Day 3! We began the day with a Tigre River Tour, with a focus on emergency primary care. We were able to go through a facility and take a short tour through the mobile boat healthcare center. The boat docks at different schools and locations, having nurses whom perform many jobs: from emergency CPR to free vaccines. These are public services that depend on the government for funding, and the facilities are stocked with all vaccinations from the national program. I found it very interesting that all of their records and patient clinical histories were fully digital, which is different from the all paper facility we visited yesterday.
After lunch, we headed over to the San Isidro Public Hospital, where we heard from a director in healthcare in the municipality. It was very interesting to discover that health departments weigh off funding and priority between hospitals versus primary and preventative care by increasing the budget for one sector, while simultaneously not making any cuts to the other sector. It is an extremely complicated system that tends to be very inefficient. But overall, primary healthcare systems are optimal and less expensive, and the municipal director spoke about investing more into primary care rather than hospital care.
Last year, there was a huge investment in new machines for the three hospitals, including the San Isidro Public Hospital that we visited. This investment was very important, but they want to refocus and improve their preventative care promotion and education, so people are not coming to the hospital for colds and minor issues. The hospital should focus on people with major illnesses and emergencies, as they have about 500 surgeries per month and 200-300 consults per day in the emergency department. Redirecting people with minor problems to primary care facilities will allow the emergency department team to focus on people in crisis who need quick and immediate attention. There are also patients in the hospital for social issues, such as adults facing loneliness or children with no home, that cost much to house. They do not need immediate hospital attention, so the staff must work toward phasing them out of the hospital.
Next, the director spoke about the main challenges that the Public Hospital faces, including lack of efficiency and transparency, no updated equipment and technology (until recently), lack of communication between the municipal and provincial levels of command, and patient safety risks. It was also noted that they are now working to restructure some sections of the hospital management, as there was previously much corruption in the leadership for about 44 years. The corruption led to missing accountability and order regarding funding, and money took much longer to withdraw to be used on medicine, education, communication, and promotion.
We were then able to take a tour through their ICU, where we saw different patients with a gunshot wound, a broken neck, post-neurosurgery, and burned skin. A nurse explained the different machines and opened a crash cart for us to look through. It was an extremely educational and eye-opening experience.
