ISSUE 103 2016 JULY ESPRIU FOUNDATION THE MAGAZINE OF HEALTHCARE CO-OPERATIVISM . Triptych of The Garden of Earthly Delights HEALTH CO-OPERATIVES CULTURE Barcelona Hospital Health Co-operatives in ASISA International Radiodiagnosis Service Malaysia Photography Competition MEDICINE IS WHAT WE LIVE TO DO, NOT WHAT WE DO FOR A LIVING. HEALTH INSURANCE RUN BY DOCTORS AssistènciaSanitària Call us on 93 495 44 61 or visit www.asc.cat AAFF_Compartir.indd 3 28/10/15 16:32 summary. health. issue 103 6 6 Bone marrow transplants. Dr. Cassan july, august and september 8 Radiodiagnosis Service the cornerstone of Barcelona Hospital. Daniel Romaní 10 The Zika virus. Dolors Borau To celebrate the 5 fifth centenary of Hieronymus Bosch health co-operativism. 16 16 Interview with Dr. Jagdev Singh Deo, President of Koperasi Doktor Malaysia Berhad: “So as to compete, the cooperative health sector needs incentives and less of a tax burden” 19 HLA Hospital Group at the world’s leading health tourism Summit 21 Moncloa University Hospital opens the Kovacs Back Unit 22 Assistència Sanitària renews its agreement with FC Barcelona for a further five seasons 25 SCIAS publishes its first Sustainability Report 27 Agreement between the EU and the International Co-operative Alliance to strengthen the MEDICINE IS WHAT co-operative movement WE LIVE TO DO, monograph. NOT WHAT WE Hieronymus Bosch. Fifth centenary exhibition 33 Carles Torner: How do we view Bosch today? 34 DO FOR A LIVING. 36 Alberto García Otero: A journey through the enigma 40 Interview with film director José Luis López Linares: “The Garden of Earthly Delights is practically HEALTH INSURANCE a lesson in theology” 44 D. Sam Abrams: An apple tree and a serpent RUN BY DOCTORS culture. 49 49 Pause AssistènciaSanitària 50 Film criticism: Images of the years of strife 52 The World Turns: ASISA International Photography Competition Remembering Salvador Espriu Call us on 93 495 44 61 56 or visit www.asc.cat AAFF_Compartir.indd 3 28/10/15 16:32 @ readers’ letters. Quarterly magazine. Third stage. Num Paradoxes of our time 10 3 What a paradox. Public opinion worldwide trusts in july, august and cooperatives more than any other type of business; there are more than 1 billion cooperative members in the world, september 2016 issue and such organisations, totalling 2.6 million, employ more than 250 million workers all round the globe… The Health co-operatives magazine fi gures provided in the article by Ms Van Valkenburgh in Executive Board: the last issue of compartir. are record-breaking, and yet, Dr. Ignacio Orce (Autogestió Sanitària-ASC), how much ignorance there is: I am sure that in a public Dr. José Carlos Guisado (president of IHCO), Dr. Enrique de Porres (Lavinia-ASISA), survey the great majority of respondents would only be Teresa Basurte (SCIAS) and Dr. Oriol Gras able to mention by name a couple of cooperatives in their (Foundation trustee). own country, much less discus how this type of business Executive Editor: Carles Torner Pifarré functions. It is revealing, though perhaps not all that Editor-in-Chief: Paz Hernández surprising, because what this paradox really highlights is that in today’s world a job well done is not always Contributors to this issue: Teresa Basurte, Dr. Adolf Cassan, Daniel Romaní, Dolors enough, above all when it is done in silence, and not used Borau, Dra. Perla Luzondo, Jose Pérez, David as marketing and advertising to “sell” the image. Fernández, Oriol Conesa, Carles Torner, Alberto García Otero, Meritxell Tizón, Sam Abrams, Jordi Virallonga, Xavier Farré, Enric Sòria and Paz Hernández. Photography and illustration: Keith Adams, Tomás Merino Pons Mar Aguilera, Alianza Cooperativa Internacional, Edmon Amill, Manuel Valladolid Espinosa Herrera, Pep Herrero, Manuel Moreno, Museo Nacional del Prado, Juan Manuel Sotillos, Joma, Jordi Negret and Jorge Villa. Proofreading and translation: Núria Sàbat (catalan and castilian) Jason Garner (english) Editorial staff: Servimedia SA Editorial Secretary: Joana Alcocer Design and page layout: ec.lluch Printing: ILUNION Retail y Comercialización Registered publication B. 28059-1991 Fundació Espriu Av. de Josep Tarradellas, 123-127, 4a planta. 08029 Barcelona. Tel.: 93 495 44 90Fax: 93 495 44 92 Juan Ignacio Luca de Tena, 12, 3ª. 28027 Madrid. Tel: 91 595 75 52. NIF: G-59117887 www.fundacionespriu.coop [email protected] july 2016 05 editorial. To celebrate the fifth centenary of Hieronymus Bosch The Espriu Foundation has a humanistic vision of medicine, championing the great tradition of doctors associated with the arts. Because healthcare is inseparable from the humanisation promoted by literature, painting, music and fi lm, through their representations of human life. Our founder, Dr Espriu, embedded into the DNA of the foundation, and of the magazine that gives it voice, this link between medicine, cooperatives and the arts. When we learned that the Prado in Madrid was organising a fascinating exhibition to mark the fi ve hundredth anniversary of the death of Hieronymus Teresa Basurte Bosch, we decided to dedicate the central pages of this 2016 summer edition to President of the Espriu him. When a society decides to term an artist as a classic, this means that every Foundation and of SCIAS time we revisit its works we fi nd beauty, relevance, meaning. Which means that its work remains necessary in order to interpret our modern society. The magnifi cent exhibition covering the output of Jheronimus van Aken has just that virtue: it explains the artist to us in great depth, offering us a panoramic vision, while revealing to us the extent to which his work remains necessary. Our founder, The monograph we present here lets us stroll along three different conceptual Dr Espriu, trips. The fi rst is a visit to the exhibition itself, pausing before a number of the embedded into paintings and giving us time to contemplate them. The second is a fi lm: Bosch. the DNA of the The Garden of Dreams, directed by José Luís López Linares, a documentary bringing together the voices of great writers and artists who stand before the foundation, and painting and explain what they see in The Garden of Earthly Delights, how the of the magazine picture has affected them, why they return to it time and again, as if drinking that gives it from a fountain. The third account takes us on a delightful journey through the voice, this poetry born out of Bosch’s work, focusing on the lines of two great poets: Rafael link between Albertí and Gerard Vergés. In our constant desire to link together the great human questions raised by art medicine, and medical practice itself, I would like to end by inviting our readers to visit cooperatives the paintings in this exhibition together with us. and the arts. health. prevent and cure Few medical procedures are as worthy of such high regard as a bone marrow transplant, not because it is a particularly complex procedure to perform, which in itself it is not, but because of the huge impact of its results. Bone marrow transplants Dr. Adolf Cassan The bone marrow is a very special tissue found within our Another possibility, which is less common and can bones, and which is constantly producing the cells that only be employed for certain illnesses, is to take the trans- make up our blood. During early childhood, there is active planted elements from the same patient, obtained once bone marrow in almost all the bones, while adults only there has been a response to the treatment: in this case we have active bone marrow in the longer bones, the pelvis, refer to autogenic or autologous transplantation. the sternum, the ribs and the vertebrae. Lastly, while in the past the haematopoietic stem cells The bone marrow tissue contains some very special to be transplanted only came from the bone marrow, they cells, known as stem cells or hematopoietic cells (hemat- can now be obtained from the blood in circulation, known opoesi means blood formation), that are the precursors of as a peripheral blood transplantation, and also blood from all our blood cells: red cells, white cells and platelets. Their the umbilical cord. In such cases the material to be trans- main characteristic is that they can multiply and give rise planted is obtained from volunteer donors or voluntary to other similar cells, while some also become modified donations of umbilical cord blood identified through na- and progressively transformed into mature blood cells. tional and international registers. The purpose of a bone marrow transplant, then, is to replace these haematopoietic cells which for various rea- sons have become inactive or are functioning abnormally, with others that are active and healthy. INDICATIONS BASIC PRINCIPLES AND TYPES OF BONE MARROW A stem cell transplant is the chosen treatment for TRANSPLANT medullary aplasia, a condition often of unknown The transplant is based on the property of stem cells to origin, or in other cases caused by intoxication reproduce themselves and to generate all the blood cor- or other environmental factors, characterised by puscles: thanks to this it is enough to transplant a certain the deactivation of elements of the bone marrow, quantity of these cells because, once they have integrat- leading to a blood cell deficiency. ed within the bone marrow of the patient, they begin to It is also a procedure employed for the constantly produce the elements that make up the blood. treatment of certain types of leukaemia, such It is a simple procedure, when compared with the trans- as some acute leukaemias and chronic myeloid plantation of solid organs, although it does require prior leukaemia. These disorders are characterised by preparation and complex subsequent care. an uncontrolled and anomalous proliferation of The source of the elements to be transplanted may white blood cells, that infiltrate the bone marrow vary widely, with a distinction being made between dif- and prevent the production of other normal cells, ferent types of haematopoietic stem cell transplants.