Today we adventured to Tigre, Buenos Aires, to witness life on the islands. On our boat ride across the river, I noticed many unique aspects about the local culture. As everything is separated by the river, services that would normally be done by roads, such as busing kids to school and delivering groceries, are done by boat. Upon our arrival at the primary care center at Tigre, we were given a tour of the facility and were educated on the services provided there. Looking around, it was very unlike a typical US primary care facility, with an extremely small capacity (only four rooms and six chairs in the waiting room area) and limited specialties.
After discussing with the chief EMT at Tigre, we concluded that there are many issues in regards to this public hospital, including a lack of adequate staffing, transportation, capacity, and funding. Across the whole municipality, with a population of roughly 10,000 (more in the summer months) and a span of over 200 km, there is only one ambulance that is available for emergency services. The ambulance was a smaller motorized boat that contained equipment for various emergencies. This service is limited in many ways, most importantly, by harsh weather conditions that can prevent the boat from reaching a patient in need. While there is a system in place to categorize the urgency of the emergency, calls and other communication systems are often blocked by poor service, again limited the island’s ability to provide quality care to everyone in a timely fashion.
After departing the primary care center at Tigre, we enjoyed a lunch at Vivanco and then took a bus to another public health facility in San Isidro. This area belongs to Sanitary Region V in Buenos Aires and is run by local taxes. While this is a public hospital, people with addresses outside of San Isidro are often rejected in order to serve the local community first, except in cases of emergency. This can again lead to delays in care for patients outside of the area who don’t have access to private care. Increasing primary care facilities can help patients receive care that is more proactive and, in turn, limit the burdens on public hospitals.
While the public system, in theory, is supposed to be available to everyone, this is not always the case. Today, we saw firsthand the disconnect between primary care facilities and hospitals within the public sector. Since drastic changes to the economy in recent events, the need for primary care from the public sector has significantly increased. However, solely receiving federal funding from taxes is not enough to mend this disconnect and inequality faced by the public primary care centers and hospitals. As primary care is cheaper, people often lead toward this option over hospitals which can lead to extreme overcrowding and high demands for smaller, more local, facilities such as the one in Tigre. A main part of this issue is that provinces and municipalities manage their own healthcare services, which can result in uneven quality, fragmentation of services, and insufficient care. The public health sector’s reliance on federal funding from taxes is insufficient to help support these gaps in healthcare. The budget constraints on the public sector from recent economic instability hinders equitable care. This has led a system where those with private insurance receive faster, higher quality care through private hospitals like Austral while the rest of the population is left vulnerable to health disparities.
¡Adios amigos, hablaremos mas mañana!
