Kodi zosowa zachipatala za anthu zikuyenera kukwaniritsidwa bwanji? Pokhala kulibeko pazofalitsa zapadziko lonse lapansi komanso chifukwa chowotchedwa ndi otsutsa osakonda kunyumba, Venezuela ikupanga njira zothandizira anthu onse zosiyana ndi zomwe zimayendetsedwa ndi msika waku US komanso ku Europe. Mwina palibe chomwe chimapangitsa dongosololi kukhala lapadera kuposa mtundu wa madokotala omwe akuphunzitsidwa kuyendetsa.
Chochititsa chidwi choyamba kudziwa za pulogalamu yamankhwala ammudzi ku Venezuela ndi kuchepa kwa zomwe zimadziwika kunja kwa Venezuela. Kuyesera kuphunzitsa masauzande ambiri omwe akufuna kukhala madokotala mumayendedwe opewera anthu aku Cuba, ambiri mwa asing'anga atsopanowa ochokera m'mabanja opeza ndalama zochepa, alibe chidwi ndi zoulutsira nkhani zapadziko lonse lapansi. Poyerekeza ndi nkhani za umbanda, kukwera kwa mitengo komanso kuchepa kwapang'onopang'ono pazachuma, m'malo awa kuyesayesa kupanga "gulu lankhondo la jekete zoyera" kuti masomphenya a chithandizo chaulere chapadziko lonse lapansi ndi zipatala m'dera lililonse chikhale chowona. kufunika kumvetsetsa Venezuela lero.
Komabe madotolo atsopano aku Venezuela tsopano ali ofunikira kwambiri pakugwira ntchito komanso mawonekedwe amtsogolo achitetezo chotsitsimutsidwa mdziko muno. Kuphatikiza apo, panthawi yomwe mankhwala nthawi zambiri amakhala otseguka kwa anthu osankhika okha ndipo ntchito zachipatala zikusokonekera ndikusungidwa ndi maboma odana ndi anthu otchuka, chitsanzo cha ku Venezuela chopanga chithandizo chamankhwala champhamvu cha anthu nthawi zambiri chimakhala chovuta chikuwonetsa padziko lonse lapansi. mlingo.
M'ma TV omwe akupita patsogolo komanso odziyimira pawokha ntchito yofunika yachitika kale yotsegula maso padziko lonse lapansi ku mapulogalamu atsopano omwe amapereka chithandizo chaulere chaulere ku Venezuela. Nkhaniyi ikuyang'ana kwambiri gawo lotsatira la polojekitiyi: kuphunzitsidwa kwa madotolo masauzande ambiri pansi pa pulogalamu yamankhwala ammudzi yothandizidwa ndi Cuba. Ndi funde loyamba la madotolo ammudzi omwe adamaliza maphunziro awo mu Disembala 2011, awa ndi akatswiri omwe tsopano akupanga njira zatsopano zachipatala zapadziko lonse lapansi, kuyambira ku zipatala zakumidzi mpaka ku zipatala. Pakati pa nkhani yotsatirayi ndi kuyankhulana kwachindunji ndi omaliza maphunziro, kufufuza uku kumafuna kuunikira ku Venezuela, ndipo ndithudi Latin America, mtundu watsopano wa madokotala: khalidwe lawo, makhalidwe awo, ndi masomphenya awo amtsogolo a zaumoyo ku Venezuela ndi dziko lonse lapansi.
Chiyambi cha Medicina Integral Comunitaria (MIC) ku Venezuela
Comprehensive Community Medicine (MIC mu chidule cha Chisipanishi) ku Venezuela idabadwa kuchokera ku mgwirizano wathanzi adasaina mu 2005 pakati pa Purezidenti Hugo Chavez ndi Fidel Castro. Monga gawo la mgwirizanowu, posinthana ndi kutumiza mafuta ku Cuba ithandiza dziko la Venezuela kuphunzitsa madotolo ammudzi 30,000 kuti agwire ntchito ya "Barrio Adentro" yaku Venezuela (Mkati mwa Barrio) yaumoyo wa anthu.
Wokhazikitsidwa ndi thandizo laku Cuba komanso wothandizidwa ndi madotolo masauzande aku Cuba, Barrio Adentro adakula mwachangu kuyambira 2003 ndipo ndi gawo lofunikira pakukulitsa chithandizo chaumoyo ku Venezuela. Netiweki ya Barrio Adentro ili ndi magawo anayi, yopereka chithandizo chaulere kuchokera kuzipatala 7,000 zam'deralo mpaka zipatala. Pulogalamuyi ndi kuyeza yakhala ikuthandiza anthu opitilira 500 miliyoni ndikupulumutsa miyoyo yopitilira 1.4 miliyoni kuyambira pomwe idakhazikitsidwa.[I]
Mogwirizana ndi mapulogalamu ena a boma, Barrio Adentro wakhala chinthu chofunika kwambiri pakusintha kwa zizindikiro za umoyo ku dziko la South America pazaka khumi zapitazo. Izi zidawunikidwa mu a phunziro ndi Council for Social and Economic Research yomwe inapeza kuti pakati pa zizindikiro zina, pakati pa 2003 - 2006 yokha imfa ya makanda inagwa ku Venezuela kuchokera ku 18.5 pa obadwa 1000 mpaka 14.2 pa obadwa 1000.
Zachidziwikire, kukulirakulira kwa chithandizo chaumoyo ku Venezuela m'zaka khumi zapitazi kwafuna kuchuluka kwa madotolo owonjezera, ndi kuchuluka kwa madotolo pa anthu 10,000 aliwonse. kotulukira kuyambira 18 mpaka 58 kuyambira 1998 mpaka 2012. Komabe ambiri mwa madotolo atsopanowa sakanatha kutengedwa ku ntchito zachipatala zaku Venezuela. Pamene oyang'anira a Chavez adafuna kuti awonjezere chithandizo chamankhwala chakumayambiriro kwa zaka za m'ma 2000 adapeza kuti masukulu apamwamba azachipatala mdziko muno sakufuna kutsegula zitseko zawo kwa ophunzira ambiri, makamaka omwe akuchokera osauka. Pakadali pano, kupatulapo mwaulemu, madokotala achichepere ofunitsitsa ochepa kapena akatswiri okhazikika achikhalidwe anali ndi chidwi chopita kukagwira ntchito kutawuni. oyandikana nawo (madera osauka) kapena machitidwe akumidzi akumidzi, amakonda kufunafuna ntchito zolipidwa kwambiri m'zipatala zabizinesi zamisika.
M'malo mwake boma la Chavez linatembenukira kwa wothandizana nawo Cuba kuti athandizidwe, osati kungotumiza madokotala kuchokera ku Cuba, komanso kuti athandizidwe pophunzitsa mtundu watsopano wa dokotala ku Venezuela wokonzekera kupereka chithandizo chaumoyo cha anthu onse a ku Venezuela. Chifukwa chake mu 2005 National Training Program in Comprehensive Community Medicine (MIC) idabadwa. Pansi pa ntchitoyi, madotolo aku Cuba omwe amagwira ntchito ku Barrio Adentro atha kuwirikiza ngati aphunzitsi, ndikuphunzitsa omwe alowa m'malo aku Venezuela kuti ayambe kuyang'anira ntchito zachipatala mdziko muno.
Pofika chaka cha 2013 ndondomekoyi ikubala zipatso. Madotolo ammudzi opitilira 14,000 tsopano akugwira ntchito m'zipatala za boma ndi zipatala m'dziko lonselo (8,160 adamaliza maphunziro awo mu Disembala 2011 ndi 6,200 mu Disembala 2012) ngati gawo la zaka ziwiri zakumidzi / zakumidzi zomwe madotolo onse ammudzi ayenera kumaliza akamaliza maphunziro awo. M'malo mwake pulogalamuyo ikukulitsidwa, pomwe boma la Venezuela likufuna kuphunzitsa kuchuluka kwa 60,000 madotolo ammudzi pofika chaka cha 2019. Pakadali pano mapulogalamu omaliza maphunziro awo akukonzedwa kwa omwe akumaliza kukhala kwawo ndipo akufuna kukhala akatswiri pagawo linalake lamankhwala.
Mbali ndi Zolinga za Comprehensive Community Medicine
Kupitilira kupereka madotolo atsopano achipatala ku Venezuela, cholinga chachiwiri cha MIC ndikukhazikitsa njira yatsopano yophunzitsira zachipatala ndi chithandizo chamankhwala ku Venezuela potengera njira zopewera zomwe zimagwiritsidwa ntchito ku Cuba. Mothandizidwa ndi masukulu atsopano aboma monga Bolivarian University of Venezuela (UBV), pulogalamu ya digiri ya zamankhwala ammudzi imatha zaka zisanu ndi chimodzi kuphatikiza maphunziro okonzekereratu azachipatala. Mosiyana ndi madigiri a zachipatala, kuyambira chaka choyamba ophunzira amakumana ndi odwala mwachindunji pothandiza madokotala azipatala zapafupi ndi kutsagana nawo paulendo wa kunyumba ndi nyumba. Monga adafotokozera wolemba Steve Brouwer, yemwe adalemba zambiri pa pulogalamu ya MIC, madotolo aku Cuba amatenga gawo la "kuwonetsa, ndi machitidwe awo komanso chisamaliro chaumoyo wopewera kudwala. oyandikana nawo, mmene dokotala woukira boma amalimbikitsira chidaliro pakati pa odwala ake m’deralo, ndiyeno amawaloŵetsamo m’kupanga chitaganya cha thanzi”.[Ii] Ophunzira amaphunziranso m'chipatala ndi kumidzi m'zaka zawo ziwiri zomaliza za maphunziro, kuonjezera kukhudzana ndi odwala komanso zochitika zothandiza.
Kusiyana kwina ndi chitsanzo cha maphunziro azachipatala omwe amaphunzitsidwa ku Venezuela ndikuti pulogalamu ya MIC ndi yosiyana kwambiri. M'kalasi, m'malo moyambitsa sayansi yamankhwala payekha m'zigawo zakutali, mfundo zomwezo zimaperekedwa mu "maphunziro apamwamba" kupyolera mu maphunziro amitundu yosiyanasiyana omwe amalukira pamodzi maphunziro kuchokera ku anatomy kupita ku immunology. Othandizira amati njira iyi imagwiritsa ntchito bwino chidziwitso cha sayansi pakumvetsetsa kwathunthu kwa thupi la munthu komanso mawonekedwe ovuta.[III] Makalasi nthawi zambiri amachitikira m'zipatala za netiweki ya Barrio Adentro, pomwe ophunzira amagawidwa m'magulu osiyanasiyana ophunzirira, kapena ma nuclei.
Cholinga chachitatu cha pulogalamuyi ndikupanga madokotala omwe ali ndi makhalidwe osiyana ndi omwe amayendetsedwa ndi msika wa zaumoyo zomwe zafala ku United States komanso anthu olemera kwambiri a ku Venezuela. Madokotala ammudzi akuyembekezeka kukhala ophunzitsidwa mwamphamvu komanso osamala za chikhalidwe cha anthu; odzipereka ku chithandizo chamankhwala chaboma ndipo amayang'ana kwambiri zosowa za odwala ndi madera awo m'malo mofunafuna ntchito zopindulitsa m'zipatala zapadera. Hugo Chavez adalimbikitsa madokotala ammudzi pophunzitsidwa kuti akhale "madokotala a socialism", ndi analengeza kwa madotolo ammudzi ongomaliza kumene maphunziro awo pamwambo mu February 2012 wakuti “Dokotala akhale mtsogoleri wa anthu; dokotala weniweni samangokhalira kuchipatala, koma amapitanso kumudzi”.
Pulogalamu ya MIC ndi gawo la maphunziro apamwamba omwe amapangidwa pansi pa ulamuliro wa Chavez. Amene amaphunzira zachipatala cham'deralo salipira maphunziro ndipo amalandira ndalama zochepa (pakali pano pafupifupi 40% ya malipiro ochepera) kutengera ndalama zogwirira ntchito, ndi ophunzira ambiri ochokera m'madera osauka. Pulogalamuyi yapereka mwayi kwa masauzande ambiri omwe akufuna kukhala ophunzira azachipatala omwe sakanatha kulowa m'sukulu zachipatala zachikhalidwe mdziko muno, mwina chifukwa choti sangakwanitse kapena chifukwa cha tsankho lobisika m'masukulu ololedwa. Komanso, ambiri mwa ophunzira a MIC ndi akazi: 77% ya madokotala ammudzi omwe anamaliza maphunziro awo mu December 2012 anali akazi.
Venezuela yafalitsanso mankhwala ammudzi ku Latin America ndi padziko lonse lapansi kudzera mu "Salvador Allende" Latin American School of Medicine (ELAM) ku Caracas. Kudzera mu bungweli, ophunzira 2,200 ochokera kumayiko 42 panopa akuphunzitsidwa, mwachilolezo cha boma la Venezuela, pazamankhwala ammudzi. Akamaliza maphunziro awo akuyembekezeka kubwerera kumayiko akwawo kuti akalimbikitse zithandizo zachipatala kumeneko ndikutumikira anthu awo.
Kuwunika Pulogalamu
Polemba mu 2010, mtolankhani waku US Steve Brouwer adanenanso kuti zitha kutenga zaka zingapo kuti madotolo ammudzi afufuzidwe bwino. Zowonadi, ndi mafunde oyamba a madotolo ammudzi omwe adamaliza maphunziro awo mu Disembala 2011, pokhapo pomwe madokotala atsopanowa ayamba kugwira ntchito m'dongosolo laumoyo wa anthu onse ndizotheka kuyamba kutero ndi maziko aliwonse otsimikizika.
Komabe, kutengera kafukufuku wake komanso momwe adawonera maphunziro ndi maphunziro a MIC, Brouwer adapereka kuwunika kwabwino kwa pulogalamuyi. Iye adanena za ntchito ya National Academic Coordinating Committee ya Barrio Adentro polimbikitsa kusintha kwa pulogalamuyo ndipo adanena kuti "zofooka zoyamba za pulogalamuyi zinagonjetsedwa mofulumira", zomwe zinawonetsedwa pakukwera kwachiphaso ndi kusungirako kwa ophunzira atsopano pakati pa 2006 ndi 2008. XNUMX. Komanso, adanena kuti kafukufuku wa ofufuza zachipatala aku Cuba ndi Venezuela "amasonyeza kuti Medicina Integral Comunitaria (MIC) ikupita ku njira yoyenera".[Iv]
Nduna za boma zaperekanso ndemanga zabwino za madotolo ammudzi, omwe ndi zotsatira za imodzi mwamadongosolo a maphunziro a boma. Pamwambo woyamba womaliza maphunziro a madotolo ammudzi mu February 2012, mochedwa Purezidenti Hugo Chavez adanena omaliza maphunziro, “Ndili ndi malipoti oyamba a ntchito yanu yabwino kwambiri. Mukutumikira anthu”, pomwe nduna ya zamaphunziro ku yunivesite, Yadira Cordova, anati kuti madokotala ammudzi adzakhala "madokotala abwino kwambiri omwe dziko lino labereka".
Komabe, mtundu wa pulogalamu ya MIC ndi omaliza maphunziro ake adatsutsidwa ndi mamembala otsutsa, magulu azama media otsutsa, komanso moyipa kwambiri, ndi mabungwe azachipatala aku Venezuela. Mawu awa amatsutsa kuti ophunzira a zamankhwala ammudzi ammudzi alibe maphunziro othandiza pazipatala komanso ukadaulo. Amanenanso kuti pulogalamuyi ilibe zida zogwirira ntchito, maphunziro ndi otsika komanso kuwunika kocheperako.
National Academy of Medicine, bungwe loyimira madokotala ku Venezuela, likuwoneka kuti latsogolera kutsutsa kwa MIC. Mu lipoti la 2012 la National Academy loyesa malingaliro a akatswiri azachipatala okhudza madokotala atsopano omwe amawaika m'chipatala, makumi asanu ndi atatu mwa anthu XNUMX aliwonse omwe anafunsidwa adafotokoza kuti madotolo am'deralo ndi "oipa", ndipo palibe "opambana". Lipotilo linapitilira fotokozani pulogalamu yokwanira yamankhwala ammudzi ngati "chinyengo chowona chamaphunziro".
National Academy idatsutsanso kulowa kwa madotolo ammudzi m'chipatala chaboma, kutsutsana ndi kusintha kwa lamulo la Venezuela pakugwiritsa ntchito mankhwala mu 2011 kuti alole omaliza maphunziro a MIC kuti azichita mwalamulo. Mu a kuyankhulana ndi flagship conservative paper El Universal mu October 2011, pulezidenti wa National Academy, Claudio Aoun Soulie, anapezerapo zotsutsa zotsutsa pulogalamu kulungamitsa kaimidwe izi. Komabe pafupifupi zotsutsa zonse zomwe zatchulidwa zinali zolakwika; mwachitsanzo, ophunzira a MIC sadziwa za zovuta zazikulu zomwe zimakhudza anthu aku Venezuela, kuti samalowa m'maopaleshoni kapena kubereka, komanso kuti sapanga malo akumidzi kapena ngozi kapena mwadzidzidzi. Woimira akuluakulu azachipatala ku Venezuela anapitiliza kunena kuti, "Ngati sitisiya chithandizo chamankhwala kuperekedwa m'manja mwa anthu osayenerera, madandaulo okhudza kusachita bwino adzachulukira mphindi imodzi".
Pamene funde loyamba la madotolo ammudzi adamaliza maphunziro awo mu Disembala 2011 zodzudzula izi zidatengera mawonekedwe a kampeni yonyoza pulogalamu ya MIC. Mabulogu "amawulula" zomwe akuti akulakwitsa ophunzira a MIC ndi ma memes akunyoza ndi zina nthabwala za pa intaneti kusonyeza madokotala a m’deralo kukhala osakhoza ndi opusa kunachulukirachulukira, pamene kudzudzulidwa ndi madokotala ochiritsira kunkawoneka mopanda malire, ankhanza, ndipo nthaŵi zina konama kotheratu. Mu a kuyankhulana ndi nyuzipepala yaku Venezuela Nthawi mu November 2012, mkulu wa College of Doctors m'chigawo cha Anzoátegui, Asdrúbal González, adafika ponena kuti madokotala aku Cuba ku Venezuela ali ndi "60 - 70% ya vuto la matenda", ndipo adanena za madokotala ammudzi omwe amawaphunzitsa. , "Sindikudziwa chifukwa chake akuphunzitsidwa, koma sikuyenera kukhala madokotala".
Kampeni yolimbana ndi chithandizo chamankhwala cham'deralo idadzetsa kusamvana pakati pa nzika zambiri za mtundu wa pulogalamuyi komanso momwe omaliza maphunziro ake alili. Zolakwika izi zidawunikidwa mu a kafukufuku wamsewu ndi media media yaku Venezuela Noticias 24 mu February 2012 maganizo a nzika za madokotala ammudzi. Ngakhale panali mayankho ambiri abwino, woyankha wina adati amangoonana ndi dotolo wakuchipatala osati dotolo wa mderalo, nati, "Ngati kuti uphunzire udokotala uyenera kuphunzitsidwa zaka zisanu kenako ukamaliza maphunziro awo, sichoncho." Ndizomveka kwa ine kupita kwa dokotala yemwe waphunzira digiriyo kwa nthawi yochepa”. Madotolo ammudzi omwe amaphunzitsidwa amaphunzira kwa zaka zisanu ndi chimodzi, kuphatikiza ma internship akumidzi ndi zipatala, asanakhale zaka ziwiri ndikupitilira maphunziro apamwamba, monga amachitira madotolo ena.
Kwa asing'anga ndi othandizira azachipatala athunthu, kampeni iyi yayimira zambiri osati kungowukira kwa pulogalamu ya boma kapena kudzutsa kutsutsa kulikonse kovomerezeka kwa MIC. Zikuwonetsanso momwe akuluakulu azachipatala aku Venezuela amachitira komanso omwe amateteza njira zachipatala zozikidwa pa msika zomwe zikuwopseza mwayi ndi zokonda za gululi. Kuzipatala zachikhalidwe zaku Venezuela, kuchuluka kwa madotolo ophunzitsidwa bwino aku Cuba ochokera kumayiko opeza ndalama zochepa, omwe tsopano akugwira ntchito m'zipatala zaboma limodzi ndi madotolo ochokera kumagulu azikhalidwe, nthawi yomweyo ndi nkhani yandale komanso yamagulu. Ndizotheka ndithu kuti madokotala ena amaonanso kuti madokotala a m’dera lawo ndi amene amapikisana nawo polowa m’mapulogalamu omaliza maphunziro awo ndi ntchito, zomwe zikuwonjezera kudana nawo.
Othandizira zachipatala zamagulu am'deralo ayankha zodzudzula ndi zosokoneza pofotokoza zomwe zili mu pulogalamuyi komanso momwe zidakhalira pomwe akulozera momwe madokotala ammudzi amathandizira. Mwachitsanzo, patatha miyezi isanu ndi umodzi kuchokera pamene pulezidenti wa National Academy anachenjeza za “mphindi ndi mphindi” zolakwa za omaliza maphunziro a MIC, Unduna wa Zaumoyo. inanena kuti silinalandire dandaulo limodzi lokha la kulakwa kwa dokotala wa anthu. Otsutsa pulogalamuyi akuwunikiranso kuti ophunzira amalandila maphunziro athunthu ndi madotolo ophunzitsidwa bwino. odziwika padziko lonse lapansi Mankhwala aku Cuba[V], phunzirani zambiri zothandiza pa intaneti ya Barrio Adentro, ndipo m'zaka zawo zachisanu ndi zisanu ndi chimodzi za maphunziro amapita kumidzi ndi chipatala. Kuphatikiza pa izi, ambiri omaliza maphunzirowa amanyadira zomwe mankhwala ammudzi amawaphunzitsa monga madokotala, monga kutenga nawo mbali pazachipatala komanso kuthandiza anthu pazachipatala.
Akuluakulu nawonso yosangalatsa kuti pulogalamu yokwanira yamankhwala ammudzi yakhala ikuwongolera kuyambira pomwe idakhazikitsidwa. Zosintha zaposachedwa zikuphatikiza kukhazikitsa zokambirana zapadera za ophunzira m'zaka zawo ziwiri zomaliza, kupatsa ophunzira zida zophunzitsira zambiri, komanso kuti ophunzira a MIC ayambe kuphunzira zachipatala kuyambira chaka chachitatu cha maphunziro.
Momwemonso, mtolankhani waku France a Jean Araud adawonetsa kufanana pakati pa kampeni yolimbana ndi madotolo ammudzi ndi kampeni ya otsutsa mu 2003 motsutsana ndi madotolo aku Cuba a Barrio Adentro system, omwe adajambulidwa ngati akazitape aku Cuba kapena osadziwa zamankhwala. Araud ananeneratu kuti monga mu 2003, zodzudzula omaliza maphunziro a MIC zidzalephera kulepheretsa anthu kufunafuna chisamaliro chawo, popeza madotolo ammudzi "sakulowanso nthumwi zaku Cuba" koma m'malo mwake ndi madotolo aku Venezuela omaliza maphunziro, "opereka chithandizo chaumoyo chaumunthu komanso chapamwamba kwa anthu chonse.
Maganizo Otsiriza
Boma la Venezuela likufuna kukhazikitsa pulogalamu yatsopano yophunzitsira zachipatala kuyambira pansi ndikuphunzitsa madotolo masauzande ambiri kuti akhazikitsenso dongosolo laumoyo wa anthu mdziko muno yakhala njira yolimba mtima, ndipo phindu lake tsopano likuwoneka kutalika ndi kufalikira kwa dziko. . Zachidziwikire kuti pulogalamuyi idakumana ndi zopinga ndi zovuta zambiri, monga kusowa kwa zida zoyambira, kufunikira kwa madotolo aku Cuba kuti agwire ntchito yovuta yophunzitsa maphunziro atsopano, komanso malingaliro odana ndi azachipatala. Kupitilira apo, poganizira za kuyesa kwamankhwala am'deralo m'magawo ake oyambilira komanso kuyembekezera kuti ophunzira azichita nawo maphunziro odziyimira pawokha, mwina pali omaliza maphunziro omwe sanakwaniritse bwino lomwe; chinthu chomwe anthu otere adzayenera kukumana nacho pazaka ziwiri zakukhazikika kwawo. Komabe, n’chimodzimodzinso ndi ena omaliza maphunziro awo kusukulu zachipatala zamwambo za m’dzikoli.
Komabe kutengera zomwe zilipo komanso mogwirizana ndi zomwe zapezedwa pa kafukufukuyu, madokotala ambiri atsopano aku Venezuela akuwoneka kuti ndi achifundo, ophunzitsidwa bwino komanso odziwa ntchito yake. Umboni ukusonyeza kuti tsopano zikugwa pa chikhalidwe kuvomereza kuti ambiri mwa ogwira nawo ntchito m'deralo ndi ophunzitsidwa bwino kuposa mmene ankaganizira poyamba, ndi kuti zambiri zodzudzula cholinga MIC pulogalamu yatsimikizira kukhala kupanda chilungamo, ndi kusocheretsa dala pa zoyipa. Madokotala ambiri wamba adzadabwa pamene m’mpikisano waposachedwapa woloŵa maphunziro apamwamba pa yunivesite yotchuka ya Andes ku Mérida, atatu mwa madotolo anayi a m’mudzi amene anafunsira anavomerezedwa ku malo 40 operekedwa, pamene mpaka mazana aŵiri omaliza maphunziro. kuchokera ku mayunivesite achikale sanali.
Pofika chaka cha 2019 ndizotheka kuti madotolo pafupifupi 60,000 azigwira ntchito pachipatala chaulere ku Venezuela, kutsatira zomwe zachitika. Social Medicine Journal akufotokoza ngati "chitsanzo chofuna kwambiri pakukulitsa maphunziro a udokotala m'dziko limodzi".[vi] Uku ndikugulitsa ndalama zambiri kudziko lomwe, ngakhale lipeza ndalama zamafuta, limawonedwa ngati la "dziko lachitatu" lomwe lili ndi zovuta zambiri pakukula kwake. Ngakhale kuti m'mayiko ambiri gulu la ndale limadziwitsa anthu kuti palibe zothandizira zothandizira zaumoyo komanso kuti mabungwe achinsinsi ayenera kutengapo gawo lalikulu pakupereka chithandizo chamankhwala, kuyesa kwa Venezuela ndi mankhwala ammudzi kumapereka njira ina. Ndi chifuniro cha ndale n’zothekadi kutsimikizira anthu onse kuti ali ndi ufulu wolandira chithandizo chamankhwala kwaulere, komanso n’zotheka kuphunzitsa madokotala ofunikira kuti ntchito imeneyi ikhale yaumunthu, yaukatswiri, ndiponso yapagulu. Mwina ndicho chifukwa chake sikunamvekenso zomveka bwino zamankhwala ammudzi zomwe zakhala zikumveka kuchokera pawailesi yakanema padziko lonse lapansi mpaka pano.
Kupitilira zomwe boma la Venezuela, mabungwe azachipatala komanso owonera akunja atsimikiza zatsatanetsatane wamankhwala ammudzi, kafukufukuyu akupempha owerenga kuti awone zomwe madokotala ammudzi omwe angomaliza kumene maphunziro awo amaganiza za pulogalamuyi. Mu gawo lachiwiri la kafukufukuyu, lomwe liyenera kusindikizidwa sabata ino, akatswiri atsopanowa ochokera m'mitundu yonse amapereka ndemanga zawo zamaphunziro awo ndi zomwe akumana nazo pogwira ntchito limodzi ndi madokotala wamba m'zipatala za boma. Zofunsazo zimawululanso zambiri zamakhalidwe komanso zokhumba zamtsogolo za "gulu lankhondo lovala ma jekete oyera" aku Venezuela..
[I] Njira zothandizira anthu ku Venezuela zagawika m'magulu awiri osiyanasiyana, onse omwe ndi aulere kugwiritsa ntchito komanso otseguka kwa anthu onse, ndipo pamlingo wina amalumikizana ndikuthandizana. Chimodzi mwa izi ndi netiweki yatsopano ya Barrio Adentro, yomwe imakhala ndi madotolo aku Cuba komanso ophunzira azachipatala aku Venezuela komanso omaliza maphunziro awo. Netiweki iyi imayang'ana kwambiri chisamaliro chapagulu ndi anthu amdera, ndipo chithandizo ndi chaulere, kuphatikiza mankhwala. Maukondewa amaperekanso chisamaliro chapamwamba komanso ukadaulo ku Comprehensive Diagnostic Centers (CDIs), Comprehensive Rehabilitation Centers (CRIs), ndi zipatala zapakati zotchedwa ma ambulatory.
Ukonde wachiwiri ndi machitidwe azipatala zaboma, momwe madotolo wamba aku Venezuela amagwira ntchito, ambiri omwe amagwiranso ntchito m'mabungwe apadera. Akatswiriwa amaphunzitsidwa m'sukulu zachipatala zachikhalidwe cha dzikolo ndipo ndale amaonedwa kuti ndi yabwino kwa otsutsa osasintha.
M'zaka zawo zoyamba zamaphunziro, ophunzira a madotolo athunthu amaphunzitsidwa ndi madotolo aku Cuba ndipo amapeza chidziwitso chothandiza mkati mwa netiweki ya Barrio Adentro. Komabe, m'zaka zawo zomaliza za maphunziro, madotolo ammudzi omwe akuphunzitsidwa amapitanso m'zipatala za boma, ndikugwira ntchito limodzi ndi madotolo achikhalidwe. Atamaliza maphunziro awo, madotolo ammudzi amakhalanso ndi chilolezo chokhalamo kwa zaka ziwiri zomwe zingaphatikizepo kuikidwa m'magulu onse azachipatala, motero akupitiriza kugwira ntchito m'zipatala za boma pamodzi ndi madokotala wamba. Ubale wogwirira ntchito pakati pa magulu awiriwa ukufufuzidwa mozama muzoyankhulana zochitidwa ndi omaliza maphunziro a mankhwala ammudzi m'nkhani ina.
[Ii] Brouwer, Steve, (2011). Madokotala Osintha: Momwe Venezuela ndi Cuba Zisinthira Lingaliro Lapadziko Lonse la Zaumoyo, Monthly Review Press, New, York, p112
[III] Ibid, p120 – 121
[Iv] Ibid, p122 – 125
[V] Komanso, malinga ndi a Ndemanga ya MEDICC lipoti mu 2008, 68.5% ya aphunzitsi omwe ali pa pulogalamuyi amakhala ndi udindo wa Mlangizi kapena Pulofesa Wothandizira malinga ndi zofunikira zomwe Unduna wa Maphunziro Apamwamba ku Cuba. Pofika chaka cha 2013 chiwerengerochi chikhoza kukhala chokwera, popeza madokotala aku Cuba omwe ali pa pulogalamuyi akupitiriza kukulitsa luso lawo lophunzitsa.
[vi] Borroto Cruz & Salas Perea (2008), The National Training Program for Comprehensive Community Physicians, Venezuela, Zachipatala, Vol. 3 No.4
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