Galapagos ICE

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A Brief Overview of Medical Resources and Challenges

in the Galapagos Archipelago

The two main hospitals are based on San Cristobal Island and Santa Cruz Island, and a number of satellite clinics (called sub-centros) serve the less-populated islands (Isabella and Floreana) and rural areas. There are also a small number of private clinics.

Although Galapagos ICE sometimes operates on other islands, we work primarily within Puerto Ayora and the rural areas of Santa Cruz Island.

Medical Personnel

Currently on staff at the Puerto Ayora Hospital are two general practitioners, one OBGYN and one pediatrician. The number of nurses fluctuates but always remains below an acceptable level. In addition to these doctors there are a small number of Ecuadorian “rural doctors” serving a required time of one year in the Galapagos.

Ecuadorian Rural Doctor Program

The Ecuadorian government mandates that all Ecuadorian medical students and nurses, upon completion of their medical studies, serve in a struggling “rural” clinic or hospital for one year. The Galapagos Islands receives a number of such “rural doctors” from the mainland each year. While any medical help is welcome, there are a number of problems associated with the administration of the Rural Doctor Program in the Islands. First, due to a shortage of experienced doctors in the Islands, these new doctors are largely unsupervised; and second, because new rural doctors replace the old ones after a single year, sustained development of medical knowledge in Galapagos hospitals and clinics is limited.

One of the implications for Galapagos ICE is that our medical volunteers are sometimes working with medical professionals who do not have a great deal of medical experience.

Hospital/Clinic Visits: External Medicine

The following numbers of individuals visited the hospitals and clinics on Santa Cruz and Isabella Islands for external medicine in the last three years. Note that the number of visits went up in 2007 after a new wing of the hospital opened and hospital hours were extended.

Reliable medical statistics in the Galapagos Islands are difficult to obtain, but some data are available. For instance, the department overseeing hospital information at the Puerto Ayora Hospital did a study and found that for 2008, the top ten diagnoses for patients visiting External Medicine were: respiratory infection, amebiasis, parasites, diarrhea syndrome, urinary infection, tonsillitis, laryngitis, anemia, pneumonia and contact dermatitis.

Hospital/Clinic Visits: Emergency Room

The following numbers of individuals visited the Emergency Rooms on Santa Cruz and Isabella Islands in the last three years.

The top ten diagnoses for patients visiting the Emergency Room for 2008 were: appendicitis, gastroenteritis, wounds, respiratory problems, diabetes mellitus, bronchitis, intoxication, gastritis, cholecystitis, and hypertension.

Public Distrust of Galapagos Medical Care

The deep local distrust of medical care in the Islands cannot be understated. When confronted with a serious medical issue, most residents, if they can afford it, elect to fly to the Ecuadorian mainland for medical care. This dynamic has different consequences, one of which is a skewed official record of medical problems in the Islands.

Stephen Weinrib, an endocrinologist from North Carolina (assisted by Lindsay Luce, Alice Bartlett, and Rosie Wilson) collected data from 125 Galapagos residents who attended a series of free diabetes clinics in July of 2009. They found that a clear majority of those surveyed obtain medical care on the Ecuadorian mainland. 46% of those surveyed said that their last visit was for a regular checkup and 20% for a combination of emergency services and a regular checkup on the mainland.

The financial burden this puts on residents who seek off-island medical care—and most do—averages about $1131 USD per year (see Table 2). This includes airfare to the mainland, lodging and the cost of the medical care itself. When considering the following chart, it is important to realize that half of Galapagos residents earn less than $400/month or less (Rosero & Valdivieso, “Gender and Women’s Rights in the Galapagos,” Galapagos Report 2007-08, 51).

It perhaps does not come as a shock, therefore, that when asked what two health issues in the Galapagos were most in need of improvement, the majority of participants answered better medical staff and more specialists. Following in second place was drinkable tap water and then better hospital/emergency equipment.