Visit to the Tampere University Hospital: ER & Specialized Neonatal Care

On Wensday, June 23th, we went to the Tampere University Hospital, one of the five University Hospitals in Finland, corresponding to one of the administrative and territorial division of the Finnish Health System, each of them serving about 0.5 to 2 million people. The most complex medical interventions were performed in this clinical, academic and research institutions. First, we went trough the emergency room: It was very hard to find a single person in a bed... I couldn't find out whether this was always like that or it was an exceptional situation. But the most important point was the fact that they did not have the need to hospitalize people there because there are enough places to receive people in other clinical services of the hospital, in order to give the patient appropriate medical care (The opposite is the rule in the Public Health System in Chile, this is such a huge problem now!). On the other hand, we visited the Service of Neonatology. Here, not surprisingly, I could see a picture very similar to what you could see in my country: the very same technology, the very same division of spaces... maybe some little differences in specific protocols or practices (for instance, you do not feed newborns with donated human brest milk), but essentially, the picture is very, very similar.

Now some reflections. First, regarding to the difference in dealing with medical emergencies: Even though Finland do have many more resources (both in quality and in quantity compared to Chile), However, the Chilean private sector in Chile works pretty much like the Fin

nish one, even though it covers only the 20% of the whole population, more or less. Again, there is a problem with the distribution of the resources. Some people argues that more equity implies and slower rate of economical growing... but I think that we should provide a minimum to all people. The problem is that always someone must pay for that, and political willingness is needed. Also, providing more economical resources to the health systems or institutions not always improve the quality and quality of services that are provided... I do not know how t

o implement a solution, but I think it surely implies a set of interventions at different levels.

Second, regarding to the virtual "lack of differences" in the way neonatal care is provided: This was not surprising in any way, considering that Chile has maternal and perinatal indicators quite similar (or even better in some aspects) to the Finnish ones. This fact demon

strates that, frequently, the most important problems in health have more to do with finding the best mens and strategies to implement the right politics to generate the desired effects than with uncertainty respecting what to do. Sometimes the problem is a matter of lack of resources, it is true, but most of the time the

big problem is the tendency of the social systems to resist to the external change (It is not difficult to recognize self-perpetuating social dynamics of many kinds, sometimes with desirable and other times with not desirable consequences).

I think social change requires a great deal of creativity for findings ways to make people think and reflect about the system they are conserving by their particular actions. I think this is the origin of every successful and long lasting social in-tervention.