Although Barcelona in recent weeks has been in the global media focus, the truth is that it has not been easy to start this seventh notebook. It seems like everyday life and the ability to get surprised are enemies. It seems like we do not see the same way the streets we have walked many times. I have get used to writing from hills full of mosques, aseptic hotel rooms, jungles, ancient buses, desserts, savannahs, marginal districts, and battered hospitals. But stories are there, in every corner, in every conversation with a loved one or with a stranger, in the false headlines of the press, even in what is not said, in the things that are not spoken of.

Ivan Zahinos writing in Riberalta – Bolivia

My neuronal drifted, anaesthetized by a good deal of apocalyptic news, once again focused on what the press and the politicians insisted on making me think. But I made an effort to travel and look for the essence, the memories, the conversations with many co-workers, … I spent a couple of days going deep (both physically and mentally) into global information, into reality, into what I have learned, here.

Skyline of Maputo, Mozambique

A week ago, right the day of the publication of the sentence against the independent leaders, I went to the emergency services of one of the most important referral hospitals of Catalonia — Parc Taullí. Being used to going to health centres all over the planet to evaluate their services, to meet the people in charge, to see them from the side that provides the service, it feels estrange to visit them as a patient or accompanying a family member. The patients were piled on stretchers in the emergency corridor while the professionals were not able to respond to all the needs, questions, and demands of the companions. Once again I felt the pride emanated by health workers, their dedication, their closeness, their quality and warmth.

But in that oppressive atmosphere I also felt on the skin the 28% health spending reduction that has been suffering Catalonia for 8 years. Those who read these lines and are from this area, they are surely thinking “there’s nothing new under the sun. People from other countries may be surprised. In that corridor I thought that a health system, is a living organism that does not suddenly die when taking away the nutrients, it shrinks little by little, sometimes so slowly that you do not perceive it until there is no turning back. In fact, it is more accurate to say that it is a parasitized being that is slowly dying.

The Foundation Institute for the Development and Integration of Health (IDIS) — lately I only have to see disturbing euphemisms in the names of the well-intentioned foundations aims “to promote the improvement of the health of citizens and to value private health ” (www.fundacionidis.com). Because of the figures in their latest report, they are doing well, at least with regard to the second part of their objective: more than 2.5 million people in Catalonia are already users of private health, that is, 1 in 3 citizens.

There is no doubt that we are facing a classic physics experiment, the communicating vessels. Policies designed and implemented in recent years in Catalonia are suffocating the public system. Queues grow, waiting lists get long, visits to specialists can take many months, and emergency services are collapsed. On the other hand, it gives wings to private health, which states that its services contribute to the clearing and saving of the public system. Hundreds of members of the board of directors of clinics, insurances, and private hospitals occupy the chairs and grab the microphone (well, it is better to talk in past tense, occupied and grabbed because now in the gatherings only talk about the same topic) to brand in our minds: public health is not sustainable.

It is now, scrubbing with the scourer of what has been lived to get rid of the drowsiness that this (supposed) developed world produces, that I wonder, is that where we are going? To a meagre public system for the poor and a private health system for the rich? To make medical visits in which the professional has a stethoscope in one hand and the cash register in the other? I have already seen this model in many countries and it is the ideal fuel for inequality, frustration, anger and finally (not exclusively) conflict and violence. If there is no health for everyone, there is never social peace.

I left that hallway with my body and mind uneasy. I didn’t doubt that all the media would be available to my mother, who was in good hands, but the red alarms sounded in my mind. On the way to look for the car, the conflicts, the burdens, and the races between independent groups and the local police followed. Disturbed by the strangeness of the environment, other news came to mind (my brain would be a study copy in the hands of Hume) that had long been around me.

We are together

On September 8, the government of Spain published a report on the cooperators. Among other interesting facts, it called my attention that, currently, only the 18% of them are less than 35 years old. I read the news while in Bolivia, and since then, all these weeks I have been thinking a lot about this number. The economic crisis and conservation policies have left international cooperation at its worst. It certainly does not seem like a career opportunity for young people today. But I keep thinking if there will be no other reasons that explain this low percentage. At a time when we travel more than ever, it seems that travel is just another showcase to see what the screens show us, to live the experiences, to almost feel that you could get lost in that destination. But it does not seem that seeing reality is the same as wanting to transform it, or perhaps the youngest no longer see cooperation as a way of doing it. If this is the case, I don’t blame them: 20 years in this world mean a lot of contradictions. But, even without being able to talk about impact, about transformation, without knowing to what extent what we do provides more or less global justice, what I do not doubt is that, at least, knowing so closely the inequality that exists in the world, it makes you see with other eyes the blessings that we have here and that we should not lose.

Perhaps that is why, at this moment in which in my city it seems that the important and urgent thing is to talk about other things, I stop along the way and leave here these thoughts that I hope will fulfil two objectives. Those here, that let’s not forget that we have a gift that must be taken care of and defended. To those abroad, as in many of their countries, on this area also they want to take away the right to health, which is done little by little, but effectively, and therefore brothers and sisters, we are in the same fight.

Iván Zahínos
Coordinador de Relaciones Internacionales
medicusmundi mediterrània

*Translated from Spanish into English by Susanna Pujol Clivillé