Addressing Health Challenges in the Impenetrable (Chaco, Argentina) 

This article was originally published June 15, 2019 by Alfredo Zurita on Read the original article.

The lack of medical facilities, technological support and funding for the unfavorable zone have made it difficult to hire and maintain qualified doctors in the Impenetrable Chaco region. A major challenge for people living in rural areas it that they have very few doctors providing health or primary care services.

In the past, rural doctors in Chaco practiced alone or with another colleague, in villages with dirt roads, and in hospitals that rarely had ambulances, and at most a laboratory and elementary radiology. The doctors did not envy those who had remained in the cities, given the superiors facilities, incomes and more recognition.

But medicine has changed so much now what matters to the doctor is not the dialogue with the patient, nor the clinical examination, which few doctors do, but the results from the laboratories and image tests. This has significantly re-shapped a doctor's practice to depend greatly on technology, even for problems that the clinics could solve. The dependence on technology has inadvertently discouraged doctors to practice in rural areas.

Further, the differences in income and recognition between the general practitioner and the specialist are so great that being a general practitioner in a rural area is almost like an adventure or someone who is desperate for work.

That latter has been the case in many provinces which have doctors from Venezuela. These doctors accept positions in rural areas that no Argentine doctor wants, because the alternative is to be waiters in Buenos Aires. Even though most of them are specialist, they cannot practice in big cities until they re-validate their licenses.

Some of the rural areas also attract Cuban doctors, who are poorly paid in their country and can earn more in a year of mission abroad than they would earn in their entire life in their home country. However, most Cuban doctors are general practitioners and not specialists, and because the law only allows specialization, this results in higher overall costs for hiring Cuban doctors.

In Africa, Canada and the Nordic countries where there many small isolated rural populations, special personnel are trained for rural areas. Medical assistants are prepared not to face a few dozen of the most common diseases. They attend cases of outpatients and hospitalization, and operate like the doctors. However if doctor's opinion is need, they can accessed by the internet to deal with the less common cases.

The solution that seems most suitable is the creation of a career as a rural doctor, which ensures stability and incentives for several years - perhaps in the same way as the military. The health workforce shortages facing rural communities require attention from government, philanthropy, universities, community colleges, and local community leaders, who must work together to recruit health professionals to care for the under-served communities

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