Reactive Agent Lack Halts Lab Work

Once more, the chaotic management of public hospitals under administration of the Caja has raised its ugly head. This time, it has halted lab workups of body fluids needed for everything from diagnosis to determining paternity.

Microbiologists complain that they have nearly run out of reactive agents needed for working with blood, urine and other fluids, reported the leading daily paper La Nacion.

For example, labs at Calderon Guardia Hospital in downtown San Jose, one of the largest public facilities in the country, was supposed to receive the chemicals Wednesday but no one could assure the paper it would happen.

For some provincial hospitals such as at Sarapiqui and Heredia, the chemicals arrived only last week after six months without a shipment, according to Jose Valdelomar, head of the Caja Professionals in Medical Sciences Union.

Some public medical centers still have run out of reagents and are still waiting, he added. But Dinorah Garro, chief of Social Security logistics, denied that the hospital labs lacked the vital chemicals, maintaining that an alert had been issued about "a possible lack."

She maintained that distribution of the reactive agents had begun Jan. 28. But the union maintains that budget restrictions on purchases begun a year ago have had their affect on purchases, which Valdelomar says have been 10 times smaller than in previous years--and more expensive.

Last year, the Caja found itself in a tight financial squeeze that forced President Laura Chinchilla to bailout the supposedly financially independent institution that runs public hospitals and clinics. (See past articles.)

The President at that time warned that she could not repeats the bailout. The Caja has been placed in an untenable situation of an aging work force that dried up employer-employee contributions while her predecessor, President Oscar Arias, raised wages within the public medical institution.

But, according to Valdelomar, the attempts to cut back spending have further complicated matters. Instead of handling the situation for the central Social Security office, each medical center is buying its own chemicals. Deprived of discounts for volume, this makes them 10 times costlier, he says.

The microbiologists began to take matters into their own hands, exchanging different chemical reactives among themselves as one institution tapped into the resources of another.

According to the union, when microbiologists placed a formal complaint with the central office, medical manager Dr. Zenith Rojas, issued a directive for the hospitals to do exams on an emergency basis. This, the Caja directors deny.

The union sticks to its story, maintaining that for the past several weeks some institutions have been only doing workups on an emergency basis. But Caja chief of logistics Garro says that she has sought a review of purchasing procedures after lawmakers charged the loss of 3 billion colones worth of chemicals and medicines.