Santo Domingo. – Directores de distintas áreas del Servicio Nacional de Salud destacaron la inversión de casi mil millones de pesos en equipamiento de centros durante los 19 meses de la presente gestión, además de mejoras en infraestructuras, inauguración de centros y unidades de servicio, designación y capacitación de personal, además de abastecimiento de insumos y medicamentos, entre otras acciones que evidencian una significativa mejoría en el servicio público de salud, abandonado durante 16 años.
Los directores de Centros Hospitalarios y Materno Infantil del SNS, así como el director del Ney Arias Lora, durante participación en medios televisivos, resaltaron la millonaria deuda encontrada y calificaron como deplorable el estado de los hospitales, muchos de ellos con trabajos de reconstrucción paralizados funcionando a la mitad de su capacidad.
La doctora Yocasta Lara, citó casos de los hospitales Padre Billini y Nelson Astacio, cuyos trabajos reiniciaron en esta gestión y no se detendrán hasta concluirlos. También refirió la situación del hospital de Jarabacoa, sin equipo de Rayos X y usuarios debían trasladarse a La Vega o Santo Domingo para esos estudios, también en el Taiwán de Azua, la Unidad de Cuidados Intensivos nunca había funcionado y ya ofrece el servicio; en Nuestra señora de Regla, en Baní, que el laboratorio solo hacía hemogramas y las cirugías estaban suspendidas, ahora todo tipo de pruebas, además de que fue completamente remozado. También destacó la apertura de un departamento de oncología en el hospital San Vicente de Paúl y unidad de Gastroenterología en el Luis L, Bogart de Mao.
De Igual manera, el director del Ney Arias destacó que el SNS encontró una deuda de más de cuatro mil millones de pesos en hospitales la cual ha ido reduciendo. Explicó que solo en el centro que dirige, era de 60 millones y actualmente tienen más de un año sin deudas a suplidores y el centro funcionando en total capacidad, con un superávit mensual y aumento en la asistencia, que reportó más de un millón 200 mil servicios ofrecidos a la población durante el pasado año. “Era prácticamente imposible decir que un hospital, que son los alegados barriles sin fondo, pudiera tener un año sin deuda a suplidores”, agregó.
Julio Landrón aseguró que muchos centros de la Red Pública están muy por encima de la mayoría de las clínicas, no solo en el servicio sino también en hotelería. “En este gobierno pasó a la historia eso de que no hay guantes en los hospitales, jeringuillas, que hay que salir a comprar un suero y eso es un gran avance”, dijo. Sobre la formación de los directores, dijo que más del 90% están capacitados en gerencia de salud, ya que el SNS está invirtiendo en la capacitación de los galenos para garantizar la adecuada gerencia de los centros públicos.
Mientras, la directora de Centros Hospitalarios explicó que la falta de especialistas en zonas remotas obedece al desinterés de los médicos en residir en esas provincias a pesar de que ofrecen incentivos especiales. Dijo que se evalúa instaurar la pasantía de postgrados y otros beneficios que son discutidos con el gremio médico.
“En el SNS estamos trabajando 24/7, sin descanso en fines de semana ni feriados, para supervisar los centros de salud, identificar y suplir necesidades, llevar equipamientos e implementar otras acciones para procurar que la población no tenga que trasladarse fuera de su localidad o deba pagar para recibir servicios de salud” declaró Yocasta Lara.
Mortalidad materna y neonatal
El director Materno Infantil y Adolescentes del SNS, Martín Ortiz, garantizó que este año el principal desafío es la tolerancia cero a la mortalidad materna y neonatal, con la priorización de los 20 hospitales materno-infantiles que registran el 80% de estas muertes y que son fortalecidos en sus protocolos de atención, equipamiento y personal requerido, entre otras acciones para garantizar la sobrevida de las madres y sus bebés.
Calificó como difícil el año 2021 por la mortalidad materna a causa del COVID-19, que fue de un 26.7%, es decir, más de 30 mujeres que no contaban con la vacuna. Sin embargo, de diciembre a la fecha, luego de la vacunación masiva, afirma que no se ha muerto una embarazada por COVID-19.
Asimismo, Ortiz destacó el peso que significan las parturientas extranjeras, principalmente haitianas. Dijo que, de 17 mil partos en 2018, aumentó a 30 mil en 2020, en 2021 fueron 35 mil y en lo que va del año, hasta febrero, van 6,094 haitianas, un 26% del total”.
El galeno explicó que todo eso incrementa la mortalidad materna. El país registró en 2021 un 41.7% de muertes de haitianas, este año van 45 muertes maternas, 19 dominicanas y 27 haitianas, estas últimas representan un 57% de las muertes. “Estamos cargando con una mortalidad materna que no nos corresponde. Nos quitan ese 41.7% de la mortalidad materna y estamos mal pero no tanto, es una carga muy pesada para el Estado”.
El doctor Ortiz explicó que el problema es la condición en que llegan a las Emergencias, directo desde la frontera a parir, sin chequeo previo, con trastorno hipertensivo del embarazo, es decir, presión alta y preeclampsia severa, además de muy mal nutridas, con anemia.
Destacó que el tiempo promedio en cuidados intensivos de una dominicana, por complicaciones en el parto, es de cinco a seis días y de nacionales haitianas es de 15 días, debido a las condiciones en que llegan.
De igual manera, explicó que una embarazada complicada aumenta la posibilidad de mortalidad neonatal por prematuridad. Dijo que las embarazadas con COVID sin vacunas o con trastornos hipertensivos terminan el embarazo antes de tiempo, causando más prematuros y eso eleva la mortalidad neonatal.
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