By Socialist Party of Uruguay
The current pandemic is causing us to live with fears that we thought had been overcome. More than 100 years ago, the agents that caused the diseases that plagued humanity were discovered, vaccines were developed, and some time later, ATB was created. This added to the results of the application of some preventive measures promoted the belief that we were protected forever from infectious diseases -contagious, the main cause of death at that time.
The increase in life expectancy, while the prevalence of chronic diseases also made us forget in part the risk of infectious diseases. However, there have been numerous epidemics and pandemics in these years. Tragic examples are the badly named Spanish Flu, the Asian Flu and in more recent years the Avian Flu, and the Sars as a manifestation of the coronavirus that has its reservoir in animals. These have put the scientific community on alert, taking into account that the conditions of contemporary life in large cities and the mobility of people expose us to permanent risks.
The pandemic in Uruguay
At the end of February, the virus was installed and the first cases were reported on 13 March. So far, in early May, the number of cases and deaths is relatively lower than in other countries in the region. These are concentrated in Montevideo and Canelones (metropolitan area). Although there is no clear picture of the distribution of the disease, more than a month and a half after its installation it begins to affect the most vulnerable sectors of society.
Within the multiple variables that affect the development of the disease, we take into account elements that we are not in a position to modify (at least in the immediate future), both environmental and biological: the arrival of winter, mutations of the virus or a demographic situation complicated by the proportion of older adults may become decisive in the immediate future. Unknown phenomena may also emerge that radically change the current reality.
However, in the search for an explanation to the reduced number of patients, it is proposed that Montevideo, where the largest number of cases is concentrated, is a large city with restricted areas of great concentration of inhabitants, flat, with permanent winds, with a riverbed surrounding the whole south and large green spaces.
– It should be noted that the progressive governments of the Municipality of Montevideo have prioritized the rescue of public spaces, green spaces and have transformed vacant lots into squares and parks equipped for meetings, which today are places with less risk of contagion
Beyond the more or less predictable course of the pandemic, the moment it sets in our country is very particular because it coincides with the change of government. Change from a progressive government to a right-wing coalition that includes post-fascist parties.
Therefore, except for some uncommitted measures of the new government, we will face the epidemic with a social, economic and health care situation generated in 15 years of progressive governments. Thanks to this, we do not have to add to the nightmare of the coronavirus the frightening possibility of being treated in a dilapidated, dirty and under-tech hospital, but we do have some strengths resulting from the application of legal policies.
In these fifteen years there has been a break with the neoliberal policies of reducing the weight of the State and the breakdown of the social protection system that the reactionary parties in government had been applying. On the contrary, policies of universal, quality social protection were developed with the commitment and participation of citizens.
How we faced the Covid 19 pandemic
When we talk about confronting the disease, we do not only refer to the symptoms and signs of it and the possibility of death. We value other negative effects: on interpersonal relationships, the economy, work, employment, education, recreation, the emotional and psychological aspects of isolation, the neglect of other diseases
Like any health situation, the best conditions to face the disease refer to the population living with the best quality of life, (not necessarily the customs developed by the upper classes), with management of health care standards, with access to good information and with an accessible and quality health system.
– The population’s living conditions, although there are still important shortcomings, have improved considerably, and Uruguay is one of the countries with the highest HDI in Latin America.
-Management of the population in health care. The population’s attitude of responsibility in the face of health problems must be considered.
The FA governments have appealed very insistently to citizen responsibility in the face of health problems. This has led to the development of a culture of individual and collective care that has already had great success. Uruguay has had practically no dengue fever, despite the fact that it is widespread in neighbouring countries and that the vector exists in our country. We are the only country in America (together with Canada) that has not had epidemic or endemic cholera. The number of smokers has decreased dramatically and we were pioneers in banning smoking in enclosed places. Control of consumption of alcoholic beverages, sodium salt, and reduced consumption of sugar are other examples.
At present, and despite the fact that isolation is not compulsory for a large number of people, public and private companies have complied with the proposal and taken steps to facilitate it
The use of mouthpieces for the entire population, even with the contradictory message about it from international and national organizations, is becoming widespread.
There was a positive response from public employees and retirees to the proposal of discounts to finance the coronavirus fund.
There was an immediate and supportive response from the population, collaborating in the resolution of urgent problems of the most vulnerable sectors. Popular pots, collection and distribution of basic necessities, etc.
The information system and health promotion allow the whole of society to be reached. It is linked to the previous point and allows to deepen in the promotion of health with the education in healthy conducts being practically extended to all the population..
Since the first years of the FA’s government, access to PCs has been universalised for children and adolescents (Ceibal Plan) Tablets were distributed to low-income retirees (Ibirapitá Plan)
The policies of the public telecommunications company facilitated the creation of a computerized country. Access to mobile phones was also made possible and virtually all Uruguayans have access to mobile telephony.
This not only allows access to the necessary information about the pandemic, but also allows the continuation of the educational process in all branches of education and facilitates interpersonal relationships, collaborating for a more tolerable isolation and the affective approach.
-Health care Since 2008, Uruguay has had a National Integrated Health System that integrates public and private providers. FA health policies have valued the first level within the PHC strategy, and in particular promotion and prevention; however, the investment made in these years has also generated substantial improvements at all levels of care
– The implementation of NHRS meant a more equitable distribution of health resources. It allowed the economy of private sector services that were in a permanent state of crisis to be cleaned up and the situation of public service providers who serve 38% of the population to be significantly improved.
The chronic lack of resources, which were limited by neoliberal policies in the public health sector (prior to 2005), turned hospitals and polyclinics into chaotic, risky, ruined and dirty places, with a total lack of asepsis, 19th century technology, and insufficient and in many cases poorly qualified personnel (admitted for political patronage).
The economic investment and the determined and militant efforts of many of those who worked in public health during these years, together with good management of resources, managed to reverse the situation. Although it still has fewer resources than the private sector, it is in a position to meet the needs of patients even in the current situation. The attention was dignified, new hospitals were built and others were recycled, the same happened in auxiliary centers and polyclinics .
Most of the collective wards with dozens of patients were abolished and individual or two-person wards were built, avoiding overcrowding..
As an example, maintenance costs increased from $300,000 to $9,000,000 per year for 500,000 square meters of building area
The number of CTI beds, which are essential for the treatment of Covid19 , increased from 72 in the capital in 2005 to the current 196, which are also located in seven departments in the interior. Having its own resources is important when a possible agreement with the private sector can be hampered by the priority needs of its own patients.
The number of ambulances also tripled.
Today’s technology has moved from the 19th to the 21st century and medicines are reaching the entire population in adequate quantity and quality.
The priority of systematic and organized work at the first level facilitates the care of non-institutionalized patients.
Staffing is now more tailored to user needs .
Another achievement inherited by this government from its predecessors is related to the substantive progress made in the technical training of health personnel. These achievements are the result of the selection of new professionals, the retraining of existing personnel and the significant increase in resources allocated to professional training centers.
Increased investment in development and research has made it possible to make a leap in quality in scientific training. Examples of this are the selection to participate, as the only underdeveloped country, in the research on the therapeutic use of the BCG vaccine in Covid 19 or the production in the country of the diagnostic kits that prevents us from importing them.
Finally, it should be noted that despite the fact that the government has had this situation of relative advantage, it has not taken the most adequate measures. It has been permanently exploiting the media and claiming successes that do not belong to them, with an erratic discourse that disorients the population.
The ministers and other members of the government occupy the television slots that were denied to the unionized workers on May 1st, with inconsistent information and inappropriate behavior (they do not know how to put on their mouths). In order to respect the freedom of the market, they allow essential items such as mouthpieces, alcohol at 70 percent or alcohol gel to be sold at exorbitant prices.
They promised from the beginning to carry out a number of daily tests which was not achieved until today .
They suggested that the use of mouthguards on public transport was essential and announced that they would be distributed free of charge, which was not the case.
They proposed measures to support the most vulnerable and closed shelters, literally leaving people in the streets at the beginning of winter in the midst of the epidemic.
They took resources from the salaries of public employees and pensions but refuse to touch the large salaries of the private sector and capital.
They generated facts for the resignation of directors of health centers, who were facing the situation in spite of the lack of resources to which they have been subjected.
Although currently advised by an honorary technical commission, the business chambers are exerting pressure to return to work beyond what is convenient.
The estimate of expenditure to support the most vulnerable is absolutely negligible within the budget promised to tackle the pandemic.
It is worth noting the ignoble attitude of this government that not only uses the media to meddle politically with the epidemic but also, in a scenario of citizen concern, makes the discourse of a coalition member defending the dictatorship and human rights violators go unnoticed. It is an attack against democracy with the entry into parliament of a Law of Urgent Consideration, which does not contain any urgent measures in its more than 500 articles, at a time when the debate is limited and the response of society; fundamentally the workers’ organizations, are committed to solving the problems that distress the population.