Chronic Illnesses That A.I. Can’t Treat
<p>Amid cuts to public health, the government of El Salvador is placing much of the care for chronic illnesses in the hands of Gemini, Google’s AI service. But for Jorge, who travels 224 kilometers every week for his dialysis, his problems lie elsewhere.</p>
Víctor Peña Roman Gressier
Every week for the past four years, Jorge Calderón has traveled 224 kilometers to attend a four-hour hemodialysis session — one-third of the 12 hours required by medical protocol for chronic kidney disease.
Getting there is a journey. He walks along the same paths, crosses the same river and the same sugarcane fields, and traverses the same rocky streets. He rides in the back of a public transport vehicle and takes four buses to the San Juan de Dios National Hospital in Santa Ana, the health center closest to his home.
He lives deep in the heart of the El Corozo district, where, within a five-kilometer stretch in a straight line, another 12 cases add to the disease statistics in San Francisco Menéndez, a rural town in Ahuachapán bordering Guatemala.
According to government data announced on national television on April 14, some three million Salvadorans suffer from at least one chronic disease, in a country of about 6.4 million people.
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On a television program with President Nayib Bukele, Edgardo Von Euw, a scientific advisor to the government’s artificial intelligence program Doctor SV, added that only one in ten people is aware of their chronic kidney disease.
According to 2024 data, El Salvador has the second-highest mortality rate from chronic kidney disease in Latin America, at 128 per 100,000 inhabitants. The disease is the leading cause of death among people aged 40 to 59.
However, the country has only one nephrologist for every 853 Salvadorans, according to data from the Ministry of Health and the El Salvador Association of Nephrology and Hypertension, cited in a 2024 report by El Faro.
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Amid cuts to public health staffing and budgets, the government has announced that Doctor SV, a mobile app, will use Google’s Gemini artificial intelligence system to treat chronic diseases: first cardiovascular and kidney diseases —the two with the highest mortality rates in El Salvador— followed later by cancer.
According to the announcement, people should use the app to organize their medical information and treatment plans. But Jorge Calderón’s problems lie elsewhere: the public health system cannot keep up with the demand for treatment of his condition, and he lacks the resources to afford a second weekly treatment.
Rafael Aguirre, secretary of the Union of Social Security Doctors, questioned the government’s commitment to Doctor SV. “Only 5 percent of the population uses this app,” he said, referring to download statistics on cell phones and low rural coverage.
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“Sixty percent of the population who die do so due to cardiovascular diseases and chronic degenerative diseases that cannot be treated with the app,” Aguirre added.
“We're in real need. We are low-income; I am sick and live far from the city,” Jorge told El Faro on Tuesday, April 28. That same day, as usual, Jorge was on his way to the hospital.
His illness also crowds out his work as a farmer and construction laborer. He depends on external financial aid and on what his wife collects selling secondhand clothing. “My life hasn’t changed in all this time,” Jorge lamented.