The backroom clinic: How Cuenca’s pharmacies became mini hospitals
In Cuenca, pharmacies are like bus stops. There’s always another one just down the street — and sometimes three or four 
clustered together like gossiping hens. It’s not uncommon to see five within sight of each other, each offering the same range of off-brand antihistamines, stomach-settlers, and herbal slimming teas. One might assume this is overkill. But spend any time here, and you’ll realize it’s not excess — it’s adaptation.
Two hundred meters from my house, a brand-new pharmacy opened directly across the street from an existing one. I assumed it was doomed from the get-go. Cuenca already has more pharmacies than bakeries — and that’s saying something.
Some Cuenca pharmacies offer full-spectrum medical care.
But this one came with a twist. The young woman behind the counter isn’t just a pharmacist. She’s a doctor. Not a theoretical, still-in-med-school kind of doctor, but a real one — with a stethoscope in her bag and a small backroom with a padded bench where you can drop your pants and she’ll give you an injection on the spot if you need it.
As it turns out, Katerina’s father also owns a pharmacy across town, and this location is part of a broader effort to build her medical practice. Upstairs, she has a small but well-equipped consulting room, and she can do far more than just hand out pills. She draws blood for lab tests, installs contraceptive implants, stitches up wounds, changes dressings, manages diabetes care, and provides ongoing wound care–if you need it.
It’s the kind of hands-on, full-spectrum basic care that in other places would require multiple appointments, referrals, a half-day off work, and a copay of a week’s pay.
It’s a business model born of necessity and common sense. In a city where private clinics can be expensive and public ones oversubscribed, this micro-clinic hybrid offers something rare: immediate care.
She sells antihypertensives and antibiotics, yes — but she also checks your blood pressure, listens to your chest, and administers vitamin shots, all without an appointment. You walk in looking for something for a headache and leave with a jab in the arm and some surprisingly sound medical advice which is often offered free of charge.
This model isn’t unique to her, though her youth and energy make her stand out. Many pharmacies here blur the line between drugstore and consultation room. It’s not medicine-by-the-book, but it’s medicine that works for people on tight schedules and tighter budgets. You won’t find paperwork, long queues, or waiting rooms full of posters about hand hygiene. What you will find is access — and a kind of surprising competence that rarely gets official recognition.
Some expats raise an eyebrow at this informality. “Backroom injections?” they say, as if describing a back-alley deal. But this isn’t back-alley — it’s backroom. It’s visible, clean, regulated (more or less), and very much part of how healthcare actually functions in a city like Cuenca. When your sciatica flares up and you need a quick shot, or your kid’s got a high fever, the thought of waiting a week to see a specialist — or a whole morning in an IESS clinic — suddenly makes that little backroom look very appealing.
And let’s not forget: many of these pharmacies are run by women. They’re part of a practical economy of care that runs alongside the formal system and often outperforms it in terms of speed, friendliness, and affordability. They’re not trying to compete with the hospital — they’re filling in the cracks that hospitals leave behind.
The pharmacy across the street is still open. Business seems steady, especially on Mondays when they have a 20% discount. Maybe she’ll make it. Maybe she won’t. But as long as Cuenca keeps operating in that elastic space between formality and function, I suspect that backroom injection bench will remain a fixture — just another way this city looks after its own, one jab at a time.
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Author’s note: The pharmacy mentioned in the article is located on the hill behind Supermaxi on Av. las Americas. Charlie Larga prefers not to advertise individual local businesses by name unless they are well-known landmarks.
