Written by Evelin Maza, Evelin Mercedes Maza Guia is a physician from the University of Oriente in Anzoátegui, Venezuela.

In this issue

• Cultural views toward healthcare in Latin America

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This month, we have decided to focus on attitudes toward healthcare in some regions of Latin American. Dr. Pedro Lizardo has offered some of the common sayings he has encountered as a physician and resident of several Latin American countries. We will have a bilingual anatomy chart in the next issue.

Cultural views toward healthcare in Latin America

• There are several countries where a myocardial infarction cannot be treated as fast as it should due to the lack of quick response from the ambulance and emergency paramedics team, thanks to this, most people go on their own vehicles to the hospitals before waiting for paramedics to arrive, or even worse, they may even wait for the next day. “Mejor voy yo mismo al hospital, para cuando llegue la ambulancia ya estaré muerto” — “I’d better go to the hospital by myself, by the time the ambulance arrives I’ll be already dead”
• Some Latin American countries like Chile, Argentina, Uruguay and Venezuela have universal health care even though most hospitals don’t have all equipment available. “En el hospital me atendieron gratis y me mandaron algunas medicinas, aunque tuve que esperar mucho tiempo y casi no había doctores ni insumos” — “I was treated for free at the hospital even though they were lacking doctors and medical equipment”
• In some Latin American countries (Venezuela, Argentina), contrary to the U.S, you could get treated for an myocardial infarction or cardiovascular related disease almost right away after arriving to the hospital without having to wait for any diagnostic procedure thanks to the more focused semiology based medicine and lack of diagnostic equipment. “En el Hospital de Venezuela me atendieron enseguida por el infarto que tenia sin tener que esperar por los resultados de los exámenes, de haber esperado como en otros países quién sabe si estuviese vivo” — “In the Venezuelan hospital I was treated right away for my myocardial infarction without having to wait for any diagnostic procedure. If I had waited for the results like some other countries who knows If I might’ve still be alive”
• The highest prevalence of cardiovascular mortality can be found in Nicaragua, Dominican Republic, and Trinidad and Tobago, with men being the highest %. This is mostly a cultural thing and “machismo”, going to the doctor or caring about your health can be seen as sign of weakness “Vas a ir al medico?, pareces mujercita” “Y eso que andas haciendo dieta? No pareces hombre” — “Going to the doctor? You look like a woman” “What? You are on a diet? You don’t look like a man”
• Old people are more reluctant to seek help for cardiovascular related problems in most countries in Latin America “No mija, yo no voy al medico, prefiero quedarme en mi casa, total, de cualquier cosa uno se muere” — “No deary, I don’t go to the doctors, I’d rather stay at home, in the end, you could die from anything”
• There’s a big difference between the high (rich) and low (poor) layers of the social economic structure when it comes to seeking medical consultation in almost every LA based country. The rich will go the doctors almost immediately while the poor will seldom do it, this is due to the cost of the medicines and even social and cultural misconception “Ayer fui al medico y me mando 3 pastillas bien caras que la propia consulta, para eso me quedo en mi casa la próxima vez” — “I was at the doctor yesterday and he prescribed 3 very expensive pills to me, they cost more than the consultation itself, I’d rather stay at home the next time”
• Old people will seldom complain about cardiovascular related symptoms, some can even suffer from very elevated blood pressure (200 diastolic/100 systolic) and won’t even notice or care about “Papa! Tienes la tensión demasiado elevada! No entiendo como sigues vivo!” “Tengo años así cariño, eso es normal” — “Dad! You have extremely high blood pressure! I don’t get how you are still alive!” “I’ve had that pressure for years my dear, it is something normal for me”
• It is culturally accepted to first seek help or suggestions from family members or friends before actually going to the physician when it comes to health related problems, including cardiovascular ones “Compadre debería ir al médico? Tengo como un dolor en el pecho” “Si te empezó ahorita no creo que sea algo tan peligroso, mejor esperate a ver si te empeora” — “Hey man, should I go to the doctor? I have some sort of pain on my chest” “If it is something that just started I’d rather way until it gets worse”
• Some poor rural areas of several Latin American countries (like Colombia, Ecuador, Venezuela, Guatemala, Peru, Bolivia) will mostly seek for holistic and herbal cures before actually going to a medical consultation “Mija mejor tomese este tesito de hierbas, le caerá mejor que esas cosas que le manda el médico” — “Deary, you better take this herbal tea, it will work better than those things the doctor prescribes you”
• Here are some questions you could ask to a Latin american citizen in order to better discern about their myocardial infarction symptoms.
  • Tiene dolor en el pecho? — are you experiencing chest pains?
  • Siente náuseas? — do you feel Nausea?
  • Esta sudando mucho? — are you sweating a lot?
  • Siente como si se fuera a morir? — do you feel like you are about to die?

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