IESS Hospital Carrasco Staff Warn of Medicine and Supply Shortages

The People Who Work There Are Sounding the Alarm

The medical staff at Hospital José Carrasco Arteaga — Cuenca's main IESS (social security) hospital — issued a public statement on April 2 warning of worsening shortages of medicines and surgical supplies that are directly affecting patient care.

This isn't a rumor from a Facebook group. This is the hospital's own doctors, nurses, and administrative staff going public with concerns they say have been ignored internally.

What the Statement Says

The staff's public declaration raises several specific concerns:

Medicine shortages are limiting treatment. Essential medications that should be available in a hospital of Carrasco's size and classification are frequently out of stock. Patients are being told to purchase medications externally — something that shouldn't happen in a public hospital where they've been paying into IESS their entire working lives.

Surgical supplies are insufficient. Operating rooms are being affected by a lack of basic surgical materials. This means some procedures are being delayed or rescheduled, and in some cases, patients are being asked to source their own supplies — surgical gloves, sutures, and other items that should be standard hospital inventory.

Staff disputes management's claims. Hospital management has publicly touted successes and improvements, but the staff on the ground say the reality doesn't match the press releases. The statement specifically accuses current hospital leadership of painting an overly optimistic picture while conditions deteriorate behind the scenes.

Leadership concerns. The declaration criticizes what it describes as authoritarian management style and a lack of technical knowledge among current hospital directors. Staff members say decisions are being made by administrators who don't understand medical operations, leading to supply chain failures and prioritization of optics over patient care.

The demand. The staff is calling on IESS national leadership to appoint competent, technically qualified directors who understand hospital management and can address the supply crisis before it worsens further.

Context: Why Carrasco Matters

For expats who are new to Cuenca or unfamiliar with the healthcare system: Hospital José Carrasco Arteaga is the largest IESS hospital in Cuenca and serves as the primary facility for hundreds of thousands of IESS affiliates across Azuay province.

If you're an expat who has voluntary IESS affiliation — which many retirees and visa holders maintain for its relatively affordable coverage — Carrasco is where you'd go for surgeries, specialist appointments, emergency care, and medication dispensing. It's the backbone of public healthcare in this city.

The hospital handles everything from routine blood work to complex surgeries, cancer treatment, dialysis, and intensive care. When it's functioning well, it provides remarkably competent care for what affiliates pay. When it's not functioning well — as the staff is now warning — the consequences fall hardest on the most vulnerable patients.

This Isn't New, But It's Getting Worse

If you've been in Cuenca for a few years, you've probably heard complaints about IESS before. Long wait times, appointment backlogs, and occasional supply issues have been chronic issues across the IESS system nationally.

But the staff going public with a formal statement suggests the situation has crossed a threshold. When doctors and nurses risk professional consequences to issue public warnings, the problem is typically worse than what they're saying publicly.

The broader IESS system has been under financial pressure for years — partly due to the pandemic's impact on Ecuador's economy, partly due to management and governance issues at the national level. Carrasco, as a major regional hospital, absorbs the consequences of those systemic problems.

What This Means for Expats

• If you have IESS coverage and take regular medications, don't assume they'll always be available at the Carrasco pharmacy. Ask your doctor to write prescriptions you can fill at private pharmacies as a backup. Fybeca and Pharmacys offer many of the same medications at reasonable prices
• If you have a scheduled surgery or procedure at Carrasco, confirm your date is still on track. Supply shortages can mean last-minute postponements. Call the hospital directly a few days before your appointment
• Consider maintaining supplemental private insurance alongside your IESS affiliation. Many expats carry both — IESS for routine care and prescriptions, private insurance (or out-of-pocket payments at private clinics) for situations where IESS can't deliver timely care
• Private hospitals in Cuenca — Hospital del Río, Clínica Santa Ana, Hospital Monte Sinaí — remain fully operational and well-supplied. If you need a procedure and Carrasco can't accommodate it, these are your alternatives
• This is a management and supply chain issue, not a quality-of-care issue. The doctors and nurses at Carrasco are competent and dedicated — that's precisely why they're speaking up. The problem is with the administrators and the supply pipeline, not the medical staff
• If you're deciding whether to enroll in voluntary IESS, this situation doesn't necessarily change the calculus. At roughly $80-90/month for full coverage, IESS is still valuable — but go in with realistic expectations and always have a Plan B for urgent care
• Follow this story. If IESS national leadership responds positively and appoints new directors, the situation could improve quickly. If they don't, expect continued deterioration. We'll update you as this develops

The staff at Carrasco took a risk by going public. The least we can do is pay attention.

Source: El Mercurio