Argentina's health system devastated but health workers rally.

Abstract

The financial crisis of the past year has had a devastating impact on health care in Argentina. With an unemployment rate of about 20% and an estimated 19 million of the population of 37 million living below the national poverty line, public clinics and hospitals have been swamped with patients who can no longer participate in private insurance systems sponsored by unions and employers. Speakers at the Fifth Argentine Health Congress, held in August in Mendoza, painted a stark picture. An estimated 18 million Argentines now have no medical coverage and must depend on the overburdened public health system. The Argentine peso had been on a par with the US dollar for a decade but with the devaluation it is now worth little more than 25 US cents. This has caused the price of imported drugs and medical supplies to skyrocket and supplies to fall. "Practically 80% of the supplies we use are imported, from a simple glove to the latest antibiotics," Francisco Diaz, president of the Association of Private Clinics Sanatoriums and Hospitals, told the newspaper La Nacion. Ruben Torres, director of Health Services in the Health Ministry, announced that annual per capita spending on health care in Argentina had dropped from US$ 650 to US$ 184 because of the devaluation, a drop from one of the highest rates in Latin America to one of the lowest. Dr Horacio Mingrone of the F.J. Muniz Hospital in Buenos Aires said in an interview that patients are waiting longer to seek medical treatment because of their economic situation. "Their first priority is to find a way to live, to eat, the care for their families," he said. "Health comes second." Dr Mingrone, whose hospital specializes in infectious and respiratory diseases, said that the patients who come to the hospital now are sicker than ' they were in the past. For example, 40% of the HIV-positive patients he sees for the first time already have AIDS. He added that patients who could have been managed as outpatients with highly active retroviral therapy (HAART) if they had gone to a doctor earlier, now often are admitted with opportunistic infections, such as hepatitis C and lung diseases. He also noted that doctors in the Buenos Aires province and the capital itself are seeing more cases of diseases associated with poverty and poor hygienic conditions, such as hantavirus and leptospirosis, which formerly occurred primarily in areas outside the capital region. People suffering from chronic illnesses such as diabetes and AIDS have had great difficulty obtaining the imported drugs they need to maintain their health. In May, the Argentine Society of Nephrology said medical care of the approximately 17 000 Argentines with chronic kidney disease was seriously compromised because of the increase in costs for dialysis supplies. Recipients of transplanted organs have reported that it has become much more difficult to obtain the immuno-suppressant drugs they need to prevent their bodies from rejecting the new organs. And new transplant surgery is often postponed. Other types of non-emergency surgery have been postponed as well. The construction workers' union insurance plan put 20 pacemaker operations on hold in May. In April, the newspaper Clarin reported that Posadas National Hospital in Buenos Aires province had to suspend scheduled operations. In several provinces, an increase in low-weight births has been reported, an indication that the mothers were undernourished. In Mar de Plata, 13% of the babies born in public hospitals in 2001 weighed less than 2.5 kilos, La Nacion newspaper reported in July. It quoted Dr. Liliana Racciati, an obstetrician in charge of the high-risk ward at the Inter-zonal Specialized Maternal-Child Hospital there, as predicting that the percentage would be higher this year. And psychiatrists in Buenos Aires told Inter Press Services of an increase in the number of people see king psychiatric help because of stress related to unemployment and an inability to support their families. …