“Doctor, I want to ask your permission because I am not going to remain isolated. I cannot lose that job.” The consultation came to a doctor at a health center from a patient with a diagnosis of covid-19 who had already postponed a changa for 14 days but then, when the infections of his daughters were confirmed, decided not to postpone it again, for the risk of running out of that income. Since the beginning of the pandemic, those who work in the health system, especially in the public sector, are the ones who are putting the body. Its leading role is exclusive. In Rosario, with a network of 80 centers, it is in Primary Health Care where the social dimension is unavoidable. The teams went out to vaccinate, to deliver medication and even to distribute bags of food. Now they oscillate between commitment, exhaustion, demands for better working conditions and powerlessness. “If the pandemic was not solved with medical interventions but with social isolation, wouldn’t it have been someone else who had to be at the forefront of the strategy and not the health system? Faced with the problem of the guy who is left without a job, it is not (the Secretary of Health) Leonardo Caruana who has to tell him ‘I’ll give you 10 lucas.’ The problem of isolation is not solved with a health intervention but with a political intervention, “said Ricardo Cordone, a doctor at the center of Casiano Casas.
Rosario/12 he spoke with a group of professionals with extensive experience, who put the body daily in these spaces, where the population comes to raise their problems. “We feel that the health system is ours, not of (Hermes) Binner, nor of (Débora) Ferrandini, but ours and of the population,” emphasized Andrea Montaner, head of the Ceferino Namuncurá center. Lucas de Candia, a general practitioner, also made a difference: “This does not happen to hospitals that happens to us. Nobody falls down to tell them ‘I can’t isolate myself because I don’t have enough to eat.’ falling all together “. Still impacted by the food demand that evidenced the quarantine – especially in its first stage, later alleviated by the Emergency Family Income and the partial return of informal income for bricklayers and other jobs – Juan Pedro Bonifazzi, also a doctor in centers health department of the province, raised the difficulties of maintaining sanitary measures. “It is difficult to reinforce care, it is difficult to isolate because people are losing their fear of being infected, the antiquarantine media bombardment is added. I believe that it is necessary to work from the bond with each patient to be able to reinforce what care. In the conditions they live in. people are very difficult, the vast majority of those infected are by close contact with a positive case, “he said.
Putting all the focus on health infrastructure is insufficient. “Never like before, this shows that the health sector is limited to solve a problem. When we talk about health we think only of doctors, and a hegemonic way of solving it. And this pandemic put it in crisis – said Cordone -. We had to turn the strategy around, because in the face of the slogan of before the slightest doubt, go to your doctor, we had to say to him “ if the slightest doubt, stay at home. ” This produced a relationship crisis between the users and us, even in some colleagues produced a crisis in self-esteem, why am I now, if we have nothing to do in this. Where the crisis of the organization of the State that responds with the health system appears, when the response did not have to be from the health system health but to other areas, who guarantees that people stay at home? You have to bring them food, medicine, money. It seems to me that it puts the state organization in crisis in the face of the answers to the needs. ades of the people. “
In a dialogue by zoom, Montaner adds that “the first director of Primary Care (Ena Richiger) said that people have problems, and we have secretariats or programs, which sometimes do not fit in with people’s problems.” It is precisely the work teams of the health centers – in this article there are medical professionals, but it is not fair to forget nurses, social workers and psychologists, among others – the place where the limits of health responses resonate .
De Candia establishes four stages since March 20, when the Preventive and mandatory Social Isolation was established. “There was a first stage in which everyone was saved, few people circulated. There was a lot of uncertainty, a lot of fear, we saw what was happening in Europe. For health centers it was not so long, about 15, 20 days, and there We saw how we started to work, we put triages, differentiated circuits. But we had to continue attending. Something that the teams quickly understood is that people have other problems and have to continue attending to them. Mental health patients, chronic patients, are situations that they can be put on hold for a week, a month, postponed, but there comes a time when we have to continue working. There we could install work circuits “, states the professional about the second stage. The third was when “it seemed that we had solved the problem, Rosario found the cure. We did not have cases and when we had one, there were plenty of people.”
The current stage that De Candia describes is the fourth. “As it happened in all parts of the world, it was full of cases and the system is stressed with work, there is a lot of work, there are many patients, from covid and other problems. There is a slightly greater dissociation between the monitoring of chains of contagion but the need to install a notion of care “. At this point, what those who work in the health system feel is the dissociation between that daily reality and what is seen outside. “The rest of the population is still in a stage of great relaxation, the bars are enabled, the parks are full. All the daily, daily effort, you feel that it makes no sense, you turn on the television, you went out to look outside on Sunday, everyone the parks are full of people, “he says.
“The feeling is very helpless,” adds Cordone, who considers that “this is a time when you have to organize in another way. Now we don’t have to tell people to stay at home, but ‘if you have a symptom came. ‘What do we need now? Make the diagnosis as quickly as possible, isolate positive people as quickly as possible, and give solutions to the issues that need to be solved to be isolated. ” At that point, they question that today the call to 0800 555 6549 involves five days of waiting. “The guy ate a week, and if his throat hurts today and if they take a long time to come and it doesn’t hurt anymore, he came out, and it may be contagious,” he concludes. He considers that in health centers it could be swabbed, not only to reduce times but also to avoid the concentration of possible infections in hospitals. “How do we make the system adapt to the needs of the people and not the other way around?”
The working conditions, the measures of force that generate contradictions, are other issues that emerged in a long interview, which exceeds the length of this note. “If the State at this time does not take care of health workers, when will it take care of them?” And, without becoming victimized, but as a contribution to the collective conscience, they say that they are in phase 1 from the beginning of the pandemic, without leaving more than to work, for a matter of care and responsibility.