EMS Around the World: Pandemic Taxes Argentine EMS

Argentina’s healthcare system faces its greatest pressure since the beginning of the COVID pandemic as the country has surpassed 100,000 deaths linked to the virus, according to recent statements by Minister of Health Carla Vizzotti and local analysts. It is the fifth Latin American nation to reach that level and stands at more than 107,000 deaths as of August 5, according to the Johns Hopkins Center for Systems Science and Engineering COVID database.

Currently Argentina has around 109,000 cases of COVID per million population. Among Latin American countries only Uruguay’s rate is greater. Even Brazil, hard hit in raw numbers, sits at fewer than 94,000. Peru leads the world in deaths-per-million (approximately 5,900), with Argentina 12th (around 2,300), trailing only Peru and Colombia in Latin America.

Some analysts fear the toll may continue to grow due to the recent discovery of lambda strain in Peru and other countries of the region. The appearance of the new strain puts additional pressure on the Argentinian healthcare and EMS sectors, leaders say, and forces the state to take additional measures to deal with the situation.

Vizzotti says: “Although we have strengthened the national EMS and vaccinated the medical staff, we are seeing an increase in infection cases which threatens the functioning of the entire industry. The presence of new strains increases the rate of infection and mortality.”

To help stem a rapid spread of the lambda strain, healthcare authorities in Buenos Aires—with some 15 million people the second-largest metropolitan area in South America—will add 400 new beds to the city’s emergency hospitals, while its staff will increase by 70 doctors and 600 nurses. Six more ambulances will also be added.

According to the Argentinian Ministry of Health, the current situation is under control, with adequate availability of intensive care beds across the country and in Buenos Aires. At present the country has more than 150,000 hospital beds and 121,000 doctors (more than half involved in emergency care), which is generally comparable with developed countries.

Healthcare Sectors 

In Argentina the SAE (Sociedad Argentina de Emergencias) is the main emergency medicine organization. EMS services are free. The healthcare system has a complex structure, being split into three sectors: public hospitals, union-run obras sociales healthcare schemes, and private prepaid medicine. Obras sociales are social security organizations integrated with national insurance services.

The private sector forms the third major component of Argentina’s healthcare system and consists of private healthcare facilities and professionals providing independent services for private patients for payment.

Since the beginning of the pandemic, all three sectors have reorganized their activities to deal with COVID-19 patients, including in emergency cases, though they have differed by waiting times and the range of provided services. Together they ensure almost 100% access by local populations to quality emergency services. Argentina is one of only four countries in Latin America to achieve this, said Rubén Torres, rector at Universidad ISALUD and a former hospital executive in Buenos Aires Province, in an interview with the Argentinian publication Pagina/12.

Argentina’s medical personnel, including those employed in EMS, are educated professionals held to a high standard, while hospitals and clinics in Buenos Aires and other large cities are generally well equipped and professionally maintained, despite a lower volume of funding compared to E.U. and Western nations. The same, however, cannot be said for smaller cities and rural provinces.

Those in Buenos Aires and other major cities call 1-0-7 to summon the municipal ambulance service, SAME (Sistema de Atención Médica de Emergencias). Elsewhere 9-1-1 is also used, though service is not guaranteed everywhere. Fire departments, civil defense, and the Red Cross may also respond, and private operations have arisen to fill gaps in rougher areas where SAME crews don’t feel safe going.

As in much of Latin America, the pandemic led to serious deterioration of the financial situation for the country’s EMS and healthcare sectors and resulted in the inability of many public and private hospitals to meet pay demands. One of the reasons for this was restrictions on their ability to increase prices for their services—a move the government will not allow.

The Buenos Aires Times, citing representatives of major emergency hospitals in the country, reports the EMS and health system has suffered “dramatic underfunding” for years even before the pandemic.

As a response to this, at the beginning of July the Argentinian healthcare and EMS sectors planned huge marches across the country. These were supposed to be organized by a local healthcare workers union, Federación de Asociaciones de los Trabajadores de la Sanidad, representing some 250,000 employees, workers at hospitals, and clinics; however, the government was able to convince the organizers of the marches to postpone their walkouts.

The main demand of these protesters was a salary increase of 43%–45%, as annual inflation in Argentina has totaled almost 49% over the last 12 months, according to government data.

At present state spending on health and emergency services in Argentina does not exceed 2.5% of the country’s GDP. That prevents increases in wages for local personnel, for whom the salary of an experienced nurse does not exceed 360,000 pesos (U.S. $3,600) per year. Physicians are better paid but can be significantly overworked.

Luciano Gandini, president of the Argentine Society of Prehospital Medicine, SAMPRE (Sociedad Argentina de Medicina Prehospitalaria), says the pandemic deepened previous weaknesses in the healthcare and EMS system, including that of prehospital care. According to him, the government still delays the adoption of a national law that empowers paramedics in emergency care, which, he says, “would be a great relief to the healthcare system as a whole.”

Eugene Gerden is an international freelance writer who specializes in coverage of the global firefighting, EMS, and rescue industries. He has worked for several industry titles and can be reached at gerden.eug@gmail.com.