Not surprisingly, the healthcare problems we are facing in Canada are not unique. But that does not mean we have to find solutions on our own. We do not have to reinvent the healthcare wheel when other countries have done so before us.
Insights into other local healthcare systems abound. Consider episodes and incidents recently encountered in southern Spain, along the Costa del Sol.
Canadians might be skeptical that this area of Spain believes it has solved the problem of access to primary care physicians. An English language newspaper in Costa de Sol, Spain recently reported that “Patients will be able to make an appointment with their primary care doctor within 72 hours in Andalucía from the end of February, the regional minister of health and consumer affairs, Rocío Hernández, announced [at the end of January 2025].”
The article explains that a back office computer system has proved reliable in predicting patient demand for medical appointments. The minister comments that knowing the demand is the first step towards solving the supply problem.
Whether this proves true remains to be seen. The point, from a Canadian perspective, is that the answers we are searching may be on the demand side, not only on the supply one.
Urgencies, not quite emergencies
Consider, too, the availability of urgent care. In Spain, overcrowded emergency rooms are also problematic, at both public and private hospitals. For foreigners, the prospect of attending an ER is particularly daunting.
What can travellers do when they require urgent health care at a level one or two steps above first aid? The writer faced that issue when a very sharp knife confused her thumb with a loaf of bread. Blood was pouring profusely and did not want to stop.
A paper napkin was all that was available to apply pressure and staunch the flow. Next came a visit to a local pharmacy. These are not similar to a Shoppers Drug Mart or London Drugs megastore; not even to a Jean Coutu or Pharmaprix or local Canadian pharmacy.
Pharmacies here, and in much of Europe, are universally identified by a green cross outside the entrance. They are literally drug stores — stores that sell drugs and limited related items.
The lone pharmacist took one look at the writer’s arm, dripping blood through the paper napkin, and disappeared. She returned with an antiseptic and gauze and cleaned the wound. She then bandaged the cut and explained how to care for it.
True, payment for a box of bandages was required. But no charge for service or the other supplies used. [Post-script: the pharmacist was happy to see that the wound had properly healed, a few days later.]
Would this type of service be available under the scope of practice of Canadian pharmacists?
Art imitates life
Like Canada and the rest of the world, Spain dealt with the COVID-19 pandemic and continues to deal with its lingering after-effects. It is not uncommon to see Spaniards sporting masks as they interact with the outside world.
In many ways, the Spanish response was much stricter than Canada’s. In cities like Barcelona, residents and tourists alike were permitted to leave their residences only under very specific circumstances. They had to show identification and to travel no more than one or two kilometres to do groceries or attend medical appointments, at specified times during the week.
Were there anti-vaxxers in Spain during the pandemic? Are there still those who are against vaccines? The author cannot offer definitive proof. That said, if art imitates life, it is likely that vaccines have been part of Spanish life for a longtime.
The Museum of Malaga displays a canvas by Vincente Borras Y Abella (1867-1945), painted c.1900. The title of the work translates to “Inoculation of the Children.” There is no explanation for the horse at the bottom left, but the actions of the physician(?) and the reactions of both the women and the children, are clear.
Equally clear is that vaccinations were common enough in Spain at the turn of the 20th century to merit creation of art imitating life.
Life imitates art
In Canada, CORD, the Canadian Organization for Rare Disorders, estimates that “one in 12 Canadians has a rare disorder.” It explains that “approximately 3 million Canadians and their families face a debilitating disease that severely impacts their lives.” CORD’s mission is “to provide a strong common voice to advocate for health policy and a healthcare system that works for those with rare disorders.”
The corresponding organization in Spain is The Spanish Federation of Rare Diseases. “Its main goals are to increase awareness and make visible their common needs…”
This group also estimates that “rare diseases affect more than 3 million Spaniards.” The similar prevalence of rare disorders in the two countries reflects that Worldometer estimates the current populations of Canada and of Spain to be some 40 million and 48 million people, respectively.
Both organizations face similar, daunting challenges. Funding for healthcare and related needs of patients and their families varies from one jurisdiction to another in Canada. Research into rare, previously called orphan, diseases is not a high-priority item for scientists and pharmaceutical companies. And keeping the topic of rare diseases in the public eye is similarly not easy.
Plaza de la Merced, a square in the historic area of Malaga, mounted an outdoor exhibition in January 2025. Organized by CINFA, a Spanish laboratory that believes “we are all or will be patients one day,” the photos and commentary were titled “The View of the Patient.”
The display highlighted photos of people with rare diseases, accompanied by commentary by celebrities from a wide range of backgrounds, from photographers to singers and other performers, family members, to cooks and athletes.
The photos were candids of the patients. These were both heart-wrenching and intimate. The commentaries mirrored these feelings, expres
sing perspectives matched by the celebrities.
In one display, a professional athlete comments on a photo of a child who had just completed a round of immunotherapy. He is running a
marathon staged by his care nurse.
In a second, a young boy with a bone marrow transplant takes his family on a rural walk, to prove he can lead them and to hear them laugh.
In a third, a chef comments on a beautiful child who has a rare disease that leaves her constantly hungry. “We are all patients,” he concludes.
In yet another photo, a 21-year-old writes about her own experience as one of only two people in Spain with her exceedingly rare skin condition.
The photos make us all face what we rarely see. And experience another “outsider’s” perspective on how unique and remarkable the patients are.
Canada no doubt has similar stories to show and tell.
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