Friday, October 16, 2009

Health Care in Chiclayo

One of my primary concerns when deciding to move to Peru was the quality of health care. I had read and seen photos regarding the wide spread belief in shamanism and faith healers but did not expect them to be my only option. I also did not expect to find the elaborate, squeaky clean facilities I was accustomed to in the States. I was right on both counts. I want to be straight forward with you and say that probably 95% of the hospitals, clinics and private offices (consultorios) would not meet minimum standards in the States. The lighting is poor, the walls, floors and stairways are far from spotless, windows are broken, broken light fixtures dangle from the ceilings, the restrooms are not what you would expect to see in a hospital, and the ambulances resemble the 1950s in the States. The question then becomes; does the condition of the physical assets reflect the quality of health care received from medical personnel? In my opinion and experience it does not. I have been surprised and pleased with the quality of health and dental care I have gotten.

Let’s take a look at the various types of facilities. Most hospitals in Chiclayo as I understand it are privately owned by EsSalud, which is a private insurance company who provides health care under the direction of the Minister of Health. All employees in these hospitals including doctors are paid a straight salary. I can’t go into any more detail because frankly I don’t understand it. The name of the hospital above is Almanzor Aguinaga Asenjo. To my knowledge it is fully staffed and equipped to provide all necessary care including transplants. I believe its primary focus is on patients requiring overnight care.

Directly across the street from the hospital is a row of hearses and about a dozen funeral homes (funerarias). El Angel offers everything from tombs to underground burial to cremations. And as an added attraction they will sell you breakfast (desayuno), lunch (menĂ¹), and Lamborgini brand ice cream so you can discuss the disposition of your loved one with a full belly. Not to be outdone, Funeraria Campos to the right of El Angel offers 24 hour service and will recharge (recargas) your cell phone.

This is hospital Naylamp. It provides emergency and most other services but is not equipped for the more complicated operations. The more difficult problems are referred to its sister hospital Almanzor Aguinaga Asenjo. Its primary focus is out patient. Long lines and waiting times are the rule at this hospital.

All clinics are privately operated. The Clinica Del Pacifico has a reputation as one of the best in Chiclayo. As opposed to the hospitals above, you’d better have your credit card with you if you choose this facility. They want proof of your ability to pay up front. I toured this hospital recently and judged by Peruvian standards was impressed with the physical condition. The clinic is said to attract some of the better doctors in the area, and at least one of them speaks English. The clinic’s services cost sheet lists the cost of a private room with meals at $23 per day. The price of an appendectomy is $1,800.

This is hospital Regional Las Mercedes. It is a sprawling building occupying an entire block. It appears to date back to colonial times and was probably the single family hacienda of some wealthy individual. Today it serves those people lacking the ability to pay for health care.

The ambulance at left is typical. It is unusual to hear an ambulance siren. I don’t understand why and have not been able to get a good explanation. Maybe people prefer to take taxis to the emergency room. I also don’t know to what degree if any the drivers are medically trained. I’m told the fire department also has the capability to respond to emergency calls, but because the fire department is comprised of unpaid volunteers I would be reluctant to call them.

I am not in a position to comment on the qualifications, dedication or income of Chiclayo’s doctors, but I believe it would be accurate to say they don’t earn anywhere near what their counterparts in the States earn. As a result during the day most of them work for a hospital, or teach their discipline at a university, or sell pharmaceuticals, while pursuing their private practice out of their home in the evening.

My own doctors, Juan and Jessica have been taking care of this old body since I first met them in December 2005. I have complete confidence in both of them. I know both of them are dedicated to their profession and they spend considerable time with ongoing education – Juan in particular likes to research the Stanford School of Medicine database.

So how do you pay for health care? There are several private insurance companies, with Pacifico Seguro being the one most often mentioned. I’m told the premiums are at minimum 50% less than in the US. If you’re over 62 you’re out of luck. No one will sell you insurance. I don’t worry about it. What I pay for medical care per visit is less than the amount of co-payments I would make in the US. Even a catastrophic illness wouldn’t have a catastrophic cost attached to it in Chiclayo.


1 comment:

  1. Your research and your writing is accurate for somebody that speaks little Spanish. "EsSalud" is the public health system state run with money from three sides" employees, employers and the government. To have funeral homes near hospitals looks a good idea, as in the States I've seen som cemeteries near hospitals, but nothing as obvious as a funeral home. The Naylamp EsSalud hospital was built as offices 40 years ago. There are private "clinicas" and private health insurance, they are expensive for most Peruvians.
    The "Las Mercedes" hospital was a gift from a wealthy man, the one whose name carry the Av. Santiago Luis Gonzales. I wonder why there are not wealthy people making gifts now in Peru. Las Mercedes was built by the end of XIX century, and is run by the Chiclayo Society for Goodwill in behalf of the poorest. Actually two new hospitals are under construction, one by EsSalud, one by the government. About ambulances, it is truth, you do not listen them very much, as it is with firefighters and patrol cars.
    I believe you did well your writing and taking care of your health. Peruvian doctors use to be well prepared; hospitals and clinicas arewell equiped; they do not have the last marvel, though.