There is an average of 24 doctors for every 10,000 inhabitants. Doctors tend to be concentrated in big cities, which creates serious problems in the distribution of health services. As an example: In the province of Pichincha there are 2 doctors per 1,000 inhabitants, while in the provinces of Galapagos and Orellana this ratio is only 0.56 and 0.43, respectively.
Due to the economic situation in the country, only a small percentage of the population can access private medical care. Many populations, especially those in the Amazon, live far from cantonal public hospitals and this distance is exacerbated by the lack of roads and transportation, among other challenges such as the lack of specialists in these rural hospitals.
It is estimated that approximately 20% of the vulnerable population is unable to access medical care in the public health system. The rest of the vulnerable population manages to benefit from the public health system with many difficulties that involve waiting for an appointment, sometimes for months or even a year, to be treated.
Mobile surgery is a new way to deliver surgical care in the patient’s habitat. Instead of bringing the patient to the operating room, it is the operating room that is transported to the patient. We have had the opportunity to develop this concept, building an operating room on a truck and traveling to the most remote regions in Ecuador, where a team performs surgical interventions near the patients’ home.
The program was developed in response to the difficulties that people from remote locations have in accessing surgical services. Transportation, accommodation in the city, long waits at hospitals and the worry of leaving their homes, crops and animals unsupervised limited accessing surgery.
Cinterandes was founded in 1994, launching the first mobile surgery program of its kind in the world with an operating room built in the back of a truck. This program performs an average of 350 surgeries per year, in the most remote places of Ecuador and in the suburbs of cities.
With its mobile operating room, Cinterandes has visited 18 of the 24 Provinces of Ecuador, performing nearly 9,000 surgeries to date, traveling through the Andes mountains, the Pacific coast and the Amazon; on surgical missions with its volunteer medical staff, made up of Ecuadorian and foreign surgeons, anesthesiologists, residents and medical students, nurses and technicians, treating people who otherwise would not be able to access surgical services, in a safe way, close to the patient’s home, which means they don’t have to go far from home and travel long hours to be treated in big cities, humanizing medical service but with standards comparable to the best medical centers in the world.
Currently in our mobile surgical unit, we perform surgical interventions in the area of general surgery, such as:
Laparoscopic cholecystectomy, tubal ligation, inguinal and abdominal herniorrhaphies, extraction of superficial tumors, circumcisions, orchidopexies, among others.
Medical brigades in other provinces last four days and are coordinated in advance with a person from the community who is in charge of organizing on site. During the first day of the brigade, all patients are screened, which together with the necessary medical exams, guarantees the safety of the process. Post-operative controls are carried out through Telemedicine. When the locations of the brigades are remote and very poor, surgeries are free, thus maintaining the vision of our founder, Dr. Edgar Rodas Andrade: “The idea is that no one is denied access to surgery, because they do not have money”.
The Cinterandes mobile surgery program is internationally recognized and has been replicated in various parts of the world such as Africa. The program represents the best way of bringing surgical care to remote places or areas that do not have these health services, making surgery more humane and easily accessible for all, substantially improving the quality of life of hundreds of people annually.