Cuadernos Médico Sociales

The Rural Health Experience: Expectations, Reality, and Results. Reports from District General Practitioners and Teams. 1963–1975

Jorge Lastra Torres — Thu, 10 Jul 2025 00:00:00 +0000

Between 1967 and 1978, 19 accounts of the experiences of district general practitioners and rural health teams who had completed their internships between 1963 and 1975 were published in the Cuadernos Médico Sociales (Medical Social Notebooks). This was the result of an award established that year by the Medical Association: first, for the best district general practitioner; and then, beginning in 1969, for the best rural health care team. This recognition included the dissemination of these experiences through this journal. As Dr. Carlos Montoya stated years later, "they constitute a detailed, irreplaceable testimony to the creative and determined work of young Chilean doctors in building our health system." (Montoya-Aguilar, C., 2009). The Rural Health Program and the Regional General Practitioners Program were initiatives launched by the National Health Service in the mid-1950s, shortly after its establishment. The service was still in the process of organizing its new healthcare system when it faced the decision to expand its presence and coverage to isolated areas in peripheral centers, where the ratio of physicians and healthcare resources per inhabitant was well below the already insufficient national average.
On this occasion, we revisited these narratives to learn about the implementation of these two programs, Rural Health and Regional General Practitioners, at a time when social medicine predominated as a healthcare model and sought to address the unequal distribution of health outcomes and healthcare resources, expanding the healthcare response to those social sectors particularly marginalized by the country's development. By analyzing the main content of these stories, we sought to understand the expectations of those recruited to join these programs, identify the sociodemographic, epidemiological, and cultural profiles, and identify the resources available to provide healthcare to the population in the territory assigned to the healthcare center where they were assigned. Finally, we highlight the performance of these professionals and teams through their achievements in comprehensive medicine, which is a particularly important outcome to understand, in order to uncover the valuable meaning of these experiences and their conditions.

Mi experiencia como Médico General de Zona

Patricio E. Vargas Reyes — Thu, 10 Jul 2025 00:00:00 +0000

Regional General Physician course and professional identity: a consolidating space

Pablo Salinas Carrizo — Thu, 10 Jul 2025 00:00:00 +0000

The Chilean general practitioner program, or the assigned and training phase, along with strengthening primary care in the healthcare network, is an excellent tool for medical training. Therefore, it is worth reflecting, based on current literature on medical training, on its role as a training space, in the development of professional identity, and in the strengthening of medical professionalism. This approach also includes the implications of this approach for its management in the medium and long term, with a view to proposing measures to strengthen this state policy.

In Memory of Lautaro Fernández

Cabildo "Salud es un Derecho" — Thu, 10 Jul 2025 00:00:00 +0000

N/A

1ª Asamblea Nacional de los Médicos Generales de Zona

Editores Cuadernos Médico Sociales — Thu, 10 Jul 2025 00:00:00 +0000

Formación profesional en salud

Jorge Lastra Torres — Thu, 10 Jul 2025 00:00:00 +0000

Estudio y propuesta programática de formación en Salud Global, Medio ambiente y cambio climático en el Antropoceno

Yuri Carvajal Bañados, Pamela Schellman Jaramillo — Thu, 10 Jul 2025 00:00:00 +0000

Integrando ciencia y tradición: desafíos en la regulación de plantas medicinales en Chile

Thu, 10 Jul 2025 00:00:00 +0000

Si bien el Ministerio de Salud (MINSAL) ha realizado importantes esfuerzos para el control y la regulación del uso de plantas medicinales en Chile, se requiere un trabajo mancomunado entre todos los actores involucrados. A pesar de la existencia de una farmacopea nacional, asegurar el uso racional de las especies vegetales exige una estrategia que garantice la aplicación de metodologías analíticas robustas y modernas en el control de estos productos. Esto permitirá actualizar las políticas públicas orientadas a proteger la seguridad y promover la salud de los consumidores. En este contexto, resulta fundamental intensificar la investigación científica para validar las aplicaciones terapéuticas de estas especies, en especial las nativas. Asimismo, es imperativo implementar una estrategia nacional que proporcione a los organismos del Estado acceso a métodos analíticos, capaces de asegurar la calidad, eficacia y seguridad de los productos derivados de plantas. Además, es crucial fortalecer la educación de consumidores y pacientes, de modo que puedan tomar decisiones informadas y minimizar los riesgos asociados al uso de estos productos. Solo mediante la combinación de políticas públicas sólidas, investigación científica rigurosa y educación adecuada, será posible garantizar un uso seguro y eficaz de las plantas medicinales en Chile, consolidando esta alternativa terapéutica como una opción válida para la población.

Realzando el conocimiento indígena de las plantas medicinales chilenas: ¿racionalidad o empirismo?

Maite Rodríguez-Díaz — Thu, 10 Jul 2025 00:00:00 +0000

En el presente artículo, se revisa parte de este conocimiento ancestral, con especial atención a las descripciones etnobotánicas recogidas en fuentes históricas del siglo XVIII, como el capítulo V de la Botánica Araucana, donde se documenta el uso medicinal de diversas plantas nativas por parte del pueblo mapuche. Esta revisión busca no solo valorar la riqueza del saber tradicional, sino también aportar a su comprensión desde una perspectiva científica, ética y culturalmente respetuosa, en el contexto de la salud contemporánea.

Un viaje por las plantas ilustradas

Mirtha Parada Valderrama — Thu, 10 Jul 2025 00:00:00 +0000

El reto de Guanahacabibes: conservación costera y basura marina

Delvis Toledo de la Cruz — Thu, 10 Jul 2025 00:00:00 +0000

El presente artículo documenta con rigor y sensibilidad el trabajo multidisciplinario y colaborativo que se ha venido desarrollando en esta región protegida desde 2018 a través del proyecto Costa Limpia. Esta iniciativa, que ha movilizado a investigadores, estudiantes, comunidades locales, voluntarios e instituciones científicas, tiene como objetivo principal mitigar los efectos de la contaminación marina, promoviendo acciones de limpieza, reciclaje, monitoreo ambiental y educación ecológica.

Editorial. El personal de salud que se requiere hoy. Necesidades, sujetos y circunstancias

Jorge Lastra Torres — Thu, 10 Jul 2025 00:00:00 +0000

Diálogos para una salud intercultural: acciones en salud desde el Archipiélago de Chiloé

Editores Cuadernos Médico Sociales — Thu, 10 Jul 2025 00:00:00 +0000

Arica: viaje hacia el presente

Yuri Carvajal Bañados — Thu, 10 Jul 2025 00:00:00 +0000

Between Territorial Exclusion and Community Resistance: The Case of Laguna Verde

Margot Véliz Puente, Yuri Carvajal Bañados — Thu, 10 Jul 2025 00:00:00 +0000

This opinion piece analyzes the healthcare situation in Laguna Verde, a locality on the outskirts of Valparaíso, Chile, which brings into question the universality of access to healthcare and the territorial exclusion faced by the area. Through a detailed description of the material conditions of the Laguna Verde Rural Health Post, the precarious infrastructure and the overload of services in response to unregulated population growth are made evident.

The visit to the facility highlights the emerging and widespread use of containers as an improvised solution to the lack of space, reflecting a structural trend toward the containerization of the healthcare system. Nonetheless, the healthcare teams' community resilience also stands out, as they maintain access to healthcare under adverse conditions through creativity and commitment. Finally, it is argued that the reality of Laguna Verde reveals the urgent need for territorialized health policies that recognize new urban dynamics.

Resiliencia es un concepto elitista

Miguel Kottow — Thu, 10 Jul 2025 00:00:00 +0000

Revista de Libros y Revistas

Jorge Lastra Torres, Yuri Carvajal Bañados — Thu, 10 Jul 2025 00:00:00 +0000

When caring becomes difficult: management, disciplines, and ethical tensions in mental health

Rafael Sepúlveda — Thu, 10 Jul 2025 00:00:00 +0000

This article critically analyzes the concept of device and its usefulness for understanding mental health practices within the Chilean public system. Using the ethnography of the device and Latin American collective health approaches, it explores the effects of managerialism on clinical work and community-based resistance. It concludes that situating devices can help denaturalize institutional formats and revalue ethical and political care practices.

Public policies for dementias in Chile: historical perspective and challenges

Thu, 10 Jul 2025 00:00:00 +0000

Alzheimer’s dementia and related dementias (ADRD) constitute a high-impact socio-health issue that requires a public policy approach. This article examines the evolution of strategies implemented in Chile, from the pilot phase of the National Dementia Plan to its inclusion in the Explicit Health Guarantees (GES). Despite progress, gaps remain in access to care, socio-health support, workforce training, and funding. Addressing these challenges is essential to consolidating a comprehensive and sustainable response.

Female urinary incontinence as a paradigm of hidden disease in the sociomedical context

Mónica Naveillan, Amalia Martin, Sandra Martínez — Thu, 10 Jul 2025 00:00:00 +0000

Urinary incontinence (UI) affects 14% to 52% of women, significantly impacting their physical, mental, social, and economic well-being. In Chile, UI lacks explicit coverage and effective preventive strategies, leading to underdiagnosis. Primary Health Care (PHC), led by family physicians, plays a crucial role in addressing this issue through pelvic floor care education, promotion of healthy lifestyles, and support during critical stages such as pregnancy and postpartum. A preventive and comprehensive approach is proposed to promote early diagnosis and ensure accessible and timely care, improving the quality of life for affected women.

The Ismael Valdés Valdés Comprehensive Care Center (1967 to 1973). A model of comprehensive maternal and child care in times of change

Jorge Lastra Torres, Jossette Iribarne – Wiff — Thu, 10 Jul 2025 00:00:00 +0000

The Ismael Valdés Valdés Comprehensive Maternal and Child Care Center operated between 1967 and 1973 and, like many other initiatives of the time, was forced to close due to direct repression or repression against its members during the dictatorship. This pioneering experience represented a model in social and community medicine, progressively built since the early years of the 20th century, and consolidated as a significant contribution to the country's public health, especially for the poorest population and for the training of professionals who practiced there.

Revisiting history, through written records and testimonies from participants, allows us to reconnect with its origins, understand the tradition represented, and explore the relevance and lessons for the present.

The article is organized into three parts. First, it analyzes the historical context of the second half of the last century and the development of Health Units, interpreting the Ismael Valdés Valdés Center as part of that evolution. It then describes the main characteristics and achievements, highlighting the comprehensive care model, community participation, teaching, research, multidisciplinary and intersectoral work, and, as a central achievement, the reduction of child malnutrition. Finally, the third part presents the conclusions, highlighting that the Center was the result of the convergence of the tradition of Health Units, the situation generated by the development of the National Health Service, and the drive of the team that carried out the experience of the Quinta Normal Comprehensive Medical Demonstration Center, from which it was spun off to respond to urgent maternal and child needs. Not only did it anticipate elements of the current comprehensive and community-based model, but it also validated it in practice, showing that it is possible to significantly improve health indicators and equity in innovative ways and in partnership with the community. This model remains a benchmark for addressing the current health challenges and needs of people and their communities.

Vulneración a la Salud Colectiva y la aprobación de la Ley Marco de Autorizaciones Sectoriales o Ley permisología

Sindy Urrea Maturana — Thu, 10 Jul 2025 00:00:00 +0000