La Ley de Maternidad Gratuita y Atención a la Infancia

22 Jun

In 1998, Ecuador passed this radical law called La Ley de Maternidad Gratuita y Atención a la Infancia to address their outrageusly high rates of maternal and infant mortality.  At one point, they were among the worst in the world! This law mandates free healthcare for women and children, and has been implemented all over Quito. There are still parts of Ecuador that don´t have the facilities or resources to put this law into practice, but the Department of Public Health has launched numerous projects to change that. What this means for me, as a volunteer in La Maternidad, is that I get to see the law as it works out on the ground. At La Maternidad every service, examination, lab test, hospitalization, surgery, medication, recommendation, diagnosis, and delivery is free for the patient. As incredible as this all sounds, after a few weeks of volunteering, I´m beginning to see the potentially inevitable downfalls that still remain within the program. For example, yesterday a woman called the emergency room screaming in pain. She was 15 years old, 26 weeks pregnant, and said she was bleeding profusely. She was requesting an ambulance, which is also free of charge, but the doctor responded telling her that La Maternidad was “a full“–that they didn´t have any room for any more patients. He told her to seek care at another clinic, but she responded that they were full as well. In the end, he wished her the best of luck, and hung up the phone. Today, with another patient, the doctors were worried about the condition of the fetus´ heart. They wanted to get a fetal echocardiogram to see what was going on, but the hospital doesn´t have such state-of-the-art equipment. Don´t get me wrong, La Maternidad is a beautiful hospital that seems fully equipped. Apparently, there is still some medical technology that the government cannot afford, including sufficient space to treat all of Quito´s patients. The hospital is filled with signs that request frugality with medical equipment, lists of medical supplies that doctors are requesting, and reports that show how much has been used that month. It´s interesting to see it from both sides. I see all of the good that La Ley does–the poorest of Quito receive some of the best care there is, and the rates of maternal and infant mortality have dramatically fallen. But, I also see it from the doctors´perspective–the tight budget, having to turn down patients, and the frustration they feel when they can´t provide the care they know exists. It´s undeniable that this law has changed the Ecuadorian healthcare system for the better, for it helps the women of Ecuador get the medical care they need, but it also seems to have plenty of  room for improvement. In only 13 years, they have seen an impressive decrease in maternal and infant mortality, an increase in overall reproductive health, and an increase in the quality of medical care. One of the cool, less expected repercussions of the success of this law is that it inspired there to be free internal health clinics as well! Now, families can continue to get free healthcare the rest of their lives. This law has completely turned around the Ecuadorian health care system, and I´m excited to see even more examples of it changing the lives of the people of Quito.


2 Responses to “La Ley de Maternidad Gratuita y Atención a la Infancia”

  1. Patricia June 22, 2011 at 10:02 pm #

    Que experiencia tan maravillosa con todo lo que estas aprendiendo del sistema medico de Quito. Es admirable que todo el servicio medico puede ser gratis y a pesar de todo el trabajo aun queda mucho por hacer. Sigue adelante y aprende todo lo que puedas, se que esta experiencia va a cambiar tu vida y darte bases para el futuro. Un abrazo, Dios te bendiga, con amor


  2. David Kehlet June 22, 2011 at 10:23 pm #

    Fantastic to find out how it really works. Lots to learn.


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