Today, we started our day off a little differently! We took a boat ride to a public primary care clinic that was along the Tigre river. During the boat ride, we passed through the Tigre community and learned a lot about the islands. At the clinic, we met the captain of the only ambulance boat that serves the community. We learned about how their ambulance system works and the work that they do. We then got to tour the clinic, which is one of two of the only clinic within a 200 km distance. It was very small space (with only 4 rooms), but they use their space very efficiently. However, due to the small space, appointments are required and patients normally must wait outside. They do a lot for the community, such as activities for health promotion and taking the boat around the community to increase accessibility. A challenge that they often face is communication being quite difficult, because the service is not good in those islands. After speaking to the captain and touring the clinic, we joined one of the staff that was teaching a salsa lesson for health promotion. We then took the boat back to the mainland, where we had a delicious group lunch at Vivanco Restaurant and walked around the nearby stores.

We then drove to San Isidro, where we had a lecture led by Maria Richards, who is the Subsecretary of Healthcare Planning in the Municipality of San Isidro. We learned about the challenges of public healthcare management, specifically economically and politically. Buenos Aires is divided into 12 sanitary regions, that are then divided into smaller districts, that are focused on disease prevention for low income people. San Isidro’s healthcare system consists of 3 hospitals, 1 odontological hospital, 9 primary healthcare centers, and 1 child development center. This system is targeted to people who live in San Isidro because taxpayer money is what mostly funds it. They face challenges like funding and people from other municipalities coming to get treatment (who do not pay taxes toward that municipality/healthcare system). We then got a tour of Hospital de San Isidro, which is one of the public hospitals within the San Isidro healthcare system.

During the lecture and tour at San Isidro, we learned how the public hospitals/systems are pushing toward more primary care because it allows for more accessibility, preemptive care, and opens up more space and resources for the people that really need it. Public hospitals often face the challenge of people coming to the hospital/ER for care, when they could go to a primary care clinic, and thus taking up space, time, and resources. However, some hospitals, particularly private, do not like the idea of pushing primary care because they get money from people visiting the hospital. This then creates a lot of political tension.