This paper explores the interactions between structural poverty and production of medical care in Burkina Faso. This country represents other African countries with the same structural poverty. These interactions are examined based on healthcare professionals' perceptions as well as the factors responsible for the vulnerabilities affecting their medical work. A qualitative approach is used to analyze the materials using two temporalities set thirty years apart (1990-1994 and 2020-2021), based on long-term ethnographies on public health care institutions, opinion of care-giver relationships, semistructured interviews, and physicians' life histories. The results focus on the vulnerabilities affecting physicians' work consisting of patients' social characteristics, shaping their capacities and disabilities to support caregivers in implementing care. Interpreting the individualized dimensions of vulnerabilities makes it difficult to use learned knowledge and care for patients. This goes beyond the recurrent lack of technical and financial support to provide care; it is a systematically vulnerability but so common that it becomes a minor issue in way caregivers deal with the difficulties to be overcome in caring. These results and their permanence at a thirty-year interval suggest that these ways of thinking about vulnerabilities prevent caregivers from seeing them as part of a common condition shared with the patients and their relatives , affecting them in a common way in implementing care. This research underlines that these "pejorative" conceptions prevent the emergence of a victim figure that patients and caregivers could share, since they commonly suffer from poor working and care conditions that are acceptable in many of the world's poorest countries.< Leer menos