Building Hope: Deepening our Understanding of Health Reform in El Salvador

A first IPHU in El Salvador  took place in La Palma. Entitled “Building Hope: Deepening our Understanding of Health Reform in El  Salvador” it provided a somewhat different model for the IPHU. First, it  targeted  young health professionals working within the Ministry of Health, in health services around the country, professionals active in the process of health reform in El Salvador. Heretofore the IPHU has been targeted to  activists from a general geographical area, but not one country; and the principle attendees have been health activists outside the formal health system. Maria Hamlin Zúniga of  PHM- LA and Eduardo Espinoza, Deputy Minister of Health, were the two of the principal organizers of the course.
Because important changes are being made in the Salvadorean health system,  ALAMES, the Latin American Association for Social Medicine; the People’s Health Movement of Latin America, and the Ministry of Health  sponsored the 10 day session, attended by some 34 health professionals, many of them physicians,  from across El Salvador. It is expected that these young professionals will actively assist the Ministry in strengthening the process of health reform across the country. The participants were also expected to work in the community, with community organizations to explore and fortify ways of ensuring the right to health outside the formal health system.

The course covered issues such Globalization/Economic Crisis; the Right to Health; Comprehensive Primary Health Care and related them to the process of Health Reform in El Salvador. The IPHU was participatory, and students learn from one another as well as from the presenters. The creativity of the students was tested daily as they present the previous days learning in a popular, dramatic format.
Oscar Feo of ALAMES, most recently advisor to the Minister of Health of Bolivia helped students ground the complex concepts in their daily experience. He was a constant support and teacher to the participants.
An important innovation at this particular course was the use of Skype to connect students with presenters. Mario Rovere of AlAMES spoke to the group and answered questions. He could see the group and the students could see him. There was also a Skype farewell to Cuban doctors in the capital who had helped during the flooding emergency: again each group spoke to and could see the other group.
And despite internet and modem limitations  the students appreciated a power point presentation on  urbanization and alienation from Francoise Barten, from the Netherlands. The presentation helped to knit together some of the threads of migration, urbanization and gang and drug violence; particularly in a country like El Salvador where 1/3 of the population sends remittances home from North America.
Integrating theoretical work into practical experience has always been one of the goals of the IPHU. The Salvador IPHU was no exception: students were asked to examine issues of Globalization; of  the right to health; of social determinants of health through the lens of the ongoing Salvadorean health reform process, and the lens of community issues. A huge challenge when meeting community groups exhausted by years of struggle to clean up lead from battery manufacture, or to clean up illegal garbage dumping.
At the end of the 10 days, 34 people were committed to working ever harder, 34 people had projects that were going to see the light of day, and 34 people were looking forward to further discussion and deepening of their knowledge.

The proceedings of the event are available in Spanish at Curso Universidad Internacional de Salud para los Pueblos - El Salvador 2011