EBAIS stands for Equipo Basico de Atención Integral de Salud or, in English Primary Health Care Team. They are made up of a physician, a nurse, a pharmacist, a medical records technician and a primary care technician. The EBAISs serve 3,000-5,000 people each and work out of clinics strategically situated to provide accessible health care. These primary health care facilities provide basic care, prenatal check-ups, consults for chronic patients, pretty much anything you would go to a general practitioner for. They refer patients needing more specialized or advanced treatment to second-level care facilities—hospitals and larger clinics with specialists and lab equipment. From there patients can be referred to tertiary-level hospitals that provide the most advanced care. Ideally, patients are always counter-referred to their primary care EBAIS so that the team can continue to follow-up with and monitor patients. This week we visited two different clinics and got to see an EBAIS in action.
The first visit was to Agua Buena, a small community near San Vito (the city near Las Cruces) that is relatively well developed. The roads are paved or at least graveled. The community is actually densely populated enough to have two EBAIS (teams) working in one clinics. It was interesting to see the organization, the flow of patients and to talk to the pharmacist about some of the challenges they face. I was surprised at how efficiently the system seems to work, especially having visited “government clinics” in other countries that essentially are buildings that never get staffed. Staffing is an issue for many clinics because the EBAIS team is so small and hard to replace if someone gets sick or needs to take a personal day, but overall the way clinics are run is relatively efficient. Because each EBAIS serves a limited community, the primary care technician keeps data on every household in the community, making things like vaccinations, health risks and prenatal care easy to keep track of.
Unfortunately, I failed at taking pictures of the actual clinic. However the second day when we visited a clinic in the Ngöbe indigenous territory we got to walk around the garden at the cultural center that Alexis Rodriguez created to preserve their traditions, medicinal plants and language.
We walked across this very unsteady suspension/swinging bridge across the river…eeek!
Hector shows us a legume that the Ngöbe use as a coffee substitute
The area around the cultural centers
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