Hello everyone!! Enjoy my presentation on Ecuador! It is a simple assignment I was required to do for a nursing program I am involved with. Basically, it is a simple display of Ecuadorian culture (which was not easy to do...Ecuadorian culture and history is vast!) as it applies to the profession of nursing.

1. {
Ecuador
Cultural Understanding For Optimal Nursing Care

2. Approximately 18,000 Ecuadorians have immigrated and live within
Canadian borders. A majority of these people are settled within the
province of Ontario. Provision of nursing care of the Canadian
Ecuadorian can be improved with a basic understanding of the
people, their history, their cultural and spiritual beliefs, their
economy, and so forth. As well, this understanding would be prove
valuable for the nurse wishing to work abroad and considering the
South American nation of Ecuador.
Ecuador: Caring For It’s People

3. Ecuador: Official National Symbols

4. Ecuador: The Geography
• In 1830, Ecuador derived it’s name from the Spanish
word for the equator, which crosses it’s entire
northern sector.
• Ecuador has three mainland regions: the Coast, the
Sierra, and the Amazonia, or the Oriente. It measures
approximately 109,493 square miles, or 283,600 square
kilometers.
• Ecuador is located in western South America and is
the second smallest South American nation. It shares
borders wit Colombia to the north, Peru to the east
and south, and it’s western region along the South
Pacific Ocean.
• Ecuador also includes the Galapagos Islands in the
Pacific Ocean, approximately 1000 kilometers west of
the mainland.
• The landscape of Ecuador is variant and includes
tropical rainforests, wet-dry monsoon regions, snow-
capped volcanic mountains, and rich, fertile valleys.

5. • Ecuador’s economy is the eighth largest in Latin
America, with an average growth of 4.6%
between 2000-2006, yet it remains one of the
poorest nations.
• Oil accounts for 40% of exports and is a major
contributor to a positive trade balance.
• Ecuador exports bananas, flowers, and cocoa.
Productions of shrimp, sugar
cane, rice, cotton, corn, palm, and coffee are also
significant.
• Ecuador has potential for economic growth in
raw materials, manufactured
textiles, mining, oil, petrochemical, chemical, glas
s, pharmaceutical, and timber industries.
• The official currency of Ecuador is the U.S. dollar.
• Despite current economic opportunities, many
indigenous people continue to follow traditional
lifestyles.
• It is estimated that 55% of Ecuador’s indigenous
population lives in poverty, with 28.6% living
below the poverty line.
• The extreme poverty rate was estimated o be
17.4% of the total population in 2011.
• It is believed that over 300,000 children are
working as child laborers in Ecuador.
• Ecuador has a per capita income of $5, 820.
Ecuador: The Economy

6. • Ecuador has an approximate population of 15, 223, 680 people.
• The major coastal city of Guayaquil accounts for nearly
4,000,000 people, while the capital city of Quito contains
approximately 2,000,000 of the nations residents.
• All other residents reside within other smaller city
centers, coastal villages, and indigenous communities.
• The people of Ecuador are divided into ethnic
groupings, represented by the following terms:
Mestizos, Montubios, Afroecuatorianos (Blacks), Indigenas
(Amerindian), Blancos (White), and Other.
Ecuador: The People

7. Whites and Mestizos:
• Most privileged ethnic groups representing the top of Ecuador’s
social pyramid.
• Descendants from Spain, Italy, France, Germany, and Lebanon.
• Generally successful and employed as high-status
professionals, merchants, government officials, and financiers.
• While both Whites and Mestizos share many
commonalities, Mestizos are generally viewed as being slightly
inferior to Whites within a social hierarchy.
Blacks:
• Descendants of African slaves who worked on coastal sugar
plantations in the 16th century.
• Earn their livelihood in agriculture, general labor, fishing, and
working on cargo boats.
• Hold a slightly higher position in the ethnic hierarchy than other
indigenous peoples.
• Light-skinned blacks receive more opportunity than dark-skinned
blacks, simply because of a more similar resemblance to Whites
and Mestizos.
Ecuador: Ethnicity And Social Class Defined

8. Sierra Indians:
• Live in the intermountain valleys of the Andes and are
separated from whites and mestizos by a caste like gulf.
• Sierra Indians are usually poor and often illiterate. Most
often, Whites and Mestizos view Sierra Indians as inferior.
• Visible markers of ethnicity (for example, hairstyle) separate
Sierra Indians from the general population.
• Speak with indigenous language (Quichua), but may also be
fluent in Spanish.
Oriente Indians:
• Early indigenous people of the Amazonic region.
• Speak with two main indigenous languages, Quichua and
Jivaroan. May also be fluent in Spanish.
• Maintain similar social status as the Sierra Indians within
Ecuadorian culture.
• Oriente Indians view themselves as separate than other Indian
groups, but quickly join ranks when common causes arise.
The people of
Ecuador take
great pride in
being called
‘Ecuadorian’.
They insist, and
make it clear that
identification as
‘Ecuadorian’ is
for all it’s people.
It is not only for
the elite and
upper-middle
classes.

9. • Within Ecuador, there is a great importance placed on the
family, both extended and nuclear.
• The basic domestic unit focuses on the mother as being both
the nurturer and household manager, while the father
provides both financial and legal responsibility. This system
exists in all of Ecuador’s cultures and class levels.
• Men attempt to keep their nuclear and extended families near
them. Elderly Ecuadorians will often live with their children
until death.
• Godparents are quite important in Ecuador and often are
expected to provide financial support to their godchild.
• Families are formalized in one of two ways: Civil Marriage or
Free Union. Civil Marriage is a legal process which all
married couples are required to undergo. Free Union is
simply when a man and woman decide to form a family
without a legal process. Regardless of their
differences, Ecuadorian Constitution provides both family
structures with equal rights.
• Children are cherished immensely in Ecuadorian culture.
They are raised to appreciate respect to all people, their
community, their country, and to God.
• Homosexual activity is legal in Ecuador, but same-sex couples
are not granted all of the same legal protections as
heterosexual couples. Child adoption is not granted to
homosexual couples, but there are no laws denying a single
person the opportunity to adopt.
Ecuador: The Family

10. • Woman make up a considerable segment of the
workforce, especially in the areas of
finance, university teaching/research, and NGOs.
They are involved in political and government
roles, including indigenous and Afroecuadorian
rights and movements.
• Gender roles vary immensely across ethnicities and
classes, ranging from equal status to male-dominated
ideals.
• Through time, woman have gained significant legal
rights over their property and children within the
court setting.
• Woman in rural areas are traditionally held
responsible for the care of their husband and
children, however, with more woman joining the
workforce, these roles are slowly changing. Men are
increasingly choosing to take on domestic roles.
• Girls tend to be more protected than boys within
traditional family settings.
• Within indigenous communities, tradition prevails as
identifying the woman as the domestic caregiver
within the family unit and the man as the provider of
the physical necessities of life.
Ecuador: Gender Roles And Statuses

11. • Ecuadorian Constitution requires that children attend an
educational institution until they attain a ‚basic level of
education‛, which is estimated at nine school years.
• In 1996, the primary school enrollment rate was estimated
to be 96.9%, with 71.8% of those children staying in school
until the fifth grade.
• The financial cost of primary and secondary education is
the responsibility of the government. However, families
are often burdened with significant additional expenses
(for example, transportation cost).
• The number of quality public schools needed in relation to
the population falls below minimal requirements. Class
sizes are very large and families often find it necessary to
pay for a more adequate education, despite their financial
means.
• Only 10% of children in rural areas proceed to high school.
• The mean number of educational years actually completed
by Ecuadorians is 6.7.
• Ecuador has sixty-one universities and three hundred
institutes of higher education.
Ecuador: Education

12. • Catholicism is the primary religious following in
Ecuador, although other religions exist.
• According to the Ecuadorian National Institute of
Statistics and Census, the breakdown in spiritual
belief is as follows:
80.44% Catholics
11.30% Protestants
1.29% Jehovah’s Witnesses
6.97% Other
• 7.9% of the Ecuadorian population is believed to be
Atheist, while 0.11% are presumed Agnostic.
Ecuador: Spirituality

13. • Food preparation in Ecuador is diverse, varying with associated
agricultural availability, and altitude.
• There are several Ecuadorian meals that are typical to the various
regions of the country. For example, a popular dish on the coast is
ceviche. This is a meal prepared with seafood marinated in lime
juice, served with cassava bread. Conversely, people of the
mountainous regions prefer meat (particularly guinea
pig), potatoes, rice, and white hominy.
• Most regions in Ecuador follow a traditional three course meal of
sopa (soup), segundo (second dish; usually includes rice and protein
source), and dessert with coffee.
• Drinkable yogurt is very popular in Ecuador, often consumed with
pan de yuca (warm bread filled with cheese).
• A wide variety of fresh fruits are often available, especially at
lower altitudes.
• Religious influence will sometimes determine food preparation
and consumption in Ecuador. For example, Fanesca ( a fish and
bean soup) is often eaten by Catholics during Lent and Easter.
• Despite the availability of food across the nation, 25.8% of
Ecuadorians suffer from malnutrition due to a variety of
political, geographical, and economic factors.
Ecuador: The Food

14. • The Ecuadorian Ministry of Public health strives to provide social
support and healthcare services to all populations within it’s
national boarders.
• Patients may be seen daily in public general hospitals by general
practitioners without a scheduled appointment.
• There is also ‘external consultation’ available for the following
disciplines: pediatrics, gynecology, clinical medicine, and surgery.
• Specialty hospitals are available and part of the public health care
system. There are ontological hospitals for cancer
patients, psychiatric hospitals, gynecological/maternity
hospitals, children’s hospitals, geriatric hospitals, and so on.
• Major cities have modern, fully equipped general hospitals, while
smaller villages and canton cities generally are limited to basic
care in gynecology, pediatrics, clinical medicine, and surgery.
• Community healthcare centers are available within the cities and
rural areas for patients requiring a short stay less than 24 hours.
• Most rural communities with a large indigenous population have
a ‘rural doctor’ assigned to them. These physicians run small
clinics to meet the health needs of the people in the same manner a
day hospital would in a metropolitan area. Respect for the culture
of the people is considered a critical component of care given.
• Public healthcare does differ from the Ecuadorian Social Security
healthcare service. This health service is for individuals with
formal employment obliged by their employer to contribute.
People without formal employment can become part of this
system, but it is often unaffordable. The Ecuadorian Institute of
Social Security (IESS) has several major hospitals and institutions
throughout the nation.
Ecuador: Healthcare Service Positives

15. • Despite attempts to have equal access to healthcare across
the nation of Ecuador, the combination of 40+ indigenous
groups, their languages, and their remote geographic
locations have made this endeavor quite difficult.
• Ecuador’s poorest (those living in Amazonia, central
provinces, and urban shantytowns) receive no medical
treatment from the two main public sources: the Public
Health Ministry and the Social Security Institute.
• It is estimated that as much as 30% of Ecuadorian people
lack immediate access to healthcare services.
• It has also been suggested that as many as 70% of the
population are without health insurance and cannot afford
to pay for medical services.
• Many indigenous people have to rely on traditional
medicine and aide from NGO’s and volunteers.
Ecuador: Healthcare Service Negatives

16. • Due to environmental conditions, unavailability of healthcare
services, and environmental conditions, Ecuadorians are at risk for
many diseases.
• Some of the more common health problems in Ecuador are
malnutrition, health problems due to smoking, diabetes, heart
disease, HIV/AIDS, tuberculosis, malaria, dengue fever, diarrhetic
disease, acute respiratory infection, and infant mortality.
• There are an estimated 14, 000 new cases of tuberculosis each year.
• Growth retardation from malnutrition affects 26% of children under
the age of 5.
• There are approximately 686 malaria cases amongst every 100,000
people.
• Infant mortality is estimated to be 24 per 1000 live births.
• Life expectancy at birth is 78 years.
• Rates of malnutrition are worse for indigenous people, with
Afroecuadorian being at highest risk.
• Different geographical regions also present with unique health risks.
For example, lack of oxygen in the Andes because of high altitudes
place people at high risk for altitude sickness.
• In the Amazon, diseases like malaria and yellow fever are prevalent
due to transfer of disease through mosquitos. Deforestation in this area
has increased breeding grounds for mosquitos and, in turn, has
resulted in more cases of insect borne diseases.
• In Ecuador, only 21.9% of households have access to clean drinking
water. Only 5% of wastewater is treated and less then half of
households have sewer systems. Therefore, water borne diseases , like
cholera, can be transferred easily.
• Air pollution is high in Ecuador and result in many respiratory and air-
born illnesses. As well, there has been an increase in the number of
illnesses caused by the uses of agricultural pesticides and chemicals.
Ecuador: Health Risks

17. • As with any persons of immigration, always consider the
influence of their particular culture when providing care.
• Something as simple as a proper initial greeting can
influence a relationship. For example, Ecuadorians prefer a
smile, a handshake, and direct eye contact when
communicating. They are comfortable with close body
proximity during conversation. However, only close
friends or family will commonly use their first name.
• Ecuadorians are known to be polite and highly tuned to
body language and non-verbal communication.
• Ecuadorians view blunt communication as rude and
generally speak with courtesy. They are non-
confrontational and will generally say what they think will
please a person.
• The family is a critical unit within Ecuadorian culture and
often, health care decisions are decided by this entire unit.
• Spirituality is also highly regarded within Ecuadorian
culture. Health, nutrition, and other personal practices can
often be determined by religious beliefs, keeping in mind
the majority of Ecuadorians are Roman Catholic.
• Indigenous background and an understanding of how
different cultures live and view each other is also highly
important when caring for the Ecuadorian person.
Ecuador has a vast number of unique cultures and a
cemented view on social ranking.
Canadian Ecuadorians: Nursing Considerations

18. • Serious consideration of the Ecuadorian’s health care history and a
knowledge of culturally associated risks and exposures is critical
when providing healthcare to the individual. Knowledge of
immunization records, if they exist, is quite beneficial.
• Consider the many languages and dialects of the Ecuadorian
culture and the potential for communication struggles and the
need for an interpreter.
• With knowledge of the extreme levels of poverty within
Ecuador, understanding the environment from which an
individual has come from can produce many clues regarding
current health status and risks.
• Knowledge of the Ecuadorian’s education level may prove
useful, as well, in providing appropriate health
teaching, particularly knowing that Ecuador has many struggles
with it’s education provision.
• In essence, always remain culturally sensitive when providing care
for the Ecuadorian, or any person in general. Maintaining respect
and good communication with all individuals will help to ensure
optimal health care is delivered.

19. “Knowledge is power? No. Knowledge
on it’s own is nothing, but the
application of useful knowledge, now
that is powerful.” – Robert Liano