People-centered healthcare vs. capitalist healthcare

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by Val Reynoso

Bolivia and Chile differ significantly in the ways their governments address issues and their performance in regards to healthcare. Bolivia’s healthcare system is successful given that the World Health Organization (WHO) praised its achievements particularly in the fields of medical care, social security, water and sanitation.

The Pan American Health Organization (PAHO) also supports initiatives in the nation and has pointed out accomplishments made under the Morales administration. The WHO states that Bolivia has had its health services improved by 20%, five times greater compared to the rest of Latin America that has only seen a total improvement of a mere 4%. The WHO and PAHO also noted Bolivia’s “My Health” program established in 2013 by the Morales administration, which provides free treatment to some of the nation’s poorest residents who would not be able to see a doctor otherwise because of their low socioeconomic status. Bolivia has built over 1,004 health facilities in the past 11 years. Likewise, Bolivia also plans to construct 49 more hospitals over the next four years, chronic malnutrition in children under 5 has been cut from 32.3% to 16% and infant mortality rates have significantly declined by 52% between 2008 and 2016.

Moreover, on November 13th, 2016, Morales stated that his administration will allocate $719,000 to expand Operation Miracle, a humanitarian program created in 2004 by late Cuban leader Fidel Castro and the late Venezuelan president Hugo Chavez, that has restored the eyesight of over 676,000 people; with the prospect of guaranteeing support and services to low-income families. Morales brought up that a cataract operation in private health clinics in Bolivia costs approximately $1,000 and that with Operation Miracle, Cuba would have saved Bolivians $338 million dollars as well as the thousands of Argentines, Peruvians, Brazilians and Paraguayans that also reside in the country.

In regards to reproductive care, Bolivia has been working to improve the medical skills of midwives and increase their contact with the medical community, whose role has become more significant as of late in the country.

Many indigenous women in Bolivia do not confide in hospitals nor cesarean births, but instead prefer reliance on traditional midwives. Bolivia is including the midwives in the health system with the goal of decreasing the national maternal mortality, which is currently the highest in South America and among the highest in the Western Hemisphere, at 206 maternal deaths per 100,000 live births in 2015, with the majority being poor, rural indigenous women. The UN Population Fund is helping fund the midwife training program, which began in 2013 following the passing of a law in Bolivia that recognized traditional indigenous medicine including midwifery. Training has increased in the past months given that more midwives have joined clinic staffs and have been permitted to certify births of babies they delivered in distant rural communities.

Midwives are also taught how to, for instance, manage emergency situations like disinfecting wounds and the most effective manner of preparing a woman to be safely transported to the hospital in the case of an uncontrollable hemorrhage. The midwifery program also considers the deeply rooted cultural traditions and value of women who travel to distant places that lack hospitals and doctors, since midwives can save lives on site whereas it would take medical professionals days to arrive at said regions. The WHO stated that decades of neglect of the role of midwives has contributed to the high rates of maternal and infant mortality in developing countries. The Bolivian government, however, indeed has also made efforts to convince women to get pre-natal care at health clinics and give birth in hospitals and has even offered pregnant women an annual $247 financial incentive.

In contrast, along with the low retirement benefits Chileans are faced with due to the private pension system in place, Chile is also known for having one the most restrictive abortion bans in Latin America and in the world, which has an impact on the healthcare of citizens and especially women.

Pinochet established a complete ban of abortions in Chile in 1989 towards the end of the fascist regime, which marked an end to the prior 60 years of legal procedures. Up to 2016 in Chile, a woman who had an abortion even in the case that her life was at risk, had medical complications or she was raped, could face up to 5 years in prison for the practice.

Approximately 120,000 Chilean women illegally obtain abortions per year, which places them further at risk because the procedures are more dangerous and make them more susceptible to further complications since they are not able to get it done by medical professionals. Currently, the Chilean constitutional court has allowed abortion in only the cases of rape, if the woman’s life is in danger, or if the fetus has complications. UN Special Rapporteur Phillip Alston stated that increased efforts must be enacted to promote and realize sexual and reproductive rights in Chile.

Val Reynoso is a Politics and Human Rights undergrad, journalist and Marxist-Leninist activist.

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