The world is going to end in paper

The world is going to end in paper… one day we will all be gone and the only things left will be paper and cockroaches, equally useful things.

This last week I was in Riosucio again. The river has gone down, but the mosquitos have gone up; oh well… At least it wasn’t as insanely hot as it usually is, which worked out perfect with the fact that the hospital had no electricity and therefore we didn’t have fans. The MSF clinic (which is inside the “hospital”) had a small generator only powerful enough to provide light to one of our consultation room, our two computers and a printer.

On Tuesday, 23 children from a indigenous tribe came down to the hospital looking for health care and were promptly denied it by the hospital, since none of them had any register of even being born, never mind health insurance.  So they came to ask for our help. The health system in Colombia is drowning in paper; I have never seen something like that. You haven’t seen bureaucracy until you try to understand how the health system is organized here, and the sick people are caught in it without proper care.

Take these children for example: they live in very poor conditions, up in the middle of nowhere because of decades of displacements, from colonial to modern times. Aside from what nature can provide them, they have very little resources. It is not easy or cheap for them to get down to the “city” and get registered, so  they often don’t register their newborns. It is not only that, papers don’t seem to have a whole lot of importance in the indigenous world, I don’t think it makes a lot of sense to them that they only exist if they have this paper, so they tend to neglect it.

Anyways, they went then to register all the children and the registration place didn’t have paper… yes, that is right. Now the children have to wait until the paper is back, so they can get registered, then apply for the government health insurance and then health care, in that order. So, they came to us.

In Riosucio the MSF strategy is a bit different. Instead of just offering medical attention to everybody we try to strengthen the local health system to work as independently and efficiently as possible by covering a few specific programs and offering support to others. Therefore, we usually don’t do consults for children, since this should be a responsibility of the hospital, but seeing these children stuck in the paperwork we went to help.

We negotiated with the hospital and saw 11 of the children, and the hospital was supposed to the see the remaining, which they never did. We then decided to see all of them ourselves, but then they didn’t come back. Hopefully they will come back this week, or maybe they all got miraculously better. I know that it only took 5 days for their papers to get ready.  Now I just have to hope that they don’t lose it.