Navigating Ecuador’s IESS health system: First, hire the services of a bilingual R.N.

Jul 20, 2020 | 18 comments

By Miriam Drake

When you are not feeling well and need medical attention in Ecuador, it’s probably not the best time to learn how to use IESS or the private healthcare systems here. There are good doctors in the IESS system, but you need to know who they are and how to get to them. It’s always easier and actually prudent to have a U.S. trained bilingual R.N. consultant, familiar with IESS by your side. She knows people and she understands how to get things done within that system so that you have the best opportunity to receive the best care possible for your particular medical condition.

Your Registered Nurse, who speaks the language, knows the good doctors by first name, and can advocate for you when you are less than well, is a godsend. She can advise you, get you appointments with particular doctors, help you make practical medical decisions, ask questions of the doctors and medical personnel, and fight for you if that’s what’s called for.

Medicine is complicated. Healthcare systems are bureaucratic.Having an advocate by your side can make all the difference.

Before your initial get-acquainted meeting with the R.N., complete a medical history form, available in my book, “Expat Medical Emergency Preparation Manual”, and review the form with her. Make sure to give her a copy of your history for her files. You will need her in the future. I suggest you also make her your power of attorney for healthcare. This document officially authorizes her to make medical decisions for you in the event that you are unconscious or unable to care for yourself. To get this document completed, check first with the attorney to find out if the R.N. must be present in order to create this document. Then, get the Poder and the Declaracion drawn up at the same time.  Contact your attorney today and get an appointment set up.

Your R.N. will help you select the primary and specialty care doctors you will need for your specific health issues. You want her to be familiar with your medical landscape and concerns before you need her help in the middle of the night. If you have a medical emergency requiring a trip to the E.R, wouldn’t you feel better if you knew she would be there to help?

You can find the name and contact information of the U.S. trained Registered Nurse I recommend (Betty Alderete, or 098- 660-7720), as well as other helpful Cuenca healthcare information and resources, in the book, “Expat Medical Emergency Preparation Manual, Revised 2020 Edition”.  The book is downloadable, and costs $15, payable via PayPal and Venmo.  Contact me today at to order your copy.  The information in this book and in the seminars I offered in Cuenca during 2015-2018 are responsible for saving a good number of lives! Prepare! Take care!


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