Historic Visit
Within the framework of Israeli-Uruguayan cooperation, Dr. Ernesto Kahan
and Dr. Leonardo Szpirman conducted a workshop on Social and Community
Medicine and Epidemiology in Urban and Rural Centres, August-September,
1995. The workshop took place at FEMI's premises with the participation of
30 Uruguayan doctors.
This unprecedented on-the-spot workshop was part of a new phase of the
program for improving the quality of FEMI's health services throughout the
country.
The Israeli experts shared their knowledge and vast experience with the
objective of maintaining and improving the excellent level of health
services offered by the participating institutions. This exchange of ideas
incorporated new concepts that will eventually lead to substantial
improvements in the quality of health care in Uruguay.
During their stay, the two experts visited various health care centres in
the provinces, getting acquainted with their activities, in order to be
better able to evaluate the FEMI system. This course is a new challenge in
FEMI's constant attempt to improve the country's health services and to
consolidate its First National Integral Health System.
As a concrete result of the course, a Research Network has been
established, designed to increase the level of health care quality. A new
Research and Teaching Support Centre will be organized by FEMI for the 23
medical organizations in the provinces. For this purpose, the newly
created Centre will maintain academic and scientific contact with Israel
through the two experts. Dr. Szpirman noted that "a data bank of about
500,000 potential patients is in existence, from which enormously valuable
statistical information can be obtained immediately." He also stated that
"the quality and training of the Uruguayan doctors is first class, and the
Integral National Health System FEMI is the kind of organization that can
serve as a model for the whole world by directing primary health care
towards prevention."
Dr. Kahan noted that in order to improve the quality of health services,
"efforts should be made so that the medical institutions should seek out
the healthy individual rather than the sick individual seeking out the
institution. Special emphasis should be put on integral medicine, on the
quality of assistance, and on the improvement of research and training in
cooperation with other institutions."
Editorial by FEMI's President, Dr. Sergio Hourcade
The recent visit of two Israeli experts, Dr. Kahan and Dr. Szpirman, gave
us new strength to confront the necessary changes in our organization. The
views of these colleagues enable us to reaffirm the positive elements of
the health service infrastructure and of the level of human resources
available in our country's provinces. They dealt with issues such as:
existing capacity in the area of diagnosis and therapeutic technology,
high level human resources and organizations that cover wide sectors of
the population. They also located those elements that need improvement to
allow for development: better accessibility to doctors, greater emphasis
on preventive medicine and adequate management.
These changes will undoubtedly make the system more efficient, allowing a
better use of the economic resources available today, and, as a result and
as a goal, enable all health care workers to feel satisfied about their
work and their personal growth and increase the recipients' satisfaction
and well being.
According to Dr. Kahan and Dr. Szpirman, we possess the necessary and
sufficient conditions to significantly improve health care in the
provinces. To achieve this goal it is absolutely necessary to coordinate
and complement the collective health and public sector services. In this
way, the country could establish new directions in the health care field
for all Latin America.
We should devote ourselves to work. We will have to profoundly rethink the
ways in which we deliver health care in the provinces, considering the
overall needs of this sector by ensuring that the changes take place in
the private, public and informal subsectors together with advances in
technology. Only a systematic approach will allow change to take place.
Consequently, there is a need for significant cultural changes. Often the
barriers are inside us. We should possess the ability to transform our
system, creating changes inside and outside our organizations.
The proposals of the Ministry for the public sector, also affecting the
private sector, have sensitized Uruguayan society which is in turn showing
interest in the issue. Let's take advantage of this opportunity.
We should dare to propose changes to bring health and well being to the
community, generating the trust of the people in the health care system.
This is our duty as citizens and doctors.
The times of intense change and generating ideas are here. We should wait
no more: This is the moment to act and create the necessary changes. We
either transform ourselves as agents of change or history itself will
impose change on us, making us mere spectators.
Shalom Magazine and the entire MASHAV family mourn the death of Dr.
Leonardo Szpirman in November 1995, shortly after completing this, his
last on-the-spot course. His many years of service in the field of
Community and Occupational Health Education have helped to lay a firm
foundation for future courses conducted by the International Institute -
Histadrut.