A Conversation with Dr. Patty García: From Research to Politics and Implementation

After finishing medical training in Peru, I decided it was time to search for new horizons. In June 2018, I joined the PGSSC as research associate with great excitement to work alongside passionate people improving global surgery. The experience and diversity of the PGSSC team was surprising! I definitely missed the friendships I left in Lima, however, I later realized I did not leave them at all. Dr. Patty García was on her way…

Dr. Patty García is a researcher and professor at the School of Public Health at Cayetano Heredia University in Lima, Peru. She served as Dean of Public Health at Cayetano Heredia, Director of the National Institute of Health in Peru in 2006, and Minister of Health from July 2016 to September 2017. Throughout her career she has implemented policies in sexual and reproductive health, telemedicine, electronic medical records and other topics.

On Thursday, October 4th, we had the pleasure of talking with her at the PGSSC.

Dr. García: "Latin America is the region of inequalities. There is a portion of the population in rural areas and other groups without insurance. In Peru, we have a fragmented system. The Ministry of Health provides coverage to approximately 70% of the population which represent the most in need and the ones without insurance. The Ministry of Labor covers approximately 20% and provides services for those who have formal jobs and finally the private sector covers only 3%."

On developing surgical systems in the context of corruption, Dr. García reported: ¨When you believe you have a policy, it does not mean you have won. The majority analyze the system, but few analyze the context. The context is important. Motivation and corruption play key roles. In surgery it will be a big issue to work on. For this reason, is important to do a good baseline assessment to understand what it is known, what do they fear and what they desire.”

During her tenure at the Ministry of Health, Dr. Patty García noticed regulations impede the delivery of surgical care. For example, a certain number of anesthesiologists are required per operating room (OR) shift. Given lower staffing numbers many OR´s are remain empty and ready to be used. I am reminded of the importance to consistently revisit these regulations especially when basic care is on the line.

Dr. García remarked on the importance of finding local “champions” with a passion to improve surgical care in their countries. She elaborated: "First find your champions, second choose one problem, and third work towards strengthening the sense of ownership." Dr. García also posited that promoting surgical training opportunities at international institutions could be a possible solution requiring doctors to return to their home country after training.

Dr. García´s visit helped renew awareness of the context in which health issues develops. Considering the context and truly understanding it, it is the only way to establish an honest and authentic conversation to plan ahead to improve surgical health care worldwide.

Thank you Dr. Patty García for sharing your experiences with us at PGSSC! See you at Cayetano!