• Sinead Mulhern has been living in Ecuador for six years.
  
• Earlier this year, she spent a week in the hospital due to a collapsed lung, a severe complication of pneumonia.
• The support she received from the hospital staff and her friends confirmed that moving there was the right decision.

I was lying wide awake on a hospital bed in Ecuador, hoping for sleep yet fearful that if I dozed off, I'd miss something crucial.

Everything had come as a big surprise. The day before, I was standing by lime-green valleys, planning mountain adventures. As bachata beats blared from market stalls and birds of prey soared above, I thought about camping nearby and watching the sun sink below a sea of clouds. Or, I could return to the Monopoly board-like Andean town nearby and explore its river valleys.

But as I was daydreaming about adventures, I noticed something was wrong. I'd been having trouble breathing for a few days. As an avid runner and hiker, it felt strange that I could barely climb the steps to my apartment.

At the hospital in Cuenca — the city where I have been living for the past six years and about 200 miles south of Quito, Ecuador — I had a tube running between my ribs into the space between my lungs, an oxygen mask, and some answers. While I'd been in the countryside, my right lung had been collapsing. A severe — and rare — complication of pneumonia.

It got serious quickly

I returned to the doctor's clinic for a second visit after it was clear that an asthma inhaler and the medication hadn't helped. I had assumed I was in for a course of antibiotics and an early night.

Instead, I was sent for X-rays, and based on the technician's questions, I sensed this was more serious than I thought: "Were you in an accident?" "Are you a heavy smoker?" "Did you fall?" "Could something have caused blunt-force trauma?" I raised a brow. No to all of the above.

"We have to go to the hospital right now," my doctor told me after confirming that my right lung had collapsed. "I'm surprised you're even standing up talking to me right now."

It was a whirlwind evening. I messaged my friend Sanja, asking her to meet me at the hospital and bring a few essentials. I had been told that a surgeon was on her way and that they would perform a bronchoscopy, a procedure that involves inserting a tube between the lungs to examine the airways. Following this, a catheter would be inserted in between my lungs to drain the air buildup that had caused the collapse.

I was asked if I had family who could help me buy my medical supplies. I told them that would be Sanja.

I met Sanja in 2018, and she has become like a sister. We've supported each other through the ups and downs of expat life. She arrived shortly after the surgeon had explained in detail what she was about to do.

I felt scared and focused on my friend as the surgeon told me to hold my right arm above my head and stay still. Sanja asked the questions I was too in shock to ask for myself. I'd have been lost without her.

Medical care in South America

I grew up with access to Canadian healthcare. How would my hospital stay here compare? Would I be able to continue to live in Ecuador at altitude? Were my running and mountain adventures over?

I called my friend Jonathan in the morning, and he came right away. An Ecuadorian-American, he briefed me on what to expect and told our friends where I was.

My hospital stay lasted a week. As my anxiety subsided, I noticed differences in how things are done here. Many of them I preferred.

Visiting hours were relaxed, so I had friends popping by every day. I could see the mountains from my room. The pharmacy next door played Latin music. When I closed my eyes and listened, I felt the sun on my face and briefly forgot where I was. It was less formal too, which I preferred.

My insurance plan didn't cover this — a personal oversight I made because I figured I was healthy and possibly even invincible. Lucky for me, the care was high-quality and ended up costing a little over $3,000. I never had to wait for a room, procedure, specialist appointment, or check-up.

According to KFF, a nonprofit health policy group in the US, the average cost per day for an inpatient in a US hospital in 2022 was over $3,000.

I had no family but had built a community

I also saw the value of my personal connections and the caring Ecuadorian culture. People I didn't know well would call to check in, and friends of friends would send well wishes.

My doctor called my mom in Canada. A new friend drove me to an X-ray appointment. My friends brought tea, meals, and books. My Pilates instructor helped me regain strength.

As a foreigner in Ecuador, I sometimes feel out of place and lonely. In the hospital, though, I realized what a strong community I had built over the years.

My "chosen family" comes from the US, Ecuador, Australia, South Africa, England, and Venezuela. They are all the results of personal relationships I have built during the good times: parties, road trips, and adventures. Now, I understand that community is an investment in health, too.

From the outside, living abroad can look pretty convincing. My highlight reel is packed with nature, street art, slow mornings, and vibrant celebrations. But this was one of my lowest moments in Ecuador. And guess what? That gave me a different kind of reassurance.

Three months later, my body has healed, and I'm cleared to go up into the mountains again. Recently, I spent a bright sunny day hiking past sparkling lagoons, yellow flowers, and tangled forests. I'm grateful to know I'll have many more like this.

Got a personal essay about health emergencies while traveling that you want to shareGet in touch with the editor: [email protected].