A few days after giving birth, instead of staying home to prepare the layette, Francesca Sanna opens the door to her office. She dons her scrubs, sits at her desk, and begins examining. She does this because there's no one to replace her. The call for applications for a replacement has gone unfilled, and stopping now would mean leaving 1,700 patients without a primary care physician.

Francesca Sanna is a general practitioner, one of 65 professionals in the Oristano area. For seven years, she has worked in District 1.4, one of the largest in the province, which extends from the plains to the inland areas, including Samugheo. It includes Allai, Ollastra, Samugheo, Siamaggiore, Siamanna, Siapiccia, Simaxis, Solarussa, Villanova Truschedu, Villaurbana, and Zerfaliu, a large and fragmented area where the family doctor is often the only stable healthcare provider.

Francesca and three other colleagues work in a group practice that keeps the Solarussa, Zerfaliu, and Siamaggiore clinics open. "I decided against going during a high-risk pregnancy so as not to leave the position vacant," she says. "Two weeks before my due date, however, the doctor who was supposed to replace me wasn't available: Ares advertised the position, but it went unfilled."

With bitter irony, she adds: "I've already warned my colleagues to be ready for me to give birth." Then her tone becomes serious. "Soon, my patients could be left without a primary care physician. My colleagues have already reached their capacity and can't take on any more patients. You can't even get sick."

This story captures the crisis in community healthcare in the province of Oristano, which is now sustained primarily by the individual commitment of those who remain committed, even when the system can no longer guarantee basic conditions.

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