the patient, providing emotional support, translating, helping with decision-making, preparing meals, feeding the dog/cat, watering the plants, paying the rent and utilities, soliciting other volunteers for the long haul if needed.  Hopefully there won’t be a long haul!

It’s different here. We love Cuenca and Ecuador, and have chosen to live here for many reasons. And with time we learn, accept and work with how things are.  Instead of complaining because things are not like they used to be, figure out how to make the most of your life in this wonderful country. There is so much here to enjoy and discover.  It is a very enriching environment! We can make life better for ourselves within the medical systems as they are, by taking a few well placed steps. Let’s form our own large expat family groups and feel the love!

From 2015 to 2018, Miriam Drake, M.Ed., L.M.H.C., N.C.C., offered the seminar, “Expat Medical Emergency Preparation” which resulted in dozens of saved lives during and since then. She is a former healthcare administrator and now is a psychotherapist serving adults with grief, depression, anxiety and major life transition issues. Today she enjoys counseling others on their journeys, oil painting, world travel, learning new languages, Wudang and Yi Ren qigong practices, dancing, hiking and helping expats make improvements in their lives. She is the author of “Expat Medical Emergency Preparation Manual”, updated in 2020. For more information about how to order your copy of the book, and about her expat counseling services contact her:


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