Jacqueline Ponzo: VIII Summit in Guatemala
Jacqueline Ponzo: "The VIII Summit seeks to contribute effectively to this process at a foundational moment in Guatemala"
The 10th and 11th of November will be the culmination of an immense work that is being carried out in pursuit of installing Family and Community Medicine in Guatemala, a country that still does not have the specialty and that the VIII Summit will be the architect and engine of sowing the first seed for a future full of family/family doctors.
Dr. Jacqueline Ponzo, president of the Ibero-American Confederation of Family Medicine reviews her feelings about the most important event of recent times. Guatemala has placed its trust in CIMF, and after the enormous gesture, the organization made its entire structure available to contribute to this founding process.
What expectations are placed on the VIII Ibero-American Summit?
The VIII Ibero-American Summit will be a very important event for many reasons. In the first place, because it will be the face-to-face reunion after the pandemic, of a long time working remotely in very difficult times. Although it seems that Covid-19 is being left behind, the consequences of the health emergency still persist in each one of us, in our organizations and in our countries. CIMF remained strong and active during all this time, but meeting and embracing is very necessary, essential. The meeting allows expressing affection, without which it is difficult to live. At the same time, it favors informal meetings, those that take place on the periphery of agendas and programs, based on affinities, intuitions or shared stories. They are meetings that are also nourished by enjoyment and probably for this reason, they are very creative. As in the medical consultation, what is programmed is as important as what is unscheduled, what is spontaneous. Sometimes, the second can be the most relevant of the day. In other words, we have high expectations of what will happen in Guatemala, because of what is scheduled and what is not scheduled, what will surprise us, the joy of the meeting.
Then, from the political point of view, the event is of immense relevance. We are co-organizing the VIII Summit with the highest health authorities of Guatemala, the Ministry of Public Health and Social Assistance and the Guatemalan Institute of Social Security, and with the Pan American Health Organization. Guatemala does not yet have a specialization in Family and Community Medicine, but there is a political decision to install it and advance its incorporation into the health system for its transformation. The VIII Summit seeks to contribute effectively to this process at a key foundational moment.At the same time, it will produce documents of great relevance and value for ICMF, for regional (and even global) family medicine / family and community medicine, and for each of its associations, for the development of the specialty.
What is the impact that this could provide in Guatemala and in the region?
The first of the slogans, definition of the specialist profile in family and community medicine, includes the definition of specific recommendations for Guatemala, with a view to the beginning of higher education for the installation of the specialty in the country. The main expected impact is that from the summit it is possible to articulate a curriculum for postgraduate training that supports family and community medicine residency capable of producing competent professionals. This means: specialists capable of taking on the health care of people of all ages and the resolution of the most frequent health problems through a bond sustained over time, with a family approach and community orientation.
Guatemala is a country with more than 17 million inhabitants, a young population (only 5 to 6% are over 64 years of age) that has had a remarkable demographic growth in recent decades. Life expectancy is less than 70 years for men and 74 for women, infant mortality is 23 per thousand live births, a quarter of those over 15 years of age lack literacy, just over half of the population has access to safe sanitation (53% ) and only 61% have access to drinking water.
At the same time, it has a great wealth and cultural diversity in a territory that is also diverse. In Guatemala there are numerous native peoples and ethnic groups. At least 24 languages are spoken in addition to Spanish. All these characteristics represent enormous challenges for any health system. But this is not a problem for the advancement of our specialty; On the contrary, we are certain that only with family and community medicine can adequate and quality care be offered to the needs of the population with these characteristics. Of course, medical care is not enough and it is necessary to work on the structural, social, economic, and environmental dimensions to reduce the great problems, but medical care is necessary, as it is also necessary that it be up to the people and their needs. . Then,
What does it mean that Guatemalan politics has been interested in CIMF to install the specialty in their country?
It is a recognition that fills us with pride and also with responsibility, which requires us greatly.
CIMF is an organization based on the voluntary work of its members. It does not have paid positions and is financed with the contributions of its member associations and profits generated in academic events. The budget is scarce, because most of our associations are small (the MF/MFC still has few professionals in most of the countries) and because of the economic situation of the region in general. Notwithstanding the limitations that this imposes, there is something that is not missing from ICPM. Enthusiasm and commitment are always present, they characterize us, as well as the creativity and strength of its youth movement, Waynakay.It is true that all this is required at this time by the responsibility of this call, but the demand assumed, the response is joy and collaborative work. Definitely,
That CIMF has been identified by the government institutions of Guatemala, with whom we had no contact until receiving their call in June 2021 as the most appropriate reference for their objective of installing the specialty in the country, tells us that CIMF, that WONCA Ibero-American is occupying its rightful place, as a regional benchmark in the matter. This does not mean that we can trust and rest, on the contrary, it means more work, more study, more cooperation, to play that role properly.
Does this revitalize the ICPM hierarchy in a region like Central America where there is a strong need to strengthen health systems?
We hope that the VIII Summit will revitalize ICPM in all subregions. The work that is being carried out in the pre-summit since July, in two virtual phases, with the participation of more than 150 people, including more than 20 young people and a special committee made up of former presidents of the seven previous summits, It will leave us with growth expressed in the consolidation of groups, in the updating of topics and processes, in the opening of new lines of action and thought. Certainly more strength. For Central America in particular, we think that the Summit will be invigorating. We hope that this Guatemalan process spreads and spreads. In Honduras there is still no specialization. El Salvador and Nicaragua have associations that have been working for years with many difficulties, Costa Rica and Panama,
How do you think the future of MF in Latin America will be?
This question is difficult, because it requires imagining the future at a time of uncertainty and rapid change. Imagine medicine, the region and, in that context, think about the MF of the future in Latin America and Ibero-America, because our region includes Iberia. To a large extent, everything will depend on the paths that the region travels in the coming decades.
With optimism, I hope that solidarity, equity and care for nature will grow in the region. At the same time, I am confident that family medicine will be consolidated as family and community medicine, that it will be involved in health care with a territorial perspective, from the understanding of people and their problems in their social, community, and territorial context. Not to replace care for illnesses, but to make that care even better, specializing in people who suffer from these health problems, in each person, in each family. At the same time, assume a form of medicine capable of encompassing the historical-territorial dimension in the clinical process. It is necessary to overcome the dichotomous view that has tended to separate the clinical from the community. Less and less is it possible to conceive of quality medicine or quality health research if it is not involved with people's daily lives, in their community dimension. That is what we mean when we say of the aspiration that family medicine be consolidated as "family and community medicine". In some way this includes, but it is worth explaining, a planetary and profoundly bioethical perspective of medicine. Human health is not possible in isolation, separated from other species and from the biosphere. Covid-19 is the most recent and clear sample we have of this. Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future. in its community dimension. That is what we mean when we say of the aspiration that family medicine be consolidated as "family and community medicine". In some way this includes, but it is worth explaining, a planetary and profoundly bioethical perspective of medicine. Human health is not possible in isolation, separated from other species and from the biosphere. Covid-19 is the most recent and clear sample we have of this.
Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future. in its community dimension. That is what we mean when we say of the aspiration that family medicine be consolidated as "family and community medicine". In some way this includes, but it is worth explaining, a planetary and profoundly bioethical perspective of medicine. Human health is not possible in isolation, separated from other species and from the biosphere. Covid-19 is the most recent and clear sample we have of this. Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future. Human health is not possible in isolation, separated from other species and from the biosphere. Covid-19 is the most recent and clear sample we have of this. Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future. Human health is not possible in isolation, separated from other species and from the biosphere. Covid-19 is the most recent and clear sample we have of this. Therefore, incorporating the planetary dimension of health in the practice of our specialty is also a necessary note for the future.
Training specialists in these times means training professionals capable of working in uncertainty, solving complex problems and adapting to changes. It is to seek the integration of these skills with the ability and skills necessary to solve common health problems. MFYC is the medical specialty best positioned to take on the complex health issues of today and tomorrow; problems that have a social component, emerging diseases, others derived from poverty or environmental conditions, which are intertwined with the chronic and communicable diseases that we already know and that, far from being resolved, continue to grow or reemerge.
What do you imagine for the day after the Summit?
Literally, the day after the Summit, November 12, 2022, we are already planning it.We will have meetings for the implementation of the guidelines that emerge from the VIII Summit, both in Guatemala and throughout the region.
I imagine a post-summit with a lot of work, renewal and a lot of joy.