Hospitals and Pharmacies
As a general rule, the larger a city is, the better its medical care is likely to be. In Quito and Guayaquil, English-speaking doctors trained overseas are relatively easy to find; your embassy should have a list of recommended practices. Standards deteriorate the further you go from the cities, particularly in remote rural regions. If you have a choice, private hospitals and practices are invariably better staffed and equipped than their state-managed counterparts. Make sure you have adequate health insurance and remember to obtain itemized receipts after treatment so you can recover your costs. Carrying a credit card is a good idea in case you need to make large payments for treatment up front. You'll find pharmacies in almost all Ecuadorian towns. They're invariably stocked with a wide range of familiar drugs and medicines, which can be bought without a prescription; if you're likely to need to buy medication, make a note of its generic name, as brand names may be different (women taking oral contraceptives are better off bringing their own supply from home). For many locals, pharmacists act as no-cost, stand-in doctors, but their advice should be taken with a pinch of salt: there's no substitute for lab tests and a trained practitioner's opinion. If you see a turno sign, it means that there's a night shift and the pharmacy is open 24 hours, more common in the large cities.
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