Medellín vs Fortaleza, Brazil, which is really the better place to live? In our Medellín vs Fortaleza comparison, we comprehensively compare the two cities in 20 categories to see which is the better place to live in for expats.

We previously published an article about 11 reasons why Medellín is considered a top foreign retirement location. The foreign retirement publications have for several years been touting Colombia as a top foreign retirement location.

Also, the International Living retirement publication ranked the country of Colombia as its sixth best foreign retirement location in 2019. And Brazil is not even ranked by International Living.

However, Several Medellin Guru readers asked for a comparison of Medellín with Fortaleza, as the Live and Invest Overseas publication has been touting Fortaleza and even has called Fortaleza the “best beachfront bargain in the world today”.

Fortaleza is a Brazilian city on the northern coast of Brazil that isn’t as well known by foreigners as the larger cities of Rio de Janeiro and São Paulo in Brazil. And Fortaleza has a metro population of about 4 million.

Medellín is the second largest city in Colombia with a metro population of about 4 million located in a valley in the Colombian Andes Mountains in Colombia. And mountains surround Medellín with a river running though the city.

Many expats I have met living in Medellín prefer Medellín. And expats living in the Fortaleza tend to prefer Fortaleza. However, many of these expats living in one of these two places have never traveled to the other. It’s not really fair to compare two places if you have not been to both of them.

I have lived in Medellín for over eight years. But I have traveled several times on business and vacation to Brazil and I’ve been to Fortaleza three times. In my opinion, both places have their pluses and minuses. No place is perfect.

Note, the following 20 categories in this Medellín vs Fortaleza comparison are in no particular order. And where possible in our Medellín vs Fortaleza comparison, we provide some statistics to back up how we chose the winner of each category in our comparison.

Fortaleza, Brazil, photo by Arthur Fonseca

View of Medellín from Pueblito Paisa, photo by Jenny Bojinova

View of Medellín from Pueblito Paisa, photo by Jenny Bojinova

1. Climate – Medellín vs Fortaleza

Medellín wins here. The temperature during the year in Medellín averages 72.5 °F (22.5 °C). The Medellín weather and climate is a benefit of living in the city.

Also, Medellín is also known as “La Ciudad de la Eterna Primavera”, or the city of eternal spring. The average temperature in Medellín typically only varies by about 1 °F during the year.

In Medellín, the high daily average temperature ranges from 81.0 to 82.8 ° F (27.0 to 28.2 °C). And the low daily average ranges from 61.7 to 63.3 ° F (16.5 to 17.4 °C).

In comparison in Fortaleza, the temperature during the entire year averages a much warmer 79.9 ° F (26.6 °C).

During the year, the average high temperature in Fortaleza ranges from 85.1 to 87.3 ° F (29.5 to 30.7 °C). And the average low temperature typically ranges from 72.3 to 76.3 ° F (22.4 to 24.6 °C).

During the year on some days in Fortaleza it sometimes can get above 91.0 ° F (33.0 °C). With the warmer temperatures in Fortaleza, air-conditioning is needed by most people.

In terms of rainfall, in Medellín there is one month out of the year with heavy rain (October), which is normally over 220 mm (nearly 9 inches) of rain. The average rainfall in Medellín for the entire year is about 69 inches (1,752 mm) per year.

In comparison, it rains a similar amount in Fortaleza.  The average rainfall in Fortaleza for the entire year is about 62.2 inches (1,608.4 mm) per year.

But there is a rainy season for four months in Fortaleza with the two rainiest months when it rains two-third of the days. In March and April there is much more rain with typically over 320 mm (over 12 inches) of rain these two months.

In terms of humidity, Fortaleza has higher humidity on average. The humidity in Medellín averages 67 percent during the year. And in Fortaleza the humidity average 79 percent during the year.

Medellín arguably wins this category due to the warmer climate in Fortaleza which requires air-conditioning, which isn’t really needed in Medellín.

2. Cost of Living – Medellín vs Fortaleza

Medellín wins here. Apartment properties I have seen in Fortaleza tend to rent for or sell for at least 10-30 percent higher prices than similar properties in Medellín. And sometimes even higher.

The Expatistan cost of living website reports that the cost of living in Fortaleza is 13 percent higher than in Medellín.

In addition, the cost of living site Numbeo reports that the cost of living is more expensive in Fortaleza in almost every category compared to the prices in Medellín.

Both the Expatistan and Numbeo cost of living websites collect data using a crowdsourcing. Users enter prices for their own city and the more users that enter prices for a city, the more accurate comparisons will be. But this method has limitations. For more accurate cost of living information we recommend talking with expats living in the cities.

Some expats living in Brazil try to avoid the higher cost of living near the coast in Brazil by living in a small town in Brazil away from the coast.

Hospital Pablo Tobón Uribe, the best hospital in Medellín, photo by SajoR

Hospital Pablo Tobón Uribe, the best hospital in Medellín, photo by SajoR

3. Healthcare – Medellín vs Fortaleza

Medellín wins here.  Good healthcare is a very important category for retirees.

Medellín has nine of the top 58 ranked hospitals in Latin America. And Colombia has 24 of the best hospitals in Latin America.

In comparison, Fortaleza has none of the top ranked hospitals in Latin America. Most of the top ranked hospitals in Brazil are located in São Paulo.

Here is a list of all the top ranked hospitals in Medellín, with the rankings in the top 58 hospitals in Latin America:

  • Hospital Pablo Tobón Uribe (#9)
  • Hospital Universitario de San Vicente Fundación (#16)
  • Clínica las Américas (#26)
  • Clínica Universitaria Bolivariana (#28)
  • Hospital General de Medellín (#33)
  • Clínica El Rosario (#41)
  • Clínica Cardio Vid (#42)
  • Clínica Medellín (#43)
  • Clínica Las Vegas (#53)

In addition, WHO ranks Colombia’s healthcare system as #22 out of 191 countries it ranked, which is ranked higher than many wealthier countries like the United States (#37), Germany (#25), Canada (#30) and Australia (#32).

Brazil’s healthcare system is ranked much lower than Colombia’s healthcare system by WHO, as they rank Brazil at #125 out of 191 countries.

The bottom line is that Medellín has nine of the top hospitals in Latin America compared to Fortaleza with none of the top hospitals in Latin America. Also, WHO ranks Colombia’s healthcare system much higher than the healthcare system in Brazil. So, Medellín wins this category.

4. Traffic – Medellín vs Fortaleza

The two cities arguably tie here. In a survey by Waze in 2016, Medellín was ranked #176 in the world in terms of drivers’ satisfaction out of 186 metros surveyed and Fortaleza was ranked #151.

Both Medellín and Fortaleza have a metro population of about 4 million. So, the cities are of similar size population wise. I experienced traffic similar to Medellín while I was in Fortaleza.

In addition, traffic can get bad in Medellín during rush hours. It can sometimes take an hour or more during rush hour to get to some places in Medellín. The worst traffic in the Medellín metro in my experience tends to be in El Poblado, El Centro and Envigado.

However, there is worse traffic in Latin America than is found in Fortaleza or Medellín. In my experience, the traffic is much worse in the bigger cities of Bogotá, São Paulo and Mexico City.

Medellín's Metro

Medellín’s Metro

5. Public Transportation – Medellín vs Fortaleza

The two cities tie here.  Both Fortaleza and Medellín have metro systems and extensive networks of buses.

The Medellín Metro is a comprehensive and inexpensive system. Furthermore, it integrates two rail lines, five Metrocable cable-car lines, two Metroplús elongated bus lines, a Tranvía tramcar line and even feeder Metro buses. Medellín’s metro system has over 60 stations throughout the city.

Inside a metro train in Fortaleza, photo by Ruan Moreira

Inside a metro train in Fortaleza, photo by Ruan Moreira

In comparison, the Fortaleza Metro has three rail lines and over 40 stations but is being expanded. So, it will grow to have over 50 stations.

In addition, both Medellín and Fortaleza have extensive networks of public buses. And the buses in both cities are inexpensive.

6. Safety – Medellín vs Fortaleza

Medellín wins here. Medellín generally has lower crime rates than are found in the city of Fortaleza.

Brazil even broke its own homicide record in 2017. Brazil recorded 63,880 homicides in 2017, representing a homicide rate of 30.8 per 100,000. And in Fortaleza the homicide rate is even higher.

Fortaleza is considered one of the most dangerous cities in the world with a homicide rate of 83.5 per 100,000. This makes it the 7th most dangerous city in the world.

In comparison, the homicide rate in Medellín of 24.75 per 100,000 inhabitants in 2018 was up from a homicide rate of 20 in 2015 in Medellín.

But over the past few years Medellín has experienced a homicide rate that is lower than is found in St. Louis, Baltimore, Detroit or New Orleans in the U.S. Furthermore, Medellín dropped off of the list of the 50 most dangerous cities in the world a few years ago based on homicide rates.

The high homicide rate in Brazil isn’t the only security issue. In addition, in 2017, Brazil registered more than 60,000 cases of rape, but experts say the true figure could be higher.

Gang violence in Brazil has affected major cities like Fortaleza. Also, local citizens and visitors alike are often targeted by criminals in Fortaleza, especially during public festivals.

We previously looked at security in Medellín and expat safety tips. And in a survey of 12,548 Colombians, Medellín ranked higher than all other cities in Colombia in terms of citizens feeling safe in their barrio (neighborhood) – slide 41.

Generally, most tourist areas in Fortaleza are safe for tourists during the day. But these areas can become quite risky after dark. So, travel in groups and take taxis at night. In addition, our Medellín safety tips also apply in Fortaleza.

7. Pollution – Medellín vs Fortaleza

Fortaleza wins here Medellín has pollution problems. According to the World Health Organization’s (WHO’s) 2018 Ambient Air Quality Database, Medellín is ranked #9 out of the most polluted cities and towns in Latin America based on PM2.5 pollutants.

Medellín’s biggest issue is that it’s located in a canyon. Mountains surround the city of Medellín. So, pollution tends to stay in the Medellín metropolitan area. This is similar to the problem in Denver in the U.S. But fairly regular rain in the city can help clean the atmosphere.

Fortaleza is located on the coast in Brazil. So, air pollution problems are not as bad as in Medellín. In general, Fortaleza has less air pollution than is found in Medellín. So, Fortaleza wins this category.

However, according to WHO, in Latin America several cities and towns have worse air pollution than in Medellín. Lima, Peru; Monterrey, Mexico; five towns in Chile; and Guatemala all have worse air pollutant problems.

Pinto Martins International Airport in Fortaleza, photo by ME/Portal da Copa

Pinto Martins International Airport in Fortaleza, photo by ME/Portal da Copa

8. Travel Access to North America, Europe and Latin America 

Medellín wins hereThe Pinto Martins International Airport in Fortaleza (FOR) has non-stop flights year-round to only seven international locations in the U.S., Europe, and Latin America.

From Fortaleza you can fly non-stop to Miami and Orlando in the U.S. And to Europe you can fly non-stop to Amsterdam, Frankfurt (ends November 2019) and Paris.

Also, from Fortaleza you can fly non-stop to many cities in Brazil but only Panama City and Buenos Aires in Latin America. However, the service to Panama City on Copa ends on July 25, 2019. To get to many international locations from Fortaleza you need to connect in Rio de Janeiro or São Paulo.

Inside the terminal at José María Córdova airport in Medellín

Inside the terminal at José María Córdova airport in Medellín

Medellín’s José María Córdova international airport (MDE) is the second largest airport in Colombia. This airport has non-stop flights to 12 international locations in the U.S., Europe and Latin America.

From the MDE airport there are non-stop flights available to Fort Lauderdale, Orlando, Miami and New York (JFK) in the U.S. In addition, from MDE you can fly non-stop to Madrid in Europe. Also, you can fly non-stop to Cancún, Lima, Maracaibo, Mexico City, Panama City, San Salvador and Valencia.

In addition, there are more domestic Colombia flights available from Medellín as the city has two airports: the international José María Córdova airport and the domestic Olaya Herrera airport (EOH). From Medellín’s two airports you can fly non-stop to over 30 cities in Colombia.

The bottom line you can fly non-stop to 12 international locations in the U.S., Europe and Latin America from Medellín. So, Medellín wins this category.

9. Cost and Time to Travel from the U.S.

Medellín wins here. It is cheaper and quicker to travel from the U.S. to Medellín than traveling from the U.S. to Fortaleza.

It’s important to not only look at flight availability but also look at the cost and length of flights. Proximity to the U.S. is important for some expats from the U.S. that travel home for family or work.

We previously looked at finding cheap flights to Medellín. For example, it’s possible to find roundtrip from New York to Medellín for under $400 and roundtrip from Los Angeles to Medellín for under $500.

From New York to Fortaleza, the cheapest roundtrip I found in July was $1,038 with connections in Orlando and São Paulo – which is more expensive than the cost of flying to Medellín. And from Los Angeles to Fortaleza, the cheapest roundtrip I found in July was $1,065 with a connection in Orlando.

Also, Medellín is much closer to the U.S. than Fortaleza in Brazil. For example, it’s only about a three-hour non-stop flight from Miami to Medellín and a six-hour non-stop flight from New York to Medellín.

In comparison, it’s a seven-hour non-stop flight from Miami to Fortaleza and about a 12-hour flight from New York to Fortaleza with a connection in Miami.

Since the flights to Fortaleza from the U.S. are more expensive and much longer flights, Medellín wins this category.

Praia do Futuro (Future Beach) in Fortaleza, photo by ME/Portal da Copa

Praia do Futuro (Future Beach) in Fortaleza, photo by ME/Portal da Copa

10. Things to Do – Medellín vs Fortaleza

Medellín wins here. Medellín generally has more things to do than in Fortaleza in the city and nearby.

TripAdvisor has 230 things to do listed for Medellín. And it has 192 things to do listed for Fortaleza. While this is unscientific it demonstrates there are somewhat more things to do in the city of Medellín compared to the city of Fortaleza.

If we include Medellín plus the other municipalities in the Aburrá Valley and nearby pueblos, TripAdvisor has over 400 things listed to do. But TripAdvisor is missing many of the things to do in each pueblo near Medellín.

For example, for some pueblos, TripAdvisor has only one thing listed to do, which is inaccurate, as every pueblo near Medellín has many things to do. This is due to many pueblos near Medellín not being in the tourist guides like Lonely Planet, which only lists three pueblos near Medellín. So, many pueblos aren’t accurately covered on TripAdvisor.

The bottom line is that there are over 400 things to do in the Medellín metro area and the nearby pueblos.  But Fortaleza has less than 200 things to do listed on TripAdvisor. So, Medellín arguably wins this category.

11. Restaurants and Nightlife – Medellín vs Fortaleza

Fortaleza wins here. Both Medellín and Fortaleza have many good restaurant options. But you will have a much bigger choice of restaurants in Fortaleza.

If you look on TripAdvisor, it lists over 5,800 restaurants in Fortaleza but less than 1,600 restaurants in Medellín. Both Fortaleza and Medellín have many good restaurant options. But you will have a much larger choice of restaurants in the city of Fortaleza.

In terms of nightlife, Fortaleza a similar number of nightlife options compared to Medellín due to both cities having a metro population of about 4 million.

Since Fortaleza has more restaurant options, Fortaleza wins this category.

12. Taxes – Medellín vs Fortaleza

The two places tie here. We highly recommend talked to a tax professional to understand the tax implications before moving to another county.

Tax residents in both Brazil and Colombia are taxed on worldwide income. In both Brazil and Colombia, you become a tax resident after spending 183 days in a year in the country.

Brazil tax residents are liable to a progressive tax on their worldwide income ranging between 0 – 27.5 percent. And Colombia tax residents are liable to a progressive tax on their worldwide income ranging between 0 – 33 percent.

We looked at filing income taxes in Colombia in 2017. Colombia has many income deductions including deductions for expenses related to receiving your income, mortgage interest, health insurance, retirement savings and economic support of dependents. Also, foreign pensions (up to a limit) are reported exempt from taxes in Colombia.

In addition, in Colombia, you can exclude 25 percent of your salary (up to a limit) from income taxes. Also, some income taxes paid in another country are subtracted from income taxes due in Colombia.

Property taxes in Colombia typically range from 0.3 to 3.3 percent. In Brazil, there is an annual property tax (IPTU) for properties that varies depending on the size of the home and typically ranges from 0.5 to 1.5 percent.

The standard VAT (IVA tax) tax is the same in Brazil and Colombia, which is currently at 19 percent for many items.

13. Job Opportunities – Medellín vs Fortaleza

The two cities arguably tie here. Both cities are similarly sized. So, there are a similar number of job opportunities in both cities.

Both Fortaleza and Medellín have several very large employers and several multinational companies have offices in both cities that are headquartered in the U.S.

But there aren’t that many work opportunities in either place for foreigners. This is particularly the case in Fortaleza if you don’t speak Portuguese fluently and Medellín if you don’t speak Spanish fluently. Fluency in the local language is typically required for the best jobs in both Brazil and Colombia.

Also, to work in either Brazil or Colombia will require a visa.

14. Expat Community and Expat Friendly

Medellín arguably wins here. The expat community in Fortaleza appears to be much smaller than in Medellín.

I would estimate there may be less than 5,000 expats from North America and Europe living in Medellín. And three expats I met living in Fortaleza all told me there are not many expats from North America living there, likely less than 1,000.

In addition, the expat community in Medellín is much better organized than in Fortaleza. Medellín has several large expat groups on Facebook that are very active including:

I couldn’t find any Fortaleza expat groups on Facebook. Furthermore, in Medellín there are many regularly organized meetups for expats each week. Three expats I met living in Fortaleza told me there rarely are organized meetups in Fortaleza.

Finally, Colombia is rated as an expat friendly country by InterNations. In 2018 when looking at the best and worst places for expats, InterNations ranked Brazil as one of the least expat friendly countries – #65 out of 68 countries. And Colombia is ranked #9.

It looks like Medellín has a larger expat community and is better organized than in Fortaleza. Also, Colombia is ranked as a much friendlier country for expats. So, Medellín wins this category.

15. Internet Availability and Infrastructure Reliability

Medellín wins here.  In Medellín it is possible to get faster high-speed Internet than in Fortaleza

In Medellín, it is possible to get up to 300 Mbps Internet speed from Claro. In addition, up to 150 Mbps speed is available from Tigo-UNE and up to 40 Mbps from Movistar.

Most buildings in Medellín will have service from at least one of these three providers. And all three providers in Medellín provide triple-play Internet/TV/phone services. Also, we have a guide to Internet and cable TV providers in Medellín.

In Fortaleza, it is possible to get up to 120 Mbps Internet speed from NET, 100 Mbps from TIM and up to 100 Mbps speed is available from Vivo. And these providers all offer triple-play Internet/TV/phone services.

Furthermore, the highest speed Internet in both cities will normally be available only in the newest apartment buildings. In older buildings, you may be limited to lower speeds.

In terms of other infrastructure like electricity and water, the two places are similar. In both places and electricity and water services are generally reliable.

16. Economic Freedom, Ease of Starting a Business and Corruption

Medellín wins here. Since both places are in different countries it is good to compare the countries in terms economic freedom and ease of starting a business as well as corruption when considering them as places to live.

The Heritage Foundation ranks countries in terms of economic freedom. It ranks Colombia as a “moderately free country”. It ranks Colombia #42 out of the 180 countries it ranks in terms of economic freedom in the world.

Heritage Foundation ranks Brazil much lower than Colombia with a “mostly unfree country. It currently ranks Brazil #150 out of 180 countries in terms of economic freedom.

Brazil has a bloated and overly centralized federal government, which has been crushing economic freedom for decades in Brazil.

In terms of ease of doing business, Colombia is ranked #65. And Brazil is ranked #109 in terms of ease of doing business. So, it’s generally easier to do business in Colombia.

Corruption is found in both countries. Brazil is ranked #105 out of 180 countries in terms of corruption perception by Transparency International. And Colombia is ranked #96. So, corruption is perceived to be somewhat worse in Brazil.

Since Colombia ranks better than Brazil in terms of economic freedom, ease of doing business and corruption perception, Medellín wins this category.

The Viva Envigado Mall in Envigado

The Viva Envigado Mall in Envigado

17. Shopping – Medellín vs Fortaleza

The two cities arguably tie here.  Both Medellín and Fortaleza are similar sized cities and have many shopping options.

We have looked at 22 malls in Medellín including the 13 best malls in Medellín. There are five malls in Medellín with at least 400 shops each.

For example, Santafé mall is one of the largest malls in Medellín with over 400 shops. And in October 2018, Viva Envigado, the largest mall in Colombia opened in Envigado, directly south of Medellín, which also has about 400 shops.

Fortaleza also has many malls. The largest mall in Fortaleza is reportedly Shopping Iguatemi, which is a large shopping center with over 300 shops. Other malls in Fortaleza include RioMar, Shopping Parangaba, Via Sul Shopping, Shopping Benfica and several others.

The bottom line is that both cities have many malls and many shopping options.

18. English Proficiency Levels – Medellín vs Fortaleza

The two cities tie here. In both Medellín and Fortaleza you won’t find many locals that speak English.

In both Medellín and Fortaleza, you will find some English speakers in hotels and nicer restaurants. And some of the taxi drivers and shopkeepers in both cities speak some English. Also, executives at larger companies typically are bilingual.

But in everyday life in Medellín and Fortaleza you will be challenged to find English speakers.

Education First ranks Brazil as #53 in its English Proficiency Index with a score of 50.93, which means a low level of English proficiency. And Colombia is ranked #60 with a score of 48.90, which is also a low level of proficiency (a higher number signifies that more people speak English).

If you want to be able to speak to all the locals in Fortaleza, you will need some Portuguese. And if you want to speak to all the locals in Medellín, you will need some Spanish.

19. Learning the Language – Medellín vs Fortaleza

Medellín wins here. For those wanting to integrate, learning Portuguese is reportedly considered to be somewhat more difficult to learn than learning Spanish. Some expats that move to a foreign country want to learn the local language to better integrate and be fully self-sufficient.

In addition, Spanish has more native speakers than Portuguese. And Spanish is spoken in many more countries than Portuguese. Spanish is the most spoken language in the world after English in terms of the number of countries.

Since Spanish is considered somewhat easier to learn and is more widely used in the world, Medellín arguably wins this category.

20. Ease of Getting a Visa – Medellín vs Fortaleza

Medellín wins this category. Colombia and Brazil both have a number of visa options. And the visa processes for both countries are fairly straightforward.

However, Brazil’s visas generally have higher income and investment requirements and take longer to get.

For example, a retirement visa in Brazil requires a pension income of at least 6,000 Brazilian reals, which is about $1,509 USD at the current exchange rate.

In comparison the Colombia retirement visa in 2019 only requires a monthly pension income of 2,484,348 Colombian pesos (COP) per month ($741 USD at the exchange rate of 3,353 COP to USD).

The Brazil investment visas also have higher investment requirements than the Colombia investment visas. For example, a business investment visa in Brazil requires an investment of over $134,000 USD compared to about $25,000 USD in Colombia.

Colombia streamlined its visa process a couple years ago and you can apply online, fewer documents are required and approvals are now relatively fast, typically in about a week or two. And visas in Brazil reportedly can take at least a month to receive.

Also, Brazil has required visas for citizens from the U.S., Canada, Australia and other countries to enter Brazil as a tourist. There was a new e-Visa for tourists to Brazil from the U.S., Australia, Canada or Japan, which streamlines this but it’s still a hassle. However, starting on June 17, 2019, Brazil will no longer require visas for tourists from the U.S., Australia, Canada or Japan.

Medellín wins this category due to Colombia having lower income requirements and lower investment requirement needed for visas than in Brazil.

The Medellin Guru City and Place Comparisons 

We have compared living in Medellin with living in several foreign locations:

Also, we have compared living in different cities in Colombia:

Fortaleza at night, photo by Pedro Queiróz Ribeiro

The Bottom Line: Medellín vs Fortaleza 

In our Medellín vs Fortaleza comparison:

  • Medellín wins in 12 of our 20 categories.
  • Fortaleza wins in 2 of our 20 categories.
  • The two cities tie in 6 categories.

So, in this unscientific and somewhat subjective Medellín vs Fortaleza comparison of 20 categories, Medellín easily beats Fortaleza if you equally weigh the categories.

We found that Fortaleza doesn’t compare very well with Medellín. But it really comes down to which categories are more important for you. For example, if having a lower cost of living, “eternal spring” climate, better healthcare and proximity to the U.S. are your most important categories, then Medellín would win for you.

And if having beaches, less pollution, and a bigger restaurant selection are your most important categories, then Fortaleza would win for you.

Both of these places in our Medellín vs Fortaleza comparison have their pluses and minuses. I prefer living in Medellín due to it having an eternal spring climate year-round, low cost of living, good healthcare and proximity to the U.S.

The bottom line in our Medellín vs Fortaleza comparison is that the best place to live is the best place to live for you. Everyone has different priorities. The only way to know which place is the best for you is to spend time there.

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Editors note: updated on October 29, 2019 with new 2019 hospital rankings in Latin America.

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