I spent 5 weeks giving Primary Care at a remote mission clinic in the foothills of Ecuador: Clinica Misional "Nuestra Senora de Guadalupe". The town of 800 is a 1-hour flight and 3 buses from Quito, sits nestled between two low mountain ranges. From the veranda of the volunteer house you overlooked the heavily forested valley to a mountain some 30km away, in the morning could see residents walking their horses or occasionally cows down the path towards the town.
The clinic itself has two general medical exam rooms, two dental suites, a full Operating Room with two operating microscopes / endoscopes/ ultrasound/ etc essentially up to United States standards. Also separate lab, locker, and sterilization rooms. They offer the usual range of U.S. general medicine (minor surgery, joints), with however only limited in-house lab, due to new government regulations. Tests beyond Hematocrit / urinalysis/ HCG/ glucose available in the clinic can be obtained at private labs in the nearest city, you can get test results typically in 2 days; a lipid panel costs the patients $4.; an abdominal CT costs $40.. An in-house pharmacy offers a wide variety of medications at greatly reduced prices; the choice is limited (e.g. only one Statin, one ARB, one sulfonylurea), but workable. A 10-day supply of amoxicillin costs the patient $1. To put things in perspective, working Ecuadorians earn typically $350 - 400. a month, though unfortunately unemployment is high.
Due to elevation, perhaps other factors, mosquitos are rare, malaria / Dengue are currently non-existent. To my suprise, I most often encountered the same complaints as here at home: diabetes, hypertension, UTI's, backache. We worked 8 - 5 Monday thru Friday. Patient load was 5 to 15 per day, heavily dependent upon the mud slides which frequently block road access. Although theoretically on call whenever I'm home, that happened only once in my 5 weeks (a laceration). The government is trying hard to improve health care throughout the country.
Crime in Guadalupe is extremely low, even compared to similar towns in the U.S. All the volunteers felt very safe, even returning from an early evening walk to the store. The residents know who you are, and look out for you. The volunteer house is spacious, with private hot water showers, common kitchen where we made breakfast and ate weekends (when we weren't out sightseeing).
The national bus system is the best I've ever seen. The buses leave hourly, depart punctually (unless blocked by a mudslide that morning), cost maybe $1. for a one hour ride. The buses are greyhound-quality, comfortable, roomy, safe, not overly crowded. There are obviously some differences with the U.S., but not significantly.
As a couution, language in the clinic is strictly Spanish. The full time American nurse, Amanda, is bilingual, but is heavily involved with pharmacy, registration, and other duties, and so physicians need to be self-sufficient. None of the 3 local employees speak English. My Spanish was pretty shaky when I arrived - my High School Spanish was too many years ago - but by the second week I was confidently handling the language for the vast majority of situations. Also, although Guadalupe after dark was quite safe, the major cities are not, common sense is needed when traveling.
This was my fifth mission trip (my third with Mission Doctors), and easily the most enjoyable. The pastor, Padre Jorge Nigsch, was very supportive of clinic needs, and able to fix refrigerators, showers, etc. He is also fluently multilingual and a great guy to talk with.
Beyond the beautiful setting, and more importantly, both the Ecuadorians and the volunteers were lovely, gentle people. The generosity of the local residents was humbling. I would like to return sometime within the year if possible. The clinic is low-intensity, strictly outpatient, so long as you are passable in Spanish (I'm not fluent but did OK), it should be a wonderful experience.