Córdoba, Argentina - Child Family Health International (CFHI)
Senior/MS4 elective 2019
El Cariño Córdobés
If I had to describe my experience in Córdoba with one word it would be "cariño," which means warmth. During my month in Argentina, I had the opportunity to work at Hospital Córdoba, one of the biggest public hospitals in the city and province. I spent half of my time in the Guardia (the Emergency Room), and the other half in Internal Medicine.
Argentina's healthcare system consists of both a universal and a private system, the great majority of the lower income patients using the public system. I noticed that while the Guardia was the emergency room, often patients would come in for seemingly less pressing issues; the residents mentioned that due to no one being denied access at the Guardia, it is very poorly and inappropriately utilized. This was a similarity I noticed with patients in the U.S who do not have access to strong primary and preventive care that end up going to the ED when they become ill. Being in a public hospital with a lower number and range of resources, I learned a lot from the residents and attendings, who utilized every material to the fullest without being wasteful, and only ordered labs and procedures that were absolutely necessary. With a shortage of nurses in the area, the residents also seemed very independent and skilled, and I learned a lot by assisting them with procedures like debridements, injections and line placements.
One of the biggest things I learned from the Argentine people was their warmth. In the Guardia and on the wards, there were about four to six beds in each room. Often in the U.S., patients insist on having private rooms or complain about other patients who share their rooms. In Hospital Córdoba, many times I observed that patients shared food and drinks, and empathized with one another when one received good or bad news. Moreover, I observed this warmth and empathy even in the doctor-patient interaction-- generally the doctors interacted very closely with the patients and their families, and the patients gave full trust to the physicians.
This "cariño" was present outside the hospital as well. Whether it be sharing a communal mate (caffeine-rich drink prepared by steeping dried yerba mate leaves), greeting everyone I met with a kiss, or being invited into a home for an asado (a backyard BBQ), I could tell that there was a great sense of community and affection. Of course, it could be a generalization, but the people there just seemed happier. Life was simpler. The Argentines were content with what they had, specifically, with those in their lives. In this age of social media and cell phones, I was reminded of the beauty of authentic and deep human connections.
Hence, I came back restored and inspired, with a vision of how I wish to approach residency and my patients in the future. I was reminded of the importance of primary and preventive care, and wish to stay on top of my patients' comprehensive health and well-being to help prevent disease and complications. I also wish to be mindful of the tests and procedures I order, and be purposeful in my treatment plans. Although many times being in the fast-paced ED or medicine rounds and having no one there to explain things to me was frustrating, my Spanish improved tremendously by being immersed in the language and culture fully. I became motivated to study a little bit of Spanish each day to continually improve, ultimately for the benefit of my Hispanic patients. I also came back with a newfound appreciation for the things and people in my life that I often take for granted. Hence, this was one of the most rewarding experiences of my life, and I am so grateful. Thank you, Córdoba. Until we meet again.
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