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2024-07-27 19:57:35
A four-year-old girl was severely burned with a pot of boiling water in the Bolivian city of Villazón (on the border with her Argentine neighbor, La Quiaca). Her mother, Miguelina Tolaba (23), rushed her to the local hospital but claimed that they wanted to charge her for the hospitalization, and she decided to take her out of there.
Tolaba reported that on Monday the 15th of this month, the girl suffered second-degree burns to her chin, arms, chest, and knee. At the Hospital San Roque in Villazón, the doctors decided to keep her hospitalized, but she took her daughter to the Hospital Jorge Uro on the Argentine side. The incident generated controversy regarding the health reciprocity policy at the border, where many people work on one side and live on the other (in this case, the girl’s father resides in Bolivia).
“I declined because I didn’t have enough money to cover the expenses. I am a low-income person, I do domestic work, and I live day to day, I couldn’t afford to pay,” Tolaba explained to Infobae and clarified that “there was an idea of intervention but I was denied for some reason, they told me they were going to charge me for the lab results.”
The woman told this outlet that “I denied the hospitalization because they told me that I had to pay for the lab results or I needed to have the SUS (Sistema Único de Salud),” a health insurance that Bolivian citizens or foreigners with residency have access to. “Obviously, we as Argentinians didn’t have it,” she commented and said that her girl is better, hospitalized in Jujuy.
“Nothing was going to be free, everything was paid, that was the reason why I took my girl to Hospital Jorge Uro because I refused to have her hospitalized there in Bolivia,” added Tolaba.
At the Jorge Uro Hospital in La Quiaca, where the girl was admitted later, it was confirmed that San Roque had provided the initial care. Ultimately, the girl was referred to the Maternal-Child Hospital of San Salvador de Jujuy due to the severity of the burns, where she remains stable and under treatment by an interdisciplinary team. Her recovery could take approximately two months. When contacted by this outlet, the Minister of Health of the province of Jujuy, Gustav Bouhid, declined to make statements on the matter.
In this story, there is a back-and-forth of accusations. Vico Ramírez, the director of the aforementioned medical center in Bolivia, refuted the mother’s claims: “Yes, it is true, on Monday the 15th she was attended by Dr. Santiago Pérez, who evaluated the girl in the pediatrics service. The surgeon performed the appropriate dressing. After the dressing, they made the hospitalization record, and as there was a change of shift with Dr. Silva, the mother rejected the hospitalization. At no time was the hospitalization denied, and it doesn’t matter what nationality she is.”
The hospital director stated that he was called from the city of La Paz, from the Ministry of Health. “What bothers us is that false information is given,” he said. “If we have made a mistake, we will also take responsibility. What bothers us is that information comes out this way,” he added, casting further doubt on what transpired.
In a press conference, Pérez added the following: “I was on duty that Monday, the girl arrived with her mother and grandfather; at first glance, it was a superficial burn on the chin, but then, upon closer examination, we saw she had previous burns on chin, neck, chest, lower limbs, and since it is a second-degree burn, we proceeded to hospitalization at 19:45, and then my shift ended.”
The doctor displayed the hospitalization record with the date. On the front, there is a handwritten note from the mother rejecting the hospitalization with her signature and ID number. “At no time was she given poor care; the appropriate care was provided, as the mother was just passing through Villazón,” he insisted.
Argentina and Bolivia signed in 2019 a reciprocal health assistance agreement through which they committed to deepening cooperation in medical assistance, epidemiological surveillance systems, and health actions in border areas.
The then Secretary of Health, Adolfo Rubinstein, and the Minister of Health of Bolivia, Gabriela Montaño, signed the agreement at the Jorge Uro hospital in La Quiaca and at the San Roque hospital in Villazón, which deepened cooperation between both countries in public health assistance, epidemiological surveillance systems, and health actions in border areas.
The agreement fell within medical assistance in emergency and urgent cases in public health facilities. “The signing countries set national or subnational agreements to ensure the free and timely treatment of emergencies and urgencies affecting citizens of one of the nations who are in the territory of the other, regardless of their migration status,” the statement indicated.
The Future of Cross-Border Health Care Cooperation
The tragic incident involving a four-year-old girl from Bolivia highlights the complexities and urgent need for improvements in cross-border health care cooperation, particularly between Argentina and Bolivia. As families navigate the delicate balance of bi-national health care services, emerging trends suggest a pressing demand for more integrated and accessible medical support systems.
Growing populations in border regions often result in medical emergencies that transcend national boundaries. The recent case shed light on the challenges faced by families who lack comprehensive health insurance, as seen with the young girl’s mother, Miguelina Tolaba. Their ordeal underscores the importance of ensuring that all individuals have equal access to medical treatment regardless of national affiliation or financial status.
In 2019, Argentina and Bolivia signed a reciprocal health care agreement, aimed at enhancing cooperation and ensuring that citizens receive timely medical assistance, particularly during emergencies. However, incidents like this demonstrate that while agreements are in place, real implementation remains challenging. There is a clear potential for future advancements in policies that prioritize humanitarian needs over bureaucratic procedures.
One potential trend is the development of streamlined processes for providing emergency care across borders. This might include telemedicine solutions, allowing medical professionals to consult with patients remotely, irrespective of their location. This could vastly improve patient outcomes, ensuring that urgent medical issues are addressed without delay.
Moreover, increasing digital health initiatives may facilitate better coordination among health care providers in different countries, leading to better patient tracking and holistic care approaches. As border communities continue to grow, collaborative care networks could emerge, potentially supported by government and non-governmental organizations focused on health equity.
Finally, there is an urgent need for public awareness campaigns that educate communities about their rights and available services within cross-border health care frameworks. As families become more informed about their rights under the existing reciprocal agreements, this could lead to greater demand for accountability and improvements within health systems.