The Lancet Student

Contrasts

This blog was submitted by Natalia on 10th June 2011.
Tagged with Public Health

Latin America is generally regarded as the most unequal region of the world[1].However, one could easily believe that Argentina, with life expectancy at 75 years[2] and main mortality causes being cardiovascular disease and cancer[3], is doing OK, at least when it comes down to health care. But there are two sides to every story, and this is no exception.

Life in Argentina’s biggest cities, such as Buenos Aires, differs greatly from reality in remote villages, and even in the outskirts of the capital. Medical technology isn’t available everywhere. Even within a 45 min drive from the capital, some hospitals refer you to another hospital for a urinalysis and an X-ray.Most doctors stay in the cities, simply because that’s where the job opportunities are, so hospitals in distant towns not only lack technology but they’re seriously understaffed.

How does the system work, you ask? Well, there’s the private sector, the social security sector and the public sector. The public sector, which accounts for most of the population (roughly, 25 million people) depends on the government and is decentralized, which means again that the quality of it depends on where you live. In some public hospitals, you have to wait up to 2 months to get an appointment with a cardiologist, for instance. Other hospitals only see a fixed number of patients everyday, so if you want to be seen on that day, you’ll have to be there at 4 am and hope to make it within the first 50 patients.

And what about the diseases official statistics tend to overlook? Almost 2 million people suffer from Chagas disease[4]. TB has been increasing steadily over the past few years, with an incidence of over 10000 new cases and almost 1000 deaths every year[5]. 150000 people are HIV positive and many of them don’t know they have the disease[6].In some states, infant mortality is close to 20%[7]. In those same states, many women die from complications of illegal abortions.In Argentina and Latin America 4 million people drink water polluted with arsenic every day[8].It is ridiculous, to say the least, that in a country that was once dubbed “barnyard of the world”, children die everyday of undernourishment and malnutrition.

Most of these diseases can be prevented with governmental action: decent housing, safe drinking water, better education, vaccination campaigns… But with only a small fraction of the national budget destined to Health Care and unofficial unemployment rates close to 20%, there’s a huge part of the population that just can’t afford to be sick. And, still, with a limited budget, how do you choose what to prioritize and what to leave to its own devices?

Argentina is not just the country of soccer and tango, but of social inequity and poverty-related diseases also. It’s just an example, one of the many countries that may seem to be doing OK, but if you look close enough they’re not. Many other countries in Latin America are going through a similar situation.

Doctors are just one of the many factors that are needed to provide better health care. Most of the responsibility is in the hands of the state. But it falls unto us as future doctors to see things for what they really are… and to become a force of change to ensure a better tomorrow for our people.