One item that appears to be a real hardship for many ex-pats in Ecuador (South America in general I'm sure), is time. We peoples from the states particularly are so accustomed to a life of 'tight now'. That concept does not exist down here.
Folks that we have met and interacted with don here, fall into two categories. "I get it' and 'I don't understand.' This culture does not understand '4:17PM' or 'tight now.' Things happen in their own time and if you can adapt to that, you will fit in fine.
We all want to believe that we not only can let go, but that we are looking forward to letting go. Believe me because I have seen plenty of it, a lot of folks are NOT capable at this point. Too bad really because it is truly liberating.
In fact, start now. If the lack of stress is intolerable for you, then don't come South.