If you are concerned about health insurance and medical services in Colombia, I share my recent experience with emergency surgery in Medellín.

In a number of Facebook groups, people from North America seem to be very concerned about health insurance and medical services in Colombia.

I just spent five days in Clínica León XIII receiving emergency surgery under Colombia’s equivalent of universal health care (EPS). I hope that my experiences might put a few fears to rest.

My background – I am British and 67 years old. And I am a firm supporter of the National Health Service. I had a heart attack in 2007, otherwise fairly healthy. I am married to a Colombian and linked to her EPS insurance with Commeva.

Clínica León XIII, Bloque 3, where surgeries are performed, photo courtesy of IPS Universitaria

Clínica León XIII, Bloque 3, where surgeries are performed, photo courtesy of IPS Universitaria

My Clínica León Experience – Day 1: Wednesday

I arrived at Clínica León XIII at about 10am on Wednesday with a referral from a doctor in Synergie Salud, Jumbo, Las Vegas, plus an ultrasound scan I had had done.

The referral said I had “Colecistatis / Colelitisis” (Acute or chronic inflammation of the gallbladder, which is usually caused by the presence of stones). And that I had a temperature of 38°C (normal temperature is between 35.7°C and 37.3°C); severe pain; various other bits of squiggle finished by the word “prioritorio” (get a move on).

The ultrasound showed something like a Manta Ray swimming around my liver.

By 11 am, I had been examined by two different doctors to assess my level of urgency. Neither of them wanted to trust my rather splodgy ultrasound, containing as it did the useful advice: “this patient is ill”. And they wanted to have another ultrasound done – this never happened.

I was assessed as moderate since I was not vomiting, the pain appeared to be bearable and I was a fetching shade of Jonquil rather than the bright yellow that might have convinced them that I was a bit poorly. Priority: Triaje 3.

Clínica León XIII, Bloque 1, photo by SajoR

Clínica León XIII, Bloque 1, photo by SajoR

Moved to a Holding Room on Day 1

I was moved to a holding room containing eight reclining chairs. And I was attached to a drip supplying antibiotics and pain relief chemicals. By about 5 pm I was moved to a room in Bloque 1 (Block 1), anticipating that I would receive surgery that night, but no.

The room: two beds each with a metal locker, and a wash hand basin in the corner. The room is joined to the next one along by space containing a shower and bathroom. There was no shower head, and no seat for the toilet, but, major plus point: hot water for the stream of water in the shower unit!

Supplied in the room are a bed with two sheets and a rubberized pillow without a pillow case. No toilet paper, no soap, no towels.

In the next bed was an old gentleman attended by his daughter whom I can only affectionately describe as a “Mamacita”: a fairly typical Colombian matriarch who wanted to take over my life and treat me like a new-born.

Within seconds I had my bed made, a cover improvised for the pillow, my one or two possessions stored in my cupboard. I also received strict instructions to share the communal toilet paper, my nose was wiped and my bottom patted. I had not eaten all day and had no appetite. So, I had to endure at least half an hour of Mamacita trying to persuade me to have something to eat.

A nurse arrived with a machine with fairly irritating alarm sound, which connected me by a tube to a drip with a controlled supply of antibiotics and pain relief. I was finally informed that I would not go to surgery that day and Mamacita achieved one of her life goals by feeding me with something basically chicken that she brought in from outside in a box, plus a very welcome bottle of Quatro.

In the finish it was easier to get swept away in the cyclone of care, assistance and amiability that Paisas in general are famous for.

End of day one.

My Clínica León Experience – Day 2: Thursday

Various people showed up to talk to me loudly and slowly as part of a very useful patient care policy (no sarcasm intended here).

A doctor declared that he was going to operate on me, that I must eat nothing in anticipation of this welcome event. But he could not give me a time for the operation which would have to be scheduled by the mystical powers of León XIII. By 4pm, not hungry but still unfed and no sign of a trip to the operating theatre, I was treated to my first sample of hospital food á la León XIII.

“What was the food like?” is possibly the most frequently asked question regarding hospital treatment. I don’t suppose you want blow-by-blow details of the meals but suffice it to say that the food was basic but adequate; well prepared and very welcome.

The dinner lady appears to be proud of her work and almost seemed to take it a as a personal slight if she found a stray grain of uneaten rice on the plates when she collected the dishes.

My Clínica León Experience – Day 3: Friday

Still hovering in the air was the possibility that I would go to surgery today. I don’t remember the sequence of events that alerted me to the possibility that in fact Monday was going to be the chosen day for this much needed relief. But the poor little nurse who delivered the information probably wished that someone else had drawn the short straw.

Mamacita and I had a quick discussion (she is bilingual, which came in handy). And we went together to the huge desk behind which the tiny jefe nurse was hidden. I explained to her that I had not officially eaten for several days. And that I was attached to the world by a very uncomfortable tube filling me with chemicals that I needed before the operation, an operation that may only take place in four days’ time.

Why can’t I go home for the weekend and come back on their drip just before an appointed time and date for surgery? I felt as if I had entered a twilight zone of prioritization, which was not going to assign a time for my surgery until I was bright yellow, projectile vomiting and writhing in agony.

The nurse made some calls on my behalf and I was soon visited by a second doctor who claimed to be my surgeon. He told me that the magic event is now definitely for 1:30 pm on Saturday with the usual advice to not eat anything. An anesthetist showed up to examine my prostheses (false teeth) and enquire if I am allergic to any medicine, and that was it: Game On!

Emergency Surgery - Day 4

Emergency Surgery – Day 4

My Clínica León Experience – Day 4: Saturday – Emergency Surgery

Hang out the flags and bunting! Finally, the day of my emergency surgery had arrived.

Various rituals took place relating to plugging and unplugging my drip, the inevitable blood pressure tests, and the fitting of the tailor-made, back-to-front gown.

Speedy Gonzales whizzed me on a hospital stretcher to the surgery unit, and as I was transferred from general use hospital stretcher to the operating room hospital stretcher it was like passing into a different world.

The general hospital, while being clean, shows inevitable signs of wear and tear. From what I could see from where I lay in the operating room complex, everything was bright, sparkly, pristine efficiency. This was except for the bloody blood pressure units and their incessantly beeping bloody alarms.

Relaxed, calm and in control, the anesthetist and today’s lucky surgeon explained to me what was about to happen, and then ‘bye-bye cruel world’ with a couple of whiffs of gas-and-air.

My Clínica León Experience – Day 5: Sunday

I received a deputation from a medical team and some students, all standing far enough away from me so that they won’t catch anything. My wife ran around with bits of paper, paid a couple of bills, and that was it.

Ejected into a beautiful, sunny Medellín afternoon with my case history and a prescription for survival at home.

Clínica León XIII, Bloque 3, photo by SajoR

Clínica León XIII, Bloque 3, photo by SajoR

My Overall Emergency Surgery Impression

The bottom line, Clínica León XIII is OK, basic but adequate.

Room for improvement:

  1. I should have gone for emergency treatment a lot sooner than I did. After the initial searing pain in my abdomen I waited for the pain to go away, which it did to a degree. I was uncertain what course to pursue. And I was aware that making an appointment to see a general doctor was going to involve a delay anyway. My self-diagnosis suggested that my liver had finally given up the ghost. And since livers cannot be fixed, there seemed to be no rush to consult a quack anyway.
  2. I finally went to Urgencias in Clinica las Vegas. They were thoroughly uninterested in my plight since they do not deal with people like me on Commeva health insurance.
  3. The doctor in the Commeva facililty for Urgencias, Prosalco, diagnosed that I had Gall bladder problems. And I believe that he should have sent me straight to Clínica León XIII for emergency surgery. Instead he prescribed some really welcome pain relief and an ultra-sound scan. (NEXT).
  4. Because I arrived at Clínica León XIII several days after the onset of the pain and because I appeared to be stable, they chose not to operate as soon as they probably should have. When I went to surgery, they discovered that my bladder was in a very poor condition and it was close to infecting me with peritonitis.
  5. Assigning a date and time for the operation seemed to be unnecessarily vague.
  6. I was discharged with a prescription. And when I presented it in an official Commeva pharmacy, they were unable to supply three out of five of the items listed. Why does Clínica León XIII not have its own pharmacy, which can ensure the availability of medication needed to complete treatment for discharged patients? (I bought the pills I needed in a discount pharmacy store).

EMI is a medical service that works by attending you at home, or, in fact, anywhere you might start feeling ill. I had been thinking about signing up for this service for some time. And this recent experience has finally convinced me to do so. This cost is 84,000 pesos per month for myself and my wife.

More About Clínica León XIII

Clínica León XIII is administered by the University of Antioquia and opened in 1950. This hospital provides a variety of services including, surgery, outpatient, hospitalization, clinical laboratory, ICU for adults, neonatal ICU and emergencies.

Clínica León XIII reportedly handles over 1,000 surgeries per month and the hospital has about 3,500 employees.

Colombia has 23 of the best hospitals in Latin America and Medellin has nine of these best hospitals but Clínica León XIII isn’t on this list.

Colombia has 23 of the Best Hospitals in Latin America

Colombia has 23 of the Best Hospitals in Latin America

The Bottom Line: Emergency Surgery – My Experience at Clínica León XIII

Overall, I was quite satisfied with healthcare I received. I consider the healthcare was basic but completely adequate. But there was definitely some room for improvement.

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