Costs

Costs in Ecuador have risen since the official currency was changed to the US dollar, but it’s still affordable. Budget travelers can get by on $15 per day, staying in the cheapest hotels, eating almuerzos (set lunches) and cheap dinners, and taking buses rather than taxis. Bump it up to $30 per day, and you can stay in modest but comfortable hotels, take cab rides when you’re feeling lazy, eat in better restaurants, visit museums, go out at night and cover the occasional $10 national park fee. Spending $50 to $70 per day will allow you to sleep and eat in style and do all the aforementioned fun stuff.

Things get expensive when you start adding tours (climbing, mountain-biking, bird-watching and other tours cost $35 to $80 per day), staying at jungle lodges or haciendas and – priciest of all – when you visit the Galápagos Islands.

Tipping

Better restaurants add a 12% tax and a 10% service charge to the bill. If the service has been satisfactory, you can add another 5% for the waiter. Cheaper restaurants don’t include a tax or service charge. If you want to tip your server, do so directly – don’t just leave the money on the table.

Tip porters at the airport about $0.25 per bag and bellboys at a first-class hotel about $1 per bag. Hairdressers receive $0.50 or more for special services. Taxi drivers are not normally tipped, but you can leave them the small change from a metered ride.

Guides are usually paid low-wages, and tips are greatly appreciated. If you go on a guided tour, a tip is expected. If you are in a group, tip a top-notch guide about $5 per person per day. Tip the driver about half that. If you hire a private guide, tip about $10 per day.

If you are going on a long tour that involves guides, cooks and crew (eg the Galápagos Islands), tip about $25 to $50 per client per week, and distribute among all the personnel.

Money

Ecuador’s official currency is the US dollar. If you’re not traveling from the USA, consider bringing a small supply of US dollars with you on your trip in case you have trouble exchanging currency from your home country. Western Unions are in most big cities.

ATMs

ATMs are the easiest way of getting cash, period. They’re found in most cities and even in smaller towns, though they are occasionally out of order. Make sure you have a four-digit PIN; many Ecuadorian ATMs don’t recognize longer ones. Bancos del Pacífico and Bancos del Pichincha have MasterCard/Cirrus ATMs. Bancos de Guayaquil and Bancos La Provisora have Visa/Plus ATMs.

Cash

US dollar bills are the official currency. They are identical to those issued in the USA. Coins of one, five, 10, 25 and 50 cents are identical in shape, size and color as their US equivalents, but bear images of famous Ecuadorians rather than US presidents. Both US and Ecuadorian coins are used in Ecuador. There are no plans to print Ecuadorian versions of US dollar bills. The US$1 ‘Sacajawea’ coin is widely used.

The biggest problem when it comes to cash is finding change. It can be hard to cash a $20 bill even in big cities. No one ever has sueltos (literally ‘loose ones, ’ meaning ‘change’), so change your bills when you can. Forget about changing a $50 or $100 bill outside a bank.

Credit cards

Credit cards are great as backup. Visa, MasterCard and Diners Club are the most widely accepted cards. First-class restaurants, hotels, gift shops and travel agencies almost always accept MasterCard or Visa. Small hotels, restaurants and stores don’t. Even if an establishment has a credit-card sticker in the window, don’t assume that credit cards are accepted. In Ecuador, merchants accepting credit cards will often add between 4% and 10% to the bill. Paying cash is often better value.

Moneychangers

It is best to change money in the major cities of Quito, Guayaquil and Cuenca, where rates are best. Because banks have limited hours, casas de cambio (currency-exchange bureaus) are sometimes the only option for changing money. They are usually open 9am to 6pm Monday to Friday and until at least noon on Saturday. They’re entirely credible places, though the exchange rate might be a percentage point or so lower than that given by banks.

If you’re in a pinch, cambios (as they’re abbreviated) at the airports and major hotels in Quito and Guayaquil stay open past the usual hours.

Euros, Peruvian pesos and Colombian nuevos soles are the easiest currencies to exchange in Ecuador.

Traveler’s checks

Commission for changing traveler’s checks ranges from 1% to 4%, with the highest rates charged in small towns. Traveler’s checks are safer than cash because they are refunded if they are lost or stolen. Don’t bring all of your money in traveler’s checks, however. It’s always useful to have a supply of US cash and an ATM card.

Before you go

Make sure you’re healthy before traveling. If going on a long trip, make sure your teeth are OK. If you wear glasses, take a spare pair and your prescription.

If you require a particular medication, take an adequate supply, as it may not be available locally. Know the generic name, as well as the brand, to make getting replacements easier. To avoid problems, have a legible prescription or letter from your doctor to show that you legally use the medication.

Recommended vaccinations

Plan ahead for getting your vaccinations: some require several injections, and some vaccinations should not be given together or should be avoided during pregnancy and by people with allergies – discuss this with your doctor at least six weeks before travel. Be aware that there is often a greater risk of disease for children and pregnant women.

Dangers & annoyances

Just remember: most crimes and accidents can be avoided by using common sense. Ecuador is a safe and wonderful country for travel. No matter where you travel, it’s wise to get some travel insurance.

Drugs

Imbibing illegal drugs such as marijuana and cocaine can either land you in jail, land your money in the hands of a thief, or worse. Unless you are willing to take these risks, avoid illegal drugs.

Lonely Planet has received a couple of letters from travelers who were unwittingly drugged and robbed after accepting food from a stranger. You can see the mistake that was made here.

Scams

Be wary of false or crooked police. Plainclothes ‘policemen’ may produce official-looking documents, but always treat these with suspicion, or simply walk away with a smile and a shrug. On the other hand, a uniformed official who asks to see your passport in broad daylight in the middle of a busy street is probably just doing a job.

Theft

If travelers had to confess their top five stresses, one would surely be Backpack Separation Anxiety (BSA). It’s most commonly experienced when travelers are required to place their backpacks in a bus’s luggage compartment or overhead rack. Aside from craning your neck at every stop until it snaps, there’s little you can do to prevent it being stolen. But rest assured – for the most part, the bag-checker is on your side and knows whose bags are whose. Definitely keep your eye on it (or carry a pack small enough to bring on the bus), but don’t worry yourself silly. Bag theft occurs, but not very often. Some people buy a grain sack in the market and pack their bag in it so it will blend in with the cargo.

Armed robbery is rare in Ecuador, although parts of Quito (especially the Mariscal Sucre neighborhood) and some coastal areas are dangerous.

Sneak theft is more common, and you should always watch your back (and back pockets) in busy bus stations, on crowded city buses and in bustling markets. All of these places are worked by bag-slashers and pick pockets. But you can avoid playing victim to them by being smart.

Carrying your wallet or passport in a back pocket is advertising. But also avoid lifting your shirt and whipping out your money pouch in public. Instead carry a wallet with a small amount of spending money in your front pocket and keep the important stuff hidden in your money pouch beneath your clothes.

Leaving money in the hotel safe deposit boxes is usually reliable, but make sure that it is in a sealed, taped envelope. A few travelers have reported a loss of money from deposit boxes in the cheaper hotels. Theft from hotel rooms happens only on those rare occasions when Bad Worker and Careless Tourist (who leaves valuables in the open) cross paths.

Trouble spots

Due to the armed conflict in neighboring Colombia, areas along the Colombian border (particularly in the northern Oriente) can be dangerous. Tours into the Oriente are almost invariably safe, but there have been a few isolated incidents of armed robbery in which no one was hurt. Lago Agrio is dodgy once you leave the main drag.

While you're there

Availability & cost of health care

Medical care is available in major cities, but may be difficult to find in rural areas. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance. If you develop a life-threatening medical problem, you’ll want to be evacuated to a country with state-of-the-art medical care. Since this may cost tens of thousands of dollars, be sure you have insurance to cover this before you depart. Pharmacies in Ecuador are known as farmacias.

Cholera

This is the worst of the watery diarrheas, and medical help should be sought. Outbreaks of cholera are generally widely reported, so you can avoid such problem areas. Fluid replacement is the most vital treatment – the risk of dehydration is severe, as you may lose up to 20L a day. If there is a delay in getting to a hospital, then begin taking tetracycline. The adult dose is 250mg four times daily. Tetracycline is not recommended for children under the age of nine or for pregnant women. Tetracycline may help shorten the illness, but adequate fluids are required to save lives.

Dengue fever

This viral disease is transmitted by mosquitoes and is fast becoming one of the top public-health problems in the tropical world. Unlike the malaria mosquito, the Aedes aegypti mosquito, which transmits the dengue virus, is most active during the day and is found mainly in urban areas, in and around human dwellings.

Signs and symptoms of dengue fever include a sudden onset of high fever, headache, joint and muscle pains (hence its old name, ‘breakbone fever’), and nausea and vomiting. A rash of small red spots sometimes appears three to four days after the onset of fever. In the early phase of illness, dengue fever may be mistaken for other infectious diseases, including malaria and influenza. You should seek medical attention as soon as possible if you think you may be infected.

Hepatitis A

Hepatitis A is the second most common travel-related infection (after traveler’s diarrhea). It’s a viral infection of the liver that’s usually acquired by ingestion of contaminated water, food or ice, as well as through direct contact with infected persons. The illness occurs throughout the world, but the incidence is higher in developing nations. Symptoms may include fever, malaise, jaundice, nausea, vomiting and abdominal pain. Most cases resolve without complications, though hepatitis A occasionally causes severe liver damage. There is no treatment.

The vaccine for hepatitis A is safe and highly effective. If you get a booster six to 12 months later, it lasts for at least 10 years. Because the safety of hepatitis A vaccine has not been established for pregnant women or children under age two, they should instead be given a gamma globulin injection.

Hepatitis B

Like hepatitis A, hepatitis B is a liver infection that occurs worldwide but is more common in developing nations. Unlike hepatitis A, the disease is usually acquired by sexual contact or by exposure to infected blood, generally through blood transfusions or contaminated needles. The vaccine is recommended only for long-term travelers (on the road more than six months) who expect to live in rural areas or have close physical contact with the local population.

Hepatitis B vaccine is safe and highly effective. However, a total of three injections are necessary to establish full immunity. Several countries added hepatitis B vaccine to the list of routine childhood immunizations in the 1980s, so many young adults are already protected.

HIV & AIDS

Infection with the human immunodeficiency virus (HIV) may lead to acquired immune deficiency syndrome (AIDS), which is a fatal disease. Any exposure to contaminated blood, blood products or body fluids may put the individual at risk. The disease is often transmitted through sexual contact or dirty needles – vaccinations, acupuncture, tattooing and body piercing can be potentially as dangerous as intravenous drug use. HIV/AIDS can also be spread through infected blood transfusions; Ecuador’s best clinics screen their blood supply. If you do need an injection, ask to see the syringe unwrapped in front of you, or take a needle and syringe pack with you.

Leishmaniasis

This is a group of parasitic diseases transmitted by sandflies. Cutaneous leishmaniasis affects the skin tissue, causing ulceration and disfigurement, and visceral leishmaniasis affects the internal organs. Seek medical advice, as laboratory testing is required for diagnosis and correct treatment. Avoiding sandfly bites is the best precaution. Bites are usually painless but itchy. Cover up and use insect repellant.

Malaria

Malaria is transmitted by mosquito bites, usually between dusk and dawn. The main symptom is high spiking fevers, often accompanied by chills, sweats, headache, body aches, weakness, vomiting or diarrhea. Severe cases may involve the central nervous system and lead to seizures, confusion, coma and death.

Taking malaria pills is recommended for all rural areas below 1500m. Risk is highest along the northernmost coast and in the northern Oriente. There is no malaria risk in the highlands.

There is a choice of three malaria pills, all of which work about equally well. Mefloquine (Lariam) is taken once weekly, starting one to two weeks before arrival and continuing through the trip and for four weeks after return. The problem is that a certain percentage of people develop neuropsychiatric side effects, which may range from mild to severe. Atovaquone/proguanil (Malarone) is a newly approved combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side effects are typically mild. Doxycycline is a third alternative, but may cause an exaggerated sunburn reaction.

In general, Malarone seems to cause fewer side-effects than mefloquine and is becoming more popular. The chief disadvantage is that it has to be taken daily.

Protecting yourself against mosquito bites is just as important as taking malaria pills, since none of the pills are 100% effective.

If you do not have access to medical care while traveling, you should bring along additional pills for emergency self-treatment, which you should take if you can’t reach a doctor and you develop symptoms that suggest malaria, such as high spiking fevers. One option is to take four tablets of Malarone once daily for three days. However, Malarone should not be used for treatment if you’re already taking it for prevention.

If you develop a fever after returning home, see a physician, as malaria symptoms may not occur for months.

Rabies

This viral infection is fatal. Many animals can be infected (dogs, cats, bats and monkeys etc), and it is their saliva that is infectious. Any bite, scratch or even lick from an animal should be cleaned immediately and thoroughly. Scrub with soap and running water, and then apply alcohol or iodine solution. Medical help should be sought promptly to receive a course of injections to prevent the onset of symptoms and/or death.

Typhoid

A dangerous gut infection, typhoid fever is caused by contaminated water and food. Medical help must be sought.

In its early stages, sufferers may feel they have a bad cold or flu on the way, as initial symptoms are a headache, body aches and a fever that rises a little each day until it is around 40°C (104°F) or more. The victim’s pulse is often slow relative to the degree of fever present – unlike a normal fever, during which the pulse increases. There may also be vomiting, abdominal pain, diarrhea or constipation.

In the second week, the high fever and slow pulse continue, and a few pink spots may appear on the body; trembling, delirium, weakness, weight loss and dehydration may occur. Complications such as pneumonia or perforated bowel may occur.

Typhus

This is spread by ticks, mites and lice. It begins as a severe cold followed by a fever, chills, headaches, muscle pains and a body rash. There is often a large and painful sore at the site of the bite, and nearby lymph nodes become swollen and painful.

Yellow fever

This viral disease is endemic in South America and is transmitted by mosquitoes. The initial symptoms are fever, headache, abdominal pain and vomiting. Seek medical care urgently and drink lots of fluids.

Traveler’s diarrhea

To prevent diarrhea, avoid tap water unless it has been boiled, filtered or chemically disinfected (iodine tablets); only eat fresh fruits or vegetables if cooked or peeled; be wary of dairy products that might contain unpasteurized milk; and be highly selective when eating food from street vendors.

If you develop diarrhea, be sure to drink plenty of fluids, preferably an oral rehydration solution containing lots of salt and sugar. A few loose stools don’t require treatment but, if you have more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrheal agent (such as loperamide). If diarrhea is bloody or persists for more than 72 hours or is accompanied by fever, shaking chills or severe abdominal pain you should seek medical attention.

Altitude sickness

Altitude sickness may develop in travelers who ascend rapidly to altitudes greater than 2500m, including those flying directly to Quito. Being physically fit does not in any way lessen your risk of altitude sickness. Symptoms may include headaches, nausea, vomiting, dizziness, malaise, insomnia and loss of appetite. Severe cases may be complicated by fluid in the lungs (high-altitude pulmonary edema) or swelling of the brain (high-altitude cerebral edema). Most deaths are caused by high-altitude pulmonary edema.

The standard medication to prevent altitude sickness is a mild diuretic called acetazolamide (Diamox), which should be started 24 hours before ascent and continued for 48 hours after arrival at altitude. Possible side effects include increased urination, numbness, tingling, nausea, drowsiness, nearsightedness and temporary impotence. For those who cannot tolerate acetazolamide, most physicians prescribe dexamethasone, which is a type of steroid. A natural alternative is gingko, which some people find quite helpful. The usual dosage is 100mg twice daily.

To lessen the chance of getting altitude sickness, you should also be sure to ascend gradually or by increments to higher altitudes, avoid overexertion, eat light meals and avoid alcohol.

If you or any of your companions show any symptoms of altitude sickness, you should be sure not to ascend to a higher altitude until the symptoms have cleared. If the symptoms become worse, immediately descend to a lower altitude. Acetazolamide and dexamethasone may be used to treat altitude sickness as well as prevent it.

Hypothermia

If you are trekking at high altitudes, be prepared. Symptoms of hypothermia are exhaustion, numb skin (particularly in the toes and fingers), shivering, slurred speech, irrational or violent behavior, lethargy, stumbling, dizzy spells, muscle cramps and violent bursts of energy. To treat mild hypothermia, first get the victims out of the wind and/or rain, remove their clothing if it is wet and replace it with dry, warm clothing. Give them hot liquids – not alcohol – and some high-energy, easily digestible food. Do not rub victims; instead, allow them to slowly warm themselves.

Parasites

Intestinal worms are most common in rural, tropical areas. Some worms, such as tapeworms, may be ingested by eating food such as undercooked meat, and some, such as hookworms, enter through your skin. Infestations may not show up for some time, and although they are generally not serious, if left untreated, some can cause severe health problems later. Consider having a stool test when you return home to check for these.

You should always check all over your body if you have been walking through a potentially tick-infested area, as ticks can cause skin infections and other, more serious, diseases.