Today we had an amazing and very educational time visiting both an island health clinic via a boat ride in Tigre and a public hospital in San Isidro. We learned about challenges they faced being part of the public sector and what a possible solution could be.
The clinic we visited had four rooms, a general adult appointment room (which can include primary physician, psychiatrist, nutritionist, etc), a pediatric office, a dentist office, and an emergency room. However, no treatment beyond an appointment can be supported here. If the patient needs treatment or an overnight stay, they need to go to the mainland for a hospital.
On the boat ride over and while speaking to the captain of the speed boat ambulance pictured to the right, we discussed the various challenges faced by the residents of the many islands across the 200km area that are only serviced by one ambulance and two health clinics, only one with emergency capabilities. Also, because the rivers are the only way to get anywhere in this area, seeking care is highly dependent on weather and river conditions. Many will miss appointments or forgo treatment due to rain or cold because of travel conditions and the fact that there is no indoor clinic.
However, the only factors that would prevent the ambulance from getting to a location are if the fog is too dense, they have to cross the larger river during severe weather (which can be dangerous), or if the health care team would be put in danger by going.
While at the clinic, we also had the amazing opportunity to participate in one of the clinic’s health promotion initiatives… a dance class! We looked very silly in our business casual outfits, trying to follow the lead of the nurse who teaches the class, only doing two of ten moves right, but we had so much fun dancing with the nurse and some of the members of the community who were attending the lesson.
During our visit to the public hospital in San Isidro, we attended a lecture in which we learned about challenges that the public sector faces. A major obstacle is receiving enough funding and beds for patients. An aspect of Argentine culture that complicates this is that they are a hospital culture, going for anything as mild as a stomach bug or anything beyond basic first aid. Regarding funding, the hospital is financed by local taxes and subsidized by the provincial Ministry of Health, if enough need is demonstrated and money is available. Additional funds can be given through national programs, such as support for patients with diabetes. For public hospitals to receive any funding, extensive amounts of paperwork are required to explain the need and what the money would be used for.
A relatively new development in response to the changing political atmosphere is that now people can be turned away from a public hospital if they do not live in the local area, unless it is an emergency. This is because the hospitals are primarily funded from local taxes so it is the new stance that the people who are paying for the service should receive as much of it as possible, as opposed to those who have not paid into the system.
However, the solution to funding issues and hospital overcrowding brings me to the importance of Primary Care. By focusing on early health intervention such as proper vaccine scheduling, healthy diets, regular exercise, health education, and seeking care from outpatient primary care physicians, more people can stay out of the hospital. This not only frees up room and time in the hospital for those who truly need emergency care, it also saves the hospital money to put towards better services to patients, up-to-date technology, and a higher quality of care. Patients can also experience a better quality of life and can spend less time in the hospital waiting while treatment is brief.
We had first-hand experience and education today about the benefits of primary health care promotion and a push towards dehospitalization to not only save hospitals time and money, but to give a better quality of care to patients and a better quality of life to those who will fortunately not be patients because of early intervention