By Michael Littmann
With all the nasty fighting and name-calling by gringos offering their “expert opinions” of IESS’ new pricing structure in the CuencaHighLife comments section, I am somewhat surprised that no one has made reference to the quality of health care provided by the system. In my “expert” opinion, it is garbage.
I came to Cuenca four years ago. It has been a good life and Cuenca is a nice place to live. I live a quiet lifestyle, bother no one, and have learned to live with all the problems I encounter here. I have only left a handful of posts on this site, maybe five or six, all positive, thanking those (expats and Cuencano) who have assisted me.
I am a diabetic and the first thing I did upon my arrival in Cuenca was to begin a search for quality health care. I was told by dozens of expats to avoid Confiamed as they did not reimburse as promised, offering nothing but excuses.
On the advice of the Seguralmeida Insurance Agency in Cuenca, I joined Años Dorados. Several months later, however, Años Dorados went out of business and never reimbursed the expat members (leaving dozens of us, including me, stranded). The Seguralmeida Insurance Agency offered no assistance in the matter.
That is what led me to IESS.
For two years, I paid into IESS, and never really used its health care services. Once every three months I would go to Hospital Seguro Social in Monay to pick up a three-months supply of diabetic prescriptions. Ok. Not bad, I thought.
One morning last September I awoke up to find that a callus on the bottom of my right foot was bleeding. To a diabetic that is not good. So I immediately went to the IESS hospital emergency room and saw a doctor. I was told that it was not too bad and that I had caught the problem it in time. I was given a shot, some medication, and told to go to the Clinica Pie in the hospital (diabetic foot care clinic) for further treatment.
At the diabetic foot care clinic a nurse attended me. I have neuropathy in both feet, so while I was lying in the prone position I felt nothing, and I had no idea what she was doing until it was too late. The nurse had cut out the callus completely. I knew I was in real trouble at that moment. I knew it was not going to heal.
I was told to come back to the clinic in two days for more treatment. I did, and returned every two days for the entire month of September.
In early October, as the foot did not look good to me, I went back to the hospital emergency room to see a doctor again. They did blood work, gave me more medication, and told me to come back to the ER in four days. When I did, I was told that I needed to see a specialist. There were no appointments available until the following week and on the morning I was scheduled to the see the specialist, I awoke with a pink foot — cellulitis — and a bad smell.
The specialist said I needed to be hospitalized immediately but there were no beds available. I was told to go home and I would be called when a bed was available. Four days later I got the call to report to the hospital.
I went to the hospital on a Thursday afternoon at 12:30 p.m., as instructed, and sat in the lobby until 4 p.m. before being allowed to go upstairs to my 6th floor room. A nurse spent all of 10 minutes with me, taking my personal information, and afterward I sat on the edge of the bed with my foot dripping blood and oozing puss until 8 p.m. until someone come back to help me.
The next morning I was hooked up to an IV (antibiotics) for the first time. I saw no doctor until Monday morning when I was told they were going to amputate part of my foot as the infection had reached the second toe. How had the doctor determined the need for amputation when I had not seen one until then? I have no idea.
Surgery was done Tuesday evening in a dirty, dusty basement operating room that made me think of what a 1950’s abortion clinic must have looked like. I spent the next week in bed recuperating.
When I asked my doctor questions, he made fun of me on several occasions in front of his medical students, pounding on his chest that this was Ecuador and he did not have to speak English. True enough, but I tried my best to communicate in Spanish, but there were medical terms which I could not grasp. When I asked for a translator (a young man who worked on the floor who understood and spoke English perfectly), I was told “no” by the doctor.
It should be noted that I studied Spanish in high school and college, I lived in Spain for two years, and Mexico for two more, and I studied Spanish upon my arrival in Cuenca. I have never had a hard time communicating with the locals — until then, in the hospital, where communication was critical.
When I was told I could go home, there was no follow up instructions, no surgical shoe/slipper provided, no nothing. I was expected to walk out of the hospital on bandages. I was forced to personally cut up one of my shoes to go home (a $250 special diabetic shoe purchased in the U.S.).
Every word of my experience with IESS is true so here is my take on its health care services. In my case, it was a system characterized by gross stupidity and inefficiency. The problem that led to the amputation began in the diabetic foot care clinic when the nurse stupidly cut out the callus. The problem was then compounded by the inefficiency of the emergency room when they failed to diagnosis the problem properly and in a timely manner. The amputation should never had happened. I feel lucky to have made it out of the IESS hospital alive!
The day after getting out of the hospital, I called Bellgenica Insurance. No more IESS for me! After Años Dorados and IESS what else is left? Is Bellgenica Insurance any good? I have no idea. I have had the insurance since last November, but have not used it yet. That will be my next health care adventure.
My only desire in writing this article is to provide information to the expat community about my experience with IESS — and maybe to help other expats who might be sitting on the fence about whether to remain with, or join, IESS. I leave the decision to you.
If you are currently enrolled in IESS for their health care services and have had success with them so far or, if do not believe my experience with IESS: Good luck and God Bless.