The anesthesiologist Szymon Bernas and his wife, Anna, a nurse, led a peaceful and comfortable life with their two children, Bartek (12) and Barbara (4), in Lodz (Poland), 120 km southeast of Warsaw. It seemed like a solid project until one day a fracture declared itself that threatened to collapse everything. In October 2021, after several days with abdominal pain and lack of appetite, Szymon detected two lumps – “quite large”, he specifies – in the girl's abdomen.
The tests, carried out with great urgency, revealed the existence of a neuroblastoma, a type of cancer that originates in nerve cells, usually before the age of five. To the initial blow received by the family, evidence gradually added, like stab wounds, that the country's system lacked the resources to treat Barbara adequately.
You had to react. In a situation of fear and stress, you had to react. “I made the decision one day when I was watching my daughter, who was physically ill, very weak from the treatment. I told my husband: 'Szymon, our daughter wants to live, we have to help her.
In conversation with La Vanguardia via videoconference, Anna Jurga is moved. She can't help but cry when she remembers such a difficult moment. “If we stayed in Poland, Barbara was not going to survive the treatment,” she says. The specialists had decided to apply strong chemotherapy to the patient, with a great risk of sequelae, after deciding that it was inoperable. In another Polish city, Wroclaw, they did opt for surgery, but later gave up performing a biopsy. In this period, the girl suffered two infections. “We were affected, lost, we didn't know what to do”, recalls Anna.
A surgeon and an oncologist from Lodz recommended they try the Comprehensive Cancer Center in Tübingen (southern Germany). At the same time, a Polish association of relatives and patients with neuroblastoma noted the name of Sant Joan de Déu.
Curiously, years ago Szymon Bernas did a brief internship at this hospital in Barcelona. They decided on him. Because? "For many reasons; the first, that the date of the interview (telematic) was very fast and in this disease time is key ”, says the parent. Another continues: “Dr. Mora (Jaume, scientific director of the SJD Pediatric Cancer Center), told us that he had no more chemo and that there was a possibility of operating. 'Barbara is our patient,' he told me. It is very important for a doctor to pronounce these words because it means that he takes responsibility for the health and life of the patient.
Bartek stayed in Lodz in the care of neighbors and distant relatives – the boy has no grandparents. On January 23, 2022, the rest of the family traveled to Barcelona with luggage full of uncertainty and fear, which began to lighten with the first visit with Dr. Mora, explains Anna: “She did not stop looking at the girl. Afterwards, he walked us to the door, noticing how she walked. Although the girl was in complicated conditions, even without doing tests, only with observation, Dr. Mora told us that he did not think that she had metastases. And it turned out to be true!"
After the surgery, shortly after a month, on February 26, the family returned to Poland. At the beginning, controls every 6 months; now, every 6. At the end of the conversation, Barbara bursts into the videoconference, rambunctious and shy. “It is very good, it has grown a lot; she is a very active girl, she plays a lot with her brother. Today she has quarreled with another girl from the nursery, ”says her mother.
The Sant Joan de Déu hospital, the only pediatric center with this service in Spain, celebrates 10 years of international activity, in which it has treated 5,218 children.
Activity has been increasing from 199 patients in 2013 to 822 in 2022. The majority come from Russian-speaking countries (27%) and Europe (25%), and the main specialties are pediatrics (19%) and oncology (18%) ). Last year, 26% were cancer patients. This activity is studied as a success story at the IESE business school.
“We studied it from many angles because it has many derivatives. From health, to public-private collaboration, including the Barcelona brand or medical excellence”, explains Professor José Luis Nueno.
"It is a unique case -he continues- because its selection of segment products within health is extremely careful and focused on difficult cases, which require a lot of specialization and long stays".
According to Nueno, international work has an impact on attracting talent: "It puts you on the map as a hospital and you can attract influential doctors from the State, even from abroad, and bring back doctors who have left. It allows you to supplement your salary." .
On the other hand, this activity has a significant impact on the positioning of Barcelona and Catalonia as the most important biomedical hub in southern Europe, says Manel del Castillo, managing director of the center.
"Firstly -he specifies- it allows us to give opportunities to children with very serious diseases. Secondly, it contributes to the general expenses of the hospital with more patients that help our sustainability. And thirdly, it gives us experience in the field of disease very rare. For example, last year we treated 80 cases of neuroblastoma when five were diagnosed in all of Spain".
According to Antoni Arias-Enrich, adviser to the international department, attention to foreigners leads to some 100,000 overnight stays a year for relatives and companions in Barcelona. It is not a minor fact.
"A few years ago, the city's tourism discourse was limited to a very specific sector. Now it has taken a leap," reasons Eduard Torres, president of Turisme de Barcelona: "We are talking about culture, museums, music festivals, sporting events. .. The discourse of the coming years will be that of sustainability. Not everyone will be able to come to a very crowded city that, if they want to extend their stays, will have to distribute visitors throughout the territory. The medical visitor is ideal for this. Their stays are longer, it leaves an interesting cost and could be distributed throughout different parts of the city and the country. It fits perfectly within the sustainability discourse that we will have in the coming years. If we add that this visitor contributes to strengthening hospitals, to better remunerating doctors and to retain talent, is that there are no contraindications".
Promotion has been essential in the success of the international program of Sant Joan de Déu. Word of mouth is important. "They say that for one satisfied hospital patient another eight come," says Del Castillo. On the other hand, the center has been promoted digitally, through Russian or Chinese search engines, and directly before governments of different countries, among foundations, insurance companies...
Market diversification has been key, explains Del Castillo. "If not, we would not have been able to overcome the Trump government in the US, which meant the veto of the subsidiary of a Venezuelan oil company that sent us a good number of patients." The invasion of Ukraine has also had a strong impact on the hospital's activity, but the decrease in patients from Russia or Ukraine is being offset by the increase in those from the Persian Gulf.
