Interview

with the former and current directors of

Sanatorio Adventista del Plata

Dr. Schulz first talked with SAP director Dr. Gunnar Wensell, just before his retirement at the end of 1998.

AIMS: Dr. Wensell, I remember the days when we came in 1966. You were coming from the remote mission field and I was fresh out of the university. Tell us about you and your family.

WENSELL: My wife and I belonged to a traditional Adventist family of this area. I am married to Lissie Block. We have three children and four grandchildren.

AIMS: Your professional career?

WENSELL: In 1965, when I finished medicine at the University of Buenos Aires, our first call was to serve as missionaries in Bolivia. We had the privilege to serve, with my family, in two hospitals in that country: the hospital of Chulumani at an altitude of 6,000 feet among the Aymara Indians and later in Guayaramerin in the hot tropical jungle on the Rio Mamore, which borders Brazil, from where most of our patients came.

From that hot, humid place we were called to work in the Peruvian Altiplano where we stayed for two years at the Juliaca Clinic at 13,000 feet, a city mostly with indigenous Quechuas. At the end of ten years in the Inca Union, we requested a return to the Austral Union, with the intention of catching up, especially in surgery, after all these years of isolation. We planned to go to Loma Linda, California, where I could take a residency in urology, but barely a year after being at the Sanatorio Adventista del Plata and having passed the ECFMG, the Union showed us the unavoidable necessity to go to Paraguay because Dr. Ira Bailie had just returned to the United States after many years of serving as a missionary physician in that country for training at Loma Linda, and we helped there.

The years of 1969 to 1972 we went to the United States, where I attended a residency in urology at Loma Linda University under Dr. Roger Barnes and also with Dr. Henry Hadley and Dr. Richard Kuhn.

Upon returning to Argentina, we had the opportunity to initiate the service of urology at the Sanatorio Adventista del Plata as a pioneer in the country with the new transurethral endoscopic surgery, contributing to educate other physicians in the country in that specialty as well as participating in numerous other courses and congresses, spreading this new operating technique, which was novel in those years outside the U.S.

At the same time, Dr Pedro Tabuenca, general director of the institution, asked me to act as associate vice-director. When Dr. Dario Rostan became director, I remained as vice-director.

In January of 1986, the Board of Directors of the Austral Union asked me to take the office of general director of the SAP, then a high-complexity 180-bed medical center.

AIMS: What problems were you facing when you became director?

WENSELL: Our task was to continue what our predecessors did and to confront the challenges of the growing technological cutting edge to offer better medicine to the patients coming to this institution. The great challenge came when the Universidad Adventista del Plata, following the necessary studies, evaluations, surveys and approval by the Boards of the General Conference, South American Division and the Austral Union decided on the creation of the School of Medicine. Our hospital turned to the medical school hospital.

AIMS: What were the main difficulties?

WENSELL: In 1994 the hospital experienced a flurry of planning activity. To be a medical school hospital and for our health professionals to participate in teaching was a great responsibility. In the previous years, there was an emphasis on the formation of physicians in the specialties that were still missing. These were incorporated to the SAP as the professionals were completing their specialty training, and we were able to offer practically all the specialties existing in medicine. However, becoming part of the teaching system was a new experience for the great majority of our physicians. This required the dedication of many hours to attend classes, seminars and special courses to prepare teachers in medicine.

AIMS: Yes, I remember one of these intensive courses was financially supported by the Academia Group in Loma Linda, a group of professionals who had worked at the SAP at some point in their lives.

WENSELL: That's correct. We also had to adjust the schedules to take care of the academic load and continue the clinical work. This created some difficult situations that thanks to the cooperation and good will of everybody involved were settled. At the end of 1998 the first class finished their five years of academic formation, having two more years of clinical training before they receive their diplomas.

AIMS: What are the professional challenges you are facing today?

WENSELL: The worldwide changes happening in the field of health, requiring lowering the costs of service, maintaining the quality and, above all, never forgetting that as an Adventist institution we not only have to care for the physical health but also the spiritual, making our physicians able to share with those coming to us, the Physician of physicians, our Lord Jesus Christ. All these challenges make it necessary for us to maintain a very close relationship with God.

AIMS: You emphasize very much the religion and church aspects of the function of this hospital. Is this a personal and isolated idea, or is it widespread in the hospital?

WENSELL: Ninety-eight percent of the personnel of the SAP are members of the Adventist church, and we are united in an ideal, which is common to all of us. In spite of the difficult times we happen to be living in, under God's direction, the institution and all those who are a part of it, have the desire to accomplish the mission that Jesus left to us to preach and to redeem the souls for His kingdom. Currently the SAP is a modern high-complexity medical center with almost ninety full-time salaried missionary physicians covering all medical specialties and equipped with the latest generation instruments and technology. Additionally we have a modern better living center which is lending high prestige to the institution and the church.

AIMS: What do you think of the future?

WENSELL: The future brings many challenges. Many changes are needed in the methodology of work and new horizons to be reached, but never forgetting how God led His church in the past. If we permit Him to lead us now, we can have the certainty that He will show us also the road to follow in the future.

. . . Next, Dr. Shulz sat down with Dr. Haroldo Cecotto, SAP's current director:

AIMS: Dr. Cecotto, thanks for allowing us to look into the future of the Sanatorio Adventista del Plata, with you as its brand-new director. Tell us about you and your family.

CECOTTO: In February 1999 I'll be 45 years old. My wife, Berta, is a pediatric physician. We have four children, three studying at the university and the youngest still at the intermediate level.

AIMS: What about your professional career?

CECOTTO: After receiving my diploma in medicine, I worked for five years privately while taking a surgery specialty training. In March of 1985 I entered the Adventist organization at the Sanatorio Adventista Loma Linda (Chaco, Argentina). Since 1991 until now I was the director of that institution. Now the church confided in me the direction of this prestigious and beautiful institutionthe Sanatorio Adventista del Plata.

AIMS: What's the biggest challenge?

CECOTTO: My main preoccupation when taking the direction of the SAP is to have this great structure adequated to the demands of the current market. An updating is mandatory to maintain the quality while reducing substantially the operative costs.The most imminent task, however, is to confront the critical juncture caused by the the situation of the country, our geographical region and also our own church which have all contributed to reach a point where the institution began to operate with red ink in the bottom line. General measures have been taken to adjust expenses and maximize income. The next step would be to study in depth every service to see their cost viability, benefit, inversions, etc. and the activation of new projects.

AIMS: Do you think the organization has been slow or inactive seeing the necessity of changes or the implementation of them to prevent financial distress?

CECOTTO: Certainly, I believe the organization has been a little bit slow in adapting to the global reality we are living in today. However, we are working on this subject. We have even contracted the services of an external consulting firm to help us in this process.

AIMS: How do you see the future?

CECOTTO: I am convinced that the Lord will continue conducting this almost-centenarian institution and that the precious human capital it has will be able to make the changes and the effort in order to continue providing the best medical attention in this region of South America.

AIMS: Dr. Cecotto, thank you very much for your insights to be shared with SDA professionals around the world.

CECOTTO: I thank you for the opportunity to communicate, and I hope we can continue this in the future.