As most of you who have followed AHD over the years know, one key part of our mission is to build a financially self-sustaining model of healthcare in rural Latin America that isn’t permanently dependent on huge infusions of funding from the U.S. After trying many strategies, we have found a formula that has largely succeeded. Our two hospitals last year were 100% self sustaining on an accrual basis, and 70% on a cash basis.
Like many things in the developing world, this sustainability is fragile. Our in-country revenue is dependent on partnerships with Ecuador’s public sector and on some payments from patients in the community who can afford to pay a modest amount.
The main public sector financing agencies in Ecuador (the Ministry of Health and the Social Security Administration) are inadequately funded in the best of times, and it often takes them over a year to pay for services that we provide to our patients.
But the current situation in Ecuador is grave. The country is deeply in debt. Its major source of revenue is oil. When the price of oil is high, Ecuador can do things like build better roads and even build some hospitals and clinics. But the price of oil has plummeted in recent weeks, which will decimate Ecuador’s budget, right at the time when it needs to spend money to battle the coronavirus.
Unfortunately, this means that the Ministry of Health and Social Security Administration will likely stop or significantly reduce their payments to AHD for quite a while. Our challenge will be to figure out a way to reduce our own costs, while maintaining the critical health care services that our communities need now more than ever. While this situation is daunting, this type of uncertainty is something that we have grown used to over the years, and we have faith that between our supporters in the States, and the amazing ingenuity and dedication of our staff on the ground, AHD will get through this current crisis.