The Coronavirus In Bogotá: When Ambulances Don’t Reach Your Neighborhood

The coronavirus has dragged the south and part of the west of Bogotá into emptiness and desolation. Environments where official protection is more fragile, or non-existent, and the backwardness in infrastructure accumulates years of unfulfilled promises. Alejandra Martínez, social leader from the southern town of Ciudad Bolívar summarizes the situation: “For a year it has been impossible for an ambulance to reach our sector. It seems that the inhabitants of this part of the city do not have the right to this service ”.

For decades, the Colombian armed conflict has marked the rhythm of life in settlements in the south and in certain parts of the west. These are, in general, families with peasant roots, often displaced by poverty and war, who have settled on the slopes of the city (in recent years the Venezuelan humanitarian crisis has been added to the demographic map).

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According to official figures, 69% of deaths associated with the virus in Colombia are concentrated in the lowest-income towns, such as Ciudad Bolívar or Bosa, among others. These are rough suburbs, grouped in the first three steps of a tax and administrative system known as “strata”.

In strata one and two are the poorest neighborhoods of Bogotá. Those most stigmatized by precariousness and with fewer hospitals, specialists or diagnostic centers. A study of the Faculty of Economics of the renowned Universidad de los Andes established in August of last year that a citizen in a neighborhood of stratum one is ten times more likely to die or be hospitalized due to the coronavirus than a resident living in an area of stratum six, which shelters the wealthiest areas.

Many families in these sectors have resorted to hanging a red cloth on the facade of their homes as a desperate call for financial help. In many cases they are workers, masons, domestic workers, street vendors or informal recyclers. Trades that do not allow teleworking. The Andes study points to the strong need to go out to work to earn a day-to-day life as the central factor behind the high rates of contagion in the south west.

The figures are, in any case, insubstantial for people like Inés Duque, an unemployed educator, 56 years old and a resident of the town of Bosa for three decades. She has attested to the mayor’s insufficient data collection capacity. That is why he does not believe. He knows numerous cases of neighbors who have passed by without reporting the contagion because they were not affiliated with the social protection system, because they feared being stigmatized or, simply, because there is no “human power to answer” on the District’s hotline.

Alejandra Martínez, a 46-year-old social leader and neighbor of neighboring Ciudad Bolívar, agrees. Despite the fact that in July of last year he presented several symptoms associated with the virus, the medical visit, which a District worker assured him he had sent, never happened.

The Colombian capital has been governed in the last two decades by mostly left-wing leaders, some with certain populist overtones, as well as a center-right technocrat. Today the first mayor in history is in charge of the city, the centrist Claudia López for the Green Party.

All its predecessors have added visible results in areas such as the renovation of schools and public libraries of good architectural design and planning in marginal areas of the city.

In the hospital chapter, however, the lag has become more evident today than ever. The southern axis of Bogotá has a deficit of at least 4,000 hospital beds, according to calculations by Luis Gonzalo Morales, a public health expert and former Secretary of Health for former center-right mayor Enrique Peñalosa. In his opinion, the “deterioration, obsolescence and insufficiency” of the network is an urgent matter.

Despite having some of the neighborhoods with the highest housing density, and accounting for around 30% of the capital’s population, the south brings together 4.06% of the total supply of health services (hospitals, clinics, diagnostic centers , laboratories, outpatient centers), according to data from the mayor’s observatory.

Analysts like the doctor Víctor de Correa-Lugo describe the panorama as an urban and cultural segregation comparable to “the caste system of India”. A reality that has become even more acute with the gradual contraction of the role of public health in the system.

Social medicine activist Claudia Naranjo explains that the logic of the market and official oversight has led to a “hyper-concentration” of the best of the offer in the hands of a handful of insurers known as Health Service Providers (EPS), companies not infrequently involved in corruption scandals, and which in turn have built their facilities around the most select neighborhoods of the capital.

The doctor and councilor for the Green Party Luis Carlos Leal adds that since the early 90s of the last century the “State has ceased to be the governing body of the health system by transferring functions to public and private insurers.”

Over the years, an increasing number of second or third level hospitals, which fulfilled a seminal function in the primary care of lower-income citizens, were dismantled.

Bogotá, with almost seven and a half million inhabitants, is the capital of the most unequal country in a region where social fractures prevail, according to the Development Index for the Region. William García, a researcher on urban issues at the Javeriana University of Bogotá, states that the “scarcity of hospital centers in marginal areas is not a singularity of Bogotá.” On the other hand, it is the absence of an efficient mass transport network. It is enough to remember that the metro project for the city is at least 70 years behind.

“In our case (Bogotá) there are not only access barriers to hospitals in terms of the scarcity of urban equipment in the south,” says García, “but also access barriers to a massive public transport system that rationally connects with the health centers. That is very complicated. In certain areas the journeys are absurdly long and expensive. What we see today is the result of a modest and unfair urban planning of the past ”.

Few are explained in Ciudad Bolívar, for example, why the red buses of the mass transport service, known as Transmilenio, have never stopped at three of the stations stationed on the main road of the humble Divino Niño neighborhood. These are phantom stops where any waiting is a waste of time. Or a mugging risk. The situation has exacerbated the problems of insecurity, throwing more criminal gangs out onto the streets who, for example, have repeatedly blocked one of the nearby avenues to take money or boxes of food.

“They take advantage,” says Alejandra Martínez, “because they have realized that the District’s attention to this part of Bogotá is non-existent. If there is one thing for sure, it is that neither the bandits are going to be arrested, nor are they going to help us overcome this crisis ”.

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