Cuts, shortages, and broken equipment leave Vicente Corral Moscoso struggling to serve southern Ecuador’s patients.
A system under pressure
Cuenca’s Vicente Corral Moscoso Hospital, the largest public medical facility in southern Ecuador, is collapsing under mounting demand and shrinking resources. Despite treating more patients every year, the hospital’s 2025 budget was cut by 12% compared to 2024, leaving staff and administrators scrambling to cover basic needs.
The situation mirrors a wider collapse in the national health system, where hospitals are reporting food shortages, medicine gaps, and deteriorating infrastructure. In Cuenca, however, the strain is especially severe. Vicente Corral Moscoso is the only Ministry of Health hospital in the city, yet it must serve a population of 1.4 million spread across Azuay, Loja, El Oro, Zamora Chinchipe, and even Chimborazo.
Overworked staff and fear of layoffs
Inside the hospital, nurses and doctors say they are exhausted. “A single nurse, with one assistant, has to care for 15 to 20 patients,” one worker said during a union protest in June. Demonstrators demanded more personnel, medicines, and infrastructure improvements, as well as a collective bargaining agreement to protect jobs.
The workforce is stretched thin: of the 1,206 employees reported in 2024, less than half hold permanent positions, with hundreds working on temporary contracts or under the Labor Code. Outsourced staff, such as cleaners, report months without pay.
Assemblyman Roque Ordóñez, who inspected the facility this summer, confirmed the atmosphere of insecurity. “Doctors are overburdened, there’s a shortage of nurses, and people live in fear of being dismissed,” he said.
Medicines in short supply
The pharmacy shelves are not completely bare, but patients are regularly forced to buy their own prescriptions. The hospital’s director, José Arias, claimed in June that the center maintained about 80% of its medicine stock. Even so, deliveries from suppliers are often delayed, and some basic drugs are missing.
Two women from rural Cuenca recently described their ordeal after bringing a relative with an advanced prostate condition to the hospital. Doctors ordered immediate surgery, but the earliest appointment was set for November. In the meantime, the family had to purchase painkillers themselves—though hospital records listed the drugs as if they had been dispensed free of charge.
Broken machines, stalled care
Damaged equipment has become another bottleneck. Colonoscopies have been suspended for more than eight months because no functioning colonoscopes remain. Of five endoscopes, only two are operational.
Staff say these failures force delays and create risks for patients whose conditions require urgent diagnostic testing. The problem is compounded by outdated facilities, with infrastructure largely unchanged since the hospital’s founding 48 years ago.
Crowds without space
The hospital has only 230 beds, yet each day it receives about 700 outpatients and 400 emergency cases. On a mid-August visit, hallways were overflowing with patients from neighboring provinces. Many had already waited hours, and some had traveled long distances only to be told their care would be delayed.
Despite years of overcrowding, no expansion plan has been implemented. Administrators have tried to adapt consultation rooms, but overall capacity remains static.
A shrinking budget in a growing crisis
The financial picture paints the starkest contrast. In 2019, Vicente Corral Moscoso operated with $44 million. This year, its budget sits at just $42 million, down not only from last year’s $48 million but also from six years ago—despite skyrocketing demand.
Nationwide, Ecuador’s health spending has collapsed: the Ministry of Health lost $260 million in 2024 and another $161 million in 2025, bringing its total budget to $2.8 billion. Meanwhile, political instability has undermined the sector, with five different health ministers passing through President Daniel Noboa’s administration in less than two years.
At Vicente Corral Moscoso, the combination of scarce funds, crumbling infrastructure, and relentless demand leaves staff and patients trapped in a daily struggle—one that shows no sign of easing as the hospital attempts to serve the south of the country with fewer resources than ever.
10 years ago, this would have been something the US would point out as a country that cannot take care of itself.
In 2025, this article could have been written about many states in the US, as they are going through the same problems that Cuenca is. The US is being torn down more and more every day, and it will be too late when people take their heads out of the sand.