A report of the General Audit of the City of Buenos Aires (AGCBA, for its acronym in Spanish) indicates that at least in four Buenos Aires public maternities have shortcomings. Ranging from the lack of operating rooms and care rooms to the precariousness of the facilities and the antiquity of the beds, going through the absence of emergency exits and even tools to fight fires.

It is a survey that the Watchdog approved at the end of last year, on data from 2012, collected in the maternal and child area of the hospitals Penna, Argerich, Piñero, and Santojanni, and that analyzed several aspects, such as the building status of those centers and staffing.

In principle, the AGCBA highlights a finding that, initially, may not be relevant: "The statistical information (prepared in these hospitals) does not constitute a reliable instrument for the implementation of health policies and the efficient management of resources.” It also adds that wrong measures would be implemented based on the figures reported."

However, the observation takes magnitude when the organism maintains that "the delivery rooms of Penna and Santojanni hospitals are insufficient" for the number of annual births. Even more, both centers, together with the Piñero, "do not have an operating room every fifteen hundred births." As a matter a fact, in the latter there is only one area for operations, and none of the hospitals analyzed have "a sufficient number of the electronic fetal heart monitor."

Following the building issue, the Audit lists: "In the Piñero, the delivery room does not have a special area for washing and preparation of instruments," and there are no spaces known for recovery or immediately postpartum, a lack which also appears in the Penna and the Argerich hospitals.

"In none of the hospitalization rooms of the four hospitals does the minimum space between each bed/cot exist. There also aren’t any separation elements - fixed or mobile - to respect the privacy of patients." The report adds that, in that sense, there is a law and a standard that is not being fulfilled. On the one hand, technicians say that "the building conditions of obstetric centers make it impossible to comply with Law 1040/03" (which establishes the right of women to be accompanied at the time of delivery and hospitalization). On the other, they also fail to reach the agreed average of the 9 square meters considered necessary to house the newborn next to his/her mother's bed and, at the same time, allow medical and nursing functions.

Back in the Piñero, the AGCBA asked what would happen if a baby was born with some complications, and the response was that "the resuscitation sector of the newborn and the neonatal hospitalization are not in the same plant, which implies a difficulty in moving a newborn with complications."

According to the report, "In none of the hospitals audited, the delivery room, the newborn care sector and the neonatal hospitalization have direct communication."

Also, both Penna and Piñero do not have rooms for observation and isolation of cases that may be suspected of infection. And in the space of hospitalization of the Santojanni "the rubber floors are detached in several sectors, moisture was observed on the walls, the ceiling of the central aisle is made of removable aluminum sheets and poor lighting."

Regarding the equipment of the maternities, the research affirms that a feature shared by the four hospitals is that "in the hospitalization sector, the furniture is in poor condition, there are old beds -of more than 20 years-, with the metallic legs eaten away by the rust." And as if that weren’t enough, the beds don’t allow the patient to change position during delivery."

Another issue that caught the attention of the auditors was that, after the tour of the Penna Hospital, they warned that "it does not have a stock of complete medicines that covers the dosage for 24 hours of care of the pathologies".

Security and AC

"In the Argerich, Piñero and Penna hospitals, the emergency exits do not exist or are closed," the AGCBA warned, adding that both the latter center and the Santojanni have evacuation plans that "are not approved by Civil Defense." The report concludes: "The aforementioned demonstrates deficient pavilion security conditions, which would make it impossible to carry out an evacuation."

Also, there are three areas of the Piñero that "do not have the prescribed fire-fighting equipment," and the Santojanni directly does not have the adequate tools to extinguish electrical fires.

Regarding air conditioners, the researchers noted that the Argerich’s "does not have temperature regulation and the drain generates leaks in the ceilings." Piñero’s "is not suitable for the surgical area," and that, as much in that nosocomial as in the Penna, they could not install the apparatuses that were bought "due to the electrical overload that it would generate on the system."

Competitions and Vacancies

On the other hand, that first observation of the City Watchdog, on the elaboration and analysis of the statistics by the health centers, regains substance when warning the "inaccuracies" registered in the neonatology services, which "make it impossible to make accurate calculations to plan both physical and human resources."

In that sense, the report states that Penna Hospital has "nursing deficit in all areas, in addition to the lack of administrative staff and cleaning." The agency clarified that "there are charges pending appointment and vacancies," as well as in the Piñero.

In the Argerich, meanwhile, "there are charges pending appointment in the area of obstetrics, and deficit in the nursing department," with the aggravating circumstance that the health center of the Boca neighborhood had requested that endowment through a note dated in the year 2012.

In the Hospital Santojanni "there is a shortage of personnel and appointments of vacant Headquarters in the Archive area and the Statistics Division," concluded the Watchdog.