Without a doubt, the single most recognized member of the community in small villages is the rural doctor. While there are rural physicians who commute to the villages regularly during the week and lend their services a little in spite of themselves, most rural doctors who work in small remote communities, do so consciously as a result of their commitment to the profession and their neighbors. Health care providers are indispensable not only because they cure and prevent disease, they are important because they have the intelligence, ability and leverage necessary to transform their communities, whether this be by creating centers for villagers of special needs, acquiring hard to come-by medicine or equipment for the local health facility, or simply by being there when they are needed to provide comfort and security for the weak and sickly. They are brilliant entrepreneurs, with a heart.
What They Do
Doctors, sanitary agents, and nurses tend to work on a fixed schedule, while specialty doctors such as children’s doctors, eye doctors, therapists, kinesiologists and dentists commute and staff the local health center at least once a week. While in rural villages with standard population pyramids, the demand is for the services of doctors and nurses to vaccinate and control newborns and young children, in villages with inverted population pyramids the focus is in the care of the elderly. Some of these villages even offer small-scale geriatric housing services for those who can no longer live by themselves, those who don’t have a family or those whose families live far.
Doctors are revered. Even many years after they are gone, doctors, pharmacists and midwives stay in the minds of the older generation with affection and melancholy. Why? They brought virtually everybody there to life and saved many when nobody else was near. Back in the day, they were among the few who had access to means of transportation, and lent them selflessly whenever the need arose.
What Needs to be Addressed
For all their importance locally, I have been always received with a mix of curiosity and anxiety that I suspect, has a little to do with the sense of urgency that surrounds health care provision in rural villages. These professionals are often community referents and find interest from the “outside world”, be it from politicians, NGOs, religious groups or other non-profits, an important factor toward potentially channeling outside much-needed attention and resources into their communities. The Argentine Asociation of Rural Medicine goes further by outlining a specific policy agenda for the coming years based on their specific needs. I was fortunate enough to interview its then president, Dr. Arturo Serrano on one of my travels to the province of Santa Fe.
Rural doctors are crusaders, with some villages counting on the services of one, for a population of over four thousand. In most villages, the situation is less critical. According to Dr. Serrano, villages face a lack not only of qualified professionals willing to lend their services in remote areas given harsh living conditions, but also a lack of the equipment necessary to attend to the specific needs of villagers, and an all around absence in public policy at the national and provincial level focused on retaining qualified doctors and health care providers. There are other problems, such as insufficient or inappropriate supply of medicine that sometimes gets caught in the middle of cross party politics and personal antipathies, although to a lesser degree, than do funds that go towards investment and infrastructure development.