La situación de las cataratas en la ciudad de Buenos Aires: un estudio de caso en el Hospital Ramos Mejía / The situation of cataracts in the city of Buenos Aires: a case study in Ramos Mejía Hospital

Background: When a person has cataracts his or her lens becomes clouded by proteins, causing diminished vision. Though cataracts cause poor vision or in more serious cases blindness, what is special about cataracts is that they are treatable. Surgery replaces the clouded lens with a new artificial lens called an intraocular lens. In Argentina in 2006 only 10% of cataract surgeries were realized in the public sector, and the Ministry of Health of the Nation decided to develop a program called Program Eye Health and the Prevention of Blindness to fight these and other inequities in the realm of visual health. After 7 years of this program, I wanted to investigate how the present process of receiving cataract surgery is for those who utilize the public health system. For this reason I completed a case study of a public hospital in Buenos Aires where I investigated the population that receives cataract surgery there and the barriers that the population faces in seeking treatment. Methodology: The study was based chiefly on interviews with 4 doctors who work with cataracts and 11 of their patients. The interviews were conducted in the exam room in the Department of Ophthalmology in the Ramos Mejía Hospital. The patients ranged in age from 36 to 86 years and some of the patients were waiting to receive the surgery while others had already received the operation. The patients were asked about demographic information, details about how they accessed the treatment, and their general experience. The doctors responded to questions about their patients, differences between the different sectors, and the Program Eye Health. Secondary information for the 2010 Census was utilized, as were statistics from the Program Eye Health and Prevention of Blindness. Interpretations were also made regarding the population, access to treatment, treatment, and the doctors’ motivation. Results: The interviews demonstrated that the patients receiving the surgery in Ramos Mejía Hospital were varied but generally from the lower middle class. The majority of the patients did not have health coverage and many were female. Half of the patients were from nearby, but some patients travelled from farther. They were motivated to seek treatment here from previous experience with the hospital or because of its prestigious reputation that extends outside of the local zone. Though the patients endure inconvenient timetables to receive an appointment and long waiting times, to them coming here is worth the trouble because the treatment is free and of high quality. All but the chief of the team that operates on cataracts had little knowledge of the Program Eye Health and Prevention of Blindness, and though the program is used to order intraocular lenses for the surgery, none of the patients know who financed or will finance his or her surgery. Though the hospital does good work, there are still barriers that keep the people from accessing care. The physical difficulty of traveling to the hospital, the long distance and necessary to travel multiple times, and the inconvenient hours to obtain an appointment are factors that make the process difficult for potential patients