Located on the western coast of South America between Colombia and Peru, Ecuador is a culturally and geographically diverse country with a population of around 17 million people. Ecuador also includes the famous Galápagos Islands, an archipelago of volcanic islands about 600 miles from the mainland.
Despite high poverty and income inequality, most people have access to quality health care — especially those living in major cities such as the capital, Quito. Basic health care has been free since 2008, and the country is considered to have one of the most efficient health care systems in the world.
Even so, in rural areas, many of Ecuador’s most vulnerable populations still struggle to find skilled care when they need it most.
A shortage of medical supplies and health care workers
Despite the availability of health care, there aren’t enough doctors in Ecuador. The country has around 2 doctors for every 1,000 people. The U.S., by comparison, has a doctor to patient ratio of 5.5 to 1,000.
Public hospitals are often ill-equipped, lacking medical supplies needed to treat patients — particularly those in more remote, rural areas. Health care is significantly better in urban areas, where the majority of the population resides.
Poor maternal, neonatal, and child health
Significant progress has been made to improve the health of mothers and children over the past few decades. Still, maternal, perinatal, and nutritional conditions remain the second-leading cause of premature death in Ecuador behind noncommunicable diseases.
Most women do not receive any antenatal care, while maternal mortality is 59 deaths per 100,000 live births. The infant mortality rate is 12 per 1,000 live births — a huge improvement from approximately 76 in the early 1980s — and the under-5 mortality rate is 14 per 1,000.
Poverty and the burden of malnutrition put the health of Ecuador’s youngest generations at great risk. Nearly 1 in 4 children under 5 suffer from chronic malnutrition.
The threat of infectious disease
Diseases like hepatitis A, typhoid, dengue, and malaria are all common in Ecuador. Those living in poverty without proper access to clean water or sanitation are at higher risk of contracting these diseases.
Bringing HOPE to Ecuador
Our history in Ecuador
Project HOPE’s work in Ecuador dates back to the third voyage of the SS HOPE in 1963. At that time, Project HOPE medical volunteers treated widespread tuberculosis, parasitic diseases, and malnutrition and then led a nutrition program to improve health care for women and children.
In 1989, we continued work to reduce morbidity and mortality in mothers, infants, and children by educating communities and health workers in the provinces of Azuay and Manabi.
In 2011, Project HOPE volunteers aboard the USNS Comfort traveled to Ecuador as part of the U.S. Navy’s Continuing Promise mission and provided health care to more than 5,200 Ecuadorians.
Today we continue work to improve and protect the health of the country’s most vulnerable indigenous populations — especially its women and children.
Improving the health of mothers, infants, and children
Project HOPE has worked closely with the Ministry of Health to save the lives of Ecuador’s mothers, infants, and children. We have trained nurses and community health workers in maternal care, child spacing, growth monitoring, diarrheal disease control, and nutrition and breastfeeding, as well as hygiene, immunization, and home gardening.
We have helped develop training modules and manuals that served as guidelines for training and program implementation, and have also established mothers’ clubs to address community health concerns.
Promoting good health by improving family income
To reduce vulnerability, we have helped women increase their income through our Village Health Banks program.
This program gives women access to small loans to help start or grow their businesses so they can lift their families out of poverty and provide their children with basic nutritional food and medicines. In return, women attend health education classes where they learn how to prevent illness and lead healthier lives.
Today this work is run by a local NGO, ESPOIR, which was formed by Project HOPE in 2003.
Responding to disaster
When devastating disasters strike, Project HOPE stands ready to deliver lifesaving supplies and medical volunteers.
In April 2016, Project HOPE sent an assessment team after a magnitude 7.8 earthquake struck the northern part of Ecuador. The team coordinated with local officials and international organizations to assess the damage on the ground and deliver urgently needed volunteers, medicines, and medical supplies.
Protecting communities from COVID-19
Project HOPE is supporting the Ministry of Health, front line health care workers, and communities to better detect, contain, and respond to the threat of COVID-19.
With support from partners, we have procured and delivered personal protective equipment for front line health workers. We are also providing virtual training in partnership with Brown University and the opportunity to conduct e-Consults with experts in the U.S. in partnership with the Weitzman Institute.
In addition, with support from AstraZeneca, Project HOPE is partnering with the Catholic University of Cuenca to train community health workers on disease prevention and health promotion for underserved and indigenous populations. Health workers then train community leaders on COVID-19 prevention and risk communication. They also implement mass media campaigns to raise awareness and ensure communities have the latest and most accurate information.
Protecting Health Workers’ Mental Health
In 2021, Project HOPE began implementing a mental health and resilience training program to provide Ecuador’s health care workers with the knowledge, tools, and techniques to protect their mental well-being and resilience while working on the front lines of COVID-19.
In partnership with the Universidad Catolica de Cuenca, Project HOPE implemented a mental health and resilience project based on the HERO-NY training from New York City Health + Hospitals. Project HOPE implemented the project in 118 hospitals across 23 provinces in Ecuador with the support of the Ministry of Health, training 477 master trainers who cascaded the training on to 1,505 health workers nationwide.
Training Community Health Workers to Reach Indigenous Populations
In order to strengthen primary health care actions by increasing community participation, Project HOPE partnered with the Universidad Catolica de Cuenca to develop the “Training Community Health Promoters with an Emphasis on COVID-19” program in the provinces of Azuay, Cañar and Morona Santiago.
In total, 337 community promoters were trained and 1,200 community leaders across 13 provinces received information on COVID-19, including many in rural and indigenous communities. The trainings were translated into Kichua and Shuar and also included mental health content as a new training module.
Protección de la salud mental para los trabajadores de la salud
En 2021, el Proyecto HOPE comenzó a implementar el Programa de Entrenamiento en Salud Mental y Resiliencia, para brindar a los trabajadores de la salud del Ecuador los conocimientos, las herramientas y las técnicas para proteger su bienestar mental y resiliencia mientras trabajan en la primera línea del COVID-19.
En asociación con la Universidad Católica de Cuenca, Project HOPE implementó un proyecto de Salud Mental y Resiliencia basado en la capacitación HERO-NY de New York City Health + Hospitals. Project HOPE implementó el proyecto en 118 hospitales en 23 provincias del Ecuador con el apoyo del Ministerio de Salud, capacitando a 477 entrenadores maestros que transmitieron la capacitación a 1505 trabajadores de la salud en todo el país.
Capacitación de Promotores Comunitarios en Salud para llegar a las poblaciones indígenas
Con el objetivo de fortalecer las acciones de atención primaria de salud incrementando la participación comunitaria, Proyecto HOPE se asoció con la Universidad Católica de Cuenca para desarrollar el programa “Capacitación de Promotores Comunitarios de Salud con Énfasis en COVID-19” en las provincias de Azuay, Cañar y Morona Santiago.
En total, 337 promotores comunitarios fueron capacitados y 1200 líderes comunitarios en 13 provincias recibieron información sobre COVID-19, incluidos muchos en comunidades rurales e indígenas. Las capacitaciones se tradujeron a Kichua y Shuar y también incluyeron contenido de salud mental como un nuevo módulo de capacitación.
Project HOPE’s work has improved the lives of people across Ecuador for more than three decades. In response to COVID-19, Project HOPE has worked with partners to empower thousands of health workers with PPE and training. To date, master trainers in Project HOPE’s COVID-19 Preparedness and Response curriculum from Catholic University of Cuenca have trained more than 900 health and academic professionals.
Project HOPE’s Village Health Bank Program continues to transform the lives of women living in poverty. Our local NGO, ESPOIR, operates more than 300 active VHBs, which have provided services and education to more than 10,000 women across four regions of the country.