The Garrahan paediatric hospital in Buenos Aires swarms with patients, parents and medical workers. Families stand shoulder-to-shoulder waiting for appointments, while staff race between dozens of operating rooms. In wards decorated with cartoon characters, mothers and fathers rest cheeks on their children’s.
The Garrahan treats more than 125,000 patients each year, including 40% of Argentina’s paediatric cancer patients and 70% of children with complex congenital heart diseases. It also performs 50% of child organ transplants.
But, despite being the country’s largest and most important paediatric hospital, doctors and nurses now fear for its survival. Medical workers say they are facing “financial suffocation”, which risks having a devastating impact on quality of care, and they have staged protest marches to draw attention to the public health sector’s dire financial situation.
“It is becoming impossible to continue providing the quality of care that patients deserve,” said Mercedes Méndez, a 60-year-old palliative care nurse.
Argentina has been battling deep-seated economic problems for decades – it has contended with some of the world’s highest inflation rates and is the biggest debtor to the International Monetary Fund. In response, last year almost 56% of the electorate voted for the wildcard candidate Javier Milei, a self-described “anarcho-capitalist” and libertarian economist, for president.
Since his inauguration in December 2023, Milei, who campaigned with promises to take a chainsaw to the state, has implemented a major austerity drive, slashing government spending, firing thousands of public employees and freezing budgets.
While the budget for the Garrahan has not been reduced, staff say the cost-cutting is nonetheless affecting its services. In one example, they said unfilled delivery orders have forced surgeons to resort to decades-old operating techniques, while in another, they said medicines given to outpatients were being rationed. The Garrahan hospital denied both accusations.
Several staff members warned that the drop in living conditions and a reduction in real wages were pushing a significant number of people out of social security and prepaid health insurance plans, which is “overburdening” the public health system.
“It is the most vulnerable people who come to our hospital. And there are more and more of them now because people are being left without social security,” said Méndez. In September, it was reported that the nationwide poverty rate had climbed to 52.9% in the first half of the year.
One consultant neurosurgeon, who asked to remain anonymous for fear of reprisals, said that patients were now choosing between “coming to the hospital or eating”. “For patients with, for example, tumours, we need to see them every three months. But we’re losing that control because people, especially those who might live 2,000km away, can’t afford the plane or bus tickets,” he said.
Staff also fear that economic problems are beginning to affect care. Alejandro Lipcovich, an administrator at the hospital and union leader, said that outpatient medication had recently been restricted, and that staff had complained about operating room supplies.
The neurosurgeon said he had recently had to conduct operations without absorbable plates and screws, which are used for bone fixation, because deliveries failed to arrive.
“The absorbable screws and plates we use in craniofacial surgeries have not been paid for, so in some cases we have had to resort to surgical techniques we haven’t used for 10 or 15 years,” he said. “It is completely safe, but we have not had to do that for more than a decade.”
Such surgeries are time-sensitive and if delayed can lead to cognitive issues in a child’s brain development, the neurosurgeon explained. “At first we kept saying it’s just a delay, but we were waiting and waiting, and could not wait any more,” he said. The ministry of health and the Garrahan denied that any deliveries had been missed or unfilled.
Workers also said that due to the annual inflation rate – which in October 2024 hit 193% – their salaries have essentially devalued “by half”.
“The problems started seven years ago, but last year, with the transition of the government, it got dramatically worse,” said Dr Pedro Núñez, a physician in the emergency department. “We’ve lost 50% of purchasing power since December, and while inflation has stabilised [slowing to 2.7% monthly in October], we’re still four steps down.”
The neurosurgeon said that loss of salaries was felt most acutely by nurses, pharmacists and technicians, adding: “Most of them now earn below the poverty line.”
Some workers at the hospital said that they were earning less than needed to pay for the basic family food basket, despite regularly working 12-hour shifts and undertaking 24-hour on-call duties.
The neurosurgeon worries the hospital will soon face an exodus of staff. Responding to Milei’s catchphrase of “there is no money”, the surgeon said: “Argentina has economic problems, yes, but there is money. This is a political decision.”
Analysis by the Argentinian Association of Budget and Public Financial Administration found that in 2024, public spending adjusted for inflation fell by almost 30% compared with 2023, while total spending on health has been reduced by 20%. Guido Rangugni, the association’s vice-president, said that financing for the treatment of chronic diseases fell by 60% and sexually transmitted diseases by 82%.
Diego Alonso, the director of the Foundation for Health Research and Management, an NGO, said his analysis found the prices of vaccines and medicines had increased by more than 300% since December 2023. “This has subsequently led to a decrease in HIV, sexual and reproductive health, oncology and viral hepatitis programmes, among others,” he said.
The ministry of health said that salary increases had been in line with the “rest of the national public administration” and that the public health system has been in an “emergency state for 22 consecutive years”. It said that national hospital budgets, immunisation programmes, the acquisition of medicines and supplies, and financing for vulnerable sectors are “guaranteed”.
The Garrahan hospital said that quality of care is “assured”, there has been no rationing of outpatient medicines and staff losses are on par with previous years. When asked if it would address salary complaints, the hospital said it would not answer questions about the personal administration of workers’ income and expenses, and denied that staff were living below the poverty line. It also said patient numbers had not increased.
Hospital staff say they will continue to protest about the public healthcare system’s critical financial situation. However, the neurosurgeon said: “We don’t have many hopes. This government doesn’t want to listen.”
