Ecuador
Risk Overview
Ecuador presents two separated risk environments. The mainland combines arrival altitude in Quito, volcano climbing above 5,000 metres, and a security situation that has deteriorated in parts of the coast and Guayaquil in recent years, warranting current-state checks before travel. The Galápagos, a thousand kilometres offshore, swap those risks for isolation: strong-current diving, limited medical capability and long transfer times to the mainland for anything serious.
Medical Infrastructure
Quito and Guayaquil hold the capable facilities. In the Galápagos, capability is limited to basic clinics; there is a hyperbaric facility on Santa Cruz whose operational status should be verified case by case rather than assumed. Any serious medical event in the islands is a mainland evacuation, and commercial flight schedules are not an emergency plan.
Entry Requirements
Most nationalities enter visa-free for tourism. Galápagos entry requires a transit control card, park fee and proof of onward travel; requirements are checked at mainland airports before boarding. Verify current rules, including any security-related state-of-emergency measures on the mainland.
Altitude and Dive Notes
Galápagos diving involves currents, cold thermoclines and remote sites; it is not beginner diving, and the distance from definitive care argues for conservative profiles. On the mainland, acclimatise in Quito before attempting Cotopaxi or Chimborazo, and use guided ascents with operators who carry oxygen.