Offering 2,237km (1,398m) of Pacific Ocean coastline and breathtaking views in the Andes mountains, the South American country of Ecuador can be an exciting destination to head to. However, don’t leave home without protecting your health against some hidden dangers.Average life expectancy in Ecuador, according to 2016 World Health Organisation figures, is 51st in global ranking for longevity. Women have an average lifespan of 79, while for men this is 73.5. The nation spends more than nine percent of its GDP on healthcare, meaning residents are reaping the rewards.
Access to high-quality medical care will depend on whereabouts in the country you live. The tropical forest east of the mountains is sparsely populated, with only three percent of the population living across a huge area. As you would expect, medical services there are basic, and there are no specialist treatments available. However, major population centres, such as Quito (the capital), or Guayaquil (the largest city) are home to modern, extensive medical services expats will be happy to use. You will have the choice between contributing to the national health care system or taking out private health insurance, and this will affect where you can receive treatment.
When you are in good health, it is easy to overlook the importance of health services such as a nearby 24-hour emergency room or a specialist consultant, but do bear in mind that your health can change quickly and drastically.
In addition, the nation has a number of significant health challenges of which to be aware.
Institutional chaos and a lack of clear responsibility, caused by incoherence in funding, reporting and monitoring, has caused the water supply and sanitation services to be unreliable and insecure. Much of the drinking water is not safe and very little wastewater is treated. This helps spread disease.
The climate and geography of the country also encourage the spread of serious illness. The rivers and lakes, which are so beautiful to look at and photograph, provide endless opportunities for mosquitoes to breed and multiply. Unfortunately, this includes the Anopheles species, which transmit serious and life-threatening illnesses to those they bite.
Periodic droughts and floods can also cause health issues in their wake. To a lesser extent so can strong earthquakes, when significant damage to buildings, roads and infrastructure may lead to overcrowding and supply issues.
Protect Yourself From Health Issues
There are several steps you can take to protect yourself from serious illness and infection in Ecuador.
Start by getting all relevant vaccinations four to six weeks before you arrive. That will give the vaccines enough time to develop and your body the biological protection it needs.
Make sure you have access to mosquito nets, and that you use them. At the very least, a mosquito net should cover are area over your bed so you are protected as you sleep. You won’t notice as you are bitten, but the effects of disease can last a lifetime.
Unfortunately, you will be surrounded by mosquitoes as you try to relax during the evening too. Bear in mind that, because of its proximity to the equator, Ecuador essentially has 12 hours of daylight and 12 hours of darkness all year round. Bug sprays vary in their effectiveness, so ask around for recommendations. You will get used to the smell. Placing citrus candles around you may also be useful. However, none of this is fool proof so you should aim to keep covered as much as you can. Bare arms, legs and necks are especially tempting for mosquitos, so try to wear long sleeves and trousers, and wear a collar or light scarf if possible.
Remember to find clean water to drink and brush your teeth with. Even a simple stomach bug can bring days of misery.
There is a risk you may develop altitude sickness in Ecuador. You should become familiar with the symptoms and act quickly to seek help if you appear to be developing those symptoms.
There are a number of effective vaccines which have been developed against serious and life-threatening illnesses. As a result of the wide uptake of these vaccines, many developed countries with efficient vaccination programmes have low levels of these diseases within the native population. However, you are at risk of encountering them when living in Ecuador.
The vaccinations you probably received when you were a child – and should definitely seek now if you did not – include:
• Rotavirus: the most common cause of diarrhoeal disease among infants and young children
• DTaP/IPV: diphtheria, tetanus, pertussis (whooping cough) and polio
• Hepatitis B
• MMR: measles, mumps and rubella
• HPV: human papillomavirus
• Hepatitis A
It’s also important to keep routine vaccinations received in adulthood up to date. It may be that you have yet to receive these, either because of your age or the countries in which you have lived. However, you must make sure they are all up to date before travelling to Ecuador:
• Td/Tdap: tetanus, diphtheria and pertussis (whooping cough)
• HPV: human papillomavirus
• Hepatitis A
• Hepatitis B
Don’t dismiss the seriousness of flu. Most who have not suffered from it believe it is a bad cold; it’s not. Doctors can miss life threatening illnesses such as sepsis and meningitis, which can kill within hours of symptoms, because they present like flu. The damage done to the lungs and other organs by flu can itself cause death, and does so in significant numbers each year. Children are unlikely to suffer long term ill health from flu, but their hygiene practices mean they are ‘super spreaders’. Anyone suffering from long term illness, who is pregnant or who is elderly can die from contact with the virus spread by unvaccinated children.
You are unlikely to have been vaccinated against typhoid during routine vaccination programmes, but it is important to receive this jab. Realistically, you are unlikely to contract typhoid unless you are visiting a more remote area or eat somewhere very basic, but a protective injection takes away the possible risks.
Your chances of being bitten by a domestic or wild rabid animal in Ecuador are low, but if it happens you will be in serious peril. The chance of survival after symptoms appear are exceptionally low. Choose to have the vaccine before you arrive in Ecuador. If you don’t, and get bitten, seek help immediately and do not wait for symptoms to appear.
Unfortunately, there is no vaccine which will prevent you getting malaria. Instead, you should take anti-malarial medicines. Begin before you arrive in Ecuador and complete the course. Protect yourself from mosquitoes as far as possible and be aware of the effects of malaria. Seek help immediately if you think you may have contracted the disease.
Other Diseases Caused By Mosquitoes
Sometimes the chikungunya disease occurs in Ecuador and the Galapagos islands. When this happens, alerts are published on the website for the Center for Disease Control and Prevention.
There are also periodic outbreaks of dengue fever; again, check for alerts. The presence of Anopheles mosquitoes means yellow fever is an additional risk to consider.
Within the past five years, there has been a sudden spread of the zika virus to countries where it was previously not seen. This is spread from the bite of an infected mosquito and in addition to immediate illness, it can cause serious lifelong disability to unborn children, so pregnant women must be especially careful.
There are no vaccines to protect yourself against chikungunya, dengue fever or the zika virus. You must do everything you can to prevent bites, be aware of the symptoms, and seek medical help immediately if you become ill.
Look Out For Health Alerts
Worry about potential illness and diseases should not dominate your life and cause undue concern. Instead, take practical measures to reduce the risk and be aware of any health alerts for the area in which you live. Keep an eye on the websites Travel Health Pro, Fit For Travel and the website for the Center for Disease Control and Prevention.