Sunday, October 02, 2022 | 6:05 a.m.
Javier Ramírez is a pediatrician and can afford to say that he knows the province from end to end, even the places where no one else has access. However, these journeys are not framed as pleasure trips, but in the effort to bring medicine to those who need it, who must wait weeks or months to be treated. In his case, the pediatric population, which ranges from the first months to 14 years.
He has been doing this for five years in what he calls itinerant medicine, since together with nurses and other medical professionals they are part of the SIMisiones program (previously called Misiones Te Cuida), which depends on the Ministry of Public Health and seeks to bring the primary care to prevent diseases, early detection and referral of cases to more specialized centers when necessary.
“We tour the entire province, all the towns, the places, aboriginal villages. Where they go asking us to go, here we go. I really like primary health care, which is going and taking care of places where there are usually many people with many needs. Needs in terms of respiratory distress, monitoring of patients because there are people out there who are chronic patients and it is very difficult to get an appointment or to see a specialist, ”he shared in dialogue with El Territorio in a break between the end of his shift in the Samic of Eldorado and his going to El Soberbio to render his services in the local hospital.
The program deals with adult medical care, medical clinic, gynecology for pregnant women, pediatric care, dentistry (control, repairs and extractions), basic health checks, such as weight and height, as well as taking blood pressure, vaccination, ultrasound, mammography and Pap, among others.
“Within our training in pediatrics we have contact with specialists, who tell us what we have to look at and reinforce. We transfer the same thing to chronic patients, but it costs a lot due to the issue of distances, shifts, ”said the doctor from Corrientes, who chose the red land many years ago.
And he added that this year they have more facilities to coordinate shifts in the Health Park with specialists according to the pathologies that the patients have.
Those who live in big cities can hardly imagine that there are people who lack basic health care, let alone the most complex. Those far from urban centers, members of small towns and Mbya villages live this reality on a daily basis that responds to the lack of medical professionals.
Ramírez discovered his pediatric vocation while he was studying.
In this sense, Ramírez recognized that the neighbors sometimes travel more than ten kilometers to reach the mobile point when they find out that the doctors and nurses will be in their neighborhood, municipality or place. Some even queue from 4 in the morning to sign up.
“In places like this, people take advantage and the mother signs up so that the gynecologist can see her, the father for the clinician, they bring the girl and I make the medical file, the Anses file, I deworm her, I give her vitamin and iron if you are at risk of malnutrition or underweight,” he explained.
Meanwhile, he maintained that towns such as Wanda, Puerto Esperanza, San Antonio and surrounding areas are quite uncovered in health matters and although there are some doctors who are going, they are not enough because “the number of people is impressive.”
Regarding the situations with which he finds himself the most in pediatric care in the municipalities, he pointed out that due to the time of year, respiratory difficulties, bronchiolitis, pneumonia, asthma are seen a lot.
“In El Soberbio we had to refer a little one month old who had biliary atresia, who was in liver failure and we had to send him to Barreyro. They compensated the baby and now he is waiting for his turn to be transferred to Garrahan, ”he said regarding that experience that might have cost the little boy his life.
Along the same lines, he added: “These are medical emergencies that do not happen very often, but they do happen and that I cannot solve in the care I provide, that is why I have to refer. Before the pandemic, we had congenital heart disease in Iguazú, which was transferred to Eldorado and then taken to Garrahan by medical plane.”
He also said that in aboriginal villages they find many children with poor follow-up and they find many cases of diarrhea and vomiting, for which they end up being hospitalized for dehydration and low weight.
“Pediatricians are needed everywhere, they are concentrated in the most complex centers, in level III hospitals. My week starts on Mondays, I come to Dos de Mayo to do an office, on Tuesdays I have a 24-hour guard at the Samic in Eldorado and then I am at the El Soberbio hospital, which has no professionals, ”he said regarding part of your week.
Ramírez considered that the shortage of pediatricians is due to an economic issue, to a search for specialties that give more revenue such as cardiology, ophthalmology or anesthesiology.
“It is not easy, the pediatrician is already born for pediatrics, since the faculty already has a special character, the same happens with gynecology or general medicine. It is very difficult to convince someone who knows they want to be a cardiologist to opt for pediatrics.”
“Now I have a resident on rotation who wants to do pediatric cardiology. In Eldorado we have a child nephrologist and a child traumatologist, we need the boys to be trained to complete our staff and not always refer Posadas”, she celebrated.
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