{"id":2151,"date":"2021-08-08T16:18:49","date_gmt":"2021-08-08T16:18:49","guid":{"rendered":"https:\/\/www.deepadaptation.info\/?p=2151"},"modified":"2022-11-10T14:59:40","modified_gmt":"2022-11-10T14:59:40","slug":"future-of-health-care","status":"publish","type":"post","link":"https:\/\/www.deepadaptation.info\/es\/future-of-health-care\/","title":{"rendered":"El futuro de la sanidad en un mundo que se hunde"},"content":{"rendered":"

por Stuart Jeffery<\/em><\/em><\/p>\n\n\n\n

\n

\"La verdadera medida de cualquier sociedad se encuentra en c\u00f3mo trata a sus miembros m\u00e1s vulnerables\"<\/em><\/p>\n<\/blockquote>\n\n\n\n

La famosa cita de Gandhi es muy pertinente a la hora de considerar la atenci\u00f3n sanitaria de la que dispone una comunidad. Pero en estos tiempos vol\u00e1tiles, inciertos, complejos y ambiguos de Covid-19 y del probable colapso que se avecina por las emergencias gemelas del clima y la ecolog\u00eda, \u00bfc\u00f3mo cuidaremos de nuestros miembros m\u00e1s vulnerables, incluidos los que requieren atenci\u00f3n sanitaria?<\/p>\n\n\n\n

En su art\u00edculo sobre la salud centrada en las personas, Asiya Odugleh-Kolev<\/a> se\u00f1ala de forma \u00fatil algunos de los retos a los que se han enfrentado los sistemas sanitarios y las comunidades durante la pandemia de Covid-19, especialmente en lo que respecta a la integraci\u00f3n de los servicios y la salud emocional. Dado que Covid-19 es s\u00f3lo un precursor de la serie de colapsos a los que se enfrenta el mundo, y que en general hay muy poco escrito sobre c\u00f3mo podr\u00eda cambiar la atenci\u00f3n sanitaria de forma realista en las pr\u00f3ximas d\u00e9cadas, estos escenarios futuros parecen estar maduros para el debate.<\/p>\n\n\n\n

La pandemia de Covid-19 ha puesto de manifiesto nuestro deseo de atenci\u00f3n sanitaria de una manera que muchos de nosotros en Occidente nunca hab\u00edamos experimentado realmente, una necesidad que quiz\u00e1s tiene menos que ver con el deseo y m\u00e1s con la necesidad de salvarse de la muerte. Esta necesidad, nacida de nuestro profundo miedo a la muerte, es algo que durante mi \u00e9poca de enfermera presenci\u00e9 repetidamente. La necesidad de arreglos externos que abdican de la responsabilidad personal s\u00f3lo es superada por el deseo de salvar nuestra propia vida o la de un ser querido a cualquier precio. La idea de que la muerte es una parte esencial de la vida sigue metida en el fondo del sof\u00e1 de nuestro inconsciente colectivo.<\/p>\n\n\n\n

Nuestros antepasados tuvieron que enfrentarse a la muerte de una manera fundamentalmente diferente. Hace unos a\u00f1os, mientras investigaba mi propio \u00e1rbol geneal\u00f3gico, descubr\u00ed a una tatarabuela que dio a luz a 16 ni\u00f1os, la mayor\u00eda de los cuales murieron antes de cumplir un a\u00f1o, antes de que ella misma muriera al dar a luz. No puedo ni imaginar lo que habr\u00eda experimentado cada vez que un ni\u00f1o mor\u00eda. Hoy en d\u00eda, en el Reino Unido, estas muertes infantiles y maternas son tan raras que se convierten en esc\u00e1ndalos nacionales.<\/p>\n\n\n\n

Mientras escribo esto, la \u00faltima oleada de Covid-19 en el Reino Unido est\u00e1 bajo las garras de la \u00faltima variante, pero esto es en un pa\u00eds que ha vacunado a dos tercios de su poblaci\u00f3n adulta, y sin duda tendr\u00e1 suficiente capacidad de la UIT para hacer frente a las nuevas variantes, siempre y cuando la vacuna siga siendo ampliamente eficaz. El sur global, en particular la India, de donde procede esta cepa, no est\u00e1 haciendo frente a la situaci\u00f3n; un problema agravado por el hecho de que los pa\u00edses ricos est\u00e1n comprando vacunas a un nivel mucho mayor que los pa\u00edses de ingresos bajos y medios.<\/p>\n\n\n\n

El Servicio Nacional de Salud del Reino Unido depende de su capacidad para reclutar m\u00e9dicos de \u00c1frica y otros pa\u00edses menos favorecidos para mantener nuestro personal sanitario, una capacidad de reclutamiento que se basa en la injusticia econ\u00f3mica mundial. El fracaso que suponen nuestros insostenibles bajos niveles de formaci\u00f3n en el Reino Unido s\u00f3lo es comparable a nuestra incapacidad para ver el cambio demogr\u00e1fico que har\u00e1 que el n\u00famero de personas mayores, de m\u00e1s de 85 a\u00f1os, casi se duplique en 2043 (ONS, 2018<\/a>). El coste per c\u00e1pita de la asistencia sanitaria es el m\u00e1s elevado en este grupo de edad, cinco veces superior al de las personas de 60 a\u00f1os (Public Health England, 2019<\/a>). El NHS no es sostenible ahora y ciertamente no a medio o largo plazo. Por supuesto, una o dos nuevas variantes pueden cambiar esa demograf\u00eda en los pr\u00f3ximos a\u00f1os; al fin y al cabo, el futuro es vol\u00e1til, incierto, complejo y ambiguo.<\/p>\n\n\n\n

Si el NHS del Reino Unido tiene dificultades para sostenerse, el panorama mundial es peor. La mitad de los pa\u00edses de la OMS tienen menos de 3 enfermeras por cada 1.000 habitantes, en comparaci\u00f3n con el Reino Unido, que tiene alrededor de 8 (OMS, 2021<\/a>). La situaci\u00f3n es similar para los m\u00e9dicos; simplemente no hay suficientes cl\u00ednicos en todo el mundo para satisfacer las necesidades actuales de atenci\u00f3n sanitaria.<\/p>\n\n\n\n

Al reto demogr\u00e1fico y a la insuficiencia global de personal cl\u00ednico capacitado, debemos preguntarnos qu\u00e9 sucede cuando el cambio clim\u00e1tico, la emergencia ecol\u00f3gica, el agotamiento de los recursos y la contaminaci\u00f3n aumentan su influencia en el mundo. \u00bfC\u00f3mo podemos mantener la salud y la asistencia sanitaria en un mundo que est\u00e1 en colapso o en declive? La consecuci\u00f3n del Objetivo de Desarrollo Sostenible de la ONU de una asistencia sanitaria universal ser\u00e1 sin duda m\u00e1s dif\u00edcil ante el colapso.<\/p>\n\n\n\n

Hay al menos un ejemplo de un pa\u00eds que ha pasado por un colapso econ\u00f3mico y, sin embargo, ha visto prosperar la atenci\u00f3n sanitaria. La crisis del petr\u00f3leo que sufri\u00f3 Cuba a principios de los a\u00f1os 90 destruy\u00f3 su econom\u00eda, pero el compromiso de mantener la asistencia sanitaria -y, posiblemente, lo que es m\u00e1s importante, la concentraci\u00f3n en la formaci\u00f3n de los m\u00e9dicos- hizo que la asistencia sanitaria en Cuba fuera una de las \u00e1reas menos afectadas por la crisis (Jeffery, 2008<\/a>).<\/p>\n\n\n\n

Puede que las secuelas de Covid-19 proporcionen un renovado enfoque global en la atenci\u00f3n sanitaria, con un cambio en la formaci\u00f3n, la cooperaci\u00f3n y el apoyo internacionales, la salud p\u00fablica entrando en la primera l\u00ednea de la pol\u00edtica, etc. Vivo con una esperanza desesperada.<\/p>\n\n\n\n

Sin embargo, podemos estar seguros de que aumentar\u00e1 la ansiedad a medida que la demanda y la asequibilidad de la asistencia sanitaria aumenten mientras la salud global disminuye en el futuro. Esta ansiedad, nacida de nuestro actual rechazo a afrontar nuestra mortalidad y nuestro aferramiento a la necesidad de curas r\u00e1pidas para cada enfermedad, probablemente har\u00e1 que los gobiernos protejan la asistencia sanitaria en mayor medida que otros \u00e1mbitos de la econom\u00eda, al menos si esos gobiernos desean permanecer en el poder durante mucho tiempo.<\/p>\n\n\n\n

Mientras que los colapsos sociales y econ\u00f3micos ser\u00e1n tangibles, ya existe una crisis de significado y prop\u00f3sito, una crisis espiritual que est\u00e1 impulsando el colapso m\u00e1s amplio y que se juega en nuestra negativa a aceptar la muerte. \u00bfQuiz\u00e1s hay un aprendizaje de la Naturaleza, un conocimiento y una comprensi\u00f3n que se perdieron cuando nos volcamos en los falsos dioses del progreso y el crecimiento perpetuo?<\/p>\n\n\n\n

Asumir la muerte y la enfermedad como parte de la riqueza de la vida ser\u00eda un gran salto para las sociedades modernas, en el que podr\u00edamos intentar aprender de la forma en que nuestros antepasados se enfrentaron a ella y de c\u00f3mo el resto de la naturaleza tambi\u00e9n lo hace. Tal vez, ese aprendizaje, combinado con nuestro mayor conocimiento de la salud p\u00fablica, podr\u00eda hacer que el colapso de la asistencia sanitaria fuera menos doloroso de lo que podr\u00eda ser.<\/p>\n\n\n\n

Stuart Jeffery es un enfermero y antiguo directivo del NHS que ahora da clases en la Universidad de Kent sobre atenci\u00f3n sanitaria global sostenible. Ha creado un nuevo grupo de trabajo sobre adaptaci\u00f3n profunda en el futuro de la asistencia sanitaria y social<\/a> y busca personas que se unan a ese debate. <\/em><\/p>\n\n\n\n

Imagen: \"Protecci\u00f3n\" de Rini Widariyanti, de su \"Detr\u00e1s de la m\u00e1scara 2020<\/a>\"exposici\u00f3n. Rini y su marido, Made, son artistas contempor\u00e1neos indonesios afincados en Bali. Sus medios de vida se han visto gravemente afectados por el impacto de la pandemia en el turismo de Bali. Ya no mantienen un sitio web, pero se puede contactar con Katie<\/a> en el equipo editorial de DA Forum que puede ponerle en contacto con ellos si desea apoyarlos comprando alguna de sus obras.<\/p>","protected":false},"excerpt":{"rendered":"

by Stuart Jeffery \u201cThe true measure of any society can be found in how it treats its most vulnerable members\u201d Gandhi\u2019s famous quote is highly relevant when considering the health care that is available to a community. 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