Centro de Salud Santa Clotilde Staff

I'm on call again tonight, but it's currently pouring rain, so I should be patient free for a while. I've spent some of my first two weeks here trying to figure out how this health center fits into the bigger Peruvian health care system.

Santa Clotilde is pretty unique because it is a partnership between the Catholic Church and MINSA (the ministry of health). So Father Jack is the director of the health center but he is an employee of the church and not the ministry of health. This is huge, because it has offered Sta. Clotilde (Santa) continuity. My understanding is that for other areas of Peru, the directors of health care systems are often political appointees and so there can be a lot of turnover. The employees here are a mix of those employed by the church part of the health center, others employed by the MINSA part of the health center, and those given contracts by the local government. Not sure who's employed by whom, but it mostly seems to work. The medical providers tha work here come from all over Peru. There are 4 Peruvian doctors that work at Santa...none are planning on staying for more than a few years and none are from Santa. One of the docs is doing his Serum...this is a year of service that all doctors and nurses must do after they finish medical school. He is from Iquitos and is plans to go work somewhere else before doing a residency. There is another physician that is contracted by the church and she's been here a year and will likely stay another year, before she heads back to Lima to try and get a residency spot. The 3rd doc was contracted by the city council and has been here 6 months...he's not sure how long he's staying, he hasn't been getting a steady paycheck, which doesn't help. He also aspires to find a residency spot in Lima. The 4th doc is also from Lima and is on vacation right now for his wedding, but my understanding is he'll be here two years. Our midwife is contracted by the church and she's been here a year, but also plans to return to her hometown. All the docs say this is a great experience b/c you get to manage cases you wouldn't in a big city, but they all want, understandably, to be closer to home and to more opportunities for their families. It underlies how difficult it is to find physicians who are willing to stay in a rural setting without giving them some real incentives. I don't know how much the doctors make here...but it's not enough to compensate from being far from their family.

January 15, 2009 by Blanca Baldoceda

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