Dialysis Patients Travel Hours as Ecuador's Public Health Debts Pile Up

A new El Comercio health report shows how Ecuador's public payment delays can become a patient-access problem.

According to the Frente de Pacientes de Dialisis, patients are traveling to other cities where dialysis slots are available, or buying medicines and supplies out of pocket so they can be treated. El Comercio reports that the reason is the same in each case: the Ministerio de Salud Publica (MSP) owes two years of services to private dialysis centers that have public agreements.

The Debt Figures

El Comercio reports that the MSP owed $206.6 million to private dialysis centers as of July 31, 2025, equal to two years of services. The IESS owed another $44.6 million as of June 2025.

The report says those figures were obtained by assembly member Franklin Samaniego through a formal request, not published by the MSP, IESS or the Ministry of Finance.

El Comercio also reports that the patient group does not know the current debt with the 115 clinics that have MSP agreements or the 84 clinics allied with IESS.

What Patients Are Facing

The report says many patients do not manage to attend the 12 monthly sessions they require.

One patient in La Troncal must travel to Duran after a local center stopped accepting MSP patients, according to El Comercio. Her daughter pays $70 for each round-trip taxi ride and $20 in supplies per session.

Another patient in Los Rios receives eight of the 12 monthly sessions he needs because he does not have enough money to travel more often.

Dario Jimenez, president of the Asociacion de Nefrologia del Ecuador, told El Comercio that when kidneys fail, potassium is the most dangerous waste that accumulates in the blood and can lead to death in days or weeks.

What This Means for Expats

For foreign residents, the lesson is about care continuity. Even if you use private insurance or private providers, public-system stress can affect appointment availability, referrals, supplies and emergency capacity.

Anyone managing a chronic condition in Ecuador should keep written treatment records, know the nearest alternative provider and ask directly how a clinic handles supply or payment interruptions.

Source: El Comercio