This is going to be a rant

Some things here are just little annoyances; homesickness it’s sometimes called.  A scarcity of fresh vegetables.  Mosquitoes that bite through your socks and shirt and ants surrounding the honey jar like Aztecs at a virginal sacrifice.  Too much traffic for this little port town; I can’t ride my bike anywhere in peace.  Screens with giant holes.  Poor internet connectivity and not being able to talk to my baby a million miles away.  Heavy rains for most of the past 10 days and wet floors & walls, lakes in the roads and mud everywhere.  I better get used to the wetness; hopefully in Seattle we can find a house that doesn’t leak!

Another Saturday market clinic

But that’s not the rant.  What’s really frustrating these days is the fact that I only have 3 weeks left here in paradise and I don’t feel that our clinic is ready to continue to provide consistent, long-term care to our diabetic and hypertensive patients.  The politics and the economics are metaphorically killing me, and quite literally killing our patients.  

Egos.  Avarice.  Conflicts of interest.  (here comes the rant).  I don’t necessarily believe that healthcare is a right, like freedom or air, because unlike those examples, healthcare costs money.  In Ecuador, unfortunately, the single most important determinate of the quality and amount of healthcare one receives is how much one can pay.  This policy has deletrious effects on the overall health of the nation and its people.   I do believe that people have a right to receive healthcare if a given society can afford it.  And basic, preventative medicine is within the budget of most countries, certainly including Ecuador.  Sadly, patients often have little or no protection from the inevitable conflict between health and profit in a system that rewards physicians, drug companies, hospitals, therapists, etc., only when patients are sick and procedures are being performed, instead of rewarding them for keeping patients healthy and keeping overall costs down.  If your physician is also a salesman, beware!  It’s not healthcare, it’s healthanomics!

Think about it; how much is that cancer worth, or your old, overused gallbladder?  And a failing heart?  Or, best of all, your poor body image and precarious self-confidence (implants, liposuction, lifts & tucks, teeth whitening, etc)?  In the U.S. and in Ecuador, all these ailments are worth a hell of a lot more than keeping you healthy with a prescription of oatmeal and 2 miles of roadwork a day.     



Warning: This product is contra-indicated in

Glaucoma and in sane, healthy lifestyles.   



Speaking of roadwork, I just got back from a little jog out to my favorite beach in the world, Tortuga Bay, and possibly the most irreverently blissful bodysurfing I have ever experienced.  Then I stalked a little reef-shark in the shallows as the sun fell through the evening.  And now a full moon is rising over a breezy tropical night.  Aaaahh, Galapagos.  If only…