Between Illness and Hunger: Adequate nutrition is a cornerstone of patient care in hospital settings, essential not only for physical recovery but also for psychological well-being. When patients are malnourished, their ability to heal diminishes, complications increase, hospital stays lengthen, and in severe cases, mortality rises. Globally, studies have repeatedly highlighted the prevalence of malnutrition among hospitalized patients. For instance, a study in Australia and New Zealand found that 32% of patients were malnourished and nearly a quarter consumed less than 25% of the meals provided. Similarly, research in Türkiye reported malnutrition risk in 11.6% of hospitalized patients overall, with rates climbing to 20.4% among those over 65.
Ecuador is no exception to this trend. A comprehensive study of 5,355 patients across 36 public hospitals in 22 provinces revealed that 37.1% of hospitalized patients were malnourished. While this underscores the critical importance of hospital nutrition, Ecuador’s public healthcare system is currently grappling with severe food shortages, jeopardizing patient health and dignity.
The roots of this crisis lie in historical and recent healthcare reforms. Although Ecuador did not formally adopt neoliberal health-sector reforms, it experienced several structural changes, including cuts to public budgets and partial outsourcing of services. Public health expenditure reached only 1.5% of GDP in 2000, increasing gradually after the right to health was enshrined in the 2008 Constitution, peaking at 5.28% of GDP in 2021, before declining again to 4.9% in 2022. Despite this progress, budget allocations for essential hospital services, particularly food, have fallen sharply in recent years.
The Ongoing Food Shortage in Ecuador’s Public Hospitals
Between 2023 and 2025, the Ecuadorian Ministry of Health’s budget decreased from USD 3.2 billion to USD 2.7 billion. Allocations specifically for food, security, and cleaning services fell from USD 115.8 million to USD 37.2 million—a drastic 67.8% reduction equivalent to USD 78.6 million. Compounding the issue, funds often arrive late or in small installments, leaving hospitals with unpaid debts to food suppliers, sometimes reaching USD 60,000.
Hospitals in major cities including Quito, Guayaquil, Ambato, Santo Domingo, and Orellana have reported inability to provide complete meals to patients. In many instances, patients have relied on donations from food banks and local organizations. For example, Quito’s food bank donated more than 1,700 kilograms of chicken, vegetables, and other supplies since June 2025 to alleviate shortages. Even hospital staff have been forced to bring food for patients during on-call shifts to fill nutritional gaps.
Impact on Patients and Healthcare Workers
Malnutrition in hospitalized patients exacerbates illness, delays recovery, and increases the likelihood of complications. For vulnerable populations, including elderly patients and those with chronic conditions, the consequences can be severe. Hospitals’ inability to consistently provide meals violates patients’ right to health and dignity.
Healthcare workers are also affected. Many rely on hospital-provided meals during long shifts and on-call duties. Staff members have resorted to sharing their own food with patients to mitigate the crisis. Yet, some hospitals continue to insist on serving five meals per day on paper while restricting families from providing external food, leaving patients at risk.
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Broader Systemic Challenges
The food crisis highlights wider structural deficiencies in Ecuador’s public healthcare system. Hospitals already face chronic shortages of medicines and medical supplies, compounded by multimillion-dollar debts to external providers of essential services, including laboratory testing, imaging, and dialysis. Many providers have suspended operations due to unpaid bills, further straining hospital capacity.
The convergence of malnutrition, inadequate medical supplies, and financial instability underscores the urgent need for comprehensive healthcare reform and increased budget allocations to public hospitals. Without intervention, patient outcomes will continue to deteriorate, and the system will face escalating costs and inefficiencies.
Conclusion
Ecuador’s ongoing hospital food crisis represents a critical threat to patient health and well-being. Malnutrition among hospitalized patients delays recovery, increases complications, and can be life-threatening, while also violating fundamental rights to health and dignity.
Budget cuts, delayed fund disbursements, and inadequate supply chains have left hospitals unable to provide essential nutrition, forcing reliance on donations and ad hoc staff interventions. The situation underscores the fragility of Ecuador’s public healthcare system, which is further burdened by shortages of medicines, medical supplies, and unpaid debts to service providers.
Addressing this crisis requires immediate action, including increased funding, improved resource allocation, and stronger oversight of hospital nutrition programs. Failing to do so risks further deterioration in patient outcomes, public trust, and the overall sustainability of Ecuador’s healthcare system.
Proactive interventions to ensure adequate hospital nutrition can protect patients’ health, accelerate recovery, and uphold the country’s commitment to the right to health.
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FAQs of Between Illness and Hunger
1. How prevalent is malnutrition among hospitalized patients in Ecuador?
A study across 36 public hospitals in 22 provinces found that 37.1% of hospitalized patients were malnourished, highlighting the urgent need for consistent nutrition support.
2. What caused the current food shortages in Ecuador’s hospitals?
The crisis stems from budget cuts between 2023 and 2025, delayed fund disbursements, and reduced allocations for food, security, and cleaning services, leaving hospitals unable to meet patient nutritional needs.
3. How does hospital malnutrition affect patient health?
Malnutrition increases the risk of complications, delays wound healing, prolongs hospital stays, raises readmission rates, and in severe cases, can be fatal. It also worsens the psychological well-being of patients.
4. Are healthcare workers affected by the food crisis?
Yes, many staff members rely on hospital-provided meals during shifts. Shortages have forced them to bring food for patients or share their own meals, increasing their burden.
5. What solutions could address the hospital food crisis in Ecuador?
Immediate interventions include increasing budget allocations, timely fund disbursement, improving hospital supply chains, leveraging food banks strategically, and stronger government oversight to ensure patients receive adequate nutrition.
