In the ISSS, and health clinics doctors are given 15 minutes maximum to spend per consultation. Patients often must wait a month for an appointment. Specialization appointments can sometimes require 3-4 month waiting periods. If patients are late they are often given a new appointment for one month later. Equipment is old and outdated and doctors are ordered to use costly treatments as infrequently as possible.
Medication is often poor quality and in insufficient quantity.
Even basic medication such as pre-natal vitamins for pregnant woman is rationed out so a woman receives enough for two to 3 weeks every month rather than enough for a daily dosage throughout the course of her pregnancy. The doctors were in their third strike this year, the first strikes by a union of doctors in El Salvador. Since then an additional work stoppage has been held nationally and the situation remains unresolved. It lasted for 24 hours. The first strike came 8 months after negotiations were halted by the ISSS, to send a message to the ISSS leadership with the aim of re-opening negotiations.