Pediatric cardiology health brigades: from medical triage to social triage

https://doi.org/10.18294/sc.2018.1789

Published 16 October 2018 Open Access


María Fernanda Olarte-Sierra PhD in Social Sciences. Co-researcher, Program for Innovation in Rare Human Congenital Heart Diseases for Colombia (PINOCCHIO), Fundación Cardioinfantil, Instituto de Cardiología. Researcher, Group of Medical Anthropology, Department of Anthropology, Faculty of Social Sciences, Universidad de los Andes, Bogotá, Colombia. image/svg+xml , Roberto Suárez PhD in Education Sciences. Associate Professor, Principal Researcher, Group of Medical Anthropology, Department of Anthropology, Faculty of Social Sciences, Universidad de los Andes, Bogotá, Colombia. image/svg+xml , María Alejandra Rubio Anthropologist. Research Assistant, Program for Innovation in Rare Human Congenital Heart Diseases for Colombia (PINOCCHIO), Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia.



Abstract views
1031
Metrics Loading ...

Crossref
Scopus
Google Scholar
Europe PMC

Keywords:

Health Services Accessibility, Delivery of Health Care, Social Work, Vulnerable Populations, Colombia

Abstract


This article explores the sociocultural aspects of a program of pediatric cardiology health brigades that provides care to children from low-income populations in peripheral regions of Colombia. We analyzed the brigades as a humanitarian strategy to close the gaps of inequity in access to health care, and as a particular context of the medical encounter, the experience of heart disease and the definition of care trajectories. Based on ethnographic observation of brigades and interviews with families receiving care and with health personnel, carried out in 2016 in five different cities, we looked at the dynamics that shape the medical encounter and questioned the mechanisms (medical and social) through which it is evaluated and decided which families can access care in Bogota. We conclude that the brigades, as initiatives that continue to be anchored in humanitarism instead of contributing to the transformation of the conditions that generate health inequities, reproduce and exacerbate such inequities by selecting which lives receive priority to be saved.

References


1. James A, Prout A. Constructing and reconstructing childhood: contemporary issues in the sociological study of childhood. London: Taylor and Francis; 2015.

2. Tak YR, McCubbin M. Family stress, perceived social support and coping following the diagnosis of a child’s congenital heart disease. Journal of Advanced Nursing. 2002;39(2):190-198.

3. World Health Organization. A conceptual framework for action on the social determinants of health [Internet]. Geneva: WHO; 2010 [citado 19 feb 2018]. Disponible en: https://tinyurl.com/hphekdb

4. Hoffman JIE. The global burden of congenital heart disease. Cardiovascular Journal of Africa. 2013;24(4):141-145.

5. Van Der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, Roos-Hesselink JW. Birth prevalence of congenital heartdisease worldwide. Journal of the American College of Cardiology. 2011;58(21):2241-2247.

6. Sandoval N. Cardiopatías congénitas en Colombia y en el mundo. Revista Colombiana de Cardiología. 2015;22(1):1-2.

7. García A, Caicedo M, Moreno K, Sandoval N, Ronderos M, Dennis R. Diferencias regionales en cardiopatías congénitas. Revista Colombiana de Cardiología. 2017;24(2):161-168.

8. Joumard I, Londoño JL. Income inequality and poverty in colombia - part 1: the role of the labour market [Internet]. OECD Economics Department Working Papers No. 1036. OECD Publishing; 2013 [citado 19 feb 2018]. Disponible en: https://tinyurl.com/ydamrx3w

9. Oliver A, Mossialos E. Equity of access to health care: outlining the foundations for action. Journal of Epidemiology and Community Health. 2004;58(8):655-658.

10. Hernández M. El Derecho a la salud en Colombia: obstáculos estructurales para su realización. Revista de Salud Pública. 2000;2(2):121-144.

11. Fundación Cardio-Infantil, Instituto de Cardiología. Informe anual 30 años [Internet]. Bogotá: Fundación Cardio-Infantil, Instituto de Cardiología; 2003 [citado 19 feb 2018]. Disponible en: https://tinyurl.com/y982vtfd

12. Cueto M. La “cultura de la sobrevivencia” y la salud pública internacional en América Latina: la Guerra Fría y la erradicación de enfermedades a mediados del siglo XX. História, Ciências, Saúde-Manguinhos. 2015;22(1):255-273.

13. Clarke G. Non-governmental organizations (NGOs) and politics in the developing world. Political Studies. 1998;46(1):36-52.

14. Bremmer RH. Giving: charity and philanthropy in history. New Brunswick: Transaction Publishers; 2000.

15. Green A, Matthias A. Non-governmental organizations and health in developing countries. Londres: Palgrave Macmillan; 1997.

16. Piotrowicz M, Cianciara D. The role of non-governmental organizations in the social and the health system. Przeglad Epidemiologiczny. 2013;67(1):69-74.

17. Fassin D. El irresistible ascenso del derecho a la vida: Razón humanitaria y justicia social. Revista de Antropología Social. 2010;19:191-204.

18. Fassin D. Entre las políticas de lo viviente y las políticas de la vida: hacia una antropología de la salud. Revista Colombiana de Antropología. 2004;40:283-318.

19. Guerrero R, Gallego AI, Becerril-Montekio V, Vásquez J. Sistema de salud de Colombia. Salud Pública de México. 2011;53(2):S144-S155.

20. Geertz C. The interpretation of cultures. Nueva York: Basic Books; 1973.

21. Johnson J. On receiving the diagnosis of multiple sclerosis: managing the transition. Multiple Sclerosis Journal. 2003;9(1):82-88.

22. Rivera-Navarro J, Cubo E, Almazán J. The diagnosis of Tourette’s Syndrome: communication and impact. Clinical Child Psychology and Psychiatry. 2009;14(1):13-23.

23. Schouten B, Meeuwesen L. Cultural differences in medical communication: a review of the literature. Patient Education and Counseling. 2006;64(1-3):21-34.

24. Auyero J. Patients of the state: An ethnographic account of poor people’s waiting. Latin American Research Review. 2011;46(1):5-29.

25. Murdock D. That Stubborn “doing good?” question: ethical/epistemological concerns in the study of NGOs. Ethnos. 2003;68(4):507-532.