Medical Tourism

I recently returned from a medical "missionary" trip to Cuenca, Ecuador. This is something I have always wanted to and I was fortunate to get invited as I found out.

We replaced 31 hips and did a few other operations in five days. Hip dysplasia is quite common in Ecuador because of the way babies are traditionally bundled and maybe for genetic, altitude or size issues. The adults I saw before their surgery were incredibly disabled, and as there is no social safety net as in Canada they were also quite poor.

This type of medical tourism can be quite fun. You work hard but you play hard too. We started every day with a nice breakfast in our hotel, followed by a vigourous 20 minute walk to our hospital. We worked hard for 10-12 hours but it didn't seem like work because of the teamwork and camraderie. We then all sat down to a nice meal at the hotel, washed down by a bottle of Chilean wine which costs about half what it costs in Canada.

Your airfare is tax deductable and your living expenses are covered by charitable donations. If you are organized you can arrange side trips to the Galapagos,or Machu Pichu.

Leather goods, alpaca sweaters and pottery are incredibly cheap and of good quality so everybody shopped like crazy before during and after the mission. (We of course had to fill out the bags of medical equipment we emptied.) We had a bus tour the day before the mission with mandatory shopping stops and had a bus tour out into the country after the mission.

I had some reservations about this kind of work which I will discuss below.

1. This type of mission focuses on treating a small number of patients and doesn't address the root causes of the problem.

While it is true that we only treated a small number of patients, these are patients who are horribly disabled. We saw about 90 patients the day before the mission started and we did 31 in a week. Some of these 90 were unsuitable for the treatment, the rest will wait for next year. In addition the paediatric team tried to educate health care professionals and patient on proper infant bundling to prevent hip dysplasia and on early recognition.em>


2. The money spent on a mission of this size would be better spent digging wells, building health clinics etc.

It is hard to argue with this point and in fact doctors working the 3rd world full time have made this point. We did actually have a side project involving piping clean water into a smally village. Unfortunately the nature of the 3rd (and to an extent the 1st) world is that had we stayed home and simply donated the money, how much of it would have gone to wells and health clinics and how much into somebody's pockets?

3. We ascend on a city, do a complicated procedure and then fly out with no follow-up.This was again a problem I wrangled with. We did stay for two days after the surgery and we worked with local doctors for follow-up. Historically there have been low complication rates. I do wonder about what happens when somebodies new hip dislocates or gets infected after we leave. Aside from the possible lack of expertise in treating it, they may not be able to afford the treatment. 1.

All in all though a very positive experience and one I would like to do again next year.