Headquarters of the Department of Health in Río Piedras. (Archive)
The proximity of the general elections on November 3 and a government transition process could be an obstacle to the implementation of the new Strategic Plan of the Department of Health (SD), which includes a map of action for the next five years and that comes “At the wrong time,” said the former state epidemiologist Ángeles Rodríguez.
“Establishing a five-year plan less than two months before the elections, it seems to me out of time, it seems to me that it is something that should have been done before,” said the doctor, although she said that the incoming government administration “has to look at all those suggestions ”.
After recognizing a need to regain the trust of the people in the efforts it carries out, Salud drew up an ambitious plan that prioritizes establishing rigorous transparency measures in administrative processes and increasing the traffic of information to and from citizens. The plan itself presented exclusively to El Nuevo Día recognizes that in the agency “one of the threats with the greatest impact is the ideological-political factor” , an evil that has caused unfinished initiatives to be added at the end of each four-year period.
Rodríguez called for prioritizing the professionalization of people who occupy key positions in the agency as part of the new conceptualization of Health. “The actions of screwing people based on political criteria go against the purpose of professionalizing, not only in Health, the agencies in general terms,” said the doctor.
“The main problem we have both in Health and in other agencies is that through the decades skilled personnel have been replaced by people without credentials, without knowledge, simply because they share political ideologies or have worked for the party, “ said the former epidemiologist of the State.
Likewise, he stated that not only the particular electoral period can affect the implementation of the plan, but that the agency's own performance in the past months calls into question the implementation capacity. “Before making a strategic plan, an emergency plan should have been worked on, because they are things that are not expected, there must be an emergency plan with specific metrics, responsibilities assigned based on the position, not the person, and the People in positions of authority must be people who can make the right decisions at the right time because they have the knowledge and credentials to be able to lead a response. There are things that cannot be improvised ” , he pointed out.
Along with this plan, Salud initiated an accreditation application process by the United States Public Health Accreditation Board (PHAB), a non-profit organization dedicated to promoting continuous improvement of the quality of public, state, local, and territorial health departments. Accreditation by PHAB is voluntary. That is seen with good eyes by Víctor Ramos, president of the College of Surgeons of Puerto Rico , one of the entities that offered its recommendations to Health for the preparation of the plan.
“Definitely that had to be done a long time ago, it gives credibility to the Department if accreditation is achieved, it forces it to have to do things well because if not, you will not pass the accreditation,” Ramos stressed.
The agency ensures in its Strategic Plan that it seeks to promote a system with greater access to health, expand services aimed at vulnerable populations, promote the participation and inclusion of interest groups, and strengthen and expand the coverage, quality and effectiveness of the health services, emphasizing the need to strengthen the agency's regional offices.
Another of the main axes is the preparation for emergencies and disasters, recognizing the need to strengthen the response processes, based on the experiences with Hurricane María, the earthquakes in the south of the island and the COVID-19 pandemic.
Regarding the latter, Ramos indicated that among the recommendations of the College they emphasized that “agility in the response (to emergencies) was important, the communication of what was done was important, that it was necessary to decentralize. The problem is that people cannot access the services provided by the agencies, that is something general that happens in Puerto Rico ” .
The need to speed up the Health response during emergencies and depoliticize the agency are two priority issues, also considered the infectious disease specialist Miguel Colón, a doctor at the Auxilio Mutuo Hospital, as well as the San Juan Municipal Hospital and the Ashford Presbyterian Community.
“I hope they do and that they knock down the politicization of the Department of Health, because you don't play with the health of the people,” the specialist, who treats COVID-19 patients, in reaction to the Strategic Plan. Colón also emphasized the urgency for Health to be transparent in the information it offers to citizens.
“They have to tell the truth,” he stressed, recalling as an example the handling of the death toll caused by Hurricane Maria. “ At first they said of the few deaths that occurred in Puerto Rico after Hurricane María and all of us who were on the battlefield, as it has been with the pandemic, those of us who were in the field days after the hurricane, we saw related deaths, not directly to trauma, but we had deaths first from leptospirosis, the dialysis patients, ”he said.
This lack of transparency and the politicization of the agency has been a constant, Colón lamented, recalling his experience during the handling of the influenza A (H1N1) pandemic, which reached Puerto Rico in the summer of 2009. At that time, Colón was president of the Puerto Rico Infectious Diseases Society and the secretary of
“I had several meetings in the Department of Health at that time and you could see the mess and the politicization of the Department of Health,” he said, adding that the same happened at the beginning of the COVID-19 pandemic this year.
“When this began, they said that the virus was not going to reach Puerto Rico because there were no direct flights from China to Puerto Rico and they took time to prepare because a pandemic in the country was not politically correct. If we had prepared ourselves from the beginning, when the neurosurgeon (former secretary Rafael Rodríguez Mercado) was present, we might not have had to lockdown (emergency shutdown) ” , he said. Colón also stressed the need to strengthen the agency's epidemiological team.