La Sanidad Militar como herramienta de la Diplomacia Médica / Military Health System as a Tool of Medical Diplomacy

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La Sanidad Militar como instrumento de diplomacia médica: estudio retrospectivo de las evacuaciones de pacientes mauritanos al Hospital Central de la Defensa Gómez Ulla (2005-2015) / Military Health System as a Tool of Medical Diplomacy: Restrospective research of Mauritanian patients evacuated to Central Hospital of Defense Gómez Ulla (2005-2015)

INTRODUCCIÓN: La Sanidad Militar española juega un papel predominante en el acuerdo de cooperación entre Mauritania y España en 2003, que permite prestar apoyo médico a enfermos mauritanos en el Hospital Central de la Defensa. Este hecho constituye un ejemplo de cómo la medicina militar es empleada como elemento de diplomacia internacional en aras de la seguridad común. Material y MÉTODOS: Estudio transversal, retrospectivo entre 2005 y 2015 que incluye a pacientes evacuados desde Mauritania hasta España en virtud del acuerdo firmado entre ambos países en 2003. Las variables seleccionadas fueron de control y sociodemográficas, independientes (baja no de combate y baja de combate) y dependientes (enfermedad, accidente, intervención quirúrgica, y anestesia realizada). RESULTADOS: Durante el intervalo entre 2005 y 2015, 174 pacientes fueron seleccionados, y 89 cumplieron los criterios de inclusión. Sesenta y nueve pacientes (77,5%) eran varones y 51 (57,3%) eran militares. El motivo de evacuación fue por enfermedad 85 pacientes (95,5%) y por accidente en 4 pacientes (4,5%). Los pacientes atendidos por tipo de especialidad fueron: traumatología 20, oftalmología 16, neurocirugía 9, otorrinolaringología 8, oncología 5, cardiología 5, urología 4, cirugía plástica 4, pediatría 3, cirugía general 3, neurología 2, neumología 2, digestivo 2, ginecología 2 y cirugía vascular 1. Uno de los pacientes (1,1%) falleció en el hospital. CONCLUSIÓN: La Sanidad Militar española juega un papel determinante como instrumento de Diplomacia Médica

INTRODUCTION: Spanish Medical Corp from 2003 plays a predominant role in the cooperation agreement between Mau-ritania and Spain, which allows medical support to Mauritanian patients in the Central Hospital of Defense «Gomez Ulla» (Madrid -Spain-). This is an example of how military medicine is used as an element of international diplomacy for the sake of common security. MATERIAL AND METHODS: Cross-sectional, retrospective study between 2005 and 2015 including patients evacuated from Mauritania to Spain under the agreement signed between both countries in 2003. The selected variables were sociodemographic control and independent (non-combat casualty and combat casualty) and dependent (illness, accident, surgery and anesthesia performed). RESULTS: During the interval between 2005 and 2015, 174 patients were screened, and 89 met the inclusion criteria. Sixty-nine patients (77.5%) were male and 51 (57.3%) were military. Evacuation cause was sick 85 patients (95.5%) and by accident in 4 patients (4.5%). Patients treated by type of specialty were: traumatology 20, ophthalmology 16, neurosurgery 9, otolaryngology 8, oncology 5, cardiology 5, urology 4, plastic surgery 4, pediatrics 3, general surgery 3, neurology 2, pulmonology 2, digestive 2, gynecology 2 and vascular surgery 1. One patient (1.1%) died in hospital. CONCLUSION: Spanish Medical Corps should play a key role as an instrument of Medical Diplomacy

Imigraçao, ciência e saúde: controle de riscos e expansao de direito na bacia do Rio da Prata (1873-1911) / Immigration, science and health: risks control and expanding rights in th e Rio de la Plata Basin (1873-1911)

Este artigo analisa como o processo imigratório nos países da Bacia do Rio da Prata, em especial Brasil e Argentina, promoveu inflexões na assinatura de acordos sanitários no final do século XIX. O porto é compreendido como um dispositivo onde se definem saberes e normas e se estabelecem intervenções sobre as populações em trânsito, em especial imigrantes. Os entraves na assinatura de convenções sanitárias entre estes países estavam não só relacionados às controvérsias no interior das comunidades médico-científicas como também às tensões políticas e econômicas vinculadas à disputa por mão de obra imigrante. Nas primeiras décadas do século XX, assistimos a um deslocamento de interesses e problemas relacionados à saúde pública. Não bastava mais só conter epidemias, os estados nacionais deveriam garantir certos benefícios às populações, em especial associados à assistência à saúde. Esta nova perspectiva é analisada a partir das compreensões e usos da ideologia liberal no que diz respeito à auto-regulação dos riscos, à coletivização de bemestar e à expansão de direitos civis e sociais, alavancados, em parte, pela inclusão da população imigrante nestas sociedades (AU)

This paper analyzes how immigration process in the Rio de Plata Basin countries, specifically Brazil and Argentina, promoted inflexions in the sanitations agreements in the end of 19th century. The port is a device within in which are defined knowledge and standards and are established interventions on people in transit, particularly immigrants. The barriers in the agreements between these countries were not only related to controversies within medical and scientific communities but also to political and economics tensions linked to the labor immigrants disputes. In the beginning of 20th century, we can see a shift of interest and issues related to public health: epidemic control was not enough. The states must guarantee some benefits to the populations, especially heath care. This new view is analyzed according to the understanding and uses of the liberal ideology concerning risk self-regulations, collectivization of welfare and expanding of civil and social rights. This process is leveraged in parts by the inclusion of the immigrants in theses societies (AU)

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