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El Paseo de la Muerte

El Paseo de la Muerte


The healthcare crisis in Colombia

The San Francis of Assisi hospital is the most important public hospital of the department of Chocó on which depends 500 000 people. But like numerous Colombian hospitals, it is on the verge of bankruptcy.

Long waiting times despite life-threatening conditions, limited response capabilities, lack of medicine or failures equipment, these are some of the complications that the patients are facing. The buildings are in a deteriorated state. The nurses manage day-to-day this shaky situation. They don’t always get paid, some of them are waiting for seven months in delaying salary payment. However the nurses stay, as the only angel-guards for the patients on a hospital adrift.

Overall, this series looks back at the Colombian health system crisis. Health is a global issue, and its funding scheme is a headache for most States. The scandals of misappropriation of funds and the healthcare institution banckruptcies have followed one another since 20 years. The quality of care continues to degrade. The process reform of the 1990s should lead to an efficient and economical reorganization of the access to healthcare, with the creation of the EPS. These bureaucratic entities, similar to the HMO of US, have to affiliate population to the healthcare system and manage the healthcare budgets. But to realize some savings, EPS made the procedures more complicated. The patients have to justify in an administrative way the care they need. Lots of requests are denied and many of the sick people lose hope to receive medical treatment. They give up any attempts, and some of them die expecting to obtain a clearance.

With this paintful irony that only allows the hopelessness, Colombians have a saying to describe their obstacle course in the administrative mazes. They call it “el paseo de la muerte”, the death’s path.