Traveling and working in healthcare abroad has always been a passion of mine, which is why I jumped on the opportunity to go Argentina. Living and working in Buenos Aires was an eye opening experience I will never forget. Similar to the United States, there are private and public hospitals throughout Argentina. However, the differences lay within the resources available, and thus the quality of care between the types of hospitals. Working in the private hospital felt no different than working in one in the United States, aside from everyone speaking Spanish. The public hospital, on the other hand, was a whole different experience. That is where I learned what it was like to work in a resource poor environment.
The public hospital was one of the bigger buildings in Buenos Aires, and probably the most unkempt. Although there was always some sort of construction within or around the hospital, every hallway and room had peeling paint or crumbling walls while the bathrooms had mold growing on the ceilings. Throughout my time there, I worked with a resident, Abby, and followed her around. Morning rounds were always followed by a cigarette break next to a punched out glass window in a stairwell. We then continued to accomplish all of the tasks assigned during rounds. No EMR system meant running around to pathology, radiology, and other floors to get “consultas” from other specialists. There was no patient cap, so I helped Abby take care of whoever was on the floor. From doing bedside non-ultrasound guided paracentesis to collecting urine cultures and starting IVs, I helped her with whatever I did not perform myself. The resource poor environment led us to become our own McGyvers for whenever we were missing something or when the ophtalmascope was acting twitchy. As interesting as it was inventing ways and thinking out of the box to perform seemingly simple tasks, it was also at times frightening to think about the care patients were receiving. These roadblocks delayed patient care due to such shortages, and the lack of thorough hygeine precautions/materials added another hazard to patient safety. Antibacterial gel did not hang at the entrance to every patient door, but was just a little bottle at the “nurses’ station.” The lack of resources extended to hospital employees. The “transport” service consisted of 3 men whom I always found playing cards in a dark room, and were only called upon if there was a patient who relied on a bed to be taken to Radiology. Otherwise, patients were given directions on how to get to Radiology for their imaging. Most had to wait their turn for the one wheelchair on the floor to come back if they were unable to walk. This is one of the many struggles that patients faced every day. Working in the public hospital made me realize the true need for improvement in public health care in many countries.
Learning about these differences and how to work around the lack of resources was humbling. Standards of care vary drastically throughout the world, and I am excited to continue to experience and learn about these differences throughout residency. Since returning to the United States, I am reminded of the importance of being flexible and thinking outside of the box. There are usually many answers to a problem and it is vital to keep a broad perspective and avoid tunnel vision. My experience in Argentina not only has inspired me to continue working abroad, but also has taught me to become a more thoughtful, appreciative doctor.
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