Health

Buenos Aires residents are still on strike and there is already tension in the services

Resident doctors called for a mobilization at the intersection of Santa Fe and Juan B. Justo avenues

Resident doctors called for a mobilization at the intersection of Santa Fe and Juan B. Justo avenues – Credits: @Fabiola Czubaj

The 19 days of strike carried out by residents of Buenos Aires hospitals and health centers exhibited like never before the human resources crisis in the health system that is replicated in the country. With the staff that does not fully recover from the physical and emotional consequences of the Covid-19 pandemic, the demand for care is multiplying with salaries that are pushing professionals to resign their positions. The malaise spreads, though more silently than in the residents, to the plant and duty doctors.

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In internal WhatsApp groups, support for a mobilization with candles and lanterns on Juan B. Justo and Santa Fe avenues has grown in recent days at 8:00 p.m. today. “I turned on a light for public health”, is read in the convocation of the Assembly of Residents and Attendees of the City of Buenos Aires, which demands improvements in salary and working conditions. The Assembly of Plant Health Workers also joined.

“We came to this because it is an activity that is not used to claiming. Now, we reach a point where it becomes untenable for overload and non-response. The youngest are leading the claim, who have a different energy and a perspective that previous generations did not have or could not have because we romanticized working conditions that, in other areas, would not have been bearable,” said Jimena Roca, an on-call doctor at a Buenos Aires hospital and specialist in burn surgery.

In these almost three weeks of unemployment for an out-of-pocket salary closer to $250,000 (with a floor of $200,000), as the most urgent claim, the lack of human resources made itself felt. In hospitals, there was a decrease in patient discharges and admissions due to the lack of this human resource on the hospitalization floors, the daily follow-up of patients slowed down, surgeries were suspended and even resignations from staff positions increased, especially specialists such as cardiologists or neonatologists, among the most sensitive areas. so he could know THE NATION in recent days, in dialogue with staff who assumed these tasks reserved for residents and concurrent patients in both pediatric and acute care centers.

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“In this situation, it is unfeasible to continue practicing the profession,” continued Roca, who was on the front line of care during the pandemic. “If the demands are unilateral, it becomes a profession for masochists – he maintained –: practicing with low salaries that are close to the basic basket, with a demand for patient care that is increasing in quantity and complexity, with an overload of administrative tasks and less resources within reach. It is absolutely ungrateful, we expose ourselves to error, we are legally helpless, with no response from those who should take responsibility. And this crisis is going through the entire medical community and health professionals. Therefore, the claim has to be assumed by the entire population, otherwise we will not be heard. Without health, there are no projects, perspective or individual. No matter how much vocation and dedication we put into our profession, it has become an unequal battle: we are asking for reinforcements from the citizen who was, is, and will be treated in hospitals.”

And he added a diagnosis that colleagues from other centers had also expressed in different words: “Health in Argentina is in intensive therapy and there is no one to attend to it.”

On shifts, with the complexity of the patients, generally due to a lack of appointments to control problems such as diabetes or hypertension that complicate other conditions, also increased demand for psychiatric pathologies, alcohol and drug use, and suicide attempts. As they coincided, the conflict with the younger doctors did nothing more than expose structural problems in the health system that have been going on for years. And they affirmed that this scenario extends to the entire country and to the public and private sectors alike, who share the same professionals.

At the Ricardo Gutiérrez Children’s Hospital, the residents’ strike also complicated the work because they are in charge of the hospitalization units. “It was partially covered with the doctors on duty, who are on external duty, with a huge demand at this time and with a small number of replacements that could be agreed. We all collaborate. Working in hospitalization areas, with complex patients, with comorbidities, is very difficult. We are very few doctors on staff and heads of units who are working, in the same way that the doctors on call are insufficient, who cover not only the external demand, but also all the hospitalization”, said María Fernanda Rivas, head of the Unit of Admission to that referral pediatric center.

He commented that substitutes were requested, but these replacements were not obtained due to the low payment offered. “It is a very critical situation,” he added. We hope that the Buenos Aires government ends up solving a reality: residents cannot live below the poverty line. It is a shame.” The Gutiérrez staff filed an appeal with 29 reports from different work days and a letter was sent to the health authorities. “The conflict in the different hospitals is multiple,” added Rivas, who is president of the Gutiérrez branch of the Association of Municipal Physicians (AMM).

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Faced with all this, the trade associations of the sector seek not to lose representation, with salaries, bonuses and working conditions that do not achieve the same level of improvement as other activities. “In the city, on Tuesday of last week, the unions that bring together the health personnel joined in columns along Diagonal Norte, from Avenida 9 de Julio, to the demand of the residents. They did it with a 24-hour strike and a mobilization to the headquarters of the Buenos Aires Ministry of Health, in front of the Plaza de Mayo. A staff doctor with 15 years of seniority, who works on call as a specialist on weekends, does not manage to add $200,000 at the end of the month. If you go private, the best coverages pay less than $2,000 per visit (on average, $1,200-1,500).

Today, after noon, the WhatsApp groups were activated with versions of an agreement that the AMM would have reached with the Buenos Aires government to raise the salary increase agreed in parities from 86 to 99%. Before the consultation, in the team of the minister Fernán Quirós they did not know the details or an imminent announcement tomorrow to unlock the conflict with the residents and that they return to their tasks. Towards the afternoon, according to a message that began to circulate among the staff of hospitals and health centers, this increase “for the salaries and supplements of staff doctors and residents, for all categories”, including substitutions of guard, will be discussed tomorrow in the Central Council of the guild for a vote. The Assembly of Residents and Attendees also awaited to know the details.

In a statement that began to circulate after 5:00 p.m., a detail of that agreement with the Buenos Aires government was anticipated: a review next January of that 99% increase “if the annual inflation of the IPCBA [Índice de Precios al Consumidor de la Ciudad] exceeds that index”, an increase of 270% for the career entrance supplement and 135% for the supplement for critical function (and for guard) and pocket salaries of $210,000 for entering professionals and $200,000 for first-class residents year “with progression according to year of residence, heads and instructors”. In these chats with colleagues, the message encouraged discomfort: the agreed percentage is below real inflation for a salary that was already 30% behind that index, according to what they trusted.

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