As Director of Reproductive Health Services in the Santa Cruz Departmental Health Services, Nurse Ruth Galvez was invited to participate in in a simulated obsteteric emergency exercise with MCHIP and its partners. She watched as the exercise—which aimed to test the quality and efficacy of the health system’s response in the health network of Roboré—clearly had a motivating effect on the network’s health providers, community members and municipality representatives.
Impressed by what she saw, Galvez concluded: “This is a good strategy that should be replicated in the whole country to know what the response capacity is for these emergencies among the health services, the community and the municipality.”
The exercise in Roboré helped the network to tangibly identify the strengths and weaknesses in its capacity to respond to such emergencies, and stimulated the network leadership to work together to address the gaps. It also marked the end of MCHIP and USAID's technical assistance in the province of Santa Cruz.
Galvez began to seek financial and political support to replicate the simulation in two additional networks, linking the initiative to efforts to achieve the Millennium Development Goals. She identified two networks that had not received technical assistance from MCHIP—Obispo Santisteban and Andrés Ibáñez. The support she generated provided refreshments and transport for the exercise, and she was also able to secure an alliance with Nur University to film the simulation.
“The simulation strategy is an innovative strategy that allows us to evaluate the response capacity of the services that are working in quality improvement processes when faced with an emergency, as well as the community organization and the means of communication that is the reality that we face daily,” Nurse Galvez said.
There were two participating secondary hospitals: Montero Hospital and El Torno Hospital. The first is located in the municipality of Montero, 60 kilometers from the city of Santa Cruz. It is a secondary hospital that serves as a referral center for three sub-regions of the province of Santa Cruz. The majority of the population works in agriculture in the rural areas, and in both the formal and informal economies in the city of Montero.
The second hospital, El Torno, is 38 kilometers from Santa Cruz, and three blocks off the highway that connects El Torno with the cities of La Angostura and Santa Cruz. The majority of the population migrated from the interior of the country and works in agriculture. Nevertheless, resources are scarce and the population often works as tenant farmers.
The tertiary hospitals that serve as referral hospitals for Montero and El Torno are the Japanese Hospital and Dr. Percy Boland Women’s Hospital, both of which are in the city of Santa Cruz. Driving access to these hospitals is often made extremely difficult by heavy urban traffic during rush hours, complicating referrals.
“The premise is to save lives and in this we are working based on what we learned from MCHIP’s technical assistance,” Nurse Galvez said.