Your access to FP Insider:
At the height of the coronavirus pandemic, Peruvian hospitals were on the verge of collapse, patients were dwindling in the hallways due to lack of beds and others died on the streets due to oxygen shortages. Peru’s 32 million people are the most affected. consistent with the world’s capita, with nearly 800,000 instances and more than 32,000 deaths since the start of the pandemic. The week of September 23, the Ministry of Health reported more than 11,000 new instances and 185 deaths, and July and August, between 5,000 and 10,000 cases consistent with the day were common. At the root of these losses was a deeply flawed health care system, related to the monetary mismanagement of the country’s leaders. First, Peru was hopeful of absolutely avoiding the scourge of the virus.
On March 16, nine days after the diagnosis of the first infection in the country and before anyone died, Peru quarantined that, planned for only 15 days, is still in force in some provinces and cities, most businesses closed and only one essential services, such as hospitals, food retail stores and banks, were able to remain open. These limitations have not prevented instances from reaching thousands of people in a matter of days.
“These measures have not worked well, because Peru is a casual country; these are structural social disorders that have existed for many years,” said César Ugarte, epidemiologist and researcher at the Lima-based Alexander von Humboldt Institute of Tropical Medicine. In Peru, about 3 out of 4 employees paint casually and many families live in difficult and unhealthy situations without basic services. In Aboriginal populations, limited to physical care and continued government forgetfulness, they have been guilty of the loss of countless lives.
The strong impact of the pandemic on the country has been exacerbated by the near impossibility of obtaining medical oxygen, a shortage that persists. tenfold multiply the oxygen value while available, which was a predictable challenge: maximum Peruvian hospitals, unlike other countries, do not have their own oxygen turbines and have to supply materials abroad. government, and the challenge is even more noticeable in rural areas, where most of the already few oxygen turbines are out of service for lack of fixed services. Oxygen in the hands of the rich.
The government has not given a genuine solution to the problem, which is addressed through organizations with small fundraising campaigns, or churches, such as “Respira Pero” (“Respira Peru”), a program promoted through the Catholic Church that seeks to bring oxygen turbines to the country’s top remote villages.
Last month, the stage relaxed a little bit: “Until a month ago and a part ago, doctors told me there were no beds, there was no oxygen. Five weeks later I contact my hospitalmates and they say yes, there is a bed, in which I can bring a patient,” said Ugarte, who lately runs with COVID-19 patients. “Not that everything has been published, but the formula has been so beaten that it now has a few minutes to breathe. “
This room for manoeuvre is fading, however, and the moment the wave of the pandemic is about to strike. “We are now beginning to be informed that many other inflamed people are starting to expand chronic symptoms in the long run. people, but they are invisible,” said Jaime Miranda, director of the Center of Excellence for Chronic Diseases at Cayetano Heredia University, who explained that Peru’s fitness formula, aimed at curing the disease and not offering a long-term remedy, does not adapt “With a very aging population and increasingly chronic problems, which have no cure , not only will we have to solve the problems, but also do some continuity care, chronic support,” he said.
“They tell us that Peru is growing, that Peru is advancing and that we have had years of stability, however, the pandemic has arrived and revealed, temporarily and abruptly, how precarious and vulnerable the social fabric of the country, including fitness, is. sector, ” added Miranda.
“One of the things that catches Peru’s attention is that it is considered one of the successes in terms of economic expansion, higher GDP or poverty reduction,” said Christopher Hewlett, an anthropologist specializing in indigenous studies in the region. foreign organizations and establishments have presented Peru as an intelligent style; however, when you are on the ground, it becomes transparent that this expansion and the development of wealth increase inequality, because access to genuine fitness facilities does not really improve this period”.
Despite its sustained economic expansion in recent decades, the country’s investment in fitness has been weak, with public spending reaching only 3. 2% of GDP, well below the region’s average of 4% and one of the lowest in South America. corruption that has plagued the region and diverted the budget needed to combat the pandemic According to the International Transparency Corruption Perception Index, Peru ranks 101st out of 198 countries analyzed, away from other Latin American countries such as Chile, Argentina and Uruguay. The score, which Transparency International measures on a scale of 1 to one hundred, where one hundred represents overall transparency, is 36, which places Peru in a similar position to some other countries in the region, such as Panama and Brazil.
“Following the Odebrecht incident,” Ugarte said, referring to the global corruption scandal involving a Brazilian company that paid bribes to the world’s most sensitive political leaders, adding 4 former Peruvian presidents, “we saw that in addition to the roads, the other inflicted the buildings were hospitals, and several hospitals in many regions were half-finished when the pandemic broke out. Array arrested for corruption.
Miranda noted: “For many indicators of the World Health Organization, Peru is doing very well. That’s right, we can say that everything is fine, however, if you just look at the remote parts without looking for the context, you lose the rest and then realize that the stage is not what it seems. “
Rural spaces have been most affected by the lack of budget for the structure of new gyms. “It’s hard to convince other people to build those hospitals in rural areas, but the sad thing is that they invested, but it got so bad, “There was very little oversight, there was corruption, but when you build a hospital that costs millions of dollars, you exceed the budget and you go out of time, and then when it’s done, it was built on an alluvial plain. It’s daunting. ‘
Fragmentation of the fitness formula and its slowness are also critical factors. In addition to the public aptitude formula, which serves about 60 percent of the population, Peru has a contribution-based fitness formula, available to others with constant wages; The one consistent with the sonal formula, which is beyond that of the State; Before the pandemic, they were disconnected from each other, and when the pandemic occurred, bureaucratic and administrative disorders made interconnection difficult in the first few months, saving thousands of lives by manufacturing more appliances and available care.
Peru is also a highly centralized country, with the capital, Lima, accounting for more than part of GDP. Most hospitals, extensive care beds and oxygen access sites are located in Lima, meaning that in the jungle villages and in the combined space of millions of other people – there was no access to fitness services, which inflicted the death toll. . “Iquitos [the largest city in the Peruvian Amazon] was a disgrace in the first few months, just because no capatown had been built there,” Ugarte said. Educated Peruvians travel abroad, many villages also suffer from shortages of doctors. Lima has 12 doctors consisting of 1,000 inhabitants; Peru in total has 1. 3.
But indigenous peoples have been even more affected than small peoples. “When the pandemic arrived, the Peruvian state issued a decree on the state of emergency, but public policies developed from a purely urban attitude in Lima,” said María Pesantes, an anthropologist and researcher at Cayetano Heredia University. “Indigenous people live in remote areas, have a precarious conditioning system, and some non-unusual diseases and fitness disorders such as maximum rates of anemia and tuberculosis make them more vulnerable. When containment policy evolved, there is no idea how to do something fast to come with all its territories.
Health centres in these spaces are not only scarce, but also severely scarce staff and supplies. “Often, hospitals don’t have the right medications or equipment, so we tell patientsArray . . . they get a prescription, but the hospital doesn’t have it, so they have to look for a personal remedy instead,” Hewlett explained.
Health center staff, who are regular technical nurses, who have only studied for 3 years, or recent graduates, are not prepared to paint with indigenous peoples, who not only speak their own language, but also have classic fitness practices.
“There are a lot of prejudices that oppose indigenous practices, so fitness staff don’t know how to succeed in people,” Pesantes said. “This lack of respect for indigenous culture and wisdom means that in addition to geographical distance, there is a distance of empathy. The population is not welcome in a formula that does not take into account its truth.
The immediate action of indigenous organizations to close their territories and put the coverage bureaucracy into force has been overshadowed by government approval movements that, while well-intentioned, have led to tragedy. “A bond was issued for others living in poverty and excessive poverty, which meant that other people in the communities had to move to the nearest city to pick it up, to a bank, and those have become the spaces where those other people spread, bringing the virus to the entire community,” Pesantes said. “For these populations, it can simply be said that the state has been a vector of contagion. “
Despite this, the pandemic also strengthened the system, exponentially expanding the number of extensive care beds, which were few, and accelerating the progression of many laboratories. Doctors who learned on the fly on the first wave are now better prepared for the future. What is needed now, experts say, is a plan, not only to deal with the wave of the moment, but also to continue in the future.
For Pesantes, it is the investment in the formula of fitness, and in all facets that have been overlooked in recent years, such as rural spaces and intercultural fitness education, that will allow Peru, once all this is over, to emerge more powerful from the pandemic. Another lesson, he says, is that the government will have to pay attention to indigenous peoples, who have been ignored for decades and who, in the end, are the most productive who know their own territories.
“Even though we’re a little late, I think it’s to make a plan to prepare for the moment wave that’s coming in a few months,” Ugarte said. “We already have experience, we already know how to handle things, we already know what drugs not to use, and we already know what to do and what not to do. We can’t make the same mistake you’re making lately Madrid or Paris. “
Milagros Costabel is an independent advocate for the rights of visually impaired persons living in Cologne, Uruguay.
fashionable